How Kampala is struggling to stop Covid-19 wave

Statistics from Kampala Capital City Authority’s (KCCA) directorate of public health further show that Kampala remains the major Covid-19 hotspot in Uganda, with more than 53 per cent of the national tally.

However, even as the figures continue to swell, the response to saving the frightening situation seems slow, triggering fears of a possible super spread of Covid-19 in the city.

Apparently, KCCA has no capacity to handle the crisis at hand and their pleas to government for support have so far yielded no fruit.

For instance, by July 6, only 192, 479 people across the five divisions of the city had been vaccinated with both the first and second dose of AstraZeneca out of the more than 1.5 million resident population of the city as per the 2014 National Population Census figures.

With only a few doses administered, officials at KCCA say the city is not yet safe. They also say the Health ministry has not bolstered their capacity to stop the wave of Covid-19.

Uganda received its first batch of 864,000 doses of AstraZeneca vaccine in March and the second of 175,200 doses last month.

KCCA’s executive secretary for public health, Ms Olive Namazzi, says whereas Kampala City has unique problems in terms of population, government has not done enough in responding to the Covid-19 crisis in the city.

Ms Namazzi wonders why government must rely on donations for Covid-19 vaccine instead of securing money to buy the vaccines and save the population.

“Kampala’s population is big yet the vaccines which have been administered are very few and this means the problem is far from over. What we need now as a country is mass vaccination because the lockdown isn’t sustainable. For instance, Kampala has 800 vaccination centres, but they do not have vaccines yet the demand is very high,” she says.

At some of the vaccination centres in the city, hundreds of people turned for vaccination, but their hopes were dashed when health officials told them the doses they had would be given to only frontline health workers and those who had got the first vaccine, and the elderly.

Mr Ibrahim Kasigwa, 50, of Kisenyi I Village, told this newspaper that his pleas of the health workers to have him vaccinated fell on deaf ears. 

“I am very worried about the rate at which people are dying and that is why I came for my first vaccine. But I was disappointed when I was told they would vaccinate only those who are slightly older than me. I was told the doses are few and would be given to only a specific age group or those who got the first dose,’’ he said.

Like Mr Kasigwa, many more people have been turned away by health officials at the various vaccination centres in the city.

Health crisis 

This newspaper has established that whereas the city has at least eight public health centres, what they only do is testing for and vaccinating against Covid-19. But the testing kits are few compared to the demand. 

Besides, these city public facilities do not have the capacity to admit Covid-19 patients because they lack specialised medical equipment.

Ms Namazzi argues that had the Health ministry improved the capacity of some of the public health centres during this crisis, it would have reduced the congestion of Covid-19 patients in government referrals at Mulago, Kiruddu and Entebbe Grade B hospitals, among other facilities. 

Sunday Monitor has established that the city’s Covid-19 rapid response team, which is tasked with evacuating Covid-19 patients from the communities to hospitals, is thin. As such, most of the cases in the city remain untraced and end up spreading the virus.

A senior health official on KCCA’s Covid-19 rapid response team, who declined to be named due to the sensitivity of the matter, intimated to Sunday Monitor that the team is demoralised because they do not get allowances, yet they work long hours and retire late to their homes.

“The Health ministry isolated KCCA for reasons best known to themselves and we currently work under pain. Our team cannot visit each and every place in the city because we are very few. Most places in the city are congested yet there is limited access to health services. That’s why Covid-19 is spreading very fast in the city,” the doctor says.

The doctor also expressed concern that their lives are at risk because they are working under harsh conditions.

Statistics show that KCCA has lost at least five staff to Covid-19. Of these, three are technical staff, while two are health workers.

KCCA currently operates a fleet of 18 ambulances, which are assigned to evacuate Covid-19 patients from communities to health centres.

But the health officials say this fleet is overwhelmed by the high demand from communities and suffer logistical challenges, including mechanical expenses, and lack of fuel, which at times take long to be addressed.

When this newspaper visited Katanga, Kisenyi and Kagugube slums, the residents went about their chores with little or no adherence to Covid-19 standard operating procedures (SOPs). 

Whereas the city centre was locked down, people in the slums move about and mix freely. 

Apparently, KCCA doesn’t have any mechanism to enforce SOPs in these places.

The chairperson of Kagugube Village in Kampala Central, Mr Kassim Lubowa, says most people in the slums live hand-to-mouth and cannot afford some of the items such as soap and sanitisers or the food needed in the fight against the virus.

“Going forward, government should always consider slums as special places because there is a lot of congestion, yet there are no social amenities. Such places need to be supported in such a difficult time if we are to fight the spread of the virus,” he says.

Limited resources

In June, Kampala Lord Mayor Erias Lukwago convened a crisis meeting with the technical team to see how the authority’s capacity in handling the Covid-19 situation can be boosted.

Although the meeting proposed a supplementary budget to enable the authority handle the crisis, by press time, they were yet to get feedback from the Finance ministry.

As the Covid-19 crisis bites, the authority doesn’t have any money to handle emergencies. This has left leaders at City Hall divided.

The Covid-19 resurgence plan suggested by the Lord Mayor included, among others, coordination and leadership, management of Covid-19 cases, water, sanitation and hygiene, support to vulnerable communities, and continuity of essential health services.

The institution received only Shs4m, which was sent to town clerks across the five divisions to facilitate the registration of vulnerable people who are supposed to receive Covid-19 relief cash.

During a council meeting on Tuesday last week, Mr Lukwago expressed disappointment about the delayed implementation of the proposed resurgence plan, warning that the situation in Kampala could spiral out of hand if no practical interventions are made.

The Ministry of Health spokesperson, Mr Emmanuel Ainebyoona, says KCCA was supposed to generate a Covid-19 budget since they have a vote.

Mr Ainebyoona refers to last year where he says KCCA also asked for facilitation and were supported.

“KCCA has a vote and is supposed to generate a budget and present it to authorities. Of course, we work together since we have one noble cause, but they should have planned earlier to handle some of the emergencies in the city,” he says.

He denies that the Health ministry has isolated KCCA in the fight against Covid-19, saying the authority can be supported if they seek support.

Asked why the ministry did not improve the capacity of city health centres to enable them handle Covid-19 cases, Mr Ainebyoona said the facilities have limited space.

He also said there is no proposal from KCCA to have the capacity of their health centres improved.

By press time, efforts to speak to KCCA’s director of public health, Dr Daniel Ayena Okello, were futile.