Senior doctor dies of Covid after failing to get ICU bed

Close colleagues say Dr Kiggundu collapsed on duty at Kawempe Hospital in the afternoon and was referred to Mulago Hospital for further management.

But upon arrival, the national referral hospital could not readily get a free bed for him in the Intensive Care Unit and he died shortly after.

Dr Lawrence Kazibwe, the acting deputy director of Kawempe Hospital confirmed that Dr Kiggundu collapsed at the hospital, but denied that the deceased was on duty.

He said Dr Kiggundu had come to pick up his medicine.

Dr Kazibwe explained that Dr Kiggundu had not been well since December 24 suffering a bit of fever and body weakness and on the day he collapsed, he and his wife had gone to receive infusion medicine at the hospital.

“Unfortunately, the wife also started showing the same signs, so he started infusion medicines from Kawempe. On Sunday and Monday he comes to receive medicine, but he had not yet tested for Covid,” Dr Kazibwe told Daily Monitor by telephone yesterday.

He said he suggested to Dr Kiggundu to seek a Covid test and on Tuesday he had come to receive medicine as well as take the test.

“He wasn’t feeling very well. On Tuesday when he came back, he had come for the medicine and to take the test. Unfortunately, as he sat down to receive the medicine, he collapsed. We started first aid and rushed him to Mulago to receive care,” Dr Kazibwe added.

He revealed that a number of people suspected to have been in contact with Dr Kiggundu had been isolated already.

Asked about availability of beds in the ICU when Dr Kiggundu was transferred to Mulago Hospital, Dr Fredrick Nelson Nakwagala, the head of Covid Treatment Unit, confirmed that at first there was no free ICU bed at the time.

However, Dr Nakwagala explained that they were  later able to secure an ICU bed for Dr Kiggundu but unfortunately he died in the process of transferring him from the High Dependency Unit (HDU) to ICU.

“He was transferred to Mulago Hospital and admitted to High Dependency Unit. While there, he was being prepared to be taken to ICU, but during the procedures of transferring him, he passed away,” Dr Nakwagala said.

Health workers said Dr Kiggundu arrived at Mulago with advanced Covid-19. They speculated that the delay in securing an ICU bed for him contributed to his death.

“It is important to realise that his disease was advanced and when you have advanced disease even in ICU you can die. Of course, ICU is a better place than HDU,” Dr Nakwagala explained.

Responding to the claim that delay in getting into ICU could have accelerated Dr Kiggundu’s death, the Mulago Deputy Executive Director, Dr Rosemary Byanyima, said ICU is just more than a bed.

 She said it has other equipment and accessories around it that need to be fixed first.

“When there is need for ICU, there is a process to make it ready, because it’s not just a bed. There is equipment, accessories. You have to make sure all tubes needed are fixed and the bed is disinfected. It’s not just a bed. Otherwise, we have so many beds,” Dr Byanyima explained.

She continued: “You do not improvise ICU beds. You either have it or you don’t. We use simple terms as bed but it’s not only about the bed. There are many things around it. You have infusion pumps, ventilators, monitors…and we make sure all those are fixed.”

Dr Byanyima said when Dr Kiggundu was brought to Mulago, the medial team had not been informed earlier so that they could start preparations for the ICU admission before his arrival.

“It’s because of the way he was brought in. They had not informed ICU to start preparing. So when he collapsed [at Kawempe Hospital] , they had to just bring him without alerting the team this side. Whenever patients are to be brought in by the emergency unit, there is need to be informed [in advance],” Dr Byanyima added.

 According to Mulago hospital,  ICU admissions are also limited by the human resource available.

The Uganda Medical Association regretted Dr Kiggundu’s demise and said he was former president of the Association of Obstetrician and Gynaecologists and an advocate of reproductive health and post-abortion care.

“His death is a blow not just to us but to everyone who has drunk from his wealth of wisdom, including several civil society organisations,  and women’s movements. That he will be greatly missed is an understatement,” Centre for Health, Human Rights and Development (CEHURD) tweeted yesterday.

Dr Mukuzi Muhereza, the UMA general secretary, said it is sad that health workers cannot get the treatment they deliver to others when they are sick.

He added that despite the widespread Covid-19 infections, health workers are working amid shortage of Personal Protective Equipment.

“As long as we do not have 100 per cent PPEs availability, as long we are working in an environment which can expose you to Covid, we are exposed. The bitter most part of it is that when we get sick, we cannot get the services that we have offered others,” Dr Muhereza lamented yesterday.

According to Ministry of Health, the number of health workers who have died of Covid-19 stands at 15 but said they were still verifying the cause of the new deaths of the two doctors.

Dr Kigozi, who also passed away on Tuesday evening, is said to have succumbed to lung related complications at Medipal Hospital, according to the family.

Dr Sabrina Kitaka, a paediatrician at Mulago Hospital, described Dr Kigozi as a great mentor.

According to his family, Dr Kigozi was a go-getter who improved everything he touched. “He was a strong character, a go getter. He turned around Butabika Hospital,” one of the family members said.

Issue

Inadequte PPEs

 “As long as we do not have 100 per cent PPEs availability, as long we are working in an environment which can expose you to Covid, we are exposed. The bitter most part of it is that when we get sick, we cannot get the services that we have offered others,”Dr Mukuzi Muhereza, the UMA general secretary,