The people are locked up by water for a very long time now. There is no nearby medical facility and school for people who live there and as a sub-county, we are limited in resources to have some of the key issues addressed.
“The first time I got labor pain, that was by the beginning of December, 2019, my husband and I went to hospital. When we reached there, we stayed for a week and nothing happened. We decided to come back home and wait for the day, when the pain came back again, it was too late,” narrates Margaret Auma, a resident of Angaro village.
For the past seven months, residents of Angisa parish in Magoro sub county- Katakwi district which is found in the north eastern part of Uganda, have been wading through a flooded road to access social services and for Auma, as one of the dozens of mothers who delivered from home, she has migrated to rent a house near the health center.
The floods, as a result of torrential rain, have submerged the main 15-kilometre marram road that connects locals of Angisa to the nearby health facility of Magoro Health Center III (HC III) and schools.
A journey which initially takes one hour by bicycle, now takes 5 while other road users use boats to sail over the waters.
Since 26th December, 2019 when she delivered her child at home, Auma has moved to Magoro trading centre, a few meters away from Magoro HC III and according to her, her aim is to hang around until the baby makes at least a year old.
“To avoid more challenges for the baby, I agreed with my husband to come and get this house here so that we can access the hospital incase of anything,” said Auma.
Paul Emorut, the LCI Chairperson for Apopong village in Angisa Parish said that “since June last year, no district official has visited us in Angisa. Even during the vaccination, only a half of the children were vaccinated because the health workers were caught up by the deadline before they completed the work.”
He adds that; “in order to access any health service, like if you have diarrhea, you have to plan of spending a night at a relative’s house in Magoro sub county.”
According to Emorut, people in Angisa live a life of isolation since the outbreak of floods in June, 2019.
He also reveals that, about 6 people have died while trying to cross the water from Angisa to Magoro to access medication from the nearby health center III, which is at the sub county.
Ms. Kolostika Alungat, a resident of Aboborei village in Angisa parish and also doubles as the Councilor for elderly and Secretary for Health at sub county level, confirmed that between June to December, 2019, more than 10 women have given birth at home due to the inability to access the health center.
“When I visited some of these mothers, I also learnt that they used black polyethene bags that we use for carrying sugar from shop, as an alternative to a mackintosh,” narrates Alungat.
She adds that; “the rate of poverty is also a major contributor to some of these challenges. You can find that a household does not have shs 10.000 for transport by boat to cross over to Magoro.”
Alungat attributes the elevating poverty levels to the floods which hit the area. According to her, people had harvested enough cassava, sorghum and potatoes that would be sold, but when water came, there wasn’t even a dry ground to place any of these harvests.
“I am also a victim. My husband almost got buried in that house when it collapsed. These barely a place to lay a head for sleep,” she recalls.
Judith Asekenye, a women councilor for Magoro sub county has called for any immediate intervention in form of support of any kind from both government and any other well-wishers.
Mr James Alemu Emongot, the sub-county chairperson, said that his attempts to get help from the district to help the people living in Angisa have gone futile.
“The people are locked up by water for a very long time now. There is no nearby medical facility and school for people who live there and as a sub-county, we are limited in resources to have some of the key issues addressed,” said Emongot.
According to Mr Emongot, the parish has nearly 1,000 residents, whose livelihood depends on subsistence farming and cattle rearing.
WHAT IS ON GROUND?
Although many of the health facilities are poorly functioning, accounts by medical workers and community members to Aica paint a picture of uncertainty.
For example, locals from Tiisai village have to plan two days ahead before trekking to the nearby Bisina HC II, and in some cases, when there is no medicine in the health facility, they have to move more 20 Kms to Magoro HCIII.
Mr. Samuel Amali, the Ag. District Health Officer (DHO) for Katakwi, discloses that access to health facilities in the district remain a great challenge.
“Most of these people live in the areas of return. Initially, there was no settlement in those areas for a very long time due to insurgencies, but now due to the prevailing peace, people have gone back to live there,” said Amali.
He adds that; “What we now emphasize for the people leaving such areas is that, they move to the hospital early before the pregnancy becomes an emergency case. But the challenge we face is that, they (community) have not fully cooperated.”
The villages listed as areas of return in Katakwi district include: Angisa and Tiisai in Magoro sub county, Iising, Okulonyo and Guyaguya in Usuk sub county, Akoboi, Aeselem and Ongongoja all in Ongongoja sub county.
The named places of return have a minimum range of 15 – 20 Kms to the nearby health facility.
Amali further revealed that some of the HC IIs were not operational to the standard due to lack of staff, and the rest are struggling due to inadequate workers.
While the ministry guidelines were that each parish was to have a HC II, 112 parishes and wards in the district don’t have the facilities.
“In fact, we have written letters to the Ministry of Health and other government offices requesting them or the Office of the Prime Minister to come and construct new facilities to these areas of return, but there is no feedback,” said Amali.
Katakwi has 6 doctors, an operational theatre at the district hospital and 14 midwives.
“The number of health experts is enough. The only major challenge is that, patients prefer to run to hospital at an emergency state,” lamented Amali.
NO MORE CONSTRUCTION OF HEALTH FACILITIES
In 2016, government announced the phasing out of the HC IIs over what was called unsustainable budget.
At that time, the Minister for Health, Jane Ruth Aceng said that HC IIs would be phased out and resources re-channeled to HC IIIs in order to make them more accessible and efficient.
Although there are 108 parishes across the district, there are only 16 functional HC IIs, 7 HC IIIs, 2 HC IVs, and a General hospital at the district.
According to the policy, each HC II is supposed to have nine government employees; an enrolled nurse, a midwife, two nursing assistants, two potters, two guards and a health assistant, however, majority of them are understaffed.
The public health services delivery starts with Village Health Teams (VHTs), Heath Centre IIs, health center IIIs, and health center IVs, district hospitals, regional referral hospitals and national referral hospitals.
DISTRICT LEADERSHIP SPEAK UP
The Chief Administrative Officer (CAO) for Katakwi, Mr Saraphine Aliya accepts that the district has not done much to help the affected areas.
According to him, for cases such as the areas that require health facilities to be constructed, as a district, they cannot make their own decisions to construct more health centers.
“We all operate under law and national policy guidelines; we cannot make our own decisions. If we decide to construct a health facility somewhere, where shall we find the money to fund it as a district?” asked Aliya.
On the cases of flooded roads, the CAO attributes it to what he calls the extreme effects of Climate change.
The district Chairperson, Walter Elakas Okiring also attributes the challenges faced with the health sector in the district to climate change.
For Elakas, what is more important at this time is to seek for adaptation measures to climate change.
“As a district that is affected and a country at large, we have to brainstorm for preventive measures to avoid such cases from re-occurring as government is doing its best to make improvements in the health sector,” the Chairman said.
The second rain season has reached its peak in most parts of the country and heavy rainfall has caused many destructive flooding in several low lying parts of the country and landslides in the Mountainous parts of the Country. Destructive wind and hailstorms have ravaged plantations and crops across the whole country.
A number of villages in the districts of Bukedea, Serere, Ngora, Katakwi, Amuria, Kapelebyong, Tororo and Otuke are submerged, however, no injuries reported as residents had early shifted to safer locations.
Murchison falls got filled up submerging the tourist viewing rocks, protection fencing and access staircase and the River Nile cut off road transport to West Nile sub region when its submerged the road near Pakwach bridge.
Government has continuously sent out warning messages urging the population to keep away from river banks, and steep slopes.