Hospital grapples with lack of radiology, oxygen services

The situation has forced some patients to seek specialised services in private facilities, incurring additional costs. 

The management of Fort Portal Regional Referral Hospital, which serves Tooro and Rwenzori sub-regions, has said the absence of essential medical equipment is affecting service delivery at the facility.

The situation has forced some patients to seek specialised services in private facilities, incurring additional costs. Among the missing services is the provision of oxygen, following the breakdown of the hospital’s oxygen plant a few months ago.

The hospital now relies on oxygen supplies from other facilities such as Mubende Regional Referral Hospital.

Dr Oscar Kalisa, the acting hospital director, explained that the Ministry of Health contracted the UPDF Engineering Brigade to construct a new oxygen plant after the breakdown of the previous one. He said while the construction of the new plant is complete and the equipment has arrived on-site, the installation has not yet occurred.

"At the moment, we are getting oxygen from Mubende Regional Referral Hospital. However, our facility serves both the Tooro and Rwenzori sub-regions, which makes the oxygen supply inadequate. Some people resort to risky improvisations such as transporting oxygen cylinders on boda bodas," Dr Kalisa said.

He added: "The structure for the new plant is ready, and we recently received a transformer and other necessary electrical equipment. We're now waiting for the transformer to be connected so that the plant equipment can be installed and the system made functional."

Another significant challenge facing the hospital is the lack of specialised personnel, particularly radiologists who can interpret CT scan images, despite the recent installation of a functional CT scan.

No radiologist

Mr John Mali, the head of the radiology unit, said the absence of a radiologist forces patients to wait longer for their results because the images from the CT scan must be sent to Mulago National Referral Hospital for interpretation.

"We are radiographers, not radiologists. The radiologist is supposed to interpret the images from the CT scan. Without a radiologist, we cannot conduct some of the necessary investigations, which is a major challenge in serving our patients," Mr Mali said.

Dr Kalisa added that the hospital is congested due to a lack of structures, often resulting in patients being referred to other facilities.

He revealed that the hospital received 10 Intensive Care Unit (ICU) beds from the Ministry of Health, but only five are in use while the remaining five have been kept away due to a lack of space.

"There is limited space, especially in the neonatal unit, which currently accommodates only two babies. However, we often need to handle many more," he said.

He further noted that the hospital lacks a renal unit, which is crucial for treating patients with kidney problems.

When we get patients with kidney failure, we have to refer them to Mbarara Regional Referral Hospital, but we are supposed to offer those services here," Dr Kalisa explained. He added that the hospital also lacks a cancer treatment unit, and cancer patients must be referred elsewhere for care.

Dr Kalisa stated that the National Medical Stores (NMS) supplies only 49 to 50 percent of the hospital's drug needs, based on their budget and procurement cycle, which occurs every two months. The remaining drug requirements are not met.

"Sometimes, when patients come and find that there are no drugs, we send them to buy from outside, and they complain. We don’t have control over NMS, so we need advocacy to secure what we need,” he said.

Despite the hospital having an internationally accredited laboratory, some essential tests are not done on-site. Samples for tests like histopathology, viral load for HIV/Aids patients, and fertility hormones are sent to Mulago Hospital for processing.

Delayed samples

Dr Kalisa said there is ongoing construction of a satellite laboratory at the hospital by the Ministry of Health under the Uganda Covid-19 Response and Emergency Preparedness Project (UCREPP). The laboratory will serve the entire western region.

"Currently, we send samples to Kampala, and it takes about three days to get results. The new laboratory will help us serve our patients more efficiently," he added.

Mr Felix Ainebyoona, the communication officer at the Ministry of Health, yesterday said the management of the referral hospital needs to plan for the infrastructure they need.

He said the ministry is currently constructing ICUs at Kabale and Arua regional referral hospitals, as well as a paediatric and neonatal unit at Mbarara Regional Referral Hospital to enhance service delivery.

Mr Ainebyoona said they are aware of the non-operational oxygen plant at the hospital and plan to install equipment soon to make it operational.