MakCHS collaborates with UPDF on improving health security

There’s a common expression that “together we evolve and alone we dissolve.” It’s in that spirit that Makerere University College of Health Sciences (Mak CHS) is collaborating with the Uganda Peoples Defense Forces (UPDF) so that the two can evolve and serve the country better in areas of health and national development.

For the collaboration to be effective a Task Force/Implementation Committee comprising some UPDF officers and staff members of Mak CHS was formed to implement the key points in the Memorandum of Understanding (Mou) signed by the two partners. Thus the month of April saw the Implementation Committee go on a familiarization tour; first at General Military Hospital (GMH) Bombo to get an understanding of the UPDF medical facilities; and a week later the team had a guided tour of the CoVAB research and development facilities.

At GMH, the team was warmly welcomed by Col. Dr. Ambrose Oiko the Director of Public Health who represented the Chief of Medical Services Brig. Dr. Ambrose Musinguzi. After the welcome remarks and the introductions, Col. Dr. Oiko gave the microphone to Col. Dr. Ronald Nangamba, the Director of GMH to address the team and share the challenges and potentialities of the military hospital before he led the team on a physical tour of the hospital.

Col. Dr. Nangamba immediately delved into the diversity of challenges especially of the security nature that saturate the contemporary world, and how security considerations have therefore become a top priority for many countries, including Uganda.

“In line with its mandate of defending the country and contributing to the country’s development, the UPDF continues to play a role in the health security not only of its personnel but of the whole population as well,” said Col. Dr. Nangamba. “This however, requires innovativeness in order to engage current and emerging threats and challenges. This venture is resource demanding. Partnership in healthcare infrastructure, human resource and research among others is the way to go in order to address these challenges. GMH being the national referral hospital of the UPDF thus has a role to play in partnerships.”

He added GMH is equated to a regional referral hospital by the Ministry of Health because functionally it fits the billing of the national referral hospital. Although primarily a military hospital, it is also by practice a civilian hospital considering that many patients treated there are civilians. It being a military hospital but also a civilian hospital, and a referral hospital for the military but also a regional referral hospital comes with challenges. The hospital is officially a 100-bed facility but the average number of inpatients or admitted patients are 180 per day.

“We also have an average of 420 patients on a daily basis, and 75 percent of these are civilians and most of these come from the surrounding districts. This is Luwero District but we have patients coming from Wakiso, Kampala, Nakasongola, and from as far away as Karamoja, Kisolo, so the whole country is represented. And you need to note that these patients are not invited. We also get surprised that somebody comes from Kisolo, skipping all medical facilities along the way to be attended to at GMH. So the overwhelming numbers are exerting heavy strain on the available physical and human resource.”

Col. Dr. Nangamba enumerated the functions of GMH as follows:
1) To provide curative care
2) Provide preventive public health services
3) Optimization of troops before they are deployed to missions especially on health-related matters
4) Limited training of healthcare providers; we have partnered with some nursing schools to bring their students here for rotation and we are in advanced stages of becoming a teaching hospital of the proposed Ndejje University Medical School. Relatedly we are also a training centre of incoming health workers as posted by the Ministry of Health.
5) We are in many cases the primary health responders for health-related disasters especially those occurring in the central districts. Relatively GMH played an active role during the recent health workers strike; most of the health workers that were sent to address the challenge were from GMH. When there was an outbreak of typhoid in Kampala, GMH sent teams to respond. We have also responded to a number of Ebola epidemics and usually when such an occurrence happens GMH is expected to be the primary responder.
6) We also act as the reserve of healthcare for the military. So if there is an urgent need to deploy we provide doctors.
7) Mostly importantly GMH is taken as the one playing the core role of clinical research within the UPDF though much needs to be done. It pleases me therefore that there’s partnership coming on board which has a lot to play with healthcare-related research in the institution and UPDF being the most referral facility where most clinical cases eventually end, it will have to play a role in this partnership.

GMH has a staffing strength of 582 personnel, and is funded by the government of Uganda through the Ministry of Defense. The country’s healthcare sector is generally underfunded, so GMH as well feels the pinch because its budgetary allocation is meant to cater for the UPDF personnel and their dependents yet in practice those comprise only 25 percent of the patient volume, meaning that that 75 percent of the civilian patient that flock the hospital encroach on a budget that is meant to take care of only 25 percent of the patients. So this overwhelming number of patients who are primarily not budgeted for are creating a lot of strain on the physical infrastructure, the human resource (people get overworked because they are attending to far more numbers), on supplies etc.

Col. Dr. Nangamba concluded with the hope that the collaboration between UPDF and Mak CHS will “be used as an effective vehicle for addressing some of these challenges especially in the area of research where UPDF provides an almost virgin field for research.”

After the Col. Dr. Nangamba’s address, the team went on a physical tour of the military hospital and agreed that the collaboration would help in capacity building for the hospital through short-term trainings.