By David Oduut
Bukedea: The poor access to maternal health care in Bukedea District has worried residents with the coronavirus pandemic exposing more weaknesses.
In the fact finding visits made by this Website this week, a number of health Units in the district do not have operational maternity wards and are also hit by shortage of medical staff. The poor road network in the district has also forced a large number of women to give birth at home,which is unsafe.
In Kangole Health center II, Kangole Sub-County, the medical facility operates without a single bed for delivery much as it delivers at least 23 babies in a month.
Largely, women give birth on the floor and the nurses perform their duties without essentials like hand gloves and other protective gears.
Because of such difficulties, Ms Akwata Marita, a mother and resident, said mothers in the area have resorted to giving birth at home using traditional birth attendants.
“Currently I am here to seek treatment for the recurrent abdominal pain because I still feel like the fingernails of the traditional birth attendant are still scratching inside of me since I gave birth in April,” Ms Akwata said.
She feared that she may end up getting diseases like cervical cancer if her condition is not well attended to.
The mother of four said there is a need for the government to equip the facility with equipment, drugs and recruit more medical staff to reduce the risk of mothers from losing lives in child birth.
Ms Elizabeth Asekenye a traditional birth attendant, said mothers commonly lose babies in the struggle to give birth.
“I produced all my eight children at home, it is the same experience I am using to help but our daughters are not as strong as we were. It is sad that when there are complications we can only struggle to save the life of the mothers and in most cases babies die,” Ms Asekenye a 72-year-old widow said.
Adding that “While burying these lost babies, we console ourselves that mothers can always replace them and of course everyone knows that is very saddening.”
Mr. Kokas Ojeke the in charge Kangole health center said the facility is not coded by the ministry of health a reason it does not receive support from the ministry of health.
“We were largely supposed to give help to people seeking malaria and diarrhea treatment,” Mr. Ojeke said.
He however added that because the facility lies in a hard to reach area where the entire population of over 14,000 people rely on it to get medical help, at least 36 women enroll for antenatal at the facility every month.
“17 have already given birth since the start of this month,” Mr. Ojeke said.
The medical worker however decried the bad road connecting to Kabarwa health center III where referrals are made during emergencies.
“Emergencies are handled but in a hard way because there are very big potholes and mud on the road so ambulances always get stuck and when you are hurrying a woman with complicated labor for help, you only remain praying to God’s mercy on the patient,” Mr. Ojeke said.
He asked the district to fix the road and fast truck coding of the health facility and elevate it to Health center III status so that it gets the support from the center.
While in Malera health center three, the borehole which has been the only source of water has been spoilt for the past two months making access to water for mothers who give birth difficult.
“Here we have to move at least five kilometers to fetch water for us to clean ourselves,” Ms. Sarah Akwi, a resident of Kamailuk village, Kareng parish said.
Ms Akwi who gave birth on Wednesday said the hygiene of new mothers at the facility is compromised exposing them to other infections and complications after childbirth.
Ms. Amujar Christine Susan, another resident from Kadacar village who had gone for antenatal care said she moved on foot for 12 kilometers to access the facility as movement on motorcycles is prohibited due to coronavirus.
She said upon reaching the health facility, she was told to go back home to fetch water for taking antenatal medicine given while in the facility.
27 other women received the same instruction on Thursday as this website visited the facility.
“It is difficult to move several kilometers on this sun just to fetch water unless someone is telling you to go back home without being taken care of,” Ms. Angura Harriet told this website. She pleaded with the district authorities to fix the borehole to ease access to water.
Mr. Sadik Opolot who stays near the facility said the community recently collected money to fix the borehole but the committee that was set in place ate the money.
He said the district should also open for use the new maternity ward which has remained locked since its completion in December last year.
“This would help create space for mothers,” Mr. Opolot said.
Ms Akol Mary Clare, a nursing officer at Malera Health center III says that due to lack of running water, the facility struggles to handle deliveries.
She revealed that there is no electricity at the facility which has hampered the immunization process since drugs cannot be properly kept at the health facility.
“We are told the transformer is spoilt and we have to take our drugs for immunization to Bukedea which is 12 kilometers away for storage,” Ms Akol said adding that this has created delays in carrying out immunization for children.
In Kidongole sub county, at least 20 babies were born at home in April as the covid-19 pandemic struck.
Mr. Gilbert Okello the heath in charge Kidongole Health center three said out of the 43 mothers who were due to give birth at the facility between April and this month, only 23 delivered at the facility with others mothers only turning up with babies for immunizations.
He said 13 of the babies were born by HIV positive mothers which put them at risk of contracting the virus.
In Kabarwa Health center three, much as locals commend medical workers for being committed to their work, they say the maternity ward has become too congested to accommodate all mothers.
“There are few beds so you only get to climb on one when your baby is due, after that your lenzu becomes your bed and if you are not lucky, you end up being pushed to the verandah,” Merab Amuron told this website urging government to add more beds and nurses to the health facility.
Ms Oliver Oluka, a nursing officer, admitted that there was a shortage of beds and midwives at Kabarwa health center. She requested that due to population pressure, there is a need for more sheds where parents waiting to immunize their children can gather.
Background
In Bukedea District, maternal mortality is still high, according to the Health Management Information Systems report for 2017, around 160 mothers in the district died due to delays in accessing medical facilities and related services. This mostly affects the rural population.
According to the a survey also carried out by Uganda AIDS Commission , it was found that 18% of the expectant mothers in Bukedea district die in child labour per annum.
Here, mothers have a practice of delivering at home or unskilled traditional birth attendants (TBAs).
“The mothers who died are associated with early marriage, poor maternity facilities, lack of delivery items in the maternity wards especially in rural health units, lack of beds and mattresses, gloves and other necessities, poor communication networks and low health education and sensitization,” the report said.
Way forward
However, Bukedea district Health officer, Dr. Steven Ikodet in a recent health sector review meeting organised by Action Aid Uganda said his office was addressing many of the challenges raised by people.
“The issue of drugs at health centers has been addressed by the decentralization of the delivery tracking system so we now get drugs in time,” Mr. Ikodet said.
He however noted that a number of health center II facilities in the district have not been operationalized because they have not yet been coded by the ministry of health.
He said only Akuoro and Nalugai health center IIs have been coded and elevated to Health center III arguing the people of Kangole to be patient.
“The ministry has only allowed us to upgrade one heath center II each financial year so we are looking at how to help them in the next,” the DHO said.
For medical emergencies, Dr. Ikodet said the district lacked a functional ambulance to pick patients in need.
“The district ambulance we got while being curved out of Kumi district is too old to hold any emergencies. So far we are relying on ambulances donated by MPs but we also need an independent vehicle,” Mr. Ikodet said. He added that some challenges would be addressed after covid 19 including opening the maternity wards at Kidongole and Malera health center IIIs.
“I’m also going to cause a meeting with my health team to address some of the issues raised,” Mr. Ikodet said.
On bad roads, Mike Okwi the district secretary for works said some of the roads connecting to health facilities in the district are beyond the capacity of the district to repair as they need a lot of money.
“The roads like that of Kamutur connecting to Tajar Health center III and that connecting to Kangole Health center II need a lot of money which the district cannot get,” Mr. Okwi said adding that they have written severally to the ministry of works and transport but they have not got any response.
“When these people complain, I support them because really the roads are bad but not even our entire district budget can fix one of these roads,” Mr. Okwi said.
This Story was written with Support from Action Aid International Uganda
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