Kaoma District Hospital Annual Report 1999
Introduction
This is the first annual report for Kaoma District Hospital since years.
Kaoma District Health Management Team, included Kaoma District Hospital,
did not produce annual reports for the past few years. Our archives were
not well maintained and a major part of it was damaged by water during
heavy rains in 1997. The last report of Kaoma District Hospital and Rural
Health Centres that could be traced was of 1991. A comparison of data with
previous years has therefore shown to be very difficult and sometimes
impossible.
The format used is based on the WHO-guidelines with some minor adjustments
made. The completion of this report was only possible through the combined
efforts of many officers.
1. Hospital and environment
Kaoma District Hospital is one of the three hospitals in the district and
situated in the Boma of Kaoma. The district, with an area of 23,315 square
kilometers, is situated in Western Province and borders with all other
districts in the province except for Kalabo and Shangombo district.
Population in the district is estimated at 173,415 (1999 projections).
Within the catchment of the hospital are 6 health centres and one army
clinic (Luena Barracks Hospital) with a zonal population of 86.262 (50%) of
which 33.165 live within the immediate catchment of the hospital. The
health centers are Nkeyema, Namilangi, Njonjolo, Kahare, Chitwa and
Kasimba. Radio communication within the district is possible with Njonjolo
RHC, Kahare RHC,Kasimba RHC, Nyambi I RHC, Nkenga RHC, Kasabi RHC and
Mangango MH.
The hospital has 76 beds (incl. 2 incubators) and was constructed in 1957
as a health centre. After independence in 1964 it was designated to be a
district hospital. The district health office is situated on its premises.
The hospital has one general medical officer while the district health
office has one technical advisor health (also a doctor). The district has
two mission hospitals; Luampa Mission Hospital (2 doctors) is situated in
the southern zone of the district and Mangango Mission Hospital (currently
no doctor) along the Kaoma - Lukulu road. Kaoma District Hospitals serves
as a referral hospital for Mangango MH (population 33.999(19.6%)), bringing
the total population depending on its services to 122.261, a 69.6% of the
district population.
Kaoma district has an annual growth rate of 4.9% which is the highest in
the province (2.15%) and is the result of immigration of people from other
districts as well as the presence of refugees from Angola. The district,
especially the eastern part, is the most fertile area in the province and
is often called "The Green Basket". Major crops that are grown are maize,
cassava, sorghum and rice. The district also has some forest resources but
in contrast to the rest of the province only few cattle are kept.
Kaoma Township (Boma) is situated 4 km's north of the main Lusaka - Mongu
road. This road is tarred and runs through the middle of the district.
Kaoma Township is the districts headquarter and has an airstrip, power
supply (generator), telephone services and a secondary school.
2. General Review of the year
The year 1999 was a difficult year for the hospital. Grants were received
erratic and the amount was grossly inadequate. All along 1999 the funding
for the hospital was poor and less than 50% of the planned budget. This
resulted in a continuous accumulation of debts, of which arrears in
payments for house rentals, electricity and water bills and to food
suppliers are the greatest contributors. Health services in general were
also affected.
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Torturous experience at a government clinic
The reception given to patients in government clinics is not the best. Many Zambians will attest to this fact. At least once, most of us have experienced the most nostalgic receptions in health centres. Recently, our staffer DIANA ZULU had one such experience and she writes about what happened to her which is most likely happening to other patients in some health institutions.
In the early hours of Saturday, my three-year-old daughter developed a fever which also affected her breathing. I woke up and gave her a teaspoon of calpol and later a warm bath to try and bring her temperature down. But this did not help matters. Her temperature remained high. I started putting her on chloroquine treatment and gave her the first dose around 03:00 hours, but she continued being restless and around 05:00 hours, I could not bear to see her in so much pain. My husband and I decided to take her to the nearest clinic - Kabwata. We arrived at the clinic around 05.10 hours and found the clerk outside. My husband explained to him that we had a child who needed medical attention. The gentleman disappeared and resurfaced after five minutes to tell us that a nurse would come and attend to the child after having her cup of tea. We sat on the bench and waited for more than 30 minutes. The child started vomiting. My husband lost patience and asked the clerk to go back and call the nurse. The nurse appeared and when she saw what was happening, she asked why we had not sent for her as soon as we arrived. She ordered the clerk to pull out my daughter's record. After a while, the clerk came back without the card, saying he could not find it. He suggested that another card be issued and asked us to pay K500 for stationery. Then he demanded that we give him K10,000, whatever for! My daughter is under five years and she is exempted from the medical insurance scheme. Why this money was asked for is anybody's guess. The clerk was not impressed with my husband's refusal to give him K10,000. He briefly excused himself and went outside.
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Zambian Women Turn To Traditional Medicine
Economic hardship and a badly dislocated health care service are combining effectively to drive Zambian women to traditional medicine, some of it unwholesome. Residents of Lusaka were this week still talking about the bizarre death of a 24-year-old woman at the Sikanze Police Camp at the week-end after her bid to join the ranks of economically secure married women - using traditional medicine - ended in tragedy. Police spokesperson Lemmy Kajoba admitted that they are holding two women, aged 57 and 49, who are accused of supplying killer 'medicine' to the young woman.
Maria, not her real name, was one of several unmarried young women in the camp who were eager to move away from depending on parents to that of housewife. So when the two elderly women offered to help them secure husbands, through the use of traditional medicine, Maria was one of the first to accept the offer. Part of the portion consisted of herbs (roots, leaves and barks of trees among other stuff) for soaking and drinking. The other part consisted of herbs for bathing in while the third consisted of herbal matter for boiling in a pot to create an infusion over which Maria could steam herself under the blanket. Maria did so in the bathroom late at night after most family members had gone to bed.
As the two traditional healers explained afterwards, this part of the cure was intended to drive away the demons that usually gave Maria 'bad luck' before her potential suitors. But on the very first day that Maria began the treatment, she suffocated under the blanket and by the time her relatives got to her she was long gone - a victim of traditional medicine.
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