UGANDA: Overworked doctors circumcise men ahead of caring for HIV babies

Gant Daily
March 29, 2012

HIV services in western refugee camps overwhelmed

By AHN

Isingiro, Uganda (IRIN) – Health workers manning five health centers in two refugee camps in the southwestern Ugandan district of Isingiro say they are overwhelmed by the high number of refugees and local residents in need of HIV services.

... Medical Teams International (MTI) , a medical NGO that works in humanitarian emergencies ... runs two clinics of its own and supports three government health centers in the settlements. Some 180 health workers, only three of whom are doctors, are responsible for a population of over 139,000 people – 63,749 refugees and more than 76,000 local residents – in the area, which has an HIV prevalence of 6 percent.

The UN Refugee Agency , which provides MTI with US$2 per refugee per year for medication, says it difficult to recruit and retain health personnel to work among Uganda’s refugee populations.

Dr Isaac Odongo, MTI’s regional program manager for southwestern Uganda, noted that the need for information on HIV and sexually transmitted infections (STIs) was crucial for refugees, many of whom came from conflict-prone areas of the Democratic republic of Congo (DRC) where such information was hard to come by.

“The HIV infection rates are generally low among the refugees when they just come [but] with time, they get into reckless activities [unprotected sex] with locals and they get infected,” he said.

Uganda suffers from a chronic shortage of health workers – less than half of the vacant health positions are filled –

...

At one of the health centers in Nakivale refugee settlement there are 69 HIV-exposed infants who need close monitoring and supervision. However, the health center has only one general doctor, Dr Gideon Ndaula, who has to see HIV-positive people as well as other patients, and the same scenario is repeated in health centers across the settlement.

On the day IRIN/PlusNews visited the facility, Ndaula was performing male circumcisions and was unable to attend to other patients. Uganda’s Ministry of Health has embarked on a large-scale voluntary medical male circumcision program as part of HIV prevention efforts.

...

Health workers are often too busy to provide counseling on infant feeding for HIV-positive mothers, many of whom could infect their babies through incorrect feeding methods .

Florence Ajonye, the HIV/AIDS focal person at the heal facility in Nakivale settlement, told IRIN/PlusNews that patients often had to wait to be enrolled on life-prolonging ARV drugs, even when they qualified.

“There are so many patients here to see. The doctor sees between 30 and 50 [every day] – far too many to ensure adequate attention. Sometimes people wait for hours to be attended to. As a result… we start with those who are critically ill,” she said.

“The supplies are not enough. There are times we run short of ARVs and Septrin [an antibiotic used to prevent opportunistic infections] for our patients. ... ”

“At times we have come here [the health center] and found no drugs,” said one patient.... ”