Uganda: Disability and Death from Poor Medical Access

Namansa Patrick with his daughter Talegeruwa Julian. Julian fell while she was running and hit her eye on a rock. Patrick took Julian to one health center and two distant hospitals, and was then referred to the national hospital for treatment. Patrick asked a doctor at a regional hospital how much money it would cost to fix her eye, and was told $300. Patrick’s family earns $50 a year. Image by Jae Lee. Uganda, 2015.

Naisanga Mary with two of her surviving children. Her first child died 10 years ago from malaria when he was 2 months old, and her fifth child died five years ago, also from malaria when he was 4 years old. Naisanga Mary went to the health center with both children—each was given insufficient doses of medication. The nurse at the health center instructed Mary to buy more medicine from private facilities, but she could not gather the necessary two dollars in time. Image by Jae Lee. Uganda, 2015.

Isabirye Wilson with his daughter Mbwari Margaret. Wilson noticed that Margaret had abnormalities in her left foot and both of her wrists when she was around 6 months old. Wilson took Margaret to three different health centers and the regional hospital, but the surgery to treat Margaret cost around $300, an impossible amount for Wilson to raise. Image by Jae lee. Uganda, 2015.

Namaga Annet’s 2-year-old son died from malaria two years ago. She took her son to the local health center where they did not have the medicine he needed. Her child died while she was walking 25 kilometers to the next health center. Image by Jae Lee. Uganda, 2015.

Nabulunga Irine’s 2-year-old daughter died from malaria five months ago. She went to two health centers—neither one had medicine. While she was trying to borrow money from her neighbors to buy medicine in a store, her daughter died. Image by Jae Lee. Uganda, 2015.

Ngunju Yakut with his mother Nabaigwa Safina and his father Basoma Idi. Yakut hurt his left knee while squatting over a latrine four years ago, and his parents took him to two health centers. The latter health center referred him to the regional hospital, but the parents did not have enough money for surgery. Yakut now walks with a heavy limp and cannot work. Image by Jae Lee. Uganda, 2015.

Namukose Prossy with three of her surviving children. Six years ago, her second child died from malaria. She took her two-year-old child to two different health centers, but could not find any medicine. The child was sick for one-and-a-half weeks and died while Prossy looked for treatment. Image by Jae Lee. Uganda, 2015.

Logose Eve and Sem Baker’s two-year-old son died from malaria a year ago. The first two health centers to which they took their son did not have any medicine. The third health center, one-hour away by motorcycle, on poor dirt roads, had medicine. By the time they reached the health center, the child was unconscious. They were referred to the regional hospital, but Baker insisted that they needed to return to their village to gather enough money for treatment. Their son died on the way back to the village. Image by Jae Lee. Uganda, 2015.

Namukose Mary with two of her surviving children. Two years ago, her first child died after two days. When her two-year-old child had a high fever she took her to two different health centers, but could not find any medicine in time. Image by Jae Lee. Uganda, 2015.

Wamusudiza Gertrude with her son Nsasi Alvin. When Alvin was around six months old, Gertrude noticed that he had begun to regress in his development and that his head kept enlarging. She took him to three health centers and a hospital. At the hospital, she found that the boy had hydrocephalus (a treatable condition in which a child accumulates excess fluids in the brain). She also found that the procedure to remove the excess water would cost $200. Her household income is $30 a year. Image by Jae Lee. Uganda, 2015.

In rural Uganda, it often takes days to access basic medical care. Health centers are scattered throughout the country, but they are grossly understaffed and underfunded.

Uganda has a referral healthcare system, in which smaller local health centers refer patients to larger ones based on a rudimentary triage hierarchy and availability of providers and medicine. The health centers, both large and small, often lack the most basic necessities—in one of the highest endemic malaria areas in the world, health centers frequently do not have medicine to treat malaria.

Traveling to a medical facility can be difficult: In many remote villages, not a single person has access to motorized vehicle transport. In some villages someone may make a living by giving taxi rides on a motorcycle. But in other villages riding a bicycle for hours to reach a health center becomes necessary.

Delay in medical care leads to many preventable disabilities and even deaths. It is not uncommon for patients to go to more than three different health centers through the referral system and still not find the basic healthcare that they need. A lack of funding for staff and medicine hampers healthcare delivery on every level.