A new Mulago arises: The challenge the new hospital will face and what can be done to protect it from Uganda’s politics
THE LAST WORD | Andrew M. Mwenda | Last week, I visited the new specialised maternal and neonatal center being constructed at Mulago Hospital. With a built up area of 24,000 square meters, ten floors tall and equipped with 450 hospital beds, it is going to be the largest specialised maternal and neonatal hospital in Africa. It is being built to handle such things as in-vitro fertilisation, embryo transfer, pelvic reconstruction, hysteroscope, etc. this will be one of the most advance hospitals on our continent. It will cost $24.4 million to construct, $7.8 million in equipment and another $1 million in training of its staff. The top floor has a presidential suite and eight executive suites for the rich to pay top dollar for the best medical service.
Then I visited the old Mulago Hospital, the one that was handed over to Uganda on our independence day as a gift from the departing British colonial government. It has been shut down for renovation that will cost $29 million for civil works, $22.8 million for equipment, $1 million for training and $1.6 million for the integrated hospital management system – and they have laid 70km of fiber optic cables to handle this. The hospital, literally stripped bare except for the walls and the slabs, is being refurbished and refitted with everything new – from sockets to wiring, piping to windows, doors, sockets and switches. It will also have an organ transplant unit, which will handle transplants for hearts, kidneys, lungs, born marrow, liver, cornea etc. Later it will handle pancreas and stem cell transplants.
I was happy to learn that over the last five years, the government has been sending doctors abroad for training in different highly specialised areas such as anaesthesia, intensive care, etc. which are related to organ transplants and to maternal and neonatal issues. Listening to the hospital administrators, I was impressed by the scale and scope of the works, the quality of equipment and staff and the vision of the hospital they envisage. They told me that they are looking to a future where Mulago will make Uganda a nation for medical tourism; where specialists and patients would come from far and wide to work at and be admitted into the hospital. This is a vision of recreating Mulago of the 1960s that we have all heard about – a center of excellence.
As I listened to this vision, I also got concerned because knowing Uganda it is very likely that this vision will fail. The biggest danger to Mulago’s vision is our democracy. Uganda is a nation with a lot of space for democratic expression. And the government of President Yoweri Museveni is excessively sensitive to public opinion. So I have been thinking about how this new vision of Mulago as a highly specialised and high quality hospital can be sustained.
The biggest risk will be to attempt to make the hospital free and accessible to all. Uganda cannot afford that. If it tries, Mulago will immediately degenerate into what it had become previously – a place where the sick go to die and the healthy to contract diseases. The solution is to make it undemocratic and unfair. Undemocratic in that professional consideration, not popular pressure, should determine its policies. Unfair in that only those who can afford to pay should get access.