Health clinics in Paicho-Bungatira

According to Uganda Ministry of Health standards, every parish should have a health center, but Paicho and Bungatira have 14 parishes and only 10 health centers, of which six are closed and in bad shape because of the war. Only two health centers have staff accommodations. Most staff reside miles away and arrive late for work. Two health centers have inadequate maternity wards, and pregnant mothers give birth with the help of untrained midwives, which increases the risk of HIV infection. There is a high prevalence of preventable diseases such as malaria, diarrhea and respiratory infections and the immunization coverage is very low, 55% for Paicho and 37% for Bungatira. The health problems are exacerbated by low incomes and the inability of primary caregivers to address basic health care needs in the households.

We visited two health clinics, one in Paicho called Atoo Health Center II and the other in Bungatira, Punena Health Center II. Though they were both "level II" health centers, there were stark differences!! Atoo has only been open for about 6 months and a government hired nurse treats approximately 10 patients per day. The main disease seen here is malaria. In addition, approximately 2 babies per week are delivered but this health center does not have facilities to administer care overnight. Consequently, the mothers go home shortly after giving birth. We did not see any basic care items nor did they have lab capabilities. Their access to pharmaceuticals is inadequate, sometimes due to some staff taking them to sell to private clinics. If the clinic is unable to treat a patients condition, he/she has to walk several miles into town for treatment.

Punena has been open for 2 years and has a staff of 10. They treat approximately 250 patients per week and have a "good" supply of medical care items including a microscope for diagnostics. The "Maternity Ward" had a delivery room and a recovery room with 3 beds. Again, this facility is only open during daylight hours resulting in mothers/babies go home shortly after giving birth. This lack of postnatal care gives rise to a high mortality rate for the mothers. In the near future, World Vision will be building a staff house that will allow the clinic to be open 24 hours/day. Sara