By Mike Rwothomio

A section of youth activists and local leaders in Zombo are bitterly protesting the relocation of a government ambulance to a private health facility by some district officials.

This publication understands that the ambulance was transferred from Paidha Health Center III to Nyapea Hospital, a Catholic-founded institution, months ago.

The Ministry of Health donated a Class B Toyota Land Cruiser ambulance, registered as UG 8154 M, to the district under emergency medical services earlier this year. This modern ambulance is poised to alleviate some of the referral challenges faced by the community, with one unit stationed at Paidha Health Center III, serving Okoro Constituency, and another expected for Ora Constituency.

Sam Rwothomio, a youth activist and CEO of Zombo Mwa Forum, blamed the district for failing to inform the public formally about the transfer of the ambulance to a private facility, raising suspicions among members of the public. He also accused the leaders of levying exorbitant fees on locals seeking the ambulance’s services, which should be free of charge.

“We are demanding that the ambulance be brought back to Paidha Health Center III. We have also learned that people are being charged for the ambulance’s services, yet it’s supposed to be free of charge. The ambulance was officially launched at Paidha Health Center III in Paidha Town Council. It was shocking news to us three weeks ago that the ambulance was taken from Paidha Health Center III without prior notice. We don’t know the reason why this ambulance was taken,” Rwothomio explained to journalists in a press conference on July 6, 2024.

Robert Jakony, the National Resistance Movement (NRM) Party flag bearer for Paidha Town Council for 2021-2026 and chairperson of Paidha Black Angels FC, expressed shock over the ambulance’s transfer to a private health facility. He rallied the public to peacefully demand the ambulance’s return to Paidha Health Center III, which is under the government of Uganda.

“The ambulance has been given by the government of Uganda under the health docket to Okoro Constituency. The district resolution is very clear: the ambulance should be attached to Paidha Health Center III, which is located in Paidha Town Council. Three weeks ago, we were shocked to learn that the ambulance had been transferred to a private health facility, Nyapea Hospital. We are calling upon everyone to come forward. There is no reason to convince us that the ambulance should be at Nyapea Hospital. We are calling upon everyone to bring the ambulance back to Paidha Health Center III,” Jakony told journalists in a press conference at Paidha Town Council.

Similarly, Sadiki Onencan, chairperson of the Social Services Committee of Zombo District Local Government and male district councillor for Paidha Town Council, blamed the district’s top leadership for undermining the council, adding that the decision was taken without the council’s approval.

“We need to follow procedures when doing things. I feel like resigning from the council because if the council resolution is not being followed, it is as good as useless to be in that council,” Sadiki explained. “If any person thinks we are political, that person must have a myopic mind. This has nothing to do with politics; it’s about service provision to the community, to the public, to Ugandans.”

Princess Kristober, the female district youth councillor, said, “The doctor is a technical person; he knows what to do. Let him bring back the ambulance to Paidha, where it was commissioned. So, doctor, let’s respect that.”

The LCIII chairperson of Paidha Town Council had initially raised concern about the disappearance of the ambulance at a recent council sitting, blaming the district health officer, Dr. Mark Bramali, for his “incompetency” in failing to inform the town council leadership formally about the reason for the ambulance’s transfer to Nyapea Hospital, a private health facility.

“I saw the ambulance, which was commissioned at Paidha Health Center III, at Nyapea Hospital instead. The letter from the Ministry of Health was clear that the ambulance should be at Paidha Health Center III. The district relocated the ambulance without our notice. What kind of leadership is this? We are saying the ambulance should be brought back to Paidha Health Center III as it serves the entire district. We are saying the ambulance doesn’t belong to Paidha alone but should be stationed at Paidha Health Center III as earlier indicated,” Onega added.

During the commissioning of the ambulance in February this year at Paidha Health Center III, Dr. Mark Bramali, the district health officer, stated that the ambulance would be stationed at Paidha Health Center III to serve Okoro County and the entire district while awaiting the one for Ora County.

“In terms of the location of the ambulance, the letter states categorically clear that this ambulance is for Okoro County, and the permanent secretary of the Ministry of Health has directed that the ambulance be stationed at Paidha Health Center III unless any other changes take place. That is why we are commissioning it here today, and the ambulance will remain here. You will move with it and park it here,” Bramali said during the commissioning of the ambulance.

He added, “The boundary of Okoro County is well known, but for the purpose of managing the district, now that it’s the only one available, we shouldn’t say it should not cross to other parts of the district while we await the one for Ora County.”

Zombo District, with a population of over 290,000, faces significant challenges related to its referral system, particularly impacting expectant mothers and individuals with other medical complications. The lack of standard ambulances has often left patients stranded, with some resorting to delivering on the way to referral facilities.

District Response

The district health officer, Dr. Mark Bramali, denied reports of the ambulance’s transfer to Nyapea Hospital, saying a letter of notification was written and copied to the district LCV chairperson, the Resident District Commissioner, and the administration of Paidha Town Council, where the ambulance was stationed.

“Since we have only one ambulance and are still waiting for another one, stationing the ambulance at Paidha Health Center III would make it very difficult to access at the extreme end of Ora County. Technically, that is what I consider. I don’t want to involve myself in politics because the guidelines clearly state that the interim overall responsibility of the ambulance is in the hands of the accounting officer with guidance from the district health officer. I am talking about the technical aspect of how we can make rational use of that ambulance,” Bramali said.

Earlier, activists had accused the district leaders of levying exorbitant fees on the ambulance, which should be free of charge. Bramali responded to the allegations, stating that a fee of 30,000 shillings is being charged because the current budget is insufficient for the ambulance’s management.

“At the moment, they are giving us 2 million shillings quarterly. Considering our emergency turnover, we need 7 million shillings every quarter to keep the ambulance running, leaving us with a deficit of 5 million shillings. That is why we are still asking for 30,000 shillings to add to the ambulance, which is 6 liters of fuel,” Bramali explained.

While responding on a local radio to the circumstances surrounding the transfer of the ambulance to Nyapea Hospital, the district LCV chairperson, James Oruna Oyullu, blamed some leaders for using the ambulance transfer to gain political mileage and incite the public.

During the ambulance commissioning in February this year, the district health officer highlighted the importance of proper ambulance management, including training staff to ensure efficient service delivery. He emphasized that these services would be provided free of charge, addressing a critical gap in healthcare accessibility.

Moreover, plans are underway to repair the old ambulance to further bolster the district’s referral capabilities. With the imminent arrival of the second ambulance for Ora Constituency, Zombo District is poised to witness improvements in its healthcare infrastructure, benefiting its nine health center IIIs, eight health center IIs, and Nyapea General Hospital.

However, challenges persist, especially along the Uganda-DR Congo border, where health facilities face overwhelming demand from neighboring regions. Nevertheless, the donation of modern ambulances marks a significant step towards addressing these healthcare disparities and ensuring timely access to critical medical services for all residents of Zombo District.