The Ministry of Health’s attention has been drawn to an article titled: “Dying with dignity” published by Sunday Monitor on November 29th 2020.
The article makes a number of allegations on the COVID-19 response in the country including among others that two patients died from a faulty Oxygen Plant at Mulago National Referral Hospital, fake masks for Doctors and unfounded doubt on the country’s capacity to respond thepandemic.
Therefore, the Ministry of Health would like to respond to the various allegations contained in the article as follows:
Death of two patients
The article alleges that two patients died from Mulago Hospital’s Intensive Care Unit (ICU) in August this year due to lack of oxygen which is not true.
The patients, who include a 70-year-old referral from Rubaga Hospital ICU, a 27 year-old case referred from Hoima Regional Referral Hospital and 46 year-old case, all died of severe COVID-19 with multi-organ dysfunction.
It is therefore not true that the patients died due to lack oxygen. During this period, the Mulago Hospital ICU had other patients who posted better outcome.
Based on practical experience, COVID 19 is a multi–system disease. It affects many organs of the body based on the involvement of the various organs.
Depending on the severity of the organ dysfunction, the outcome isusually bad with most patients succumbing to the disease.
It is important note that admission into the Intensive Care Unit (ICU) is meant to benefit the patient from life support which necessities the use of machines such as ventilators and dialysis machines and supporting medications as the patients’ body fights the disease.
If the organ dysfunction is severe the patient is more likely to die irrespective of the life support interventions.
Given the current stage of the pandemic, where there is wide spread community infection, patients are presenting to the hospital rather late as they delay home trying totreat other infections that have similar symptoms with Covid–19.
Although the authors attempted to reach out to the Ministry of Health for information through an email in August 2020, they deliberately ignored reaching out to the ministry for an update by the time they published the forementioned article that is full of factual misrepresentations which ought to have been collaborated.
The authors should have also made an effort to visit Mulago Hospital which would have been a more professional way of validating the allegations from their various sources, for example the Oxygen Plant.
Currently Mulago Hospital has four new fully functioning Oxygen Plants which are supplying Oxygen to all places where it is required in optimal amounts and purity levels.
The newly installed 4 oxygen plants at Mulago makes it the largest Oxygen plant in the country able to generate 2083 litres of oxygen per minute.
In 24 hours the Mulago, the plant can generate about 2,999,520 litres of oxygen which in normal circumstances can serve about 900 beds. The four are part of the seven plants procured by the Ministry of Health to meet the oxygen needs in the country.
The seven were supplied by Silverbacks pharmacy limited, at a cost of Ugx 6.4 billion (1,742,168). This cost included 450 oxygen cylinders and 450 oxygen flow metres.
The other three oxygen plants were installed at Mbarara regional referral hospital, Entebbe regional referral hospital and Kayunga hospital.
The article makes a comparison of the cost price of the new plants with the old ones installed 10 years ago which is misleading. The cost drivers for the current plants were;
1. higher specifications due to demand for high flow and high purity oxygen necessary for COVID-19 patients.
2. High production capacity 125 cubic metres for plant as compared the old ones which of a lower production of 20 cubic metres.
3. The global demand for oxygen plants.
4. Global travel restrictions amidst COVID-19 and the urgency of oxygen plants made air transport which is expensive the only available option.
5. The brand of equipment
Furthermore, the allegation that Oxygen supplied to patients dropped from 90% to 20% is not true. We would like to clarify that Oxygen is delivered to the user wards through pipes when its purity is ranging between 93% and 100 %.
The currently installed plants are automated and cannot generate oxygen when its purity levels go below 90%.
All patients in need of oxygen are connected to a supply of medical grade oxygen which is always above 90%. This is contrary to what the authors alleged that patients are supplied with “hotair”.
Patients treated at Mulago
We would to inform the public that Ministry is doing everything available within the available to ensure the services required for COVID-19 treatment are made available.
To- date, Mulago National Hospital had a cumulative admission of 2,456 patients, with a total discharge of 2137 and the current admission stands at 160.
The total fatalities currently stand at 150 and transfer at other units five.
The cumulative admission into High Dependency Unit and ICU is 605.
It is important to note that most patientsare referred to Mulago Hospital from other hospitals in critical conditions, some coming from ICUs of other hospital with late stage of the disease.
It is also important to note that the relative higher fatality at Mulago National Referral Hospital is because most of the patients are referred from other hospitals when in critical conditions (severe organ discussion).
The allegation on fake medical masks is not true.
The Ministry of Health would like to state that all medical masks used by health workers countrywide meet bothlocal and international standards.
Indeed, No health worker in ICU at Mulago has contracted COVID-19.
This means strict use of Personal Protective Equipment (PPE) is highly protective, including the alleged fake masks.
JACK MA Donations
We would like to add that no Masks were stolen or diverted as alleged by the authors. We advise them to approach the National Medical Stores for information on the distribution of 88,360 medical supplies donated by the Jack-Ma.
These include; 18,900 Swab Collection Swabs, 394 Vira DNA and RNA extraction kits, 183 chemo nitrilegloves, 3800 Ebola Disposal Coverall, 3800 disposal protective face shields, 15 ventilation machines, 10,023 N95 Respirator Masks, 36 infrared thermometers, 920 disposable facemasks (3-ply operating theatre), 48,490 Ebola disposable protective facemasks, 800 Ebola Disposal Coveralls and 1000 disposable face shields.
Uganda ranked best in Africa on the COVID-19 Response
In August, the Lancet Commission it its report to the 75th United Nations General Assembly ranked Uganda as the best performing country on the African Continent as far as suppressing the spread of the Covid 19 infection is concerned.
This achievement was not by mere accidentbut was as a result of a resilient health care system that has a track record of dealing with emerging and remerging epidemics.
However, our health care system like any other across the global, might get challenges as a result of the upsurge of the community infections.
That is why it is important to note that the best way to avoid death is to strictly abide by the COVID-19 preventive measures instituted by the Ministry of Health and the World Health Organisation(WHO)
• regular hand washing with water and soap or using an alcohol-based hand sanitizer
• Proper wearing of face masks
• Ensuring there is social distancing of at least 2 metreson both sides whenever in public gatherings.
In conclusion therefore, the Ministry of Heath would like to state that every individual holds the responsibility to protect themselves against COVID 19.
At the same time continues to make available all the necessary requirements to enable patriotic health workers save lives.
We indeed,commend our health wokers for their determination to save lives even when the number of new infections is on the rise.