Mulago Hospital Patients Go On Strike

This is an article published in February in the Uganda Online paper...  Unbelievable...

Patients in Mulago Strike over Neglect and Lack of Drugs Hospital

9:29 PM  Sandra  No comments

Mulago hospital patients have striked over lack of treatment and medicine in the hospital. They have moved their beds outside on the verandas of the hospital to let the world know of their despair.

Yesterday, patients with spinal injuries decided enough was enough and moved their beds to the verandah in a bid to seek recognition from the doctors who had ignored them completely. Many of them claimed that they had become poor since they have to pay for their stay in the hospital and spend a lot of money to sustain them in the hospital.

Many of them say they require surgery while others require immediate attention. The hospital came to a standstill as doctors rushed urgent cases to be attended to. One of those striking said her husband had died from the hospital due to lack of attention from the doctors. After getting involved in a motorcycle accident, he was taken to Mulago to get medical attention. "...we were admitted her for four months. his body had begun rotting. Doctors recommended and operation but nothing was done," she said.

Several others who had the same case looked on as the hospital got disorganized. Those requiring surgery said they had waited too long and now would be the best time to get it as so promised. Baterana Byarugaba, acting deputy executive director blamed the situation on lack of enough anesthesiologists who help in putting the patients to sleep before the operation and at the same time monitors their breathing as the operation goes on.

Baterana said out of the required 40 anesthesiologists at the hospital, only 7 are available yet 3 of these are attached to the Makerere University Medical School leaving only 5 available anesthesiologists. He went on to explain the rest to be diploma holders who can not be trusted to take care of the life of the patients.

"Because of specialized services, we offer in an attempt to achieve our mandate, mission an vision, the hospital requires a lot of man power," Baterana added. Mulago Referral Hospital is a government hospital which is directly under the supervision of the government. It (governement) is supposed to provide medicine, manpower and any other thing that is important to the patients.

Failure to do so has led to the strike which has seen the disorganization in the hospital currently. Upon learning of the situation, a spectator who was on the verge of tears said, "Imagine that life, they are injecting money in the campaigns yet there are people suffering and on the verge of death.

New Patients in Mulago Strike over Neglect and Lack of Drugs Hospital | Uganda Picks http://www.ugandapicks.com/2011/02/patients-in-mulago-strike-over-neglect.html#ixzz1EqD8Taew

Mulago Hospital I

Ok, so i spent time touring Mulago Hospital in Uganda with Dr. Tazelaar.. Actually, he was doing a pathology seminar and one of the pathology residents took me on a tour of this behemoth of a hospital sprawled out over several hills in Kampala.

Once a mighty teaching hospital, the largest in all of east africa, Mulago was mortally wounded during the violent and corrupt reign of Idi Amin and has never recovered. It is like walking into the past about 30 years..or more.

My first thoughts upon entering the casualty ward (emergency room) was 'this is what Hell is like' and for the rest of day, as I traveled through the hospital, even into the surgery theatres, aids units, burn units, cancer units and maternity floor, it only became more hellish and, ultimately almost surreal. I have never felt such a darkness, a almost physical weight of despair, apathy, and death permeating every cracked and tumbling wall, stained and filthy concrete floor, every packed corner filled with families living right in the hospital.. Infants, children, adolescents, adults, elderly.. all coming to a hospital.. a place of hope... to find there is very little.

I think I went into a state of shock midway, because looking back at the things that I saw, I cannot believe that I didn't faint dead away, or run out screaming into the sunlight. But I stayed, and saw.. and now cannot get the images out of my head - they are branded into my very self.

Its been exactly three months since I was there.. I haven't been able to process it enough to write about it.. but I have to..Its like a burning, ripping ache that won't go away.. Maybe this is where I am supposed to be...Maybe this is where I am supposed to work

Anyway, I have posted a couple of articles and a couple of photos, (I was not allowed to take photos, but have found some through a couple of physicians from the UK who spent six weeks working in the hospital)

there is nothing pretty about what I will say, there are extremely graphic photos, almost too much to bear..emotionally and physically wrenching stories, nothing redeeming... nothing that will change the fact that this is literally a hell on earth. but maybe putting it out there will help to raise a bit of awareness. whew.. big breath...

Mulago Hospital II

Mulago Hospital is the national referral hospital, which means this is supposed to be the best public hospital in the country, which I am sure it is. Unfortunately, that statement doesn’t really mean very much. This hospital is the last place the large population of poor Ugandans can be referred if they have a serious medical condition and it is almost the last place anyone in the developing world would want to be found if they needed medical help.


Mulago Hospital, Kampala, Uganda has 6 floors and many wings and corridors, filled to overflowing with families of patients living, yes.. living in the halls.. The stench of unwashed flesh, rotting flesh, urine, blood, and death is overpowering in places.



The patients on the medical wards have a wide variety of illnesses like heart conditions, strokes and tumors, but the majority of them have infections (HIV, malaria and TB). The patients are first seen in casualty (British term for the emergency room) where they are either treated and sent out or die. In the center of the room is a large school desk piled with papers and three red notebooks. This is the casulty log. One book reads "Admitted" One book reads "Discharged" and the final book reads "Morgue" The gurneys have very thin plastic/vinyl mattresses that are torn and filthy - filled with blood stains and mystery fluids that are not cleaned between patients. Tubes for Iv's are shared without being washed, and if there are no more, there is no intubation. This temporary medical ward is filled to capacity each night. The patients that are admitted last are put into beds out in the hallway. The walls of the hallway are made of concrete bricks that have many ‘windows’ in them, thus the hallway is essentially a porch – you are outside, but have a roof over your head. (Uganda fortunately has a temperate climate.) The next morning, a decision is made as to whether the patient can be discharged or needs to be hospitalized further. In the case of the latter, the patient is then transferred from ward 3B to the ward of the team that is admitting them. Patient transport is done similarly to the way it is done in the US, only the gurneys don’t have mattresses and the floor has many seams in it, so the patient is rolled in a jarring manner from place to place.

The patients travel from quite a distance to get help and often times they have family members that travel with them. In fact, nurses do not provide personal care for the patients as there is such a shortage of them. Any personal care, bathing, etc. must be done by the family members. Even tube feeding. A patient also will only get linens, food, and water, if they are brought in by family members!! Medication is very scarce, so any pain medication or antibiotics must be brought in by family as well. Even after surgeries, there is no pain medication for the recovering patients. Sometimes there are numerous family members. The wards would get very crowded if all of the family members were sleeping or staying right next to the patient, so they are periodically removed en-masse from the wards by a physician or guard to the hallways and corridors outside of the wards. This means that there are oftentimes a whole crowd of people waiting by the doors or sleeping on the floors as you walk to the wards. One or two family members are allowed to remain with the patient and many of them end up sleeping on the floor next to the bed.

The floors are washed each day, but still are quite dirty. Some patients and many family members end up sleeping on the floor. The hospital doesn’t provide any food for the patients, so the family members do that. The food, tea and preparation equipment is kept under or beside the bed, along with lab slips, chest x-rays, etc. Thus, there is dirt from people’s shoes on the floor as well as liquid dripping from a rare IV or some dried blood, etc. It is not completely uncommon from a patient to cough up a significant amount of blood or vomit blood on the floor. There is noone to clean up the messes.

There are not many IV poles, only about 10% of the patients have fluids running into their veins. Those that are dehydrated hopefully have one as do those that need IV quinine for suspected malaria. The access to oxygen for those patients that are having trouble breathing is an even rarer commodity. I think there is only one spot on each ward where it can be accessed and the oxygen lines can reach about two of the beds. If a patient suddenly needs oxygen, the beds have to be repositioned to get him within reach of the tank. If there are already two patients receiving oxygen, well, unfortunately, the waiting patient will not get any.

Matooke

One popular local dish is matooke (bananas of the plantain type) which are cooked boiled in a sauce of peanuts, fresh fish, meat or entrails.




Matooke is served with every meal, its kind of like our potato.. It is very bland and mild, and doesn't have much taste. The best and most respectable way the Baganda cook it is to tie up the peeled fingers into a bundle of banana leaves which is then put in a cooking pan with just enough water to steam the leaves.









When properly ready and tender, the bundle is removed and squeezed to get a smooth soft and golden yellow mash, served hot with all the banana leaves around to keep it hot. In Buganda, the food production process revolves around the banana tree.







Tender banana tree shoots are removed from the plant and singed over fire to make a fine foil into which chunks of pork or beef are tied up and steamed on top of a bundle of bananas.This style of cooking preserves all the flavours and cooks up food like a pressure cooker, if not better. Dry banana leaves are used like bandages when bundles of matooke are being wrapped up for steaming.


Strips and chunks cut from the banana tree stem can be used as a foundation at the bottom of the cooking pan so as to avoid the boiling water touching the bundle of the matooke being steamed.