Patients from rural areas wait to see the doctor at CHUK. Patients referred from upcountry district hospitals to the University Teaching Hospital of Kigali (CHUK) have to wait for weeks to see a doctor, even with an appointment. PHOTO | DANIEL S. NTWARI

By VENUSTE MFITIMANA and ALEX NGARAMBE

IN SUMMARY

  • Caretakers of the patients expressed concern that the long wait not only puts lives at risk but also increases their financial burden.
  • Many of them said they cannot afford the high cost of travelling back and forth since there is no guarantee that they will see a doctor.
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 An acute shortage of doctors is affecting the quality of medical care in Rwanda as patients with serious medical conditions are forced to wait for months to be treated.

Rwanda Today has learnt that patients referred from upcountry district hospitals to the University Teaching Hospital of Kigali (CHUK) have to wait for weeks to see a doctor, even after securing an appointment.

Meanwhile, King Faisal Hospital, one of the leading health facilities in the country, has dismissed a gynaecologist and five midwives for negligence in the labour ward which resulted in the death of an expectant mother.

Caretakers of the patients expressed concern that the long wait not only puts lives at risk but also increases their financial burden.

Many of them said they cannot afford the high cost of travelling back and forth since there is no guarantee that they will see a doctor. As a result, some of the patients and their caretakers are forced to camp at the hospital, including spending cold nights in the open on the veranda.

Angelique Iradukunda from Rushashi Sector, Gicumbi District in Northern Province was initially receiving treatment at Byumba Hospital. She was referred to CHUK late last year after developing a serious complication in the right thighbone. Nearly five months later, however, she is yet to see a doctor following the cancellation of her initial appointment.

“I was sent to this hospital on December 18, 2013 for a scan after I got an injury when a tree fell on me and broke my right leg,” said Ms Iradukunda, 18.

“I was given an appointment to come back on April 9 this year. I came as agreed but, instead of seeing a doctor, I was given his number to call him for another appointment. I have been here for four days, sleeping on the ground, as I await his response. I spend more than Rwf15,000 every time I come here, and I am expected to pay for my medicine.”

Ms Iradukunda’s concern is shared by Venuste Ntibazubugingo, who claimed that he has been treated at the hospital for 15 years but his ailment has been getting worse.

“I am suffering from intestinal diseases,” said Mr Ntibazubugingo. “I was referred here by Kirehe Hospital but to get doctor here is not easy. I am often given appointments but when I come on that date I miss the doctor, and this causes me much agony.”

According to the patients found camping at the hospital, sleeping in the open is a terrible experience.

“We spend nights here, sleeping on the ground in the cold and sometimes being rained on, but we don’t have a choice,” said Evariste Rwagashayija, who was referred from Nyagatare Hospital.

“It’s also difficult to get something to eat since I don’t have any relative in Kigali. We used to beg for food from in-patients.”
However, Ministry of Health officials said that they will improve medical care and communication between the hospital and patients.

“Maybe that there is a weakness in communication with patients but we are going to remind the hospital about informing patients in case there is a change to their appointments,” said Nathan Mugume, the communications officer at the ministry.

“Sometimes there are circumstances which can prevent a doctor to be available on the given date but patients must be aware of that before spending their time and money coming to hospital.” He however added that, in case of emergency, patients have a right to go to the hospital without an appointment.
In the case of King Faisal sackings, it was not immediately clear whether the baby survived since the hospital management would not divulge more details, saying the case is being investigated by the medical council.

Disciplinary committee

The hospital’s disciplinary committee nonetheless decided to take action against the six medical professionals even before the findings of the medical council.

“We decided to dismiss them because of gross malpractice,” said Dr Emile Rwamasirabo, the hospital’s chief executive officer. “Any decision by the council is not binding on us; the expelled workers can look for employment elsewhere.”

King Faisal took the tough decision amid increasing numbers of alarming maternal deaths and baby swaps in hospitals across major hospitals in the country. Dr Rwamasirabo however said the action was not motivated by the cases since the hospital does not have many of them.

“For the past one year, for example, we have not had any mother dying in labour as a result of negligence or any other complications, while there have not been more than three infant deaths,” said Dr Rwamasirabo.

Cases of gross negligence have been a cause of widespread concern in both urban and rural hospitals but little action has been taken. Late last year, the death of a woman and her unborn child at a leading private hospital in Kigali prompted an investigation to establish whether there was negligence on the part of the medical team that handled the case. The findings of the investigation are yet to be made public.

The Kisementi-based La Croix du Sud Hospital, which is owned by one of Rwanda’s foremost gynaecologists, Dr Jean Chrysostom Nyirinkwaya, was put on the spot after Loy Mutoni, 23, died while undergoing treatment at the facility.

In a separate case last year, a family accused Muhima Hospital staff of swapping their newborn child with another.

The eastafrican