Hundreds of patients suffering from chronic multi drug resistance Tuberculosis in Acholi sub region have been left in a tight spot as Gulu Regional Referral Hospital admits lack of the MDR-TB drugs. 

The hospital TB ward can only accommodate 40 patients, but is currently holding double the capacity as the number continues to rise. The Isolated TB ward reception for those chronic TB cases is located 100 meters outside the main ward.  

When this reporter visited the hospital, patients were in a state of despair and the situation looked grim without the possibility of improving soon.

Caroline Lanyero, a nurse who was attending to Agnes Akello, 11, a patient receiving treatment for TB, said that she was very concerned.  She asked Akello’s mother Mrs. Grace Otto why the register card given to her daughter did not indicate that she was taking TB drugs. 

“When you give a patient the drugs, the card is supposed to be marked to indicate that the drug has been administered, so that whenever you administer the drugs, you know the dates and timescale, the drugs should last for twenty eight days, if a patient misses the drugs, we shall give other drugs to cover the days she has missed,” Lanyero explained. 

The next patient was Mr. Paul Okot, 56, who had been waiting patiently for any medication to alleviate his pain and wheezing. 

Lanyero questioned Okot where he was from and Okot responded: “Yes madam, I come from Lakwatime, 20 kilometres east of Gulu town,” he said in a weak, low-toned voice. 

After looking at Okot’s medical card, Lanyero politely said asked, “You too, you have not been taking your TB drugs why?” 

Okot said that he has been taking his doses promptly, and he still has more drugs to take for three days, but they were not the vital drugs. 

“My problem is that I do not know how to write and read.” Mr. Okot narrated.

Lanyero then directed all the TB patients who turned up for treatment on that Monday July 16, to leave their telephone numbers with their areas Local Councillors (LCs) for immediate contact when consignments of the TB drugs are delivered. 

However, the interview was disrupted when one of the medical sisters walked into the room and ordered the duty nurse to halt the interview since they had not been cleared to talk to the press.  Acholi Times was instead directed to Dr. Cyprian Odong, head of the Tuberculosis ward at the hospital. 

Dr. Odong said that although most of the TB patients are receiving some level of TB treatment at the hospital, 10% of TB patients who are on multi drugs resistance are being referred to Kitgum main hospital because Gulu Regional Referral Hospital does not have such drugs. 

Dr. Odong said that the Ugandan government does not supply the hospital with multi drugs resistance, but thanks to AVSI, one of the humanitarian agencies that has been working in Northern Uganda during the two decade insurgency, is providing the drugs to Kitgum main hospital.

“I have worked in Kitgum hospital for three years before I was transferred here, we were realizing good outcomes, all chronic Tuberculosis cases were being treated well,” Dr. Odong said. 

He said that Kitgum hospital has the best examination machine that has been good during his entire time working at the hospital. 

“We had an investigating machine X-ray for Chronic TB of the lung, a functioning laboratory that was doing competent work; we had teams of physicians and consultants we turned to before making decisions,” Dr. Odong said. 

According to Dr. Odong, the Ministry of Health says that it is conducting a verification exercise in the region to establish the extent of the disease, so that it is able to mobilize resources to enable it to import the TB multi drugs resistance. 

He said the major problem with chronic TB patients is that if they fail to complete their drugs regime, they will not get cured. 

He said another problem is that most TB patients live in remote areas that are hard to reach, making it very difficult to follow their progress, even though the Ministry of Health has provided motor cycles to make follow-ups. 

Dr. Odong said that the other challenge is the attitude of the carers, some of whom are abandoned and have to fend for themselves. 

“Relative do not take interest in looking after TB patients, after taking tablets, patients are required to take good nutrition, this needs a close relative, which some do not have,” Dr. Odong said. 

He said that although tracking TB patients was a major constraint, Village Health Teams (VHT) who work in outreach Health Centres II and III, had received adequate training. 

Northern Uganda still has the highest prevalence and percentage of TB and HIV/AIDS in the country. 

Dr. Sheila Baingana, a consultant of lung disease attached to the hospital, said that of the patients in Uganda with lung problems due to Tuberculosis, 70% will be HIV positive patients. 

Mr. Julius Nyerere, a TB patient at the hospital, told Acholi Times that he has been on TB treatment for 3 years now.

“I was admitted for TB treatment on March 13, 2011. I finished my treatment after 8 months, but later I was admitted soon after four month,” he said. 

He said that he has now been referred to Kitgum hospital for MDR drugs treatment, and that he is now only waiting for the transfer letter. 

Charles Otim, 56, is an occupant of the TB ward and still waits in hope that they will receive adequate treatment soon.

“My son, I have been admitted in this TB ward, I have been here for five months now and as you can see I don’t know when I will be discharge, or if I will be getting well.” Otim told Acholi Times. 

Otim’s hope for survival has faded, but he still continues taking his drugs. Thousands of TB patients will most probably die slow and painful deaths as the region lacks the adequate facilities to offer relief and give adequate treatment. Since the end of the war, NGOs have left a vacuum that has never been filled by the government of Uganda in the provision of services.  

Gulu regional referral hospital was built in 1934 during the colonial British administration as the main regional hospital for the Greater Northern Uganda, covering the then Karamoja sub region, Lango sub region, Acholi sub region and West Nile sub region, a region that is currently estimated to hold a population of 12 million according to Uganda population censure.