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Watchmen running Bugisu health centres
Bulambuli Woman MP Irene Muloni (left) hands over mattresses and beds to Muyembe Health Centre IV in February 2023. Photo/Yahudu Kitunzi
What you need to know:
- This publication’s investigations revealed that health workers rarely work at night, on weekends and on public holidays.
Many health centres, especially in the rural districts of Bugisu Sub-region, are being operated by watchmen at night in the absence of nurses and midwives, the Monitor has established.
The findings revealed that when expectant mothers check into some of the health facilities at night, they are assisted by the watchmen to deliver.
Findings also showed that health workers rarely work on weekends and on public holidays in some of the health centres we visited.
For instance, at Bupoto Health Centre III in Namisindwa District on Good Friday at about 1pm, some patients were stranded with no health worker to attend to them. The facility is about 300 metres away from the district headquarters.
Mr John Wabomba, a resident of Bupoto Sub-county, who had taken his sick wife to the health facility, said although the facility was operational, there was no health worker to attend to them.
“We have been here for the past three hours but there is no health worker to attend to us. The security guard told us they left for Easter,” Mr Wabomba said.
Ms Annet Gimono, an expectant mother, who was also found at the facility, said the health workers she found told her to go and seek treatment from a nearby private clinic or return after the Easter holiday.
“She walked away and left us seated here. We don’t have money to pay in private clinics, we have to wait until then,” she said.
Efforts to get a comment from the in-charge of Bupoto Health Centre III about the allegations were futile as his known mobile phone could not be reached by press time.
Ms Irene Namono, a resident of Bumbo Sub-county, said many facilities in the district have no health workers at night.
“They work during the day but at night, you find watchmen, who even help to deliver mothers. It’s very unfortunate,” Ms Namono said.
The Namisindwa deputy resident district commissioner (RDC), Ms Juliet Solome Namara, acknowledged that organised absenteeism is the main vice hindering health service delivery in the district.
“Some health workers have conditioned the patients that there is no working after lunch and on weekends. This is a [practice] that must be stopped because health workers are well paid to work as expected,” Ms Namara said.
Recently, Ms Namara, in company of the former Namisindwa District Police Commander, Mr Swagiya Nabunya, made an impromptu visit from 11pm-2am to some health centre IIIs, including Bupoto, Bubutu, Bumbo and Bumwoni. No staff was found at the facilities.
Some facilities had one staff on duty by the time of their visit. At Namakwekwe Health Centre III, Malukhu Health Centre III and Namanyonyi Health Centre III, the watchman said the health workers were sleeping.
Mr Emma Bwayo, the Namisindwa District youth councillor, said most of the health workers stay in Mbale City, which is about 60 kilometres away from their workstations.
“The district health officer and several in-charges sleep out of the district. So whom do you expect to monitor and supervise junior health workers whether they are on night duty or not?” Mr Bwayo asked.
Mr Bwayo added that many mothers are suffering at the hands of traditional birth attendants in the health facilities due to lack of qualified health personnel.
Mr Joseph Wambi, a religious leader, said absenteeism and poor attitude towards patients among the health workers has crippled access to healthcare.
“This is a serious concern, which the district leadership has paid a deaf ear to, despite our repeated calls,” he said.
The Namisindwa RDC, Mr Imran Muluga, said corruption among health workers in the district is also a big challenge.
“I met the heads of health centres and mobilised them to do their role and anyone who will be found culpable for dodging work and corruption will be dealt with,” Mr Muluga said.
He, however, said the district doesn’t have health Centre IVs and that as a result mothers are referred to Mbale Regional Referral Hospital to give birth and yet it is far.
“The only health Centre IV is a private facility and they charge mothers Shs400,000 for caesarean section. As a district, we also don’t have ambulances,” he said.
Ms Loyce Namakoye, a resident of Sironko Town Council, said health workers have turned various government-aided health facilities into private facilities by asking patients to pay for the services.
“We ask the government to prevail over the health workers because some people cannot afford to pay for services,” Ms Namakoye said.
The Sironko RDC, Mr Denis Epharim, acknowledged receiving complaints, saying the habit of health workers not working on weekends is rampant, especially in the rural facilities.
“I talked to the district health officer and we shall meet all the health facilities leadership to see how we can solve that problem,” Mr Epharim said on Friday.
Mr Steven Masiga, a researcher on health and education delivery, said recently in Busano Sub-County in Mbale District, an expectant mother of twins was left to give birth in a compound of the facility without medical help.
“She was attended to by the watchman. This is a sign that we need strong health management committees and strong supervision by the local government,” Mr Masiga said.
The Mbale Northern City RDC, Mr Yahaya Were, said they would take action against some health workers found to be sabotaging government programmes in the health sector.
“We have information that health workers in health centre IIs and IIIs are not regular at work and when they do appear, they arrive late and leave early. We have even registered numerous cases of expectant mothers in the division getting stranded at the facilities at night without a health worker to attend to them,” Mr Were said.
Accommodation challenges
The in-charge of a health centre III in Bududa District, who requested not to be named in order to speak freely, said they stay away from their stations due to lack of accommodation.
Also, the Sironko District chief administrative officer, Mr Luke Lokolimoe Lokwi, said most of the health facilities in the district don’t have accommodation.
But our findings revealed that even though some health workers have accommodation at their respective facilities, they have deliberately stayed out of their work stations.
The Sironko District Health Officer, Dr Paul Wakooko, said although not all health facilities work 24 hours a day, they have tried to fight absenteeism.
Mr Hosea Kigai Kimono, the Manafwa District chairperson, wondered why the health workers have poor attitude toward work yet they are well paid.
“When they are applying for jobs, they are humble. But after getting them, they start dodging work,” Mr Kigai said.
Mr Kigai, who is also a retired clinical officer at Bubulo Health Centre IV in Manafwa District, said: “When you’re on night duty, you are not expected to be absent nor sleep.”
Mr Abdullah Magambo, the deputy speaker for Mbale City, attributed the problem of absenteeism to poor supervision by district health officers.
“There is a need to intensify the supervision in health facilities and such health workers, who absent themselves from duty, should be punished to act as an example to others,” Mr Magambo said.
He, however, tasked the government to elevate some health centre IIIs in Mbale City that include Namakwekwe, Namanyonyi and Nakaloke to health centre IV in order to provide better healthcare.
In an interview with the Monitor, Bubulo East MP John Musila blamed absence of health workers to laxity in supervision and monitoring by the health department in the districts.
He said some health workers boycott night duty and go for drinking, something he said is contributing to maternal mortality.
