Uganda: Shortage of PPEs hinders fight against coronavirus

Many health workers in hospitals across the country are grappling with a shortage of COVID-19 personal protective equipment (PPE) despite the country continuing to register more cases of the disease, Daily Monitor has learnt.

The health workers say they are experiencing a shortage of medical facemasks, gumboots and coveralls despite the country being in stage four of the pandemic that is characterised by community spread.

A health worker at Mulago National Referral Hospital, who preferred anonymity for fear of reprisal from the senior management, said sometimes they share PPEs, meaning that the time of visiting patients inwards is reduced.

“You work with what is available; sometimes if you see only two health workers entering the intensive care unit, you know the PPEs have reduced. If you see six people entering, that means the supply has increased,” the health worker said.

Mr Richard Isabirye, the secretary of the Covid-19 taskforce in Mayuge District, said for about four months now, they have not received coveralls despite putting their request to National Medical Stores (NMS).

“Currently, we have to improvise because we cannot monitor confirmed cases when we are not protected. We are stuck, we have been using our own funds but the money is over,” Mr Isabirye said in an interview yesterday.

“I submitted my requisition to the Ministry of Health and NMS but up to now, they have not replied. For sure it has taken long,” he added.

Some of the lower health facilities who are not treating COVID-19 say they have had to improvise by buying cloth masks for their workers due to inconsistent supply of masks and gloves.

They also say given the shortage of PPEs, sometimes patients have to meet the cost, especially for gloves.

Last resort

Dr Hajj Eboga, the officer-in-charge of Kityerera Health Center IV in Mayuge District, said they had to make double layer cloth masks for their health workers to cut costs.

“We just buy facemasks for ourselves and one pack of face masks goes about Shs130,000, so I had to make cloth masks for our health workers to cut the costs. So they wash and iron them,” he said in an interview.

“It is a risk to use cloth masks in a health facility but what we use are double layer from cotton; it gives some protection but the mask alone is not effective. You do that and also implement other protective measures, social distancing,” Dr Eboga added.

He explained that because of the lack of steady supply from government, they are pushing the cost of buying some PPEs to patients.

At the beginning of the pandemic, the shortage of PPEs was attributed to the global high demand given that some of the medical facemasks and other coveralls had not been imported.

However, with the country experiencing the pandemic for nearly 10 months, the health workers wonder why the government has not purchased enough PPEs.

“We do not have consistent supply of PPE of all ranges; it can be a mask, gloves, and coveralls. This means a health worker is at risk of getting this Covid at work place,” Dr Mukuzi Muhereza, the secretary-general of the Uganda Medical Association (UMA), said yesterday.

“We have seen the supply is not as bad as it used to be. Probably what is happening is unavailability of money or problems of supply chain, especially the National Medical Stores (NMS). So we call upon government to look into that so that we protect our workers,” he added.

Dr Muhereza said the different health facilities have been suffering shortage of PPEs since November.

The health workers said there is a need for NMS to revise its method of supplying the PPEs and accuse the government agency of sometimes supplying less equipment than requested for.

“The Ministry of Health is very aware of this; we have been having meetings and when you ask PPEs from Central Public Health Laboratory (CPHL) they tell you it’s NMS that supplies PPEs; when you take your request there, they say ‘wait we are going to supply.’ So the only thing is to remind Ministry of Health to supply these things to the districts," one of the health workers said.

However, Dr Muhereza said not all health facilities are facing a shortage of PPEs.

“We made a round sometime back; we were in Jinja, they were complaining and in Mbale hospital they were badly off. But when we went to Moroto, everybody was happy they even had more,” he explained.

At least 1,566 health workers contracted COVID-19 last year.

Government responds

However, Mr Moses Kamabare, the executive director of NMS, said there is a delivery scheduled of PPEs which is followed without any delay.

“We receive orders on the needed quantities from Ministry of Health and we deliver as ordered. The delivery is once every month,” Mr Kamabare said.

Dr Charles Olaro, the director for curative services at the Ministry of Health, said currently there is no shortage of PPEs and they have not received any complaints.

“Coveralls are used in treatment units and not wards. We don’t use coveralls for sample collection…, burials we have clearly indicated that you don’t need coveralls, first of all the person is dead and not breathing; what you need are gloves, masks..,” Dr Olaro said.

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Mukuzi Muhereza, the secretary-general of the Uganda Medical Association (UMA): “We do not have consistent supply of PPE of all ranges; it can be a mask, gloves, and coveralls. This means a health worker is at risk of getting this Covid at work place.”

Dr Charles Olaro, the director for curative services at the Ministry of Health, said currently there is no shortage of PPEs and they have not received any complaints.