By Edgar Tushabe Muhairwe
Edgar Tushabe Muhairwe spoke to Isingiro District Speaker, Silver Mwesigwa about health, education, and water supply.
When we visited the Health Centre; there were no patients at 12 noon. How come?
It is not surprising. In the morning, there are usually queues of patients but we have two doctors. One can see about 30 patients in one hour. These are simple ailments like flu, malaria, and cough. I am happy. Patients should spend as little time in the hospital as possible.
The doctor complained about not having electricity; how does the hospital manage?
This issue of electricity is not in our hands. It is with central government and we have raised it several times but we do not know how we shall manage. This health centre is one of the best in the country, but when the generator diesel runs out, we are forced to refer patients to Mbarara Hospital (35kms away) which is a cost to the patient and a risk to lives.
How have you grown the number of health centre staff?
By 2010, there were about six health workers but they were not working and patients shunned the hospital. I remember a doctor who left because she said she couldn’t come to just treat malaria. `This is a job for a clinician and a nurse and am a trained doctor’, she said.I had cases where somebody was posted to Nyamuyanja and immediately went on study leave; abandoned the station. One would not get the doctor or medicines. We made noise about that. We were able to get the staff increased through lobbying; highlighting the problem. We have a very good District Health Officer who is very good at monitoring and evaluation. Patients are now coming from seven, eight kilometers away.
How many health centers are in this sub-county?
Two. This Health Centre IV and a HealthCentre II in a far off village. Since the Health Centre IV started, the number of referrals to Mbarara has reduced by almost 90%.
How do you budget for the Health Centre?
The health Centre receives funding directly from the ministry of Health in Kampala which administration is detached from the reality. They do not know why doctors cannot stay in the villages, they are blind to other none salary elements that make the practice motivating. If the doctor is going for an outreach but she has no fuel, no car, no money, then she is just idle at a HealthCentre IV.
We were told by the officer in charge that she sleeps in the theatre. What about her juniors? How are you handling the issue of accommodation?
Some rent in the trading centre because they are now 36 facilitaties there cannot even accommodate them. Imagine a doctor; fully trained, has decided to work for the community and forfeit the luxuries of the city. The least the government could do is provide good accommodation and facilitation. We are lucky that we have Millennium Project helping us, but when it ends, we might not handle them.
How has the hospital been able to keep a clean surrounding and sufficient flow of water?
Gravity Flow Scheme Water is one of the projects under the Ministry of Water. It is the cheapest water we can have. As a district, we were at 14% clean water coverage by 2011. The water department and engineers told us that water capacity can cover three sub-counties. It does not dry. When we did the first phase, we did about 10 taps, now we are at about 40 taps. We also have some connections in private residencies.
So how do you ensure access to water for everyone?
The technical design is done by the engineers and there is supposed to be a tap with in a one kilometer radius. We have increased the number of taps; now if there are ten homes in an area, they get a tap.
I have seen broken taps. How is maintenance managed?
We put up Community Management Committees and contribute money to maintain this project. Every family is supposed to pay Shs1000 per month for repairs and maintenance of the scheme. But people do not pay and it has failed. A neighboring sub-county uses meters; we are going to meter our water like they do.
If families have failed to pay Shs1000 per month per family, how are they going to pay everyday?
It is not going to be as costly as it is in town. It could be Shs 50 per jerry can. We have hired a water management engineer to do it and he will be paid by the same money this committee is collecting.
Some villagers say whenever somebody swindles the money and he is called to account, he resigns. How different is this going to be?
We are to privatise the water; we are getting a private contractor who will get a profit margin. We want to pull the community out of water management. It is going to be like a small process of National Water.
What do you envisage for Nyamuyanja by 2016?
These projects we are working on as a community are basic. I am talking about the project on education, the project on health, and that of water. We have registered achievements in all. What remains is being able to maintain them.