Every month, about 30 women arrive at Kashambya Health Centre III to give birth. But instead of finding a well-equipped maternity ward, they encounter a leaking building, a broken delivery bed, no running water and little privacy. Health workers at the facility in Kashambya Sub-county, Rukiga District, say they have resorted to improvisation to keep services running, warning that the deteriorating infrastructure is putting the lives of mothers, babies and patients at risk.
The health centre serves residents of Kashambya Sub-county, neighbouring Nyakishenyi Sub-county in Rukungiri District and parts of Mpungu Parish in Rubanda District. Still, decades of neglect have left it struggling to provide basic healthcare. The Outpatient Department, constructed in the 1970s, has a leaking roof that allows rainwater to seep into consultation rooms and threatens to damage medicines. Because of limited space, dental services, injections and the pharmacy all operate from a single room.
The only ward, built by World Vision in 1998, accommodates male, female and children’s patients. It also doubles as the maternity ward, labour suite, laboratory and Chronic Care Clinic. The building has developed deep cracks, with health workers fearing it could collapse during a disaster such as an earthquake. The situation has worsened after the facility’s main water tank fell from its stand and was destroyed. Two additional tanks are also non-functional, leaving the entire ward without running water. As a result, midwives and laboratory staff fetch water in jerrycans every day to conduct deliveries, clean equipment and carry out laboratory tests.
Judith Tumukunde, a midwife at the facility, says about 100 expectant mothers attend antenatal care every month, while around 30 delivers at the health centre. She says the labour ward is too small to accommodate more than one mother at a time. At the same time, the damaged delivery bed forces midwives to place newborn babies on a table immediately after birth as they continue attending to their mothers.
“When several mothers arrive at the same time, some deliver in the labour ward while others are attended to in the maternity ward using improvised curtains for privacy,” she said. Tumukunde added that without running water or functioning handwashing facilities, midwives wash their hands using water poured from jerrycans during deliveries, increasing the risk of infection.
She also says the maternity ward lacks privacy curtains, leaving mothers who cannot walk after giving birth exposed when relieving themselves. The postnatal ward has too few beds, worn-out mattresses and no blankets or bedsheets, forcing mothers to bring their own bedding. An improvised wooden duty room is sometimes used as an isolation unit for mothers and babies requiring specialised care.
Laboratory technician Edison Mugerwa Kawuki says the small laboratory has become even harder to operate without running water. He says staff spend valuable time fetching water, yet the available water is not always safe for medical use.
Privacy is another major concern. Grace Ainomugisha, a counsellor, says the Chronic Care Clinic attends to between 30 and 50 clients every week living with HIV, tuberculosis, diabetes, cardiovascular diseases, asthma and mental health conditions.
However, consultations take place in an open space where confidential discussions can easily be overheard. She says some patients withhold important information or provide false details for fear of stigma. Ainomugisha appealed for a separate clinic to protect patients’ confidentiality.
The congestion extends to dental services. Public Dental Health Officer Vallence Mukamarinda says one room serves as the dental clinic, injection room, wound dressing unit and pharmacy. He says the overcrowding compromises infection prevention and has prevented the facility from offering services such as tooth cementing because it lacks space, a dental chair and other essential equipment.
Senior Nursing Officer Sister Adellah Kyomukama says poor working conditions extend beyond patient care. She says health workers cook on verandahs because staff houses were built without kitchens, while collapsed toilets and bathrooms have forced them to share sanitation facilities with patients or seek alternatives elsewhere.
According to Kashambya Sub-county Vice Chairperson Pross Abenaanye, the ward has too few beds and old mattresses, forcing male, female, and children’s patients to share the same space, separated only by improvised plywood partitions. When admissions exceed capacity, patients are referred to Kisiizi Hospital or Kabale Regional Referral Hospital, increasing treatment costs for already struggling families. She also noted that attendants spend hours fetching water because of the persistent shortage, while the temporary OPD waiting shelter has deteriorated beyond use.
Abenaanye said repeated appeals to higher authorities have yielded little action. She added that health workers now bathe outside under the cover of darkness after the staff bathrooms collapsed.
Kashambya Sub-county LCIII Chairperson Elineo Bandaganiire estimates that about Sh4 billion is needed to rehabilitate and expand the facility. He also called on the government to upgrade Kashambya Health Centre III to a Health Centre IV to match the growing population it serves.
Rukiga District Woman MP Dr Sylvia Alinaitwe Mwanaki said she has already raised the deteriorating state of the health centre in Parliament as a matter of national importance. She warned that unless urgent improvements are made, more expectant mothers may opt to deliver from home, putting their lives and those of their babies at risk.
Responding to the concerns, Health Minister Dr Chris Baryomunsi said the Ministry of Health will dispatch engineers to assess the facility and recommend the necessary interventions, although he did not indicate when the assessment would take place-URN. Give us feedback on this story through our email: kamwokyatimes@gmail.com
