I learned a phrase very quickly once I got here, “this is Africa” (TIA). Basically it is used when you can’t believe something is happening or what you are seeing. Coming to Uganda is obviously a shock to the system. Everything, as you would expect, is completely different. The food, the culture, the way the people live, and obviously medicine. One of the biggest limitations to healthcare here is the fact that the overall population is in deep poverty (living on less than 2 USD per day). Even trying to come up with 10,000 shillings (about 4 USD) can be difficult. Here in Uganda, healthcare is touted and politicized as being free. The people of Uganda have been told that healthcare shouldn’t cost them anything; however, this is usually not the case. Many services for the patient are not free, even in government hospitals. Having surgery, CT scans, even certain medicine costs money. Changing the understanding and culture of medicine here has been one of the biggest challenges for MKMC.
When talking about the culture of medicine I would like to use the two hospitals in Masindi as examples of healthcare, with the understanding that each entity is doing the best they can with what they have. The two hospitals in Masindi are the Main Hospital and the Masindi Kitara Medical Clinic. The main hospital offers “free government supported healthcare.” The main hospital does not charge a fee for the hospital stay but sometimes lacks even the basics, like mattresses for the beds or exam gloves. The facility is overcrowded and does not have enough doctors or nursing staff to adequately treat patients. Even at the main hospital some basic medicines are not available and the patient must go elsewhere to buy them. This is considered the standard of healthcare and is free to the people.
Greetings,I just wanted to share this testimony with you. Earlier I wrote you concerning a vulnerable lady who we put on our staff who was pregnant. We took her to the hospital in Masindi (MKMC) and she was given excellent care. The hospitals in Kampala had told us that she had a tumor in her belly, but the doctors at PMI found out that this was not true. She in fact stayed there and gave birth to a healthy baby…BlessingsA very encouraging note MKMC recently received from our friends at Mercy Childcare. We are proud of our staff at MKMC and the wonderful care they are providing for individuals all across the country of Uganda.
Meanwhile, MKMC operates as a fee for service based clinic. This means fees are charged for services which are used to keep the clinic running. This is a not for profit clinic. Obviously this is a change in the culture of medicine here in Uganda, and it is one in my opinion that needs to take place. The facilities at MKMC are much better, they have the essential medicines and the equipment and staff are sufficient. With that being said, one of the biggest struggles at MKMC is that some patients do not want to pay for or cannot afford the lab tests, treatments, or hospital stay, even if these patients are in dire need of treatment. The clinic works hard with patients on payment plans and negotiates rates to help the patient, but at the end of the day the clinic must meet sustainability. Having people save for and invest in their health has been a difficult hurtle to jump. I think MKMC is helping to change the quality and perception of healthcare delivered in Uganda, but changing the culture of anything is a slow and difficult process. Uganda is a wonderful place with wonderful people, and they deserve what MKMC is bringing to the table, After-all: this is Africa.