ARUA, 9 December 2011 (IRIN) - Increased fatalities, patients paying to fuel their own ambulances, cancelled surgical operations, 11km journeys just to sterilize equipment - such are the symptoms of a healthcare crisis in Uganda's West Nile region caused by weeks of power blackouts, according to parliamentarians and medical staff.

"People were really dying [during blackouts]," said Gilbert Olanya, a member of the Parliamentary Social Services Committee, which visited the region recently and described the crisis there as "unique" in Uganda.

The region's referral hospital in the town of Arua, 430km northwest of Kampala, serves a catchment population of more than 2.8 million people across eight districts, and many others in neighbouring South Sudan and the Democratic Republic of Congo.

The region is not connected to the national grid and ever since the main generator run by the town's sole power supplier, West Nile Rural Electrification Company Ltd (WENRECo), broke down in September, the hospital's acting director Emmanuel Odar says the facility has reached a low point.

Residents are so unhappy with WENRECo they have called for its 20-year contract – due to end in 2023 - to be revoked, according to local media reports.

"We don't know why the WENRECo people are here – they are doing us a very big disservice," said Sam Wadri, of the Arua council.

"We have been affected severely," Odar said. "Sometimes, we even have to cancel the [operating] theatre list."

He explained that because of the blackouts, staff sometimes took instruments to be sterilized at a private hospital in Kuluva – 11km away – which has its own small hydro-electric power plant.

Arua hospital has a back-up diesel generator but in the absence of WENRECO-supplied electricity, this has consumed a three-month allocation of fuel in a single month.

"So how we survive the other two months, it's a very big challenge," Odar said. "If you have exhausted your budget, then you stay in darkness."
While the Ministry of Health has promised to subsidize fuel for four hospitals elsewhere in Uganda to compensate for national grid blackouts, its permanent secretary, Asuman Lukwago, said he had been unaware of the extent of power outages in West Nile.

"But we are able to help them at any time they are in a critical crisis – if the hospital is in a crisis and needs help tomorrow, we can help," he said.

Such help would be welcomed by Arua resident Linda Mutambi*, who remembers a doctor having to stitch her up in the dark when power failed during a Caesarean section about a year ago. The stitches had to be removed and re-sewn.

Now expecting her third child, the thought of returning to hospital makes her apprehensive.

"I always fear. I always think that now I'm pregnant again, what am I going to do? They are going to take me to the theatre again. I'm just imagining again power going off for me, that's what is always in my mind."

The parliamentary committee's lead researcher, Josephine Watera, said there was no doubt that maternal deaths had risen because of the blackouts, even if chronic under-reporting of such fatalities meant accurate data was unavailable.

"The situation is very bad. After going into the field, our eyes are open," she said.

She said the health centre in Yumbe, another West Nile town, had been effectively shut down as it had no water, no generator, and a broken solar panel. Patients who have been paying for already short supplies are now faced with fuelling their own ambulances, Watera said.

Local discontent with WENRECo stems not only from its frequent blackouts – despite a pledge to deliver 18-24 hours of electricity a day – but also the delayed completion of 3.5MW hydro-power plant in Nyagak, which was supposed to go online in 2006.

As an interim measure, the company operates two small generators in West Nile, but locals say these provide electricity for just two hours a day.

Angelo Izama, director of local energy think-tank Fanaka Kwawote, told IRIN the delays at Nyagak were symptomatic of a failing national procurement process.

"Regulators of any variety in Uganda tend to be weaker than the entities that they regulate. So companies that are involved, foreign or local – really project immense influence over the procedures of procurement," Izama said.

Ten percent of Ugandans have access to electricity. In rural areas the proportion is 3 percent.

Source:  Integrated Regional Information Networks (http://www.irinnews.org )