Up to international hospital Kampala today (IHK).a private hospital, this is probably the most well known in Kampala. Our contact, Diane, was kind enough to show us around the westernised hospital, it has similar facilities and lay out to our hospitals. However, Diane has been working as a volunteer here for two years and has tried to implement simple changes to improve service with variable success due to the managements reluctance for change.
We then went on to visit Kisugo hospital, a smaller midwifery led centre with limited resources recently developed to offer in-patient maternity services. It is a completely government funded hospital servicing the slum area of Kampala. This is a very different picture to what we'd seen previously at IHK. Due to lack of resources they almost lost a baby due to not having a bag and mask to resuscitate. Because of the unreliability of government funding and politics they are constantly faced with issues such as removal of clinical waste products. They can often wait up to four weeks for collection, meanwhile it is stored underneath maternity stairwell and as you can imagine the smell is overwhelming. To ease the problem of costs of removing waste labour ward midwives have been asked to wring out bed clothes and sanitary waste to reduce the weight as it is priced per kilo.
Since the opening of the labour ward a few months back the number of deliveries there has risen from 20 to 180 month. Although the midwives here have limited resources and work under very difficult circumstances they are very experienced in their role and showed true passion, grit and determination during our short stay; this seems to be partly due to the fact that they are truly autonomous in that no Drs are based at the centre and therefore they were free to express their valuable opinions and lead all care decisions to their own high standards.