Dr. Byamugisha told URN in an exclusive interview that prior to the renovation of the hospital, the delivery of health services had become difficult and expensive to manage.
All this has improved, despite the insatiable demands at the Hospital. Following months of renovation work, Dr. Josaphat K. Byamugisha, the Director of the newly transformed Makerere Health Services says he breathes with a sigh of relief.
Makerere University Hospital has received a
major face lift despite the insatiable demands at the Hospital. Dr. Josaphat K.
Byamugisha, the Director of the newly refurbished hospital, says the renovation
is a sigh of relief. Dr. Byamugisha, who is also a professor of Gynecology & Obstetrics at
Makerere University, says he no longer has to struggle each day with issues
that came with unsatisfactory services and dilapidated buildings.
The Hospital now falls under Makerere
University Health Services, which works jointly with other satellite clinics in
all the university campuses and Dental Hospital. Despite the
closure of the university as part of the preventive measures against the Corona
Virus, the hospital has remained fully operational service. Makerere University
closed for 30 days effective March 20, 2020.
Dr. Byamugisha told URN in an exclusive
interview that prior to the renovation of the hospital, the delivery of health
services had become difficult and expensive to manage. “The
diagnostic services namely laboratory, ultrasound scan and X-ray were being
managed by a private company that had done so for more than 15 years. The
complaints from the users and stakeholders had become recurrent,” says
Byamugisha.
In 2016, Uganda Radio Network (URN) published a story showing
the shocking state of the hospital, which triggered several discussions. In
July 2018, Makerere University leadership agreed to transfer management of
University health services to the College of Health Sciences, a move that has,
according to Dr. Byamugisha seen the University health services return on; “the
road to recovery”.
"The Hospital has been reorganised and a triage
unit opened, a clear cut out patient department and lying-in ward marked out,”
with University students, as its main clients.
How
Hospital Units are performing
With an estimate of over 1.5 million Ugandans suffering from
avoidable visual impairment, as a result of lack of accessible eye care
services, in August 2016 Makerere University launched an optometry (eye care)
with support from the Australian government and other NGOs involved in eye
care.
Since the installation of new equipment, the hospital has
been offering comprehensive eye care including; routine eye checkup,
refraction, eye health slit lamp examination (anterior eye and fundus
assessment), intraocular pressure measurement, Pediatric eye health and
binocular vision services (examination and therapy) such as squinting eyes,
treatment for amblyopia, as well as color vision assessment.
The hospital also offers examinations and therapy for low
vision, manages eye disease and prescribes as well as dispenses spectacles
among others. According to Dr. Byamugisha, the hospital seeks to install
the missing diagnostic equipment including perimetry and fundus photography.
“In order to benefit the community to a greater
level, we hope to conduct eye screening programs in the community so as to
provide eye care services to all people and detect ocular disorders through
screening the populations,” Byamugisha says.
HIV
Counseling and Testing
Between 2018 and June 2019, Makerere Hospital working in
conjunction with Makerere University Joint AIDs Program (MJAP) tested 5302
clients, majority of them students. And the number of HIV positive cases was 84
making 1.6% of the number tested.
Safe Male Circumcision
The hospital has been providing both hospital
based and community outreach safe male circumcision since the campaign started.
The Hospital circumcises 6000 people on average annually, according to
statistics obtained from the hospital.
The hospital has according to Dr. Byamugisha increased the
numbers of clients from close to 2000 patients annually to now around 5,800. The
most common conditions remain malaria, minor injuries, Ear Nose and Throat
conditions, Sexually Transmitted Infections, Dental Problems and Internal
Disorders.
Dr. Byamugisha attributes the increased numbers of clients to improved
services at the Hospital. He reveals that they have already started
conversations with insurance companies to enlist the Hospital.
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Laboratory
Services
In previous URN reports, the laboratory services
at the University Hospital had deteriorated as the outsourced firm M/S Crystal
Holdings Ltd was reportedly inflating the costs of lab services. In fact, the 2016 Rwendeire Visitation Committee report noted
that the laboratory services were grossly abused by requesting for unnecessary
lab tests in a bid to inflate the figure billed to the University.
A
case in point is on March 20th, 2015, where about 80% of the students who purportedly
turned up underwent 11 tests including a patient whose chief complaint was
itching of the eyes (allergic conjunctivitis). In a number of cases, a review of the patient
files revealed that results for the numerous tests purportedly undertaken were
not on file while all lab requests seen lacked clinical notes to guide the lab
technician.
As a result, the Rwendeire probe found that there was absence of a
proper system of internal controls to ensure that the University was actually
billed for the medical services rendered to students in form of segregation of
duties and proper authorisation with possible fraud.
When this reporter visited the Hospital, the administrators
explained that it had transited from private management and was now fully
managed with collaboration with the College of Health Sciences with coordinated
tests carried out with the School of Biomedical Sciences Laboratories.
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Milton Mugisha, a Lab Technician at the University Hospital
says they have, with the improved laboratory facility increased the number of
tests for clients. He notes for instance that the hospital was
able to test 20,781 samples and worked on 11,543 patients. From the lab
statistics seen by URN, majority tests carried out were malaria, UTIs, typhoid
and HIV.
The condition with the most positive tests was
UTI with 50% of the tests being positive. Mugisha says they have obtained state
of the art equipment including a three-part hematology analyzer, used to
conduct a complete blood count (CBC), Chemistry and Immuno-Assay analyzers
among others.
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According to Mugisha, with the new equipment, the laboratory
now has capacity to conduct several tests including detection of cancer, liver
function tests among others.
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Hospital Staffing
The hospital currently has 50 staff plus 6
volunteers instead of 74 workers that are expected to serve the facility. Although
Professor Byamugisha says the hospital has an arrangement where several experts
teaching at the University’s College of Health Sciences conduct specialized
clinics at the hospital on intervals.
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What
Hospital Users say
Obed Kwokuboth Jalmeo, a 2nd year bachelor of
Education student and Guild Presidential candidate, says the hospital has
changed for the better, but not yet the best. “It has changed somehow from there being no Doc [Doctor] to
you finding at least one.
From you finding totally no drugs to you finding some
at least (though most people are often referred elsewhere because the drugs are
still as limited). From not having facilities to prompt tests,” Jalmeo says. He adds that; “There's therefore still serious need to
utilize the monies paid for medical expenses to stock, create adequate space,
etc.”
Emmanuel Opolot, another student went to the University
Hospital in February this year to receive treatment. “From last year, there has been a change to me, though there
are individual weaknesses in some people, generally there is a move towards positive
change,” said Opolot.
Adding that, “The very last time I went there was to receive
treatment, and I got the very best customer care from Doctor Buyinza God Bless
him so much. Though I don't know if they have improved their Lab presence on
Sunday, it seems it is out of service practically on Sunday, if it is still so,
it should be revised and worked upon.”
A student resident of University Hall who preferred anonymity
however, says he has on many occasions got disappointed with the hospital services.
“It’s just a building, nothing else,” he said. According him, the hospital services need to be
stepped up especially in the night.
He recalls rushing a student who had a
fractured shoulder to the hospital during the guild campaigns, only to be
referred to Mulago National Referral Hospital. “A lot of money
(hospital fee) is collected but it seems it deals with minor cases like fever,
cough and flue,” he observes.