It was one time the beacon of health services in Rwenzori sub-region but the future of Kilembe Mines hospital in Kasese district hangs in the balance due to the unending disagreements involving the ministry of Health, Kasese District Local Government (KDLG), and the community of Bulembia division, writes SAMUEL MUHINDO.
Established in 1951 to serve the staff working in the copper mines, Kilembe Mines hospital extended its services to the Kilembe community and the wider Rwenzori sub-region.
Since 1995, Kilembe Mines hospital has been managed under a tripartite agreement between the Catholic diocese of Kasese, Kilembe Mines Limited, and government. Before the floods, the hospital served approximately eight sub-counties including Bulembia, Nyamwamba, Nyakabingo and Mahango.
In May, 2020, River Nyamwamba flooded into Kilembe hospital, destroying millions of dollars worth of equipment beyond repair and leaving the hospital lying below the debris left behind by the floods. This was the same case in May, 2019 and May, 2018.
Promises from the government about relocating the hospital bore no fruit. The May 2020 floods prompted Bishop Aquirinus Kibira of Kasese Catholic diocese to relocate all the operations of the hospital to Kasese town. The hospital was hosted at St Michael Kindergarten and Kasese Catholic Social Services Hall, both of which are established by the Catholic diocese of Kasese.
Kibira hoped that the government of Uganda could have found a permanent solution to the Kilembe floods. When the tripartite management agreement for Kilembe hospital expired in early 2022, Bishop Kibira notified the government that he would not be renewing it.
He instead registered a hospital called Mt. St. Mary’s hospital. The community of Kilembe still needed their ‘Kilembe hospital’. Subsequently, hospital equipment was divided between St Mary’s and Kilembe hospitals.
With little equipment, Kilembe Mines hospital was relocated back to Bulembia division. It is currently hosted at a former recreation center, exactly opposite the hospital’s former premises.
During an impromptu visit to the new ‘Kilembe Mines hospital’, the once prized hospital is a shadow of its past. A once-busy town is now deserted.
Speaking to The Observer, a medical worker who preferred anonymity but is privy to the developments at Kilembe, said the hospital’s daily patient count had dropped from approximately 100 to about 20.
“We can no longer perform major surgeries, especially amputating limbs and other surgeries. We do not have the necessary equipment. We left the equipment at Mount St Mary’s hospital. We are dead in the eyes of the public if we cannot perform these surgeries. When you look at the walls of this facility, you can tell that this is a lodge, not a hospital. The aesthetics of the hospital rooms and their walls are poor. We have two broken flush toilets, which the patients share,” she said.
She added, “Dr. Wafula, the hospital’s senior medical surgeon, was retained at Mt. St. Mary’s following the redistribution of staff and property between them and Kilembe mines. We are told that the church couldn’t allow him to leave because they paid for his further studies, and he has to pay them back before leaving.
Most of the patients who come here (Kilembe mines) return home without medication. They come here because they can’t afford the prices at Mt. St. Mary’s. The prices of major surgeries have increased to approximately Shs 2.7 million, from Shs 1.5 million, which patients used to pay before the 2020 floods. We don’t have the equipment to work on them. If Kilembe is closed, as we have heard, it will be the over eight sub-counties that it serves that suffer. We shall be redistributed to other facilities as staff, leaving behind a suffering community in Kilembe.”
In a December 2022 letter, Dr Diana Atwiine, the permanent secretary at the ministry of Health, informed Dr. Bildard Baguma, the executive director of the Joint Medical Stores (JMS), to deactivate Kilembe Mines hospital from the list of facilities that qualify for essential medicines and health supplies.
Atwine said Kilembe had failed to utilize funds for essential medicines and health supplies during the first quarter of the financial year 2022–23 (July and September 2022). The facility had been getting an annual allocation of about Shs 354 million. She directed that the Shs 354 million be reallocated to other facilities at health center III, IV, and hospital levels in Kasese municipality.
In a January 31, 2023, letter to the chairperson of the parliamentary committee on Health, the minister of Health, Dr Jane Ruth Aceng, said the withdrawal was because the facility is located near the River Nyamwamba catchment area and has constantly suffered floods.
“To address the service delivery gap, the Ministry of Health is upgrading Rukoki Health Center IV to a general hospital. There are plans to construct a Health Center III in Bulembia division to increase access to primary healthcare for the population of the catchment area of Kilembe Mines hospital,”.
Aceng promised the hospital would be reinstated once it is revamped and the ongoing Shs 17 billion World Bank-funded River Nyamwamba desilting project is completed.
“If you go to St Mary’s hospital, you shall find beds and other equipment branded Kilembe Mines hospital being used,” Richard Bomera, the Local Council III chairperson for Bulembia division, said. He alleged that Dr. Henry Mwebesa, the director general of Health Services at the Ministry of Health, had conspired with Bishop Kibira for the latter to retain the property of Kilembe hospital’s equipment at Mt St Mary’s hospital.
Bomera insisted that the hospital would neither be relocated outside Bulembia division nor deactivated.
“The hospital has been relocated to a safer and raised place opposite the former premises. The river cannot reach there. We have all seven units required for the establishment of a hospital. Although we don’t have adequate facilities, we have partners who have expressed the desire to construct for us a maternity ward at our new location. If the ministry intends to relocate Kilembe Mines hospital, let them take us to Namuhuga, where the administration of the copper mines has allocated the hospital a new piece of land where the hospital can be reestablished,” Bomera said.
Speaking to the parliamentary health committee, Bishop Kibira dismissed any wrongdoing regarding the redistribution of Kilembe Mines hospital property.
“I went through all the necessary steps and wrote to the ministry of Health. When the director general directed that I send that much to Kilembe Mines hospital, I couldn’t do the opposite. I am not here to fight the government. I shall do as guided by the ministry of Health,” Kibira added.
“I am against the establishment of the hospital in that valley. We have seen what climate change, especially the floods, can do,” said Elias Byamungu, the CAO of Kasese district.
He added that he had directed the redistribution of over 80 staff from Kilembe Mines hospital to facilities within Kasese municipality.
Byamungu added, “Stakeholders shall sit and agree on the reconsideration of Buhunga Health Center III to cater for the Kilembe community. Kilembe Mines Limited was given a license to operate Kilembe Mines hospital under simple structures that water cannot reach. A few staff provided by the government might remain at the hospital”.
On the contested hospital equipment, Byamungu said, “The church says it is them that solicited for the equipment internationally. A hospital is required both in Kasese town and in Kilembe. We need an alternative hospital for our people in Kilembe who might not afford specialized medical care at a private facility like Mt. St. Mary’s hospital”.
Emmanuel Ainebyona, the senior public relations officer in the ministry of Health, insisted that the commodities that Kilembe Mines hospital has been receiving will be diverted to other health facilities within Kasese municipality.
“Kilembe hospital had become prone to floods from the River Nyamwamba. We are going to establish a hospital in a new location to ensure the community keeps receiving medical care.”
“If the community has identified land on which a Kilembe mines hospital can be established, the permanent secretary should be informed in writing,” Ainebyona added.