Kagadi General Hospital in Kagadi District has introduced new guidelines to address facility congestion, easing pressure on limited resources and security concerns by restricting visiting hours and limiting the number of caretakers allowed to accompany patients at the facility.
The hospital management says the growing number of patients accompanied by relatives, friends and other well-wishers has, for the past years, overwhelmed the facility’s limited space and infrastructure, making it difficult for health workers to attend to patients efficiently.
The congestion has, at times, forced some patients to sleep on the floor or verandas after beds in the wards were occupied. Health workers have also struggled to move through crowded wards and distinguish patients from the people accompanying them, delaying access to medical care.
According to Mr Simon Peter Tumusiime, the hospital’s senior administrator, in the few days they have enforced the guidelines, they have already helped reduce unnecessary congestion and noise at the facility.
‘Parents, relatives, friends, and other categories of people are expected to follow the guidelines. The time for visiting patients will always be from 6:30 am to 9 am, 12:45 pm to 2 pm, and from 5 pm to 7 pm,’ Tumusiime said.
He explained that the remaining hours would allow doctors, nurses and other medical personnel to attend to patients without unnecessary interruptions.
Tumusiime said some patients previously received visits from large groups of relatives, leaving little room for health workers to move around and carry out their duties.
The guidelines will be enforced by Uganda People’s Defence Forces (UPDF) officers deployed at the hospital’s main gate.
Under the new rules, patients in critical condition will be allowed to have two caretakers, while other patients will be limited to one caretaker.
He said the hospital hopes the restrictions will ease pressure on essential services, including water and electricity, while reducing waste and the general strain on the facility’s limited resources.
Tumusiime said overcrowding had also affected the availability of beds, with some patients previously forced to sleep on verandas when the wards filled up.
He added that overcrowding could expose patients to infections they did not have when they arrived at the hospital, particularly where shared toilets and bathrooms are inadequate.
‘The crowds would not only exert pressure on resources; they had also increased hospital expenditure, created traffic within the facility and consumed parking space reserved for patients. You would find parking space meant for five patients occupied by one because every relative comes with a vehicle,’ he said.
The administrator said controlling access would also help improve security and protect patients’ belongings.
The hospital has experienced theft concerns linked to people who allegedly enter the facility under the pretext of being caretakers. The management says stronger security measures are necessary to prevent unauthorised access and safeguard patients and their property.
Theft of the baby
In May, the hospital and police investigated a case in which a 2-month-old baby was stolen at Kagadi General Hospital after the incident reportedly happened at the hospital’s outpatient waiting area, where patients and caregivers had gathered to receive treatment and medication.
The baby’s mother, Ms Winnie Tumwebaze, 36, a resident of Mpocha Village in Mpefu Sub-county, said she had spent several days at the hospital attending to another child who had been admitted for treatment since Monday, May 11.
According to Tumwebaze, Friday had been scheduled as the discharge day for the sick child. She added that by the time of the incident, she had gone to the outpatient department carrying both her sick child and the two-month-old baby, who she said had not yet been baptised or named.
‘At around 6 pm, I went to the outpatient department to collect medicine for my sick child. I was carrying both children at the time. While seated there waiting, I found several other people, including a woman I did not know,’ Tumwebaze said.
She added, ‘She looked friendly and asked if she could help me carry the baby because I already had another child on my back. I trusted her and handed over the baby to her,’
Tumwebaze said after a short while, health workers called out her name to collect medication for the sick child, and she quickly moved to the dispensing area with the sick child, leaving the younger baby temporarily with the woman.
However, she said when she returned moments later, both the woman and the baby had disappeared.
‘I became confused and frightened. When I asked the people who remained behind, they told me the woman had said she was going outside the hospital gate to buy porridge and would return shortly. But she never came back,’ Tumwebaze said.
She said she immediately rushed to the area where the suspect had allegedly gone, but failed to find her, and she informed Hospital staff and other attendants, who later joined the search, but the woman could not be traced by Saturday morning.
Patient identification
In addition to regulating visiting hours and caretakers, the hospital plans to introduce colour-coded cards to help medical personnel identify patients according to the urgency of their conditions.
Tumusiime said patients would receive the cards at the entrance, with red indicating those requiring emergency attention and green identifying patients who are not in critical condition, which will help staff organise patients according to their needs and improve the delivery of services.
‘This will help medical officers at the outpatient department (OPD) deal with different groups of patients differently. We hope this strict implementation of the guidelines will reduce unnecessary expenditure and allow the hospital to direct funds towards other essential operational needs,’ He said.
The hospital also maintains screening measures for people entering the facility as part of efforts to identify health risks and protect patients, staff and visitors.
Mixed reactions
The new guidelines have drawn mixed reactions from members of the community, with some welcoming the measures while others question whether restricted access will accommodate the unpredictable nature of illness and travel.
Mr Hope Kofiri Salongo, a Kagadi resident, welcomed the initiative, saying congestion had previously made it difficult for people to move through the hospital, particularly during emergencies.
‘Previously, you would struggle to pass through crowds in the hospital to reach medical personnel. Doctors would hardly distinguish patients from caretakers, and the crowds would also cause delays,’ Salongo said.
However, Mr Anthony Kahwamu, a boda boda rider operating at a stage near the hospital, said the restrictions could affect his income by reducing the number of customers seeking transport.
Kahwamu said patients’ relatives and other hospital visitors were among his main customers.
‘I would get about Shs45,000 a day. This is likely to reduce by half following such instructions,’ he said.
Ms Beatrice Kemigisa also questioned whether strict visiting hours would work for people travelling from distant areas, whose arrival times could be affected by transport challenges and weather conditions.
‘You cannot restrict people’s access to the hospital when sickness is neither invited nor predictable. Weather may also interrupt people’s movements,’ she said.
She urged hospital management to review the guidelines to ensure that people seeking medical services can still access the facility when necessary.
Infrastructure challenges
The new measures come amid longstanding challenges at Kagadi General Hospital, including limited equipment, ageing infrastructure, congested wards and security concerns.
The hospital’s bed capacity is reported to be about 100, placing additional pressure on services when large numbers of patients and caretakers arrive at the same time.
According to the management, the facility recently received an X-ray machine after going without one for about 17 years. Previously, some patients had to be referred to facilities in Fort Portal and Hoima for X-ray services.
The hospital has also received two medical specialists, including a surgeon and a gynaecologist, in a staffing boost intended to improve access to specialised care.
UPDF officers have been deployed to strengthen security and protect patients’ property amid concerns about theft at the facility.