4/26/2016

LongroadtogoodhealthservicesinKalangalaHealthyLiving

HEALTHYLIVING

LongroadtogoodhealthservicesinKalangala

InmuchofKalangalaDistrict,theonlywaytoaccessbasichealthcareisviaaboatcrossingtoanotherislandorthemainland.PhotobyHenryLubulwa
INSUMMARY

HealthfacilitiesarefewandfarbetweenfortheresidentsoftheislanddistrictofKalangala.ThiscomplicateshealthcareinanareaalreadyburdenedbythescourgeofHIV,writesHenryLubulwa.

RonahNankingaisa36yearoldmotherwholivesonButulumeIsland,MazingaSubcounty.Shehastwoboysandonegirl,allbelowtheageofeight.Sheisa
fishmongerwhoferriesfishtotheKasenyiLandingSiteinEntebbeinWakisoDistrict.
Shehasspentsixyearslivinginagrassthatchedwoodenhouseontheisland.Allherchildrenareofschoolgoingage.However,thereisnonearbyschooltotake
thechildrento.Duringtheday,sheworksasafishmongerandinthenighttime,shesellswaragiforsurvival.
Ihavetoworkatboth(jobs)inordertoearnalivingandcaterformyfamily,explainsNankinga,asinglemother.Sheseparatedwithherhusbandwhenhegota
secondwifeafterhavingtheirthirdchild.
Inowhavetoworkformychildren.Youknowtheyoungonesusuallyfallsickanditremainsmytasktotakethemtohospital,shesays.
Togettoanearbyhealthcentre,Nankingahastoboardaboatandcrosstoanearbyislandwhereshecanfindahealthcentre.Thenearesthealthcentreinthearea
isinLujjaabwa,anislandsituatedclosetoRakaiDistrict.
Itis21nauticalmilesawayabout36kilometresbyroad.Thereishardlyanysignoflandasshemakesherwaytohospital.Beingthefarthestsubcounty
(Mazinga)inthedistrict,itismadeupof13islands,spreadoutfarapart.
Thewavesonthelakeareusuallystrong.Theonlymeansoftransportisawoodenboat.Nankingasayssheusesabout40litresoffueltoaccessahealthcentre
whereshegetsadoseofdrugsforanysickpersoninherfamily.
40litrescostsaboutShs168,000hereandthatiswhatIusetogetafreedoseofdrugsifIneedanyfromanearbyhealthcentresincewedonothaveanearby
clinic,shesays.
NankingausuallytravelswithherthreechildrentoKalangalasmainislandinBugalatogetfreemedicalcareathealthcamps.
Ineedtohaveallthechildrencheckedforalldiseasessoastohavethemsafe.It(thecamp)isafreeeventandfreemedicineisgivenouttoallpeople,shesays.
Toofewandtoofar
KalangalaDistricthasatotalof21healthcentres.However,someofthem(HealthCentreIIs)wereclosedunderthenewpolicyundertakenbytheMinistryof
Health.AccordingtotheKalangalaDistricthealthofficerHillaryBitakaramire,theonlyoperationalhealthcentresarethoseabovethelevelofahealthcentreII.
Thisleavesuswithonly15healthcentresoperatingonthescattered84Islandsthatmakeupthewholedistrict,DrBitakaramiresays.
AresidentofNkoseinMazingaSubcountynearesttothenorthernborderwithTanzaniasBukobaislandshastotravelaminimumof11nauticalmilesonthelake
toreachthenearestKachungwaHealthCentreIIIwhichonlyhandlesmaternityhealthservices,HIVtreatmentandminorillnesses.
Ifonehasamajorillnessoranycomplication,itisbettertotraveltoRakaiandMasakasinceitappearsnearerthanBukasaandKalangalaHealthCentreIVs.
Sometimes,wereachourmainhealthcentres,onlytobereferredtoMasaka.
So,itappearsbettertocrossthere,saysRestyNakawungu,theareacouncillorwhoalsodoublesasthechairpersonKalangalaSocialServicescommittee.
Foronetomovefromoneislandtothenearesthealthcentre,heorsheneedstohireaboat,coxswain,engineandfueltoreachthenearesthealthfacility.For
instance,totravelfromKitoboanoutlyingisland,toBufumiraHealthCentreIII,oneneedstobuy20litresoffuelatacostofShs80,000,hireacoxswainat
shs40,000andaboatandengineatshs50,000.
Youuseclosetoshs200,000astransporttogotoahealthcentreandpicktabletsthatcanbesoldatShs3000inaprivateclinic.Weusuallytellpolicymakersthat

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4/26/2016

LongroadtogoodhealthservicesinKalangalaHealthyLiving

islandareasshouldbetreatedinaspecialwayifpeoplelivingtherearetogetbasicservices,saysWillyLugoloobithedistrictchairperson.
Ourprayeristhatwearecateredforsoastoimproveourhealthservices.Althoughwehave85percentstaffinginallhealthcentresinthedistrict(128medical
officers),thefacilitiesarestilltoofewtocaterforeveryone,hesays.
Noislandhospital
Kalangalahasnomajorhospital.ThedistrictreliesontheservicesofKalangalaandBukasaHealthCentreIVslocatedinKalangalaTownCouncilandBukasa
islandsrespectively.ThetwohealthcentreshandlemainlyHIVpatients,maternity,andminorillnessessuchasmalariaandcough.
ThedistricthasforthelasttwoyearsbeenaskinggovernmenttoelevateKalangalaHealthCenterIVintoareferralhospital.However,theMinisterofStatein
chargeofPrimaryHealthcareaskedthedistricttofirstinstituteafewmoreservicesinthemaindistricthealthcentreifitistoattainahospitalstatus.
SpeakingduringanHIV/AidsstakeholdersmeetingheldatthedistrictheadquartersinKalangalalastOctober,MsOpendisaid,Governmentisclearlymonitoring
theservicesofKalangalaHealthCentreIV.Weexpectthatifwegetbetterandmorecomprehensiveservices,Kalagalawillattainhospitalstatus.
Thedistricthasapopulationof53,000peopleaccordingtothestatisticsfromthe2014Populationcensus.ItalsohasthehighestlevelsofHIV.
AccordingtoKalangalaDistrictForumforPeopleLivingwithHIVAidsNetwork(KAFOPHAN),Kalangalahasatotalof10,350peoplewhoarelivingwithHIV.
ThisisthenumberofthosewhohavegoneforanHIVtest.Westillhavemanyotherpeoplewhofeartoturnupforthetest,saysHenryKizito,theCoordinator
KAFOPHAN.
This,amongmanyotherchallenges,remainsKalangalasbiggesthealthsectorproblem.ThelevelofSTIinfectioninthedistrict,accordingtothedistricthealth
officer,isatitshighestespeciallyatKalangalaslandingsitesinrecentyears.
AccordingtoDrBitakaramire,mostofthepeoplewithinthedistrictsufferfromSexuallyTransmittedDiseasessuchasgonorrhea,syphilis,andHIV/Aids,among
others.
Also,peoplewithinthevicinitysufferfromdiseasessuchasmalariaandothersresultingfrompoorhygienesuchasdiarrhoea,bilharziaanddysentery,neglected
tropicaldiseasesandthoserelatedtotsetseflies.
Thegovernmentpolicyisthatweshouldalwayshaveahealthcentrewithinwalkingdistance.However,manyofthepeoplehavetocrosstothenearestcentreby
boatorelse,onedies,DrBitakaramiresays.
Accordingtothedistrictpersonnelofficer,Kalangalahasatotalof128healthworkersinthe15accessibleandoperationalhealthcentres.
However,someofthemedicaldoctorswhoweretrainedbythedistrictwithanaimofincreasingthenumberofhealthworkersabscondedfromdutyduetothe
deplorableconditionsinthehealthcentresonseveralislandsinthedistrict.
ChallengeofservicedeliveryinKalangala
KalangalaisanislanddistrictlocatedinthemiddleofLakeVictoria.SometimesreferredtoastheSseseIslands,thedistrictdoesnothaveterritoryonmainland.
Thedistrictislocated67kilometres,about37nauticalmilesonwater,southwestofEntebbeinWakisoDistrict.
Aboutsixyearsago,37ofthe84IslandsinKalangalaDistrictwereuninhabited.Theonlyinhabitedislandswereincloseproximityandoneonlyneededacanoeto
crossfromoneislandtothenext.Althoughtherewerefewhealthcentres,itwaseasiertocrossfromanislandannex.
Nogrowthinhealthservices
AccordingtoreportsfromKalangalaDistrictNGOforumandKalangalaDistrictmedicaloffice,thenumberofhealthfacilitieshasnotincreasedsince.Many
peoplewholiveinthenumerousoutlyingislandshavebeendyingwithouttransporttoahealthfacility.
Sincemanypeoplearepoor,noonecanlookformoneyforaboat,fuelandenginehiresoastoreachthehealthfacility.Intheend,manypeoplesufferwith
untreatedpeculiardiseaseswhichleadtodeathinsomecasesandsuchdeathsarenotregisteredforreference,saysDamalieNabirimu,anofficerwithAdvocacy
forBetterHealthofficerundertheKalangalaDistrictNGOforum.
Thishasaffectedhealthservicesinthearea.Forexample,therearehealthcentreswhosehealthworkershaveleftduetopoorworkingconditions.
Communitiesaresufferingwithoutmedicalcarehencetherightofaccesstohealthservicesisdenied.Therearemanypeopledyingwithoutgettingaccesstohealth
services,accordingtoinformationfromKalangalaDistricthealthdepartment.
ResidentsofdistantislandswithnohealthfacilitiessuchasMiyana,ButulumeandNkoseinMazingaSubCountyrelyoncommunitytreatmentoutreachesthatare
usuallyorganisedbywellwisherswithintheKalangalacommunities.
AccordingtotheKalangalaDistricthealthofficer,DrHillaryBitakaramire,suchoutreachestreatahandfulofdiseasesandareonlyconductedonceayear.
KalangalaDistricthealthinspectorEdwardBugimbiindicatedthatwhereastheHealthministryrequiresallhealthcentrestobelocatedadistanceofnotmorethan
fivekilometresfromonetothenextitishardtotellthedistancebetweenhealthfacilitiesacrossthelakeinKalangala.
Currently,thedistricthasatotalof84islandsofwhich63areinhabited.However,thereareonly15effectivehealthfacilities,sevenofwhicharelocatedonthe
mainislandofBugala.Therestofthecentresaredistributedamongthe62otherinhabitedislandswhichmakestheminaccessibletomany.
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