How can we tame ruthlessness in private hospitals ?

A visit to a private international hospital in Kampala last week was a heart-wrenching experience.

My friend had given birth and this was meant to be a joyous occasion. Her trouble, however, started when she went to her regular clinic for antenatal check-up and was told she was dilating, and was already at five centimeters (women who have given birth before will understand this).

The nurse asked her if she was feeling any pain and she said no. She was asked to go back home. According to specialists, she should have been admitted because the baby was ready to be delivered.

After a few days at home without any change, she went back to the clinic for another review. A test was carried out and it was discovered she was still at five centimeters. The nurse on duty asked an assistant to induce labour. There were two expectant mothers and the measurements of the solution used to induce labour were different.

My friend had contractions so fast whereas the other one who was at four centimeters was not reacting; meaning the least of the two measurements was given to her, yet it was supposed to be my friend’s. My friend pushed the baby without much force, but it came out looking purple and made no sound.

The baby was rushed to a nearby hospital, but the parents were not assisted because they were not insured and they did not have enough money. The doctors there could not even touch the child without a cash deposit!

They had to try a second hospital. Here, the baby was admitted. Up to this point, the baby had not produced a sound, although the purple colour was slowly clearing. The doctors at this hospital were not friendly either. An old female doctor uttered words such as “your child does not have eyes...”

Nobody was saying if such a case had been witnessed before or what the actual problem was. Several tests were done without a proper explanation. On the second day, my friend and her husband could not have any more of the negativity; they asked to be discharged. They were only given a discharge sheet and when they asked for the x-ray and ultrasound scan images, they were told those were hospital property.

They went to another hospital. It had been three days and four hospitals since the birth of this child and the parents had received no proper diagnosis but negativity, hurtful words and tests.

My friend had had a normal pregnancy and this was her third child. The previous ones were all natural births. At the fourth hospital, doctors insinuated that all this was because she had been sent home after she had dilated five centimeters.

It is possible the baby was detached and because it was not delivered immediately, there was a struggle to remain breathing, the ventricles did not close on time. Another test revealed the heart was on the right side, and the baby’s blood deoxygenated. The baby was taken to nursery.

They stayed in the fourth hospital for several days and were discharged. Two days later, the baby developed a temperature. The mother called the doctor who saw the child last for some advice. She was referred to another hospital that has a neonatologist.

On reaching this fifth hospital, the first question was whether they were cash-patients or insured? As soon as they said cash, the demands started: “you won’t be admitted unless you deposit some money”. Lucky for them, they had some cash. The deposit was made and admission done.

Another round of tests started during their three-day stay here, some costing as much as Shs 500,000! Remember they took the baby there because of a temperature; no mention of that was made!

It is common in Uganda to talk about public hospitals that lack facilities, but have we ever scrutinized the way private hospitals that seemingly have it all treat their patients? A doctor’s main role is to save a life; but in these hospitals, it seems the order is “do not touch a patient unless the money part is sorted”.

I know these are businesses, but I would expect their biggest priority to be treating a patient, and restoring their life, and not leaving one to bleed to death because they don’t have cash at hand!

Lives have been lost, hospitals and doctors sued for neglect but it looks like no lesson has been learnt. Healthcare has been made very expensive and those without money die miserably.

When a pregnant mother goes to a rural hospital, she is advised on what to carry on the day they are going to give birth. These include gloves, cotton wool, gauze and a few other necessities. It is a shame for a respected hospital to send someone a bill including fees for gloves, syringes, nurse, meals, etc.

There is no problem with these things being paid for but I would prefer all that to be classified as medical care or something, not Shs 40,000 being specified as the amount being given to a nurse who did not even spend two minutes on a child.

From this hospital visit, I discovered there are a lot of underlying charges that break people’s backs. If this goes on unabated, we will have patients and dead bodies retained because of the huge bills presented to people when they finally recover or lose their loved ones.

As we make noise about what is not in some of our health facilities, let us not allow the ‘well-equipped’ ones to exploit people. It has been a gruesome three weeks for this young couple.

Jackie Nakee

The author is a Capital FM Big Breakfast show presenter.