By Patrick Jaramogi
Ntungamo, Uganda: It is not even 24 months since Itojo Hospital in Ntungamo received funds from the World Bank to undertake a facelift but the money is now missing. A tour around the 52 year old health facility brings sadness amidst the mist of deep-rooted corruption in Uganda today. Itojo hospital, which was constructed in 1968 by the administration of then Prime Minister Dr, Apollo Milton Obote, has a 120 bed capacity and 140 staff. It serves Ntungamo district and some parts of neighboring Northern Tanzania and Northeastern Rwanda. It is located some 55kms from Mbarara, along the Mbarara- Kabale Highway. The hospital that received Shs1.1 billion from the World Bank for the renovations, according to the Senior Hospital Administrator Mr. Andrew Walabyeki, is already in a ‘sorry state’. Some of the roofs that were supposed to be replaced weren’t replaced. Sections of walls in some wards that were supposed to get new paint are pathetic.The ceilings are hanging just a few months after a certificate of completion was awarded to the contractors. The Hospital today stands in a rundown condition despite several attempts to improve its status.
Efforts To Improve The Facility
In 2006, the then area Member of Parliament, who is also the First Lady, Janet Kataha Museveni, started soliciting funding from both internal and external sources, to rehabilitate the hospital. In 2007, the Egyptian Government, through the Egyptian Fund for Technical Cooperation with Africa, donated US$280,000 (Shs770m) to rehabilitate the hospital, including the construction of three new staff houses. Egypt also pledged to send three specialists (a pediatrician, a surgeon and an obstetrician/gynecologist to work at the hospital as part of the assistance package. The construction work was contracted out to Excel Construction Company Limited, a subsidiary of the Madhavani Group. In June 2011, Egypt donated pharmaceuticals, a generator and other hospital supplies to assist in the rehabilitation of the hospital. Itojo Hospital admits over 200 patients daily, and is the only facility in the region where surgery can be performed, as well as handling of all referred patients from the 47 health units in the district.
Corruption Woes Not New
This is not the first time that corruption is being cited at Itojo Hospital. It has suffered corruption cases over time. In 2012, the then Medical Superintendent was arrested for embezzling Shs20m which was meant to support the cervical cancer surgeries in the district. Dr. Trephine Mugisha was arrested by detectives from State House Medicine and Health Services Monitoring Unit. He was found with forged receipts and false accountability from the PATHFINDER funds.
Background
The Government of Uganda received financing of USD130 million (Shs475B) from the International Development Association (IDA) of the World Bank towards the cost of the Uganda Health Systems Strengthening Project (UHSSP). The Project Development Objective was to deliver the Uganda Minimum Health Care Package to Ugandans, with a focus on maternal health and family planning. The credit agreement for this project was signed in August 2010 and the project was declared effective on 11 February 2011 after which its implementation started. The Project was to initially end on 15 July 2015 but was given a no cost extension so it closed on 30 June 2017. The project had four specific objectives that included: improving infrastructure of existing health facilities, improving development and management of the health work force, strengthening management, leadership and accountability for health service delivery and improving access to and quality of maternal health, new born care and family planning services. One of the main outputs of UHSSP was to renovate two Regional Referral Hospitals, 17 General Hospitals and 27 HCIVs. The General Hospitals included: Anaka, Nebbi, Moyo, Kiryandongo, Masindi, Apac, Mityana, Nakaseke, Iganga, Bugiri, Entebbe, Itojo, Bukwo, Buwenge, Kawolo, Pallisa and Kitgum.
The Regional Referral Hospitals included: Mubende and Moroto. The HCIVs were: Kasanda,Kiganda, Ngoma, Mwera, Kyantungo, Kikamulo, Kabuyanda, Mwizi, Kitwe, Rubare, Aboke, Aduku, Bwijanga, Bullisa, Padibe, Atyak, Obongi, Pakwach, Buvuma, Budondo, Ntenjeru-Kojja, Buyinja,Nankoma, Bugono, Kiyunga, Kibuku and Budaka.
Due to budget constraints, the available funds were committed to renovating the first set of 9 Hospitals and 26 HCIVs. Under the first phase, the following hospitals were considered: Anaka, Nebbi, Moyo, Kiryandongo, Nakaseke, Iganga, Entebbe, Moroto and Mityana.
What Went Wrong?
According to the Chief Administrative Officer,(CAO) Ntungamo district Mr. Samuel Ruhweza Kaijja, Itojo Hospital needed at least Shs3B to be renovated to latest standards. But when Shs1.1B was released for the renovations, something went wrong. SpyUganda went underground to ‘dig the dung’. In our findings, SPARKS, the construction company that was awarded the tender for Phase One, did the unthinkable. Scores of district officials, including top Itojo Hospital management, said there was no value for money. “We are in tears. SPARKS construction firm did no work. All they did was to ‘eat’ the money. This is shoddy work as you can see,” said Mr. Andrew Walabyeki, the Senior Hospital Administrator Itojo Hospital. “I have been here for three years but I only managed to get to salvage the situation midway the works of Sparks,” he told SpyUganda while at the hospital. Walabyeki said he got so concerned that he organized for stakeholders’ meetings with district leaders which agreed to spend Shs7m to monitor the works. “It was then that we managed to recover some Shs200m which had been siphoned from the shs600m that was budgeted for Phase One,” he explained. He said SPARKS only roofed one staff quarters. “They (Sparks) were supposed to roof the Out Patients Building, install new ceilings, roof the staff quarters, do fresh paintings and replace locks, all these weren’t done,” he said. Walabyeki said he got so concerned when he tried to report the firm but nothing would be done. “I only chilled when I was told Sparks Construction firm is linked to the Deputy Attorney General, Mwesigwa Rukutuna.” He said out of the Shs600m released, the contractor used perhaps just Shs200m or less for works done.
First lady Intervenes
As the contractor took to his corruption antics, a Ugandan based NGO, Africa Freedom of Information Center (AFIC) had through the Global Partnership on Social Accountability (GPSA) program funded by the World Bank, and the Uganda Contracts Monitoring Committee (UCMC) trained locals on monitoring government and donor funded projects. Through such monitors, noise begun to be made. “We couldn’t stomach it anymore. When we were told by the contractors that some of the funds meant for the hospital renovation was channeled for presidential campaigns, we went far,” said Mr. Muhumuza Denis aka Savimbi, a district councilor and chairperson Finance Committee of Itojo Hospital. He told SpyUganda: “I fear no body. I approached the First Lady and asked if indeed shs200m was channeled for campaigns. She inquired and said it was wrong information.” Janet Museveni then wrote to Ntungamo district ordering that Sparks contract be terminated immediately and another contractor recruited. But already shs600m had been misused. In February 2017, a new contract was entered between Ntungamo Local District Administration and M/S Gremu Trading Company Limited, based in Ntungamo to do phase 2 of the rehabilitation of Itojo Hospital. According to the contract papers that SpyUganda has obtained, Gremu was awarded shs392,524,003 million. The award followed the districts’ contracts committee meeting (Min038/Jan/2017) sitting that was held on January 27, 2017. Under the contract, Gremu Trading Company was due to do roofing of the Junior staff quarters valued at shs147,592, 000 million. Do paintings of the junior staff at shs28.8 million, as well as do drainage works for the senior and junior quarters.
Residents React
The mood that can best describe the occupants present at the Out Patients Building Hall at Itojo is ‘ being charged’. Recently a meeting to discuss the hospital’s condition was organized by Africa Freedom for Information Center and attended by top officials of the Uganda Contracts Monitoring Committee (UCMC). The residents demanded to know why the first contractor, SPARKS, had been left to walk away Scot-free after doing shoddy work. “This is very shoddy work. The guys who did the First Phase ate money for nothing,” said Mr. Japheth Begumisa, the NRM Chairperson for Itojo parish. “Look at the locks, they got broken several years ago. Look at the ceilings, they are caving in. This is corruption,” he said. The LC secretary for Defence Hamu Hangmbagye said hell breaks loose whenever it rains. “Patients don’t have a sheltered walkway. So when it rains they either wait for it to stop or get soaked as they try to enter the hospital.”
