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The East African : Nov 3rd 2014
The EastAfrican 34 OUTLOOK NOVEMBER 1-7,2014 D E VE LO PME N T National disaste≥ cent≥e fo≥ Kampala By B. MUSINGUZI Special Correspondent EACH YEAR for the past two decades, more than 200,000 Ugandans have been affected by natural and human-induced disasters. In 2000, for example, Disused and dumped medical equipment at the Soroti Hospital. Picture: Halima Abdallah Dumped ‘donations’ now a burden on Ugandan hospitals So≥oti Hospital is an example of the eme≥ging t≥end of dumping medical ewaste that comes disguised as donations By HALIMA ABDALLAH Special Correspondent T he pile of metal and plastic material fenced off out- side the medical equipment workshop at one end of Soroti Referral Hospital in eastern Uganda could easily pass for a scrap yard oif only it were not under lock and key. “We have to store the items appropriately while awaiting disposal, else people will tamper with or misplace them. We have to check them from time to time for leakages,” said Dr Pious Okong, Health Service Commission chairman. This is not just any junk but electronic medical waste that has been classified as hazardous. The items include X-ray machines, CT scans, washing machines, electronic lamps, electrical beds, computers, boilers and ultra sound ECG equipment. “These items have radio- active materials, but we do not have the capacity nor the legal system to have them disposed of,” said Dr Joseph Epodoi, consultant surgeon at Soroti Hospital. The equipment came in as donations but it later emerged that it was being dumped. Incidentally, Soroti hospi- tal received most of the items at a time it was desperate for diagnostic equipment and other medical supplies. “Until 2005, we used to get donations from well-wish- “It’s an old machine; I would say it is dumping because we were given an old model.” Dr Asuman Lukwago, PS, Ministry of Health, Uganda ers but they would bring in junk equipment, which was either not working, or which we could not assemble completely. For example, we discovered that the ultra sound ECG was not working,” said Dr Epodoi. The World Health Organi- sation has developed guidelines for health care equipment donations to ensure they benefit the recipient to the maximum. According to the guide- lines, if the quality of an item is unacceptable in the donor country, it should also be unacceptable as a donation. In addition, there should be communication and followup between the donor and the recipient to assess successes and failures of the donated equipment. The EastAfrican has learnt that none of the donations to Soroti hospital met the WHO guidelines. “The problem is every- where. In the long run, the junk will destroy the environment and health of our people,” said Dr Epodoi. Indeed, Soroti Hospital is a microcosm of an emerging trend of dumping medical e-waste that comes as donations to poor, desperate countries like Uganda. At the National Referral Hospital Mulago, a magnetic resonance imaging (MRI) machine, which was brought in 2011, is still lying idle, never mind that the few private clinics offering such services are charging eorbitant fees, with a diagnosis costing as much as $350. Appearing before the Par- liamentary Public Accounts Committee to answer queries that the Auditor General raised about the MRI machine, Ministry of Health Permanent Secretary Dr Asuman Lukwago explained that $48,000 is needed to fix it. “It is an old machine… and I would say it’s dumping because we were given an old model, but is it necessarily dumping? Our choice was fair enough not to reject it. We just need to remodel it and import some things,” Dr Lukwago told The EastAfrican shortly after meeting the parliamentarians. But not everyone agrees with Dr Lukwago. “Yes, at that time the hospital was desperate, but the notion of a beggar having no choice must change. If you are bringing us what you do not need, you had better take it back,” said Dr Epodoi. “We are not substandard SCRAP YARD At Soroti Hospital, donated X-ray machines, CT scans, washing machines, electronic lamps, electrical beds, computers, boilers and ultra sound ECG are gathering dust at what looks like a dumpsite. At the National Referral Hospital Mulago, an MRI machine, which was brought in 2011, is still lying idle. The machine requires repairs before installation. In addition it needs specialised housing. What is more, it is emitting radiation — a health and environmental challenge. human beings. Human beings should have the same quality of life. If you are living for 100 years in Europe it is the same time we would want to live here in Uganda,” said Dr Epodoi. Repairing the machines is not only expensive but finding the spare parts as Dr Lukwago suggests is difficult. In addition, some donated items do not fit in with the electric systems in the country. For example, the hospital received an electric bed donated by Friends of Canada but it blew because of high voltage. “When giving us items, they should consider voltage. Uganda uses upto 240kv but those items cannot take more than 110kv,” said Gershom Obula of Soroti Hospital. Uganda has been responding to emergencies — like the landslides in Bududa — as they occur due to inadequate resources and poor information flow. Picture: Morgan Mbabazi epidemics killed 224 people while in 2002, drought affected 655,000 people, killing 79 persons. In 2008, drought affected 750,000 people while in 2010 landslides killed about 250 people and displaced 8,500. In the same year, floods affected over 350,000 people. These disasters result in enormous losses. For example, in 2007, the government and its development partners required more than Ush100 billion ($36.7 million) to respond to the Teso floods that affected more than 300,000 people. “Enormous resources that should have been utilised for development are spent on responding to such emergencies,” said Vice President Edward Kiwanuka Ssekandi. This scenarion is ex- pected to change now that Uganda has established the National Emergency Coordination and Operations Centre (NECOC), a 24-hour, 7-days a week central facility for early warning, disaster and climate modelling and forecasting, emergency response and recovery coordination, and disaster information. It has been established under the National Policy for Disaster Preparedness and Management as part of an integrated and multisectoral systems approach to planning, preparedness for, and management of disasters. The centre is equipped with the latest digital communications technology. It also has a mobile command and control truck and rapid assessment and response vehicles. The facility, which is housed in the Office of the Prime Minister in Kampala, has been funded by UNDP at a cost of $350,000 Office of the Prime Min- ister Permanent Secretary Christine Guwatudde said Uganda has been responding to emergencies as they occur due to inadequate resources, inadequate early warning systems, poor information flow and inadequate co-ordination. Ms Guwatudde said that since April 2011, when the National Policy for Disaster and Management was approved, the focus has shifted from disaster response to prevention, mitigation and preparedness. In setting up the centre, UN resident co-ordinator and UNDP representative Ahunna Eziakonwa-Onochie said the UN employed its “Delivering As One” system with UNDP using its experience in setting up similar facilities in countries such as Ethiopia to provide technical support while the World Food Programme provided the equipment which will enable satellite data to be available in real-time. On its part, Unicef has installed an interface to its U-Report system for further integration of information. Unicef is working with the Office of the Prime Minister and UNDP to get volunteers who can help with data gathering, disaster monitoring, early warning, and emergency and recovery response.
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