It is 10:45 am and everybody is on his/her station duty busy attending to patients in Nyamuyanja Health Centre in Isingiro district. The Centre is packed to capacity because the health workers are available to the patients despite the challenges they face.
In 2008 exactly at the same time a lady had come to deliver her third child from the same health Centre but nobody was there to attend to her because the in charge doctor was not present, he had gone for further studies.
His deputy had not yet reported for duty and the ambulance which was supposed to take her to Mbarara referral hospital had no fuel, besides the driver also had not reported.
The only alternative available for this lady was to deliver in the bush nearby and it made headlines in the local media. The embarrassing incident happened in the very eyes of the head of Millennium Development head at the UN Prof Jeffry Sucks and the then state minister for planning Omony Ojok (RIP) who were on fact finding mission of how to expand the millennium villages’ project into the whole country.
It also moved some of the medical staff in the country and ended up landing a committed female doctor to move from the comfort of Kampala to this rural health center.
Dr Doreen Kenyangi moved from Mengo Hospital to come and work in the rural Nyamuyanja HC4 and has since turned this death trap to a functional Centre.
Dr Kenyangi says she is driven by passion and has not focused on money because she believes she can make money anytime she feels she wants. She says she is still young and can get employment anywhere in the world.
“After reading the story in the media I was moved and vowed that this should not happen again and the only solution was to go to that particular Centre. I also moved from Kampala to satisfy my ambition of serving the local people as a medical doctor. To me becoming a doctor is a calling and my target is not money because I can always make it” she says.
Since her arrival about a year ago, the situation has improved tremendously as the population has regained confidence in the services of the Centre it offers. Every day about 200 out patients visit the facility and most of them pass through her hands.
The number of inpatients has also increased from about 5 to 40 and mothers delivering at the Centre have increased from 10 to 40 per month.
After that big embarrassment government patterned with Ruhiira Millennium Villages Project (RMVP) and Medical Team International (MTI) to revamp the Centre and some of the bottlenecks have been worked on.
Dr Gerald Mutungi the program manager non communicable disease and special permanent secretary Isingiro district says government has moved in to solve some of the bottlenecks in the health Centre 1V’s in Isingiro district like having constant supplies of drugs, making the theatres operational and provision of a generator for each health centre.
“With the help of partners we have been able to operationalize the two theatres of Nyamuyanja and Rwekubo Health Centre 1Vs in the district and fully equipped the delivery rooms for the expectant mothers with new delivery beds and enough drugs for the expectant mothers,” he says.
Joyce Unimana, 22, who was the first to have an operation at Rwekubo Health Centre 1V was overwhelmed by the treatment.
After the tragic loss of her three babies in a row before, couldn’t control her emotions when health staff presented her with her newborn son, following an emergency cesarean section. “I am extremely happy to carry my son.” Joyce exclaimed. “I have sad memories after losing 3 babies.”
During her third pregnancy, Joyce had managed to get to Mbarara referral hospital, but the baby was dead by the time the surgeon could operate. “This baby is so precious to me,” Joyce continued. “My husband divorced me because I had no child, but holding baby Samuel in my arms brings so much joy. I can now be called ‘mama Shukuru’. He is called Shukuru Samuel.”
The head of medical services RMVP Dr Emmanuel Atuhairwe says the project has stepped in to help the government through improved maternal and child health services, management of antenatal and postnatal care, family planning and obstruct cases.
“To decongest the health centers, we are aiming at taking maternal health services from health center 1Vs to heath center 11s to be able to handle maternal and child health services and to strengthen the referral system from the peripheral health centers to health center 1Vs in Isingiro district ” he says.
This is to bring it in line with other health centers in Nyakitunda and Kabuyanda sub counties where RMVP is operating and has largely succeeded. The referral system has been strengthened with the provision of ambulance to manage complicated cases that are referred to higher centers up to Mbarara referral hospital.
He says the project has also strengthened the village health teams through trainings and support supervision to provide basic care at household level, diagnosing and treatment of malaria in children less than five years, improvement of personal hygiene, diarrhea and simple pneumonia among others.
However Dr Kenyangi says despite the shortage of staff, lack of furniture, electricity, staff housing and lack of blood progress has continued to be made.
Despite delivering some babies at night, restituting children using torchlight, mothers have gained confidence in the health centers and since the theater began operational 13 caesarian deliveries have been handled safely and reduced the referral cases to Kabuyanda Health Centre 1V. Her resolve to work in the rural area has inspired some of the medical staff who have emulated her. Ms Pulkeria Kyasimire a midwife handles antenatal, postnatal and deliveries alone while at the same time she carries out immunization.
“I have been inspired by Dr Kenyangi to work hard to save mothers lives. For the last two weeks I have been managing the whole department of mothers and children because my workmate is sick and I cannot complain”, she said.
The district health officer Dr Edson Tumusherure says some of the bottlenecks the health centres are facing are crosscutting in the country.
“We find it very difficult to recruit and retain staff because of various reasons including poor pay and doctors shunning to work in rural areas opting for greener pastures”, he says.
He says blood shortage in health centres especially those that carry out operations is a serious problem that needs immediate attention and arrangements have been made with blood bank of Mbarara to supply these centers with Blood. “We are looking for fridges where to keep the blood to save any complicated cases that may arise during operations”, he says. Other challenges include lack of enough beds for mothers’ delivery and in wards. Some patients sleep on the floor while others share beds.
Dr Kenyangi is optimistic that with commitment from doctors the situation of expectant mothers can improve tremendously and is determined not to see mothers delivering from bushes again when doctors are available to avert the situation especially herself in the area where she operates.