Hope for Kilembe Mines hospital reconstruction hangs on prospective copper mining investors

The recurrent flooding of River Nyamwamba and other main rivers in Kasese district has caused a lot of damage to infrastructure, property and lives but perhaps the biggest loss of all has been the breakdown in the healthcare system.

Once known for its orthopedic specialization in nearly the whole western Uganda, Kilembe Mines Hospital is a shadow of its own after being hit twice by the flooding Nyamwamba river between 2013 and 2020.

 After the hospital run by the government of Uganda, Kilembe Mines Limited and the Catholic Diocese of Kasese in a tripartite arrangement was flooded on May 1, 2013, the facility was rehabilitated and normal functions restored months later. 

However, more destruction to the infrastructure at the facility was brought down by the floods of May 2020 leaving the authorities with no option other than temporarily relocating the services to Kasese town with one of the partners; the Catholic diocese offering buildings.  

The status of the Kilembe Mines Hospital would later in 2020 become unclear after the diocese moved a step to establish its own facility now known as Mt St Mary’s hospital in the same buildings where it had hosted the one under the partnership. At the time, the people of Kilembe who have benefited from the facility since the mining times, demand that the services be returned but delivery of equipment was done in piece meal manner hence leading to more questions than answers.

To some extent, the diocese was accused of holding on to the hospital staff and equipment only to be revealed later that the tripartite agreement had expired in March 2022 and was not renewed. Equipment belonging to Kilembe Mines hospital was to be taken back to the original premises but operating in buildings that used to host the social centre before the copper mines were closed in 1970s.

Amidst the confusion over the status of the hospital, the Ministry of Health withdrew the credit line from the Joint Medical Stores which meant that the facility was not going to receive medical supplies that were warranted through the tripartite agreement. To the local community and leaders, this decision meant nothing but the closure of Kilembe Mines Hospital and this was greeting with protests.

Parliament early this year instructed the Committee on Health to look into the matter of Kilembe Mines Hospital after Members of Parliament from Kasese District raised the matter demanding for answers to the questions from the community.

Committee report 

The long-awaited report was last week presented by Dr Charles Ayume the Health Committee chairperson who informed Parliament that there is no ware the facility can be restored in its original place because it would still be destroyed by floods in the future.

The Committee however, informed Parliament that much as there are plans to build a new facility at a raised site, there is urgent need to provide essential medicine to the affected population so that they can be treated in the safer buildings where the hospital is operating from currently. 

Currently, the remainder of the facility operates informally with no board of directors, no laboratory accreditation documents and no official stamp. It is being run by the Kilembe Mines Limited, Kasese District Local Government and Kasese Municipal Council which is also an informal arrangement since the expiry of the tripartite arrangement. These three entities do not have the capacity to procure essential medicines something that has left the medical staff idle.

All the 79 staff apart from Dr Edward Wafula the Medical Superintendent who opted to remain with diocese’s Mt St Mary’s Hospital in Kasese town, remained stationed at the new site of Kilembe Mines but most of them being redundant since there are no supplies for their departments.

“The Committee was informed that being a private not for profit health facility, Kilembe Mines Hospital used to receive Primary Health Care funds from the Ministry of Health and a credit line for Essential Medicines and Health Supplies (EMHS). The annual allocation to the hospital was Shs368 million for primary health care and UGX 353.4 million for EMHS” reads part of the report. 

After the deactivation of the credit line for the EMHS, Dr Diana Atwine the Permanent Secretary in the Ministry of Health directed that that medicine should be distributed to other private but not for profit health facilities across the District. 

These are; Kagando Hospital, Katadoba Health Centre III, St Paul’s Health Centre IV, Buhaghura Health Centre III, Kanamba Health Centre III, Kasanga Health Centre III and Kingamaseke Health Centre III. Others are Kyarumba Health Centree III, Maliba Health Centre III, Mushenene Dspensary, Nyabugando Health Centre III, Rweseande Health Centre IV, St. Francis of Assis Kitabu and Rukoki Health Centre IV a government facility.

The committee’s report reveals that the hospital is managed by Kilembe Mines Limited, Kasese District Local Government and Kasese Municipal Council but it is operating informally, has no board, no laboratory accreditation documents, and official stamps.

“Kilembe Mines Limited wrote to the Chief Administrative Officer (CAO) of Kasese District Local Government on 05 February 2022 requesting for continued partnership with the government in managing Kilembe Mines Hospital but no response has been received”, Ayume said adding that, ’the same request was transmitted to the Permanent Secretary, Ministry of Health but there is no response to date’.

Ayume added that, the Chief Administrative Officer wrote to the Solicitor General seeking legal interpretation of the status of the hospital with no response.

While debating the report of the Committee, MPs from different parts of the country expressed concern over the failure by the government to takeover the facility after the Catholic Church pulled out of the agreement. 

“Currently, the procurement of medicines and supplies at Kilembe Mines Hospital is through user fees and a monthly allocation of Shs7m to Shs9m provided by the District. The Committee recommends that the Ministry of Health should restore the credit line for Emergency Medicines and Health Supplies for Kilembe Mines Hospital in the last quarter of this financial gear to enable the facility operate optimally” adds part of the report.

Also in the committee report, it was established that the hospital has no legal status within the government structure which has an impact on the management and resources for running the hospital.

Kasese Municipality Member of Parliament, Kambale Ferigo said it is important that the hospital credit line for medical supplies is reactivated.

“The decision to deactivate the credit line for medicine after the floods really shocked us and it was as if the ministry had declared all of us dead. Our position as the leadership is that we need medical supplies to urgently be given to the hospital. Deciding to build the hospital is a long-term plan. We need medicine now,” he said. 

Kasese District Woman Representative, Florence Kabugho highlighted the issue of Rukoki maternity ward which got burnt 18 months ago.

“Up to now, the government has done nothing to rehabilitate the ward.  It was the Rotary club and the people who fundraised to roof the ward. But women are still giving birth under trees”, she said.

The Minister of State for Health (General Duties), Anifa Kawooya said that they have had several engagements with Kasese District leadership and that they are implementing some of the recommendations.

She revealed that they are upgrading Rukoki Health Centre IV to a district hospital.

“In the meantime, the ministry is putting up a health facility to serve the population of Kilembe,” she said.

With the hope for the restoration or rebuilding of Kilembe Mines hospital lying on when the government will get an investor to takeover the copper mining concession, the nearest health facility to be built to a hospital status is Rukoki Health Centre IV. 

Prime Minister Robinah Nabbanja mid last month informed Parliament that so far Shs2b has been earmarked to help in the rehabilitation of the old buildings as the Ministry of Health is finalizing the technical drawings and bills of quantities for new structures.