Receiving healthcare in Uganda
Having been around the health centre for a while I thought I would share with you a description of how it works here. I haven’t taken photographs of the wards and the people as it doesn't seem right to share their pictures especially in times when they are compromised with an unknown audience. Those pictures I do have – people are happy for me to share them.
If you are not an emergency you make you way to the health centre. This could be by walking, by bicycle boda or by motorcycle boda. Some people arrive in the afternoon having walked many miles within the region to get here.
At the reception you are checked in and waiting to see the doctor who will assess, possible refer for blood tests and then make a treatment plan.
Treatment is usually a course of tablets or may be an injection. Some people are admitted to hospital.
As it is a non government organisation the stock of drugs is usually pretty good. Some drugs supplied by the Ministry of Health are free – these include immunisations, Vitamin A, worm tablets, HIV treatment, Septrin (antibiotic). There is a small fee for family planning and anitmalarials. As a non government organisation the health centre is able to obtain stocks of drugs – but as these have to be paid for the charges have to be passed on to the patients.
If you arrive as an emergency you still have to make your own way. I have seen 2 people arrive as emergencies where they are not conscious and have been brought on the back of a motor cycle. This involves having a third person to sit behind the patient and hold the patient between themselves and the driver.
They patient will then be brought into the health centre on arrival where they will do what they can or they may be referred on to the district hospital if they cannot be treated effectively here. If the patient or their relatives have money for fuel then the ambulance may be used otherwise people re generally expected to make their own way.
If you are admitted to hospital you will be expected to have an attendant with you. This is generally a family member(s). Sometimes several members of the family and children are present. The attendant is expected to buy and prepare the food and feed the patient. They will also wash the patient and clean any soiled laundry or clothes. Soiled laundry is expected to be cleaned before it goes to the wash room on site where it is washed with other laundry. The attendant generally sits on the floor during the day or on the grass outside while the patient lies on the bed. At night the attendant sleeps on a rush mat on the floor beside/ underneath the bed.
When people are discharged – again they make their own way home. After having a baby it is common to see the parents and newborn disappearing off on the back of the motorbike.
This is a picture of some of the midwives, in the post delivery room. Siter Loy (the tallest) says she has adopted me as one of her daughters :)
There is a security presence at the gate. This includes an armed guard. Part of their role is to check that patients have paid their bill from the health centre before they leave the premises. Although there are still runaways – people who cannot afford to pay.
Last week there was an elderly person in the hospital who was very worried that his son (his attendant) had run away. This meant that there was no one to provide him with food or to pay the bill. The patient in the next bed provided the food for this person and I believe some arrangement was made about payment of a small fee. The organisation tries to be as helpful as possible but at the end of the day it relies on donations to operate and only has a finite supply of money.
Disposal of hospital waste is on mu agenda for follow up. I have yet to see the placenta pit although I have heard a lot about this. It’s next to where the rest of the infected waste gets buried. That is for another day.
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