The Ministry of Health announced at the weekend that it has launched investigations into controversies surrounding the death of Greenhill Academy pupil Augustine Kizito Ssemakula, who passed away at TMR International Hospital in Kampala on November 13. The move followed viral social media posts and online reports alleging a Shs150m hospital bill and the withholding of the body, claims the hospital has since denied.
‘Our responsible teams are currently investigating this matter to gather facts. But for now, no one has filed a formal complaint,’ Mr Emmanuel Ainebyoona, the Health ministry’s spokesperson, told the Daily Monitor at the weekend. Ssemakula was taken to TMR after reportedly falling from a second-floor balcony at Greenhill Academy Buwaate Campus on October 22, sustaining severe injuries that required ICU admission. The campus head teacher, Mr Benon Lubwama, contacted yesterday to explain the cause of the fall, said he was attending the burial and could not comment. The body was laid to rest yesterday in Mukono, according to A-plus Funeral Management.
The child’s parents are Mr Kenneth Nsubuga, the deputy legal advisor to the Democratic Party, and Ms Elizabeth Namakula, also a lawyer. At a vigil in Najjera, Kira Municipality, on November 14, Mr Nsubuga described the incident as an accident. ‘I tried to go to Greenhill to see where the accident happened, but I failed. I have not returned to Greenhill to ask for an explanation, but when they gave the height, no one could survive,’ Mr Nsubuga was quoted as saying. He also stated that he has no plans to sue. ‘Stop using the name of our son to fight Greenhill and the hospital. We shall not sue anyone. I would rather invest that time in consoling my wife,’ he said.
Mr Nsubuga added: ‘The late Augustine spent three weeks in the ICU. I have not cried for my boy; I last cried when my boy was in the hospital, but I know I will cry when the right time comes. This is a lesson on how a parent should behave towards a child and how the child should behave towards the parent.’ Social media users alleged that TMR refused to release the body until the bill was paid, but the hospital denied this. ‘TMR International Hospital is aware of the circulating claims regarding the circumstances of the care provided to the late Augustine and the hospital’s interaction with his family. We categorically refute these allegations,’ the management said in a November 15 statement.
The hospital dismissed the Shs150m bill but did not disclose the actual amount. It also denied withholding the body, rejecting media reports that had cited unnamed family sources. ‘We extend our condolences to the family. Augustine’s passing is a profound loss, and despite the tireless efforts of our medical team and the full spectrum of interventions provided, we were unable to save his life. Throughout his admission, the family received full clinical guidance and administrative support…,’ the facility said.
It added: ‘After his demise, the body was never withheld by TMR International Hospital. At no point did the hospital delay, deny or place conditions on the release of the body. Any allegations suggesting otherwise are entirely unfounded.”
In defence of the hospital
The Uganda Healthcare Federation (UHF), of which TMR is a member, backed the hospital. The Executive Director of UHF, Ms Grace Ssali Kiwanuka, praised the ‘exemplary care’ at TMR and explained the costs. ‘TMR International Hospital is a member of the federation, and upon receiving these allegations, we immediately engaged the facility to understand the finer details that may not be visible in the public domain. We extend our condolences to the family. Their pain at this loss is unimaginable,’ she said.
Ms Kiwanuka said the child’s injuries required multiple surgeries, specialised teams, round-the-clock care, extensive medications, and imported inputs.
‘This naturally increases the cost of care. The cost of Shs150m for 21 days in ICU sounds alarming; however, we have been informed that the total bill for this patient was significantly lower than the Shs150m being quoted online,’ she said.
Ms Kiwanuka added: ‘It is also important to keep in mind that ICU care in a private hospital typically ranges between Shs4 to 6m per day, depending on the complexity of the case. For context, during the Covid-19 pandemic, the Government of Uganda estimated an average cost of Shs3.2m per day for a single-condition ICU patient in a national referral hospital, an institution that benefits from economies of scale and subsidised resources.”
She explained that private hospitals lack subsidies and must procure specialised inputs, which drives up costs for complex cases.
Dr Daniel Kyabayinze, the director of Public Health at the Health ministry, said in a recent interview that government discussions are ongoing to regulate private facility charges.
Withholding bodies
Prof Joel Okullo, the head of the Uganda Medical and Dental Practitioners Council, said it is against medical ethics for hospitals to withhold the body of a deceased patient over unpaid bills.
‘We have told the private hospitals that it is unethical for them to retain patients or bodies because of non-payment. They should work out a formula that one can use to pay without necessarily having to retain any patient or dead body,’ he told this newspaper earlier.