Beating Covid-19 with a caring wife along the journey

During this second wave of the coronavirus disease in Uganda where there is widespread community infections, many patients and those who recover can not precisely tell where they got the infection from.

For Mr. Dick Nvule Nsubuga, 42, an Editor with Simba FM in Kampala, his wife was the rock and saving grace at a time when his contacts and social networks could not get him to a health facility to seek medication. He needed oxygen and his wife, a mother to seven months old twins, had to act fast to save him. Mr. Nvule shared his recovery journey with Daily Monitor's Irene Abalo Otto.

When I got sick and was admitted, some online journalists pronounced me dead. I saw and heard this and I felt bad.

Mr Dick Nvule at the Hight Dependence Unit at Mulago Hospital. He has recovered and recently resumed work.

I agree that people are dying. They were saying they spoke to my close family members. I wondered who they spoke to yet they did not call my wife who knew what was happening to me? 

For me, the sickness started like malaria and I felt a little feverish, one night. Around the fourth of June, I decided to go to the hospital to check for malaria. They tested me and they said I had a bacterial infection in the chest and some parasites of malaria. They gave me anti-malaria and drugs to take care of bacterial infection.

After five days of that medication, I was not feeling any improvement. I had signs of Covid. I was feeling back pain, joint pain, a slight dry cough and it would intensify especially at night.

In the morning it got worse. I could not easily breathe. I picked up my phone and tried to call my friend, the spokesperson of Uganda Red Cross. I wanted her to send me an ambulance because I had no energy to drive the car. When I called her, she was switching me off.  She was asking me to send a message. 

I took herbs, drunk a lot of neem, and ginger. After a week, there was no improvement. Then one night, I could not breathe. I called my cousin who is a doctor at Mulago Hospital at about 3am. He said we need to do a covid test. i could not get to the hospital at that time.

I later realized that she could not pick my calls because she had also tested positive. She was in the hospital in Jinja. Also on an oxygen bed.

Then I called Emmanuel the spokesperson of the Ministry of health.  He picked. I asked him to send me an ambulance because I was not feeling well. He said he was going to send the number of an ambulance driver.

I waited for about thirty minutes but there was no ambulance. Then I picked my car keys and told my madam (wife) “you are going to drive.” Madam said, “l don’t have a permit. I don’t know how I will do it. I have taken a long time without driving.”

I said no you have nothing to do now because the ambulance does not seem to be there.  She agreed and drove me to Mulago. We took one hour to reach.

That hour felt like forever because I didn’t want us to make any more delays. I did not want to scare her because I remember one time when we reached a jam, I told her that I could not breathe. I saw her panic because she thought that I could pass out in the vehicle.

When I reached Mulago, I contacted my cousin again.  And good enough he was within. He came and they tested me. I tested positive for Covid. I was a bit scared when they led me to the HDU (High Dependence Unit).  It had very many people. For good management and SOPs, the reception should only receive around five people. But there were around thirty people.  I waited at the reception for around thirty minutes.

As I waited in the queue a nurse came and they measured my oxygen level. It was low. I was to be admitted in ward number eighty two. First, I had to be put on oxygen so I sat on the veranda because there were no available beds.

They put my oxygen there, next to me. I waited for up to four hours before I got a bed at around 4:00pm. I was taken to the ward.

At the waiting lobby, i could see people being brought in very critical conditions. I remember at one time, they brought a policeman. he wore a police face mask and I assumed he was a policeman. 

He was in a very bad state. They asked me to take off my oxygen and they helped him because he was near dead. I waited for another cylinder to be brought in.

But i also observed that there were some cylinders at a corner but one medical worker said they were not working. “Let’s try,” a guy came in and started fixing them on each and everyone who did not have oxygen. I think he was also a medical person. I realized that there were not technical people to handle some of those cylinders. 

There were female doctors and nurses at the reception but these cylinders appeared to be a little bit technical to operate. Someone needed just a wheel spanner, the magalo to turn around things and that alone made the cylinders work.

Imagine that all of us who were there needed that oxygen but until this guy came with an ambulance, no one could fix those oxygen cylinders on patients. They thought they were not functioning. By the time i left that area, the guy had about eight more cylinders to fix on patients.

Then they asked me if I was able to carry my things. I had some energy to carry my bags. Then the person led me through to the lift to level two.

They admitted me to the High Dependency Units. I spent six days there. I was on oxygen support for Four days. Two days, I breathed on my own. 

But for the four days I spent  there on oxygen support  I saw a lot of things going on. People dying to the extent that  when they took me off oxygen i wanted to go home. But they put me in a separate room to monitor me.

On Friday evening, I recall a doctor telling me that I had to stay over the weekend and “we monitor you and probably we shall release you on Monday.” But another doctor had said i could leave on Saturday. This other one came saying; “yes, you never know you can get terrible when you get back home. That is why I am suggesting you go on Monday, after some days. You have to be monitored.”

But mid Saturday afternoon, I made a decision that I should push for my discharge because I realized that things were not good. People were dying in the ward. Whenever you could go inside the ward trying to exercise, you find bodies on the corridors, on beds. I said maybe I would be the next person to die. So I pushed for my discharge with the doctor.

I told him; “you know what, it is no longer Monday like you suggested. I think let me go today because I am feeling much better.”

He said; “let me discuss with my colleagues, I cannot take a decision alone.”

 So he went, that was around 3:00pm. They spoke, and then at 5:00pm the nurse came back and said; “you have been discharged. Get ready to get your things fumigated and you also fumigated.”

At around 5:30pm, I moved out of the place (Covid Treatment Unit).

I was discharged on the 12^th of June after admission on the 6^th of June. 

A lot of things happened for the six days i stayed there.

 First of all, we created friends.The biggest lesson for me has been that covid is real. When i was at Mulago, i realise that we need to help each other to survive. Especially when people are sick, they need help because next time you will need help too.  

I found someone called John Owena. He heads the Makerere University mature Entry department, something like that. He was a very good man. He had been there for two weeks and he was my neighbor.  He said we should all be friends in the wards because at one time you might need them and they might need you.

We would talk politics, health, we discuss things that people were sending on social media because we also had phones with us.

We would also discuss our health. Owena told us that he was admitted with acute Covid. He had too much cough and flu and he told us that, the trick has been eating well, eating warm food and drinking hot water .So he gave us skills on how to survive and especially at night, you have to take a lot warm water because in the night is when acute covid attacks most people.

During the day you feel some flu but you don’t show too much but at night that is when you will feel too much malaria on you, stomach ache, headache, you feel the pain more at night. We had an area where we would put some water. We actually had some kettle.  He (Owena) would put water and ask guys “wake up, it is time to drink some warm water.”  

He also taught us on how to help patients whose oxygen water has run down. He would say that, because the nurses sometimes were too few on the ground at night we needed to help each other to survive.

You would go and help those with low water levels in the tin when they oxygen becomes dry. 

At least me, although I was on oxygen, I could afford to take it off for a few minutes and run to the toilet and back. But there are those that could not do that. They have to be on it twenty four seven. Because for them their oxygen level in the body was really low.

I started on seven litres of oxygen and there was a time I was on one and a half litres then they removed me from oxygen. Others were still in bad conditions. They had nine litters of oxygen, eight and that was really bad.

We helped them in the night to go on filling water in the tin to keep the oxygen flowing well. We kind of became a family there in there.

I recall a one Fadiga from Cameroon. He was telling me he was heading a consulate in Uganda. We became friends.  Although he spoke French and very little English, whenever he needed something I would help him. Unfortunately he didn’t make it. He eventually died.

Sometimes you get tired of being in the ward seeing other people going through pain. So you excuse yourself to the latrine and peep in the window to see people at the reception. Whenever you peep, you see very many patients being brought in. Sometimes it would worry you but also you would be lucky that you got a bed in there while others did not.

I was scared the time they put me on oxygen. I thought I must be very sick to have reached the level of oxygen support. I was also praying to God to help me come through it well, and glad I made it. 

Apart from oxygen therapy, i was given dexa, IV injections and some Vitamin C.

I think what has really helped me even after discharge has been soup. I have eaten all sorts of soup. From mushroom, to bean soup, to meat soup, to mukene soup. Every morning, I start with soup before breakfast.

 The other thing that I think has also helped me is doing exercises. Because I wake up in the morning, walk around for fifty meters and go back, fifty meters and back again.  At one time, I would also throw some balls on the walls as they returned to me. Such games!

When i was discharged, a friend came to my home. I told him to keep a distance because i have covid. He ran away. (chuckles). At work, i felt a little bit of discomfort. Some people look at you with sympathetic eyes. I understand what this means to them but i always say, covid is real and people should observe the SOPs.

Dynamics of covid-19 and mental health treatment

BY Irene Abalo Otto

When Uganda’s health care systems began experiencing a surge in covid-19 cases from June, 2020, some regional referral hospital mental health units were converted into Covid Treatment Units, CTU.

“We resorted to the mental health unit because of the nature of how it had been constructed. It could easily be zoned (to prevent infections spreading to other patients in the hospital). Sooner or later, we realised we had run into trouble with mental patients. We did not have where to put them. We tried putting them in other ordinary wards but the other patients were complaining. We were lucky that we had Kyabakoza Health Centre II, which was constructed but not yet used and it has a fence,” Dr. Nathan Onyachi, the Masaka Regional Referral Hospital Director explained on Sunday. The district allowed the hospital to temporarily use the health centre as their mental health unit.  

In June, Arua Regional Referral Hospital shifted their mental health unit to the Ear, Nose and Throat admission room after the unit was turned into a CTU. Twenty mentally ill patients on admission were relocated. 

“Two of the mentally ill patients were found mixed with covid patients in the red zone. After four months when they shifted to EAT, some patients started escaping to go back to their old mental health unit which had covid patients. Up to now, the hospital is struggling to keep the mentally ill in their new location,” Mr Stephen Candia, a journalist in Arua who also attended covid task force meetings where reports would be presented on emerging issues told Daily Monitor. The management of the hospital declined to speak to Daily Monitor on the current situation. 

Other referral facilities have had to adapt and change their method of operation to avert such challenges.  

Masaka hospital realised that after shifting their Mental Health Unit to Kyabakoza Health Centre II, a new nearby facility, they needed to adopt consellign of relatives to manage their patients from home rather than admit them at the health facility. 

“Covid units have zero patients for the first time. We are keeping our fingers crossed. We do not want to get excited. We hope that it means the disease is going down. If we spend some time without receiving covid patients, we shall consider returning the mental health unit probably by the end of February,” Dr Onyachi said adding that;

“Fortunately, our mental health staff found innovative ways of avoiding admission of mental health patients. They started giving longer acting medicines that could keep them at home and somehow they have coped. Probably the worst thing they have done is to detain a patient a day or twenty four hours and then let them go home. It is also a good thing for them (staff). They did not think they could do it but they have done it,”

At Lira Regional Referral Hospital, service models also changed during the covid period by venturing more into community outreach than waiting for patients to come to the hospital. This was intended to reduce crowds at the facility to prevent the spread of covid-19 that would exacerbate the situation of the mental health patients.

“We are now doing community outreaches to have mental health patients access care. Our team of professionals go out to the patients in areas that we have mapped. There are just a few people (with mental health illnesses) coming to the health facility,” Dr Steven Oboo, the Director Lira Regional Referral Hospital said on Thursday last week.

Mental health medics say the lockdown measures instituted by the government made some patients miss out on their medications.

“They missed out on their medication. When they locked down, most health facilities had not yet delivered the medicines. They were still preparing to replenish, then the lockdown came and the facilities were still waiting for their supplies. Somehow, there were these relapses. Once there is a relapse, people sometimes have to be admitted to first normalize and calm them down, The medicines became available after the lockdown,” Dr Hasifa Nkwata, the Commissioner in charge of mental Health at the Ministry of Health told Daily Monitor last week.

This forced the patients to seek care from other facilities before options could be found for space within the existing space in the hospitals to accommodate mental health patients.  This affected the conventional set up of care for mental health patients.

“Initially, when we had just started (covid lockdown) everything was okay. However, when the lockdown ended, other services somehow continued but the mental health services suffered because there was nowhere they could be. Our units were being used as the Covid Treatment Units,”

Since the phased lifting of the lockdown began on June 4, Butabika Hospital received a high number of patients.
Dr Juliet Nakku, the deputy executive director of Butabika National Referral Mental Hospital, told Daily Monitor in July 2020 that between July12 and July 18, the hospital received about 1,050 cases needing admission, yet previously they received between 800 and 900 patients per week.
Butabika Hospital has a bed capacity of 550.  

“We do not know exactly what is causing the surge, but we suspect it could be due to two reasons. One is the fact that mental health services are not being accessed in other parts of the country.” Dr Nakku told Daily Monitor in July.

But currently, the referral facilities are adapting to the change in service delivery.

“For the referrals, it is not true that people were being referred officially to Butabika. Only that when services were not available, those who were taking care of those patients had to get other alternatives and that is how we saw the people getting into Butabika hospital. Whoever would fail to find proper care, they were shifting to Butabika,” said Dr. Nkwata.

There is no clear statistic to show the current number of patients seeking mental health care are both regional and national levels. But the commissioner mental health said fewer patients are on admission at referral facilities. Most patients are being attended to at the out-patient department, treated and they go back home.

Arua Regional Referral Hospital, Fort Portal Regional Referral Hospital, Gulu Regional Referral Hospital, Hoima Regional Referral Hospital, Jinja Regional Referral Hospital, Kabale Regional Referral Hospital, Old Mulago Hospital, Lira Regional Referral Hospital, Masaka Regional Referral Hospital, Mbale Regional Referral Hospital, Mbarara Regional Referral Hospital, Moroto Regional Referral Hospital, Mubende Regional Referral Hospital, Soroti Regional Referral Hospital.

The pandemic shifted most attention from other sicknesses at various health facilities to prevention or treatment of covid-19. Some mental health patients are on long term treatment and require refills after a specific period of time.

“She has to take medicine every day. She cannot skip. They are treating her for mental health. She used to speak to herself. I have come to pick medicine for my mother. She was admitted here for many years but when she was discharged, I took the responsibility upon myself to get her medication from here,” Ms Namudu Lillian, a 20 year old daughter of a mentally ill mother of seven from Mukono district. Ms Namuddu is a Midwifery student at Muyenga in Kampala. Namuddu was speaking to Daily Monitor from Butabika Hospital on December 2, 2020. She has grown up seeing her mother struggle with mental illness for about fifteen years after her mother’s marriage went soar. The marriage eventually broke and her father remarried. Her mother remains single.

“She wants to speak only to me. The rest of the time she is there quiet. She just sleeps in the bed. She tells me that she wants to come back here (at Butabika hospital). She says there is freedom. When she had just come back (home) from here, she used to demand us to care for her. She wants you to bath her, feed her. She never wanted to bath alone. It reached a moment when we left her to care for herself. The bad thing is that she is weak. So she stays in bed most of the time,” said Ms Namuddu.

Information obtained from medics at Butabika National Mental Hospital details that the number of out-patients visiting the unit were mainly re-attendances which does not indicate an increase in the number of admissions at the government facility from June to October 2020. 

The medics spoke anonymously because they do not have authority to speak to the media. The main mental disorders for which people seek mental health care include; epilepsy, bipolar, schizophrenia, depression and dementia.

In 2019, Butabika hospital received about 12,855 patients seeking treatment for epilepsy, 11,354 for bipolar, 10,344 for schizophrenia and 2,437 for depression. Daily Monitor is yet to get the figures for 2020 from the hospital due to bureaucratic requirements for access to the statistics.  

UGANDAN BICYCLE DEALERS SMILING TO THE BANK.

Ms Rashida Nambajwe repairs a bicycle at their family shop in Katwe, Kampala in June, 2020

Children’s bicycles were mainly used for fun rides in compounds or neighbourhoods to keep children busy during off school days. Most parents gave bicycles to their children as gifts after achieving something worth celebrating while others just bought it because the child would cry for the neighbour’s. But since the coronavirus lockdown was imposed in Uganda in March, 2020, more people have taken to riding bicycles.

It is common to find adults on Kampala streets manoeuvring traffic in small children’s bikes with raised seats. The most hilarious during the lockdown was when private cars were restricted from moving. All shapes and sizes of bicycles could be seen on the roads.

Whereas this trend in use of bicycles is likely to continue even after lockdown, the cycling lanes within the city are limited as they compete with pedestrians and motorists during peak hours.

Dealers in bicycles and spare parts are making a killing for sales which have more than doubled in the last two months.

Ms Rashida Nambajwe, 23, has known bicycle trade from the age of 13 years. She remembers coming to their bicycle and spare parts shop in Katwe with her mother and learning the trade especially during holidays.

Ms Nambajwe knows too well what her clients need. At About 4pm on Wednesday, she was washing one of the second hand bicycles for sale. The family business has been left under her care together with a brother who is a mechanic. Her other brother sells at Nakasero where he operates another shop.

She buys second hand bicycles from South Korea, Japan, American and China.

“Chinese bicycles get damaged faster unless you change some parts. The ones from Dubai, South Korea and other countries are stronger especially the ones from Japan,” Says Nambajwe.

She knows all parts of the bike for the 13 years she has been selling at the shop. Her wit and customer care is evident as she convinces a client to buy a Japanese spokes bike at Shs350, 000 as the lowest she could give him. Her current stock ranges from between 250,000 for Chinese products to Shs500, 000 for bikes from other countries that she says are more durable.

New bicycles range from between Shs500, 000 to 800,000 in shops and even higher in other shopping centres around Kampala. Most people prefer to buy second hand bicycles from retailers in areas like Katwe because they are a bit cheaper.

For the 10 years that Ms Nambajwe has seen her mother’s business grow and dwindle as modes of transport shifted to either vehicles or boda bodas within Kampala, the family could hardly afford rent of Shs850, 000. Better structures sprung up in the neighborhood and in 2018, rent was increased to Shs1 million.

But the lockdown was a life saver for the business.

“We started opening one side of the door to sell to those demanding bicycles in April. Then in May, more customers came and when we were allowed to fully open towards the end of May, we were selling at least four to five bicycles a day. “

Ms Nambajwe adds;

“Before the lockdown, we could stay the whole day or for days without anyone buying a bicycle. Some would just bring the bicycles for children for repair. Then we started selling more of Japanese car spare parts. But still, the sales were low. Some months we could even fail to raise rent.”

There are many sides to a successful business because there are good sale days and really bad ones. But for a person who has seen the money and knows how to make it out of whatever situation a business is in, Nambajwe quit her high schooling to join her mother in keeping an already failing business alive.

“I wanted to be a doctor but things didn’t go as I had planned. I was doing MEG/Islam (Mathematics, Economics, and Geography). I left school in 2018 and decided to make money instead since what I was studying for was to get money.”

Her uncle trained her to account for every coin in business. Nambajwe says she knows enough in book keeping and handling of money in the business even though she did not go through formal education to learn them.

“Sometimes my Mum comes here but she now trusts me in handling this business. I also do repairs. I learnt it from my brother.”

Her dream is to grow and have her own business so that she can lead a happy and comfortable decent adult life.

Mr John Turyamwijuka’s   hands have known nothing but grease from his early twenties. Now 55 years old, the proud father of 17 from Rukungiri district has three wives and still working as hard in his makeshift bicycle repair workshop to fend for his family.

When Uganda was put under lockdown occasioned by coronavirus on March 30, even private vehicles were not allowed on the road. Most people opted for bicycles as a means of transport since boda bodas were not allowed to carry passengers to observe social distancing measures. Most Ugandan roads lack cycling lanes but that did not deter people from venturing out since non-essential motorists were no longer on the road.

Mr Turyamwijuka watched as more people demanded for his repair service that could hardly earn him a decent meal before the lockdown. But now, he earns about thrice his income before lockdown.
The coronavirus lockdown was a mixed bag of fortunes for him. His bicycle repair work was jump started from April as the lockdown tied people to their homes.

The president advised people to cycle for their health and to enable social distancing with one cyclist on a bike. Those who had given up on using bicycles due to traffic congestion in the city quickly picked them from wherever they had hidden even the old bikes. Mr Turyamwijuka repairs more than 15 bikes per day compared to two to five before the lockdown.

“Most people have bought sports bikes and I now repair mainly such.”

He is not educated and opted for mechanics as a way of life. His hope is to educate most of his children so they can have a better life. Some of his family members are in Rukungiri while others are at his smaller home in Banda.

His was a quest to be a loving father and a bread winner. He has skills to work on any type of bicycle.

“I want to be remembered as a man who worked hard for his family and built for them a home in Kampala. I do want people to think I was idling in Kampala doing nothing.”

Mr Turyamwijuka has a small home in Banda, a Kampala Suburb, that he says he bought from Uganda Railways.

“My challenge has always been not having someone to hold my hands and support me. Sometimes I get loans of about Shs1.5 million and I have to work to support the needs of all my children. The most challenging has been school fees,” Mr Turyamwijuka tells Daily Monitor.

So without an education, he took to learning bike mechanics from his uncle who lived at Kitagati at the border between Uganda and Tanzania in the 1980s.

He went on to work as a bike repairman in Congo, Zaire before returning and settling with his family in marrying one wife after the other till he was shocked to have three with 17 children.

Because life in Banda, a Kampala suburb was taking a toll on him with dwindling income as more people preferred to use motorcycles and cars as their means of transport, Mr Turyamwjuika saved all he could to build permanent houses for all his three wives in the village. This however prevented him from schooling all his children. So some have taken to boda boda riding and others are in the village with their mothers while others have taken to bicycles and spare parts businesses.

At about 1pm on Wednesday, Mr Turyamwijuka was with four of his sons at his makeshift garage at the police checkpoint opposite Mogas station in Banda. The scorching sun let loose as he worked on a damaged sports bike wheel, realigning and fitting new spokes. His fore head glistened with sweat as he wiped it with the back of his greasy hand.

He has been by the road side for such a long time. Mr Turyamwijuka saw most of the buildings near his work station rise and the once dusty road constructed to a wider tarmac with two lanes. He survived losing his space to Kampala Capital City Authority several times during road constructions but is glad to be where he can earn a living for his family.

For a man who wants to be remembered as one who raised disciplined children, Mr Turyamwijuka works alongside one of his youngest sons, Mutatine Emmanuel, 14. At Vineyard Christian School in Banda, Mutatine has not had the privilege to have sophisticated technology to aid his learning. He has never used a computer. When Daily Monitor gave him a tablet to write his name and that of his father, it took him about four to five minutes as he searched for a letter at a time to spell the names.

Mutatine is a Primary Seven candidate hoping to sit for his Primary Leaving Examinations, PLE in November or December this year depending on how Uganda National Examinations Board will adjust the time table for the National Exams. Though he is not sure his father can afford to take him to his first choice school, Kings College Buddo, Mutatine dreams of becoming a doctor one day. He speaks good English and enjoys making his own money.

He saves part of his money and uses some to buy reading materials especially PLE pull outs in the newspapers.

“My work at the garage here with my father does not stop me from reading my books. I stay home over the weekends and spend my time reading. I will pass well. I want to become a doctor. I am just repairing my bike to save some money to help with my school requirements when school reopens. Yesterday I made Shs10, 000 and I was very happy.” Says Mutatine.

He adds;

“This bike could not break and the chains were long. So I had to adjust them and repair the brake system. It was easy learning how to do it. I have learnt a lot from my father. Now I can assemble a bike, repair it especially like this one for children. After finishing work here, I rush home, freshen up and revise my books.”

In his numerous address to the nation during the coronavirus pandemic situation, President Yoweri Museveni has always advised Ugandans to embrace cycling for physical exercise and as a way of social distancing.

To those who know the health benefits, it has been a welcome message while those who do not know how to ride have learnt and used for short distance journeys to get home essentials.

Bicycles were first introduced in Uganda in 1903 during the colonial era. They were later given to Buganda courts and used to transport chiefs and kings in place of the stretcher.

It was a prestige to own a bicycle but modernization that introduced faster modes of transport had displaced bicycle riders from most urban centres.

 

Behind the Masaka video shared by a covid patient.

BY IRENE ABALO OTTO, MALIK FAHD JJINGO AND AL-MAHDI SSENKABIRWA 

Masaka Hospital administrators last week responded affirming but rejecting some of the allegations of poor sanitation and having children mixed with adults at their coronavirus treatment centre by a patient.

Masaka Hospital serves South Central Uganda. It is expected to provide referral services with 330 bed capacity. The hospital was built in 1927 as a treatment centre for World War I veterans.

 

Whereas the hospital administrators said the patient from Mutukula was troublesome to response teams from the time she tested positive for coronavirus at Mutukula border point, some of her claims were true.

The female coronavirus patient last week recorded a 8 minutes video of herself explaining some of the situations COVID-19 patients are undergoing at Masaka Regional Referral Hospital. The video that was widely circulated on social media shows the asymptomatic patient detailing scenes at the facility and her concerns about being given medication without written prescriptions.

“Doctors get here just once to drop a medication that has no name. As for me, the doctor did not explain what kind of medication this is. As a former nurse, I do not want to take medication that I do not know. There is no prescription sheet to show what we are taking,” the patient said as she shows two unlabeled packages of folded papers and a paracetamol prescription on the other.

The patient complained of the hospital pushing coronavirus patients to a dilapidated hospital structure without running water and other sanitary facilities.

She further adds that the treatment centre is close to a mortuary which gives them mental distress when they see dead bodies being carried to it.

The patient who claims to have spent about 24 hours at Masaka Regional Referral Hospital Covid-19  treatment centre said the services at the hospital could not enable them to heal from the highly infectious virus.

On presence of children at the centre

According to Dr. Mark Jjuko, the in charge of Masaka Regional Covid-19  treatment centre, the two children seen in the video at the ward are  positive and are  being treated at the centre .Other children are relatives of patients .

“We have handled several patients with children especially those that don’t have people to take care of them at home. We take them (patients and children) through safety precaution measures and they have all lived well and no one including those that we have discharged has ever tested positive,” Dr. Jjuko told Daily Monitor on Monday.

He added;

“The ward where the female patient complaining sleeps is an annex of the treatment centre after the main ward with 22-bed capacity got filled up.”

He says all beds in the annex have insecticide treated mosquito nets.

“Despite the annex being established in an old building which was formerly housing a mental ward the place is clean and the ward has cleaners  opposed to claims made by the female patient,” said Dr. Jjuko.

Response on running water

Dr. Jjuko dismissed claims by the patient that the toilet facilities did not have running water. He said there was water in a basin as seen in her video.

The video showed water dripping into a basin in one of the two bathrooms outside the wards.

He further dismisses claims of garbage mismanagement that showed medical waste poured near a tree close to the ward. Dr Jjuko said;

“The litter shown in the video near the ward was put there to dry since it was wet following a heavy downpour .It was difficult to be placed in the incinerator when it was wet.”

However, Dr. Nathan Onyachi, the Hospital Director contradicted the In-charge and admitted that the hospital has challenges.

“She has a point on waste management, which we have told the team to improve. Improvement of this particular extension of the CTU is still work in progress, and Masaka RRH has asked for a refill of CTU funds, including some for those minor renovations, which we hope we shall receive.”

He added that;

“We decided to improve on this old building, which was previously working as a records store. I do understand, it required more renovation. But that is what we could do given the urgency and resources available. The tent you see beside the building was provided by the bank Absa, it is not yet in use because Absa is trying to create a concrete base for it. So this is work in progress. The ground on which it stands is recently graded to give the tent a level platform,” Dr Onyachi explained.

Response on meals and feeding 

Dr. Jjuko denied another allegation by the patient about poor feeding. He told Daily Monitor that the patients are fed on a balanced diet of milk, meat, and chicken and beans that are spread across their menu schedule in the week to post patients’ immunity as part of treatment.

“I was surprised to see the video of a female patient making rounds ,complaining that they are neglected when I had personally just talked to her after taking part in her admission at  the centre  ,and she even asked for  yellow banana of which one of the nurses used her own money to buy for her ,she was given  her a carton  of mineral water after refusing to share water from the water dispensers in the ward” he said .

During an accountability budget address to the nation last month, Ministry of Health Permanent Secretary, Dr. Diana Atwine indicated that the March to September 2020 budget for coronavirus response for special meals stood at Shs4.8billion shillings.

Shs227million was given to the 15 Regional Referral hospitals in the country for management of coronavirus cases. 11Billion was used to procure 37 ambulances.

The PS said in the three months, 2.3billion had been paid to feed 1,985 people in quarantine sites while Shs2.2billion had been paid for accommodation in hotels that accommodated 1,093 returnees and contacts who were quarantined.

Dr Nathan Onyachi, the Hospital Director said the official treatment unit (the Mental Health Unit) at Masaka got full at 21 beds, at a time when the facility were getting a surge from Mutukula and had challenges transporting patients to Mulago, Entebbe, Mubende and Naguru.

The treatment centre has at least 18 nurses, 4 doctors, and 4 cleaners and the doctors see patients 3 to 5 times a day according to Dr Jjuko.

By Monday, the facility had 30 patients that are still undergoing treatment. 47 have recovered and were discharged since the centre was established in April, 2020.

Article appeared in https://www.monitor.co.ug/News/National/Masaka-hospital-pathetic-Covid-isolation-centre-video/688334-5588328-13lbfm8/index.html

 

Tricks businesses are using to survive after more than 100 days of lockdown.

BY IRENE ABALO OTTO

irene.abalo@gmail.com

Traders say they can no longer bear the lockdown situation. Apart from house owners asking for rent, their children who have been home from school for over three months need food and other basic needs.

The towering Mapeera building on Kampala Road had less activity on Friday as most shops remained closed. Across the road is Pioneer mall that used to be one of the liveliest places in Kampala before coronavirus restrictions sent people home.

A congested Kikuubo Market, downtown Kampala on June 26,2020. There is outcry by traders as some businesses are not allowed to open to prevent congestion and spread of coronavirus.

Some traders who owned clothing lines and other accessories have closed and left notices that they had relocated. Others have left contacts plastered on their shop doors for online deliveries. A few other rooms are being renovated and redesigned. Most shops that used to sparkle with different designs and eateries are now empty and locked.

A few jewelry shop remains open towards Eastern gate. The parking space at the mall is half full. The security guards have tied a rope to block pedestrians from passing through the mall from the Western side. But the baker and eatery side on the Eastern side still has customers trickling in to enjoy freshly baked cakes plus other snacks.

A few touts call out passengers, asking even those who are walking in the opposite direction to board their taxis that line the street making the walkway congested for pedestrians. The touts were banned from operation by the president but have continued to operate. Most hop in and out at various police check points to evade arrest. Their task is to call passengers, sanitize and collect fares from which they get their pay from the driver depending on their agreement.

“Namugongo, Nalya, Kyaliwajjala, madam get in. Only Shs4, 000 to Bukoto.” The touts shouts as our reporter passes by Burton Street to join Wilson Road.

The touts are happy to be shouting about their business but down towards Gazaland arcade, the tricks of calling a client to buy ones’ item or service is quite unique. Moving towards Wilson Street, one would think Uganda has no corona virus.

First, they spot a potential client and approach with a greeting. Masks are worn on the chin and car bouts are full of sellable items especially weaves and second hand clothes. A few bold traders display theirs on the pavement. But others are more diplomatic in defying the ban on social gatherings.

“Good morning Madam, can I take you to my salon and plait your hair. It is not costly. Come and we negotiate. Our services are good,” says a woman in her thirties to our reporter who has short hair.

Moving through the arcade, the front shops are almost all open. More traders dealing in weaves and other hair products call out to women who they target need their service and disappear with them into rooms within the arcade. Others selling shoes near the entrance as one slopes down to William Street to join Ben Kiwanuka Street call those from a far to take a look at their products. The walkway through the arcades are packed with all kinds of goods and traders from second hand clothes to those dealing in beauty products.

Joining Namirembe road, DownTown Kampala, onto the newly constructed non-motorized road, one has to be careful because the pick pockets are back on the streets too. These take advantage of the crowds to steal from bags, pockets, and even cut through bags depending on their soft targets. So many people lose especially their phones and money in these crowds.

But there are those targeting other things among these crowds, potential customers.

“Madam, I sell good clothes for children of all ages from zero months. Come and I take you to my shop and you buy,” says a lady who looks to be in her twenties. She looked frail and dehydrated. But could afford a smile for customer care.

When our reporter asks her where the shop is, she leads the way through Namirembe Road towards St Balikudembe market to a shop where three ladies sat waiting for customers. This is not her shop. Her work is to look for potential clients among the crowd, bring them to the shop owner and she would be paid commission for whatever the client bought. Dresses for children in this shop ranges from Shs40, 000 onwards. A food vendor proposes lunch for one of the women selling in the shop and she turns her away saying she does not have money for the food.

Outside the shop, there are other ladies and men who look idle but their work is to spot potential clients.

Another lady who had observed our report enter a shop and return without items in her hands grabbed her hands and asked to take her to another shop. She was polite enough to ask for the type of clothes and at how much her client wanted to buy them so that she could know who has what would be appropriate.

That too took about ten minutes’ walk away from St Balikudembe, back to Namiremebe road. The security guard at the gate refuses to open the arcade for the clothes dealer to open her shop and select the clothes. Another vendor volunteers information that if there were few people around the security guards, he would have accepted money from the shop owner and allowed her to enter her shop to pick goods for her clients. But that Friday afternoon, around ten women and men pleaded with the security guard in vain. Almost all wore their masks on the chin, standing less than 2 meters apart, a measure guided by the Ministry of Health for social distancing to prevent the spread of coronavirus.

Across the road, Kikuubo market, arguably the busiest place in Kampala where one can find any grocery, household items and appliances either on retail or wholesale is bustling with life. Business seems to be back to normal for these traders despite the lockdown and restrictions on social gatherings.

At the entrance, two men armed with sanitisers struggle to sanitise people entering the market but it is close to impossible to have everyone sanitise or wash their hands. The two are overwhelmed.

Despite the congestion, traders close to the gate try to shout to the enforcers to stop those who are not sanitizing.

“Why should I wash my hands yet there is no social distance here and other people have passed without washing their hands. Leave me alone,” a man protests as he is grabbed by two other men forcing him to sanitise. He still refuses and this causes commotion for about five minutes with confused onlookers crowding to ask what was happening.

Another man appears from the crowd at the entrance and shouts on a mega phone asking people to maintain social distances. But the traders and customers pay no attention to his message. Others are seen brushing besides him and continuing into the market.

Two Kampala Capital City Authority enforcement officers donned in sky blue uniforms stand by about ten meters away from the gate, one looking at passers by while another chatting with a vendor chewing sugarcane. Next to them, a lady vending leggings for women stands calling out to potential clients.

She tells Daily Monitor that she cannot display her clothes along the pavement where she used to because enforcement officers always pick them and never return.

“I have to hold them in my hands like this then look for customers. Even those people selling things like toothbrushes and other plastics by the road, when they see KCCA, they have to run away. If not, their goods will be confiscated.” She tells Daily Monitor.

Two big trucks cause another commotion as they enter the market. The traders and their clients have to push and squeeze within the smallest of spaces to give way for the delivery trucks. The toxic fumes from the trucks can suffocate someone unless they are given a way to get in. The situation is like a wave, the trucks clear the way and as they pass, vendors immediately take their positions. And the crowds continue to build up.

Debris and other small particles from builders on the upper floors fly onto customers and traders as they transact. But one buyer tells Daily Monitor that it is the only place she can find affordable household items and appliances that she needs for her family.

Along the entrances, more women and men line the closed arcades. They call out to clients and send them into their shops one by one.

“I cannot stay home anymore. What will my family feed on? Even if they say people have no money, we see customers buying from us when we sit out there and call them,” Says George Mugabi, a dealer in women’s shoes.

It is more than 100 days since the lockdown and curfew were imposed in Uganda due to the coronavirus pandemic. To avoid the spread of the highly contagious disease, busy shopping centres like Arcades and Owino, are still closed among others. But traders in these businesses say they can no longer bear the situation. Apart from house owners asking for rent, their children who have been home from school for over three months need food and other basic needs.

President Museveni in his last address on coronavirus said those selling in arcades, saloons and other places that bring crowds should not open their businesses as government studies safe option for their return to trade to prevent  the spread of coronavirus.

First published; https://www.monitor.co.ug/News/National/Tricks-city-traders-lockdown-Pioneer-Mall-online-deliveries/688334-5584852-fgsq5v/index.html

Congo celebrated end of an epidemic amid a pandemic situation

BY IRENE ABALO OTTO

Africa and the rest of the world on last week celebrated the end of one of the longest and deadliest Ebola outbreaks in History. The tenth Ebola outbreak in Eastern Democratic Republic of Congo, DRC made leaders send a call for borrowing of lessons for managing the Coronavirus situation in their own countries.

The World Health Organisation congratulated DRC that declared Eastern Congo Ebola free after over two years of battling the epidemic.

“It was not easy and at times it seemed like a mission impossible. Ending this Ebola Outbreak is a sign of hope for the region and the world, that with solidarity and science and courage and commitment, even the most challenging epidemics can be controlled,” said DR. Matshidiso Moeti, the WHO Regional Director for Africa during a virtual briefing on Thursday.

She added;

“One of the most important lessons that has been learned is the need to engage with, work with and support communities to be knowledgeable and empowered to play their roles. “

Dr. Eteni Longondo, DRC Public Health Minster said the efforts used to fight the Ebola virus that was first reported in Kivu province, Eastern DCR on August 1, 2018 should be used as lessons for fighting coronavirus.

“Our experience in fighting Ebola is necessary in dealing with COIVD-19. We have the ability to fight this pandemic,” said Dr. Eteni.

The worry for most health workers was the outbreak of coronavirus pandemic during the Ebola epidemic situation in a country that has been largely affected by internal strife.

Over 1,100people who contracted Ebola survives and returned to their families and communities after treatment by Congolese health workers. Neighboring countries like Uganda were always on the lookout should cases spill over to the country.

Dr Tedros Adhanom Ghebreyesus, the WHO Director-General said;

“The Ebola repose was a victory for science. The rapid rollout of highly effective vaccines saved lives and slowed the spread of Ebola. For the first time, the world now has a licensed Ebola vaccine.”

The DRC grappled with the world’s second-largest Ebola epidemic on record, with more than 2,200 lives lost and 3,400 confirmed infections.

Whereas this is a big achievement for Eastern Congo, other five areas in the country have registered new cases of the Ebola Virus leading to the eleventh outbreak in the province.

North Western, Mbandaka, Equateur Province has reported Ebola cases on June 23. WHO African Region reported on Thursday that Mbandaka cases had risen to 24 with 13 associated deaths.

“Fabien Impanda Boliko is the lab technician in Mbandaka who identified the first Ebola case from the recent outbreak in Equateur province, DRC. His expertise and quick action led to the swift response to the outbreak” reads a tweet from WHO African Region.

The Government of DRC announced the first Ebola case in Wangatta Health Zone, Mbandaka on June 1.

Efforts to reach remote villages in Mbandaka began on Monday with high risk contacts registered to receive the Ebola vaccine to protect them.

Meanwhile, last week, the first Ebola survivor was discharged from Wangata hospital in Mandaka after spending 19 days of treatment at the facility.

Health experts explain that Ebola transmission can remain in semen for up to 550 days and can be transmitted through sex long after the patient has recovered. But there are possibilities of containing the spread since outbreaks or spot transmissions are common towards the end of Ebola epidemic and it does not mean that the virus is spreading out of control.

DRC continues to battle Ebola virus and COVID-19 amidst a struggling health care system.

By Thursday, WHO reports indicated Africa had over 332,000 confirmed Coronavirus cases on the continent with more than 157,000 recoveries and 8,700 deaths.

During a virtual press briefing on Thursday, DR. Matshidiso Moeti, the WHO Regional Director for Africa said African leaders should work towards improving their healthcare systems so that they are not strained during future outbreaks as has been the case with many countries during the coronavirus pandemic.

She said whereas parts of Congo are free of Ebola virus, leaders have to plan for their health care systems to save their population from health crises.

Dr. Matshidiso believes African leaders can equally overcome coronavirus through visionary leadership, science and innovation.

“It is vital that when COVID-1 vaccines are developed, they are made available to all.” She added.

Currently, there is no scientifically proven and approved vaccine for Coronavirus. Ebola has one vaccines and two treatments validated.

Dr. Tedros said governments should study their case situations and allow people to move on with their lives since some are low income earners and live on daily earnings.

“Create the space for isolation because for some people, it is difficult to sled isolate at home. Opening up should be measured, phased and organized. People should go on with their lives,” Dr Tedros said.

About 80 percent of Coronavirus cases in Africa are asymptomatic and most governments have imposed lockdowns and curfews to curb the spread of the virus. However, this has hindered access to healthcare services for other disease.

WHO says governments should consider other health emergencies alongside coronavirus to save the population from other crises.

Hydrocephalus which also known as “water in the brain, “can cause death

By Abalo Irene Otto 9th, March 9, 2012

Opak Rwot Ivan a primary five pupil of Pece Pimary School can not do much of what his fellow colleagues in the class can do because of physical disability.

Opak Rwot has hydrocephalus which is also known as “water in the brain,” a medical condition in which there is an abnormal accumulation of cerebrospinal fluid (CSF) in the ventricles, or cavities, of the brain.

This may cause increased intracranial pressure inside the skull and progressive enlargement of the head, convulsion, tunnel vision, and mental disability. Hydrocephalus can also cause death but for Opak Rwot, he has lived and now goes to school

Hellen Achan, the Headmistress of Pece Primary School says that she pays special attention to Opak Rwot who has hydrocephalus and is paralyzed in the leg is so passionate about education and cries when his teachers mark him wrong.

Josephine Lamuno,a teacher of Opak Rwot says that he at times comes late though he says nearby at Pece Pawel.Lamuno adds that the pupils are supportive and this encourages Opakwrot to be social and friendly though slow in speech and writing.

CURE Children’s Hospital of Uganda located in the city of Mable, in Mbale District, in Uganda’s Eastern Region handles such cases of hydrocephalus and many such children have benefited from to have their children cured.

FIRST STEP ON MY NEW LIMBS, AMPUTETED LAND MINE SURVIVORS’ TALES

By

Abalo Irene Otto

“Move your limb, try to move it a bit. No no no, not like that. Let’s try again.” An orthopedic therapist tells an amputee. “Good. Take another step.”

These are instructors at the orthopedic department of Gulu Regional Referral Hospital. The amputee, Justine Olweny is trying his new artificial limbs made at the orthopedic workshop.

The workshop makes about four artificial limbs every month for patients from the 7 districts of Acholi Sub region and beyond. At the workshop, priority is given to land mine survivors of the two decade Lord’s Resistance Army (LRA) insurgency.

Photo: An orthopedic explains to ICC officials Motoo Noguchi (L) and Judge Fenandez (R) how a Swiss limb is made at orthopedic workshop at Gulu Regional Referral Hospital early this month.

Today Ojwany Justine 57, from Atiak Sub County, Amuru district is learning to take his first step after stepping on a land mine in 2003.

Ojwang is a double amputee, he has to balance his weight to take the first step says Lucy Angee, the physiotherapist training him how to work.  It will take Ojwang about one month to walk on his new limbs made from Gulu Regional Referral Hospital Orthopedic Workshop.

“It is difficult to learn how to walk at my age. I feel helpless but I have to practice so that I can do something to care for my family.” Opiyo tells this paper while standing with the support of his artificial limb holding a pair of crochets.

Photo: A land mind survivor fitted with a new Swiss artificial limb at the orthopedic workshop of Gulu Regional Referral Hospital.

Irene Laker, 36 years, a former business woman from Pece Tegwana, Gulu Municipality lost her left limb to land mine In August 2002 after an attack by the LRA in her area.

“Life was difficult and I had to turn to God for Courage. I recovered but life was hard because I would always fall down due to imbalance.” Narrates Irene,” When I got my artificial limbs, life changed and things were a lot easier for me.” She adds with a smile.

Hawa Muhumuza, an orthopedic technologist at Gulu Regional Referral Hospital says they patients come to the workshop hopeless and weary.

“On getting their limbs fixed, it’s not easy but it is always a joy to watch them hope for a better life. Our prayer is that they find their fulfilment in life with these artificial limbs that we give them free of charge.” Says the orthopedic technologist.

At 76 years, Alice Acayo is an amputee in the upper right knee due to land mine planted near her home in Lamwo 11 years ago by LRA rebels. She is at the orthopedic workshop to have her worn out limbs replaced after using it for five years.

Fetching water and selling at a local market in Lamwo town is what Alice does to earn a living after getting her artificial limb from Gulu Orthopedic Workshop five years ago.

“Because of my new limbs, I can now do some things on my own without assistance which makes me happy. People were tired of lending a hand always.” Says a joyful Alice to ICC President Fernandez.

Judge Silvia Fernandez de Gurmendi, the president of the International Criminal Court (ICC) was in Uganda early this month to visit victims of the Lord’s Resistance Army rebels benefiting from Trust Fund for Victims assistance projects in Northern Uganda. She says the fund can only support a few but not all who need assistance.

Trust Fund for Victims is supporting war victims with physical rehabilitation through local partners like AVSI that is supporting the orthopedic works to provide free limbs to the disadvantaged communities who cannot afford orthopedic services on their own.

Dr Augustine Mindra, the senior Orthopedic at Gulu Regional Referral Hospital says a limb in private facilities could cost between 1million to 1.5 million depending on the service provider.

He encouraged amputees to access the free orthopedic service at the Gulu Regional Referral Hospital to improve their livelihoods.

Approximately 45,000 war victims have benefited from the Trust Fund for Victims in the last eight years since the ICC started channeling funds to war victims in Uganda. The funds were used in physical and psychosocial rehabilitation, support livelihood programs and medical operations of those with bullet wounds and shrapnel in their bodies.

 

IRS insecticides being used to commit suicide in Omoro.

By

Abalo Irene Otto

Leaders in Omoro district have been asked to investigate how the Indoor Residual Spraying insecticides, (IRS) known to reduce malaria transmission, were used in Binya Parish, Odek Sub County in Omoro district that has so far led to the death of four people this year.

IRS Spraying is done on walls of houses to repel and kill mosquitoes that cause malaria

This comes after a man on Monday allegedly committed suicide using the insecticide leaving behind two widows and nine children.

Tito Okello, 39 years and a resident of Orapwoyo Village, Binya Parish in Odek Sub county Omoro district was buried yesterday at his ancestral home in Orapwoyo village. He was a peasant and had portrayed a reserved behavior before he committed suicide.

According to Matthew Olobo, the former chairman LC3 of Odek Sub County who attended the funeral, the deceased left a brief note asking people to take care of his three wives and nine children. He says that the misuse of the IRS insecticides has caused a lot of suffering for the people of Binya parish.

” He died while being taken to Lalogi health center. We think the leaders should call all the Village Heath Team and investigate the how people who were spraying did their work. We can not continue to loose people like this. We know that there is trauma still in our community that needs counselling but this needs urgent attention to help our people.” 

In Uganda, the Northern region has the highest suicide rates and the doctors believe that it is as a result of the different mental disorders while others do it out of desperation.

IRS was reintroduced in Uganda in 2006 after a long period of no IRS interventions since 1960. Initial IRS activities were conducted in epidemic prone districts in the south-western part of Uganda before shifting to the highly endemic regions of northern Uganda as stipulated in the WHO position statement on IRS. Initial pilot spray rounds in northern Uganda used dichlorodiphenyltrichloroethane (DDT).

Related story

https://ugandaradionetwork.com/story/irs-re-introduced-to-curb-malaria-epidemic-in-northern-uganda-

Commercial investments bringing medical services closer to communities

By

Abalo Irene Otto

About 216 people from Nyamukino parish in Lungulu Sub County in Nwoya district have benefited from a health camp organized by a commercial farm in the area in partnership with Anaka hospital to bring services closer to the people.

 

Nancy Akumu, the Sustainable development manager at Amatheon Agri, the largest agricultural investor in the district told radio Rupiny that it is their way of giving back to the community that welcomed them into the area and appreciated the good relationship they have with the community.

She adds that as a company established in the area in 2014, they see that there ought to be more for the community in terms of health service delivery because of the long distance to the nearest health facility for the residents.

“Our research in 2014 when we first came here to do agriculture showed that the people in this community have to trek for about 40 km to get medical care. So we had to team up with Anaka hospital to bring medical services closer to the community around us, periodically.”

Otto Patrick, the laboratory technician at Anaka hospital says the tests showed that is need for more community sensitization on how to manage their own health.

He advised the residents to observe good moral behavior to avoid getting Sexually Transmitted Diseases and sleep under mosquito nets to avoid contracting malaria that proved most prevalent according to their test results.

“We did for types of tests, HIV, RDT for Malaria, Hepatitis and RPR for syphilis. For the sexual diseases, they should be responsible and have protected sex and for amalaria, they should sleep under mosquito nets to remain healthy.”

David Aranya, the LC1 of the area appreciated efforts made by the investor and Anaka hospital to keep members of his community healthy so that they can work and also develop at household levels to eradicate poverty.