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Long Read: Uganda Hospitals Filling Up As COVID-19 Infections Surge

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Earlier this week, a 36-year-old man employed in Adjumani, Northern Uganda, traveled to Masaka for burial.

Musa (not real name) has a history of fevers and arthralgia (pain in joints). After the burial, Musa was admitted in hospital with malaria and typhoid.

He was given artesunate and ceftriaxone (medication used to treat malaria) without improvement.

Musa was then presented to IMC Entebbe with dry cough, chest pain and dyspnea. His oxygen level, or saturation (SpO2) was 82% and had coarse crackles bilaterally.

Musa did not have fever and was not known to have a history of chronic respiratory disease or other chronic diseases.

The patient was isolated and put on oxygen. IMC Entebbe contacted Covid-19 response team at Entebbe Grade B Hospital which said it’s operating at full capacity hence unable to take in new patients.

IMC Entebbe contacted an official at Uganda Virus Research Institute (UVRI), who agreed to take Musa’s sample and run it through express as long as the patient was transported.

The samples were taken but IMC Entebbe got stuck with Musa for hours before being advised by Entebbe Grade B Hospital to transfer the patient to IHK, Namuwongo.

IHK, which is affiliated to IMC, rejected Musa.

IMC then called City Ambulance which agreed to take Musa to inpatient hospitals, all of which reject him upon hearing that he had pneumonia and was oxygen dependent.

The hospitals (Nsambya, Rubaga, Mengo, Kisubi) said they could only take in Musa if he had a COVID-19 certificate showing he was negative.

City ambulance decided to transfer Musa to Kiruddu Hospital as Mulago could only receive patients with positive COVID-19 results not pending ones.

Kiruddu said their isolation for inpatients was full. They turned back the ambulance. IMC returned the patient to Entebbe Grade B where they pleaded for space from a one Dr Nsereko who heads the Covid-19 taskforce there.

Dr Nsereko finally agreed to give Musa a bed. City ambulance returned from Kampala and put the patient at Entebbe Grade B Hospital.

Musa, who appeared at IMC at 9:00am, gets space in Entebbe at 8:30pm, his oxygen level is 79%.

Second case

Another patient, Peter (not real name), reported at Novik hospital in Kampala at around 5:00pm with respiratory distress. He had all other signs of Covid-19 symptoms.

Having no isolation unit at the facility, doctors organized an immediate referral process to Mulago hospital.

At Mulago, the ambulance team was bounced to Kiruddu which rejected the patient.

COVID-19 virus has ravaged many parts of the world

The ambulance team consulted Uganda Healthcare Foundation (UHF) which advised them to take Peter to Naguru and confirmed that they had secured an isolation unit for the patient.

The Naguru team rejected the patient upon arrival of the team and his family.

Since it was approaching around 1:00 am, the family had lost hope and requested the team to drop them back to their home.

The team which had left Norvik hospital at 6:30 pm, returned after midnight.

This sheds light on challenges faced by hospitals as the country struggles to come to terms with the effects of the COVID-19 pandemic.

“The protocols are going to have to become significantly more streamlined if they are going to manage a full blown outbreak,” said a doctor who preferred anonymity to speak freely.

Take COVID-19 seriously

However, this situation also is a reminder to the public to take the COVID-19 prevention guidelines very seriously.

On August 20, Director General of Health Services, Dr Henry Mwebesa instructed the Directors of private hospitals to establish holding units for the management of critically ill patients with suspected COVID 19.

The private hospitals were directed to isolate the suspected patients, obtain samples and notify relevant bodies; continue to provide clinical care while ensuring all the standard operating procedures for the treatment of COVID 19; and only when positive results return should a consideration for referral be made.

However, Uganda medical Association President Dr Richard Idro said the directives of the Ministry of Health were unlikely to bring out the desired results, especially in the urban centres.

He argued that most people in urban centres first go to private facilities when they fall sick.

“In Kampala for example, there are 1,600 health units of which only 35 are hospitals. Patients are likely to go to the nearest health centre rather than look for the 35 hospitals such as Nakesero,” said Dr Idro.

“The small health centres which form over 95% of all health units have no room to set up these isolation facilities or put a tent, some even have no parking while others have very few staff and even fewer at night,” he emphasised.

“The holding units should meet standards of infection control but with which money? Few have the resources to put in place the kind of infection control measures required to care for potential COVID 19 patients or the PPE. During the 2-4 days the critically ill patient is being treated in the proposed holding units while waiting for results, may be receiving oxygen, with costs of over one million per day, who will pay for these costs?” Idro wondered.

Way forward

A senior doctor advised that Uganda should pick a lesson from United Kingdom which in April built NHS Nightingale, the largest hospital facility to accommodate coronavirus patients needing intensive care treatment.

East London’s ExCeL exhibition centre, which normally plays host to lifestyle shows, expos and conferences, was converted into the temporary NHS Nightingale hospital, with space for 4,000 beds.

In nine days, the 87,328 square metres of double exhibition halls was fitted out with the framework for about 80 wards, each with 42 beds.

This, the doctor said, should be done at Namboole stadium.

Minister speaks out

Speaking in Lira on Thursday, Minister Ruth Aceng said Ugandans should not be worried as steps are being taken to accommodate the growing large numbers of COVID-19 patients.

“We don’t understand where the worry is coming from,” said Aceng.

Dr. Jane Ruth Aceng in Lango sub-region. this week

“We have Namboole stadium which is large enough to accommodate these numbers. If we have more challenges, we will put tents outside. Better to put people who have the virus in a tent than bundling them together with those you are suspecting to have the virus,” said the Minister, emphasising, “So we don’t have a challenge as yet.”

Officials at Namboole say the facility was being used as a quarantine centre for some of the returnees.

Namboole has been fit with 300 beds but the capacity will be enhanced to 1,000 in the next few weeks, according to informed officials.

“People better be serious because hospitals are getting full. Space is running out very fast. We may reach a moment where patients may have nowhere to go,” said a medical source.

Dr Aceng said the touted homecare of COVID-19 patients was being studied to assess its viability.

“Even asymptomatic people seep the virus. In our population, the setup of our households is not conducive for isolation because people share amenities. You find four people in single rooms. They share bathrooms, toilets and utensils. It would have been easier to isolate people at home. In developed countries, you find each room is self-contained, making it easy to isolate people,” said Aceng.

“But here, the sick person, will be tempted to come out. We saw this between March and April at the onset of the pandemic. We tried self-isolation and many of the people would leave their homes to go to the centre of the city,” said the Minister.

“Even home in isolation, health personnel should follow you up after check on you every two days. But we have challenges of the human resource. Self-isolation of COVID-19 may end up spreading the virus even more,” said Aceng.

“That is why we continue to appeal to the population to embrace prevention guidelines and protect themselves from Coronavirus.”

Uganda, which initially performed well, has lately seen a sharp rise in the number of cases of Covid-19 as well as related deaths which now stand at 28.

President Museveni declared this Saturday, August 29 as a day for national prayers during which the country will once again seek divine invention to get through the Covid-19 pandemic.

  • To prevent the spread of COVID-19:
  • Clean your hands often. Use soap and water, or an alcohol-based hand rub.
  • Maintain a safe distance from anyone who is coughing or sneezing.
  • Wear a mask when physical distancing is not possible.
  • Don’t touch your eyes, nose or mouth.
  • Cover your nose and mouth with your bent elbow or a tissue when you cough or sneeze.
  • Stay home if you feel unwell.
  • If you have a fever, cough and difficulty breathing, seek medical attention.



Source – chimpreports.com

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Charles Mbire gains $1.2 million as stake in MTN Uganda rises above $51 million

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Ugandan businessman and MTN Uganda Chairman Charles Mbire has seen the market value of his stake in MTN Uganda surge above $51 million in just two days, as the share price in the leading teleco company increased by a single digit.

The single-digit bump in the share price caused the market value of Mbire’s stake to gain UGX4.42 billion ($1.24 million) in less than two days.

The million-dollar increase in the value of his stake came after Uganda’s largest telecom company delivered the country’s largest-ever IPO through the listing of 22.4 billion ordinary shares on the Uganda Securities Exchange (USE).

Upon completing the largest IPO in Uganda’s history, MTN Uganda raised a record UGX535 billion ($150.4 million) from the applications that it received for a total of 2.9 billion shares, including incentive shares.

As of press time, Dec. 7, shares in the company were trading at UGX204.95 ($0.0574), down six basis points from their opening price this morning.

Data gathered by Billionaires.Africa revealed that since the telecom company registered its shares on the Ugandan bourse on Mon., Dec. 6, its share price has increased by 2.5 percent from UGX200 ($0.056) to UGX204.95 ($0.0574) as of the time of writing, as retail investors sustained buying interest long after the public offering.

The increase in the company’s share price caused the market value of Mbire’s 3.98-percent stake to rise from UGX178.45 billion ($49.96 million) to UGX182.86 billion ($51.2 million).

In less than two days, his stake gained more than UGX4.42 billion ($1.24 million).

In a statement after the successful listing of MTN Uganda’s shares, Mbire said the IPO shows the confidence that Ugandans and other investors have in the company, its brand and strategic intent.

“We commend all the regulators for their support in our work to become a USE-listed company and to comply in a timely manner with the listing provisions of the national telecommunications operators’ license,” he said.

Steady but sure-MBIRE who is the biggest investor on Ugandas Stock exchange with stocks valued at more than $55 million is laughing all the way to the bank after MTN declared the latest dividend payout.He has steadily grown his business empire which is believed to be more that $350 million (debt free).

Steady but sure-MBIRE who is the biggest investor on Ugandas Stock exchange with stocks valued at more than $55 million is laughing all the way to the bank after MTN declared the latest dividend payout.He has steadily grown his business empire which is believed to be more that $350. ( debt free).

He is into communications-revenue assurance-cement-distribution-oil services-real estate-oil exploration and logistics.

Source: Billionaires Africa

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2-year-old dies at Arua hospital as nurse demands Shs 210,000 bribe

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A two-year-old child died at Arua Regional Referral hospital after a nurse, Paul Wamala demanded a bribe amounting to Shs 210,000 before carrying out an operation. 

The incident happened on Saturday, after Aron Nabil, a two-year-old child was referred to the hospital for an operation after he was diagnosed with intestinal obstruction, a medical emergency caused by a blockage that keeps food or liquid from passing through the small intestine or large intestine.

According to the relatives of the child, Wamala allegedly asked them to initially give him Shs 30,000 to buy medicines to commence the procedure. He however returned shortly asking for an additional Shs 180,000 from the relatives.

Emily Adiru, a resident of Osu cell, in Bazar Ward, Central Division, and a relative of the child says although they paid money to Wamala, he abandoned the child without carrying out the operation. According to Adiru, Wamala later refunded Shs 200,000 through mobile money, after she threatened to report him to the police.

“They told us this boy needs an operation which was supposed to be done in the morning on Sunday at around 7 am. They took him inside there, some doctor came from the theatre, he called one of us and said, we should pay Shs 70,000 for buying medicine to start the operation. We paid the Shs 30,000 [but] after paying the Shs 30,000, after some minutes, the same man came and opened the door and called us again, and told us we should pay another Shs 100,000. We also paid the Shs 100,000 and we thought it is finished. We were outside there waiting for our patient to come out [but] then this man came back again and said we should pay another Shs 80,000,” said Adiru.

Although the operation was later carried out after a 7-hour delay, the child didn’t make it, and relatives attribute the death to negligence. Miria Ahmed, a concerned resident wonders why such incidents have persisted at the facility which is supposed to service the citizens.

“Is the problem the hospital, is it the management or it is the human resource that is the problem in the hospital? A small child like this you demand Shs 210,000 for the operation? Well, if the money was taken and the operation is done, I would say anything bad but this money was taken and the small boy was abandoned in the theatre,” she said. 

When contacted Wamala refused to comment on the allegations. Dr Gilbert Aniku, the acting hospital director says that the hospital will issue an official statement later since consultations about the matter are ongoing.

Arua City resident district commissioner, Alice Akello has condemned the actions of the nurse saying she has ordered his arrest so as to set an example to the rest. The case has been reported to Arua regional referral hospital police post under SD reference No:05/30/05/2022.



Source – observer.ug

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Mexican president’s Mayan Train dealt new legal setback | Tourism News

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Activists say the planned tourist train will harm the wildlife and natural features of the Yucatan Peninsula.

Mexican President Andres Manuel Lopez Obrador has been dealt the latest setback to an ambitious plan to create a tourist train to connect the country’s southern Yucatan Peninsula.

On Monday, a judge indefinitely suspended construction on a portion of the project, known as the Mayan Train, saying the plans currently do not comply “with the proceedings of the environmental impact evaluation”.

The ruling follows a legal challenge by activists who said they were concerned the 60km (37 mile) portion of the train that would connect the resorts of Playa del Carmen and Tulum would adversely affect the area’s wildlife, as well as its caves and water-filled sinkholes known as cenotes.

The original plan for the disputed section was for an overpass over a highway, but the route was modified early this year to go through jungle at ground level.

The federal judge cited the “imminent danger” of causing “irreversible damage” to ecosystems, according to one of the plaintiffs, the non-governmental group Defending the Right to a Healthy Environment. In a statement, the group said that authorities had failed to carry out the necessary environmental impact studies before starting construction of the section.

Lopez Obrador had announced the ambitious project in 2018, with construction beginning in 2020. The roughly 1,500km (930 mile) cargo and passenger rail loop was presented as a cornerstone of a wider plan to develop the poorer states and remote towns throughout the about 181,000sq km (70,000sq mile) Yucatan Peninsula.

The railway is set to connect Caribbean beach resorts with Mayan archaeological ruins, with authorities aiming to complete the project by the end of 2023. The plan is estimated to cost about $16bn.

The project has split communities across the region, with some welcoming the economic development and connectivity it would bring. Others, including some local Indigenous communities, have challenged the project, saying it could not only disrupt the migratory routes of endangered species, including jaguars, tapirs and ocelots, but could also potentially damage centuries-old Mayan archaeological sites.

The National Fund for the Promotion of Tourism, the government agency overseeing the project, has said that it expects to “overcome” the latest challenge and that work should continue after an environmental impact statement is finalised. It said the Environment Ministry was currently reviewing its environmental application for the project.

For his part, Lopez Obrador has insisted the railway will not have a significant environmental effect and has accused activists of being infiltrated by “impostors”.



Source – www.aljazeera.com

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