BY ROBERT ATIKU

MARACHA: The management of St Joseph’s Hospital Maracha is lobbying funds for construction of a new, well equipped neonatal intensive care unit.

The hospital provides curative, preventive, promotive and rehabilitative health care services to the population of Maracha, Koboko,Yumbe, Arua, South Sudan and Eastern parts of DRC.

St Joseph’s Hospital Maracha is a non profit private hospital, then only hospital in Maracha district that receives all referrals from lower units. It has served the population since 1952. In 1953, it was upgraded to a dispensary and then maternity home run by the Comboni Missionaries.
In 1972,the health unit became a fully fledged hospital still under the management of the Comboni Missionaries and it was later handed over to the Catholic Diocese of Arua in 1985.

The hospital has a catchment population of over 24000 people and it served a total of 13000 patients last year.

Mrs. Stella Anguparu a resident of Nyamio village, Micu Parish Oluvu subcounty attends to her baby in one of the incubators at Maracha hospital on Tuesday. PHOTO BY ROBERT ATIKU.

Current state of neonatal unit

The Maracha hospital neonatal unit is currently housed in a small room curved out of pediatrics department within the hospital.

According to Dr. Alphonse Taban, the Medical Director of the hospital, the unit has limited capacity with ill equipped medical equipment which are not commensurate with expected modern medical equipment standards.

“This unit has a bed capacity of six and yet we receive ten babies on average in the unit at any given time. The two incubators are of 20th Century and don’t meet current medical recommendations for incubator technology. We have no functional phototherapy machine, no baby warmers and neonatal monitors.” Dr. Alphonse revealed.

The medical director identified the other challenges facing the unit as lack of qualified staff such as neonatal intensive care unit nurses and neonatologist. And that resuscitation kits as well as oxygen concentrators are inadequate.

According to Ministry of health annual performance survey in finacial year 2016/2017,Maracha district was ranked the fourth worst place in Uganda to be born as a child.

Neonatal mortality within the district then was 48 deaths out of 1000 live births. The leading causes of neonatal mortality were identified as birth asphyxia, sepsis and prematurity.
Findings in the Survey indicated that the biggest factor for high neonatal mortality rate was the lack of neonatal intensive care unit, poor monitoring of labour and delay in referrals of mothers to Maracha hospital from the lower units.
The hospital management then started the current neonatal intensive care unit(NICU) in 2018, reducing neonatal deaths to 29 per 1000 births.

However, the hospital’s previous line graph shows the trend of neonatal mortality over four years. It revealed that there has been an increasing number of babies dying during or within seven days of birth from 2014 to 2017. Although the interventions, currently the situation is not changing for the better.

Latest details in neonatal unit admissions record book indicates that out of 304 newborns admitted in Maracha hospital NICU between February to October this year, 20 died.

 

Project Funding strategies

Maracha hospital plans to raise funds for the project through a number of strategies. These include : Fund raising run on 14th of December 2019 in Maracha. The hospital is also seeking donations from members of public in kind, cash and pledges, support from co_operate institutions, business communities, NGO’s, Donors, support from diaspora and government. There are also arrangements to organize fundraising dinner and music shows to mobilise resources for the same cause.

Unicef has already contributed neonatal intensive care unit equipment worth shs 29 million. Tickets worth shs 1.3 million are already sold for the fund raising run. And Engineer Sunday Aita a son of the soil has pledged 100 trips of sand for the works.

The fund raising run is organised on the theme : Our newborns, our hospital, our future.
Mothers of admitted newborns speak out

Mrs. Stella Anguparu from Nyamio village, Micu Parish, Oluvu subcounty who has been admitted at neonatal unit for weeks after giving birth to low weight twins (one later died) said, “I have been admitted here for more than two weeks already. The doctor says my babies were born prematurely, hence the low birth weight. The surviving baby weighed less than 1.5 kilograms. This room is squeezed and we sleep on the floor since it’s not possible to place beds for mothers here. When the baby cries at night, you get up and sit on this stool and breastfeed it before you can get back to sleep on the floor.” Mrs Stella explained.

Mrs. Eunice Draru from Amanipi village, Kamaka Parish in Oluffe subcounty said, ” I was admitted here after I gave birth to a low weight baby who was unable to breath properly and could not breastfeed. The medical workers are doing their part to help my baby. And I see a lot of improvement. We have limited spacing here but I think it will be a good idea to construct new unit for the new borns. It will help to improve services to our newborns. My kid wouldn’t be alive by now if this facility wasn’t existent.” Mrs. Draru commented.

Comments from staff

The hospital administrator Mr. Richard Alijoa said, ” I am a survivor of neonatal unit services at Kuluva hospital. Stories are told that I was born with very low birth weight. My relatives never expected me to survive. I wouldn’t be the administrator of this hospital now if other people didn’t think of offering such services. This unit is very important for our future generations. We need funds to establish this unit. We need to support children who are born in that state to make them survive. We need to reduce death rate at infancy stages of our communities.”

“It will be important for the hospital to put up neonatal intensive care unit separate from general ward so that it is easy for the staff to manage NICU on its own. Sometimes you find that a child is brought to NICU. And if you are two on duty, you’re supposed to leave the other patients in general ward and rush to help the emergency because those are babies with low body immunity.” Rev Sr Joyce Ambeifoc, the in charge general ward said.

The Belgium Technical Cooperation (BTC) has been the partner for result based financing under Ministry of Health project and they have been providing 48 percent of the annual budget and income required to provide services at the hospital since 2015. But the medical director says at the end of this year, BTC will wind up their project at the hospital. Other funds are raised from the user fees. The government of Uganda through Maracha district supports medical human resource with 12 percent of staff and Primary Health care non wage funds with 24 percent of the annual budget.

St Joseph’s Hospital Maracha has 92 medical personnel and 80 non medical staff offering services at the facility.

Other services available

Out Patients Department services (OPD)

Surgical services

Maternity services

General ward services

Nutrition unit services

Private wing services

T. B unit services

Neonatal intensive care unit services.

Xray and Ultra sound services

Laboratory services.