Kampala, Pt. 2: Mulago Hospital

June 10, 2010

Before we stopped for our first Ugandan meal, we visited Mulago Hospital, the public hospital in Kampala. Because it is public, patients receive care free of charge, although this leads to several major problems itself—mainly, a large overburdening of the system with insufficient human and financial resources.

[Photos courtesy of Google Images]

This overcrowding was apparent firsthand. As we visited the “Infectious Diseases” and “Maternity” wards, our group passed people sitting outside in some of the open air corridors or lining the halls. We later learned that family members stay at the hospital with their loved ones to care for them and even cook meals on hospital grounds; because the hospitals are severely understaffed, family members are responsible for the duties that nurses in the U.S. typically perform.

Patients themselves had little to no privacy. We saw no private rooms at all—patients simply lined the halls of the ward—and many only had a cot, not even a raised bed. Even in the delivery ward (which we did not visit), deliveries take place in an open ward, although I saw that the hospital uses a mobile curtain set-up to offer a bit more privacy when necessary. I only saw one of these in the infectious diseases ward though, so I’m not sure how many they have. For the most part, we saw patients completely in the open, which certainly made us feel like intruders.

There are vast discrepancies between the facilities and resources of a public hospital versus a private hospital. Private hospitals like MMH tend to be better funded and can provide higher quality care, yet they see fewer patients because most people cannot afford their services. On the other hand, public hospitals are overburdened and can lack basic supplies. For example, when we spoke to the intern in the infectious diseases ward, she mentioned that the hospital did not even have adhesive tape. If the patient required something the hospital did not have, the patient must buy that supply himself. But patients don’t always have the financial means for that.

Think about the facilities you’ve visited in the United States; we are extremely fortunate. All the hospitals I can think of blow Mulago out of the water. This was the first time I’ve ever seen a health facility in such a crowded and resource-constrained state, and it really provided some food for thought. I’m thankful for what I have at home—it may cost a fortune, but at least we have the capacity and resources, both in terms of personnel and advanced medical equipment, to care for the sick.