By STEPHEN KAPAMBWE –
It is a few minutes past 08:00 hours in the morning, the beginning of what would have been yet another ordinary day at the University Teaching Hospital (UTH) in Lusaka. But that was changed by the arrival of a motorcade carrying Vice-President Guy Scott.
Dr Scott was on an impromptu visit to the UTH where he sought to establish the validity of rumours reaching his office that all semblance of sanity had broken down in the management of the hospital.
The Vice-President, who was accompanied by senior private secretary Robert Kamalata, was welcomed to the hospital by Health Minister Joseph Kasonde and UTH managing director Lackson Kasonka. He was ushered to Dr Kasonka’s office where he immediately requested to be brought to speed on what serious setbacks faced UTH.
His main concern was the speed at which combined efforts of Government and management where paying off in replacing nurses that where dismissed following the firing of some nurses in December last year for striking illegally.
Dr Scott also wanted to know the water supply situation at the hospital, the way patients were being treated and whether the institution still had problems with its oxygen plant or the availability of adequate stocks of life-saving drugs.
“We received in the last two weeks 116 (newly employed) nurses, so you can see that we are getting back to the normal situation. There were 215 nurses that were dismissed but that number included nurses that were erroneously dismissed, because either they were on leave, or they were away in school, so the actual number of those that were dismissed is less than 215, specifically 130 or 133 there about,” said Dr Kasonka.
Dr Kasonka, who told Dr Scott that understaffing was the biggest problem obtaining at UTH, explained that though slow – replacement of nurses was almost complete.
Dr Kasonka said the 1,800 bed capacity UTH which had an establishment of over 3,000 employees required at least 1000 nurses for it to operate smoothly. He could not divulge the shortfall.
Health Minister Dr Kasonde informed Dr Scott that the issue of the dismissed nurses which affected public health institutions countrywide was still being handled by the Public Service Commission.
He said affected nurses had appealed against their dismissal and he was hopeful that the Public Service Commission would speedily dispose of the cases of appeal.
Dr Kasonka also informed his visitors that as regards water supply to the institution, the situation which in the past used to be alarming, had been resolved by the installation of strategic water reserves in addition to the normal water storage facilities available at the hospital.
Dr Kasonka also took the opportunity to update Dr Scott on the new oxygen plant which he said was producing enough to cater for UTH as well as other health institutions.
The drugs situation at the hospital was equally manageable. Though the hospital had isolated shortages of non-essential medicines, it had steady supplies of life-saving ones like antibiotics, anti-cancer and other drugs that are deemed essential for the UTH-type level of hospital.
But the rise in population in Lusaka has caused another problem for the hospital which required Government intervention rather than managerial acumen.
A few years ago, the UTH maternity ward used to have a daily birth rate of 35 to 40 babies on average. That number had risen to an average of 75 babies in 24 hours causing a situation where sometimes mothers admitted in the maternity are placed on mattresses on the floor.
Unfortunately, the solution to this problem lay beyond UTH.
“It is not the cost of the beds that is prohibitive,” said Dr Kasonka when asked if it was possible that UTH could increase its capacity to better accommodate those admitted to the maternity ward.
“It is the space where to put the beds which is unavailable,” he said.
However, both the Ministry of Health and that of Community, Mother and Child Health were trying to address the issue by up-grading a total of six health centres into mini hospitals in Lusaka.
Of the six, work had already started at Chilenje and Matero health centres.
According to Dr Kasonde, the hospitals that would be upgraded would have greater capacity to handle ordinary maternity cases while UTH would be left with cases that had complications.
It is hoped that capacity improvements in health centres outside the UTH would reduce the flooding of ordinary maternity cases at the referral hospital.
But while the Government was working on improving capacity at facilities outside the UTH, management at the hospital has embarked on an ambitious programme of modernisation.
They include replacing the entire filter clinic which would be rebuilt from the scratch and equipped with better facilities, such as a modern dental section and a diagnostic section that would include radiography.
It is hoped that a new bigger and better equipped filter clinic would help to reduce the much-talked about congestion at UTH.
A bigger pharmacy that would better provide medicines for patients from the out-patient is also in the offing.
Although these and other changes that have already been set in motion will disturb the normal provision of clinical services to members of the public, the decision to implement them has been made in the public interest due to the growing demand for quality health care services.
Having heard the management’s side of the story, Dr Scott started his tour by going to see conditions at the maternity ward where he talked with patients that were admitted.
He later on went outside the ward to interview relatives that were waiting on their sick.
“What problems are you facing here at UTH,” he asked.
The relatives, perhaps shocked that Dr Scott had taken time to go and find out how they were fairing, had little to say, the few that spoke up said the problems that had prevailed at the hospital in the past had largely been resolved.
“What I can say is that the situation at UTH now is much better.
Previously, we used to have a lot of difficulties but this time, we are seeing light at the end of the tunnel through the many good things that are being done to improve this hospital,” said Gift Mumba who had accompanied a relative from Mutendere Township in Lusaka.
Christine Mwanza who had a patient from John Laing Township complained of inadequate ablutions especially for those tending their sick relatives at the hospital while Neg Chileshe who was looking after her sick niece said some wards still experienced erratic water supply and that kind of compromised the standard of hygine required for patients to get better.
Dr Scott then visited wards E11 and E12 where he spoke to patients, newly employed nurses and doctors all of whom expressed relief that Government was making progress towards addressing the problem of understaffing at UTH.
Addressing journalists after the tour, Dr Scott said there was need for the Public Service Commission to expedite the processing of hearing appeals and reinstating nurses that had been erroneously dismissed in order to normalise the staffing levels at UTH as well as at affected health centres across the country.
He expressed disappointment at the slow pace at which the nurses were being replaced as well as the slow rate at which cases of nurses who were wrongly dismissed were being handled.
“I am not impressed at the slow rate at which we have replaced the nurses or dealt with their appeals. I am going to have word with the Public Service Commission to see if they can accelerate that,” Dr Scott said.
However, Dr Scott was impressed with the work which the Ministry of Health and UTH management was doing in running the hospital amidst the daily challenges.
He said although there were issues that required to be addressed, he was generally impressed at the cleanliness and stocking of drugs at the hospital in spite of the many odds the Government and management were up against.
Dr Scott said he was impressed that the hospital was achieving good customer satisfaction.
He said he was not as disappointed as he feared from some of the gossip that had reached his office.
He described plans to modernise the hospital as impressive.
He said although it was becoming less fashionable in some parts of the world to have very big hospitals owing to inherent management problems, the management team at UTH was doing very well.
The move made by Dr Scott to embark on a fact-finding mission amidst several rumours that were being circulated to the effect that operations at UTH were drastically affected following the dismissal of some nurses can only be said to have been commendable as it put to rest some of the fears that gripped the larger population in the capital city as well as the general citizenry.