Local leaders in Rukiga District are urging the government to upgrade Kashambya Health Centre III to a Health Centre IV and rehabilitate its deteriorating infrastructure, saying the facility can no longer meet the healthcare needs of the growing population it serves.
The renewed appeal follows national attention in July after media reports exposed the health centre’s crumbling buildings, lack of water and poor working conditions.
Kashambya Health Centre III serves residents of Kashambya Sub-county, neighbouring Nyakishenyi Sub-county in Rukungiri District and parts of Mpungu Parish in Rubanda District.
The outpatient department, built in the 1970s, has a leaking roof that allows rainwater into the building, threatening medicines and disrupting services. Congestion has forced dental, injection and pharmacy services to share a single room.
The facility’s only ward, constructed in 1998 by World Vision, houses male, female and paediatric patients while also serving as the maternity ward, labour room, laboratory and chronic care clinic. Large cracks have developed on the building’s verandah, raising concerns about its structural safety.
The health centre has also lacked running water for months after its main water tank collapsed. Two additional water tanks are no longer functional, forcing staff to fetch water in jerrycans for maternity and laboratory services.
In the labour ward, a damaged delivery bed has forced midwives to place newborn babies on a table immediately after delivery while attending to their mothers. Worn-out handwashing facilities mean staff rely on water poured from jerrycans during deliveries, increasing the risk of infection.
Women admitted to the maternity ward must provide their own blankets and bedsheets, while the absence of privacy curtains leaves mothers exposed during examinations and treatment.
The chronic care clinic operates in an open space without partitions, compromising the privacy of patients receiving care for HIV, tuberculosis, diabetes, cardiovascular disease, asthma and mental health conditions.
Health workers also face difficult conditions. Staff houses were built without kitchens, forcing workers to cook on verandahs. Staff toilets and bathrooms have collapsed, leaving health workers to share sanitation facilities with patients or use toilets at the Kashambya Sub-county headquarters. Some workers said they bathe outdoors at night because there are no functioning bathrooms.
The poor state of the facility was recently raised in Parliament by Rukiga District Woman MP Dr. Sylvia Alinaitwe Mwanaki and Rukiga County MP Patrick Katabazi Kiconco, prompting Health Minister Dr. Chris Baryomunsi to make an unannounced visit.
During the inspection, Joram Niwagaba, the district councillor representing the area, said upgrading the facility to a Health Centre IV would bring essential services, including emergency surgery, closer to residents who currently travel long distances to Mparo Health Centre IV.
He said the poor condition of the health centre discourages many residents, particularly pregnant women, from seeking antenatal and maternity care.
Brenda Oshabahebwa, a clinical officer at the facility, said the health centre treats about 700 patients each month and expressed hope that the minister’s visit would speed up government intervention.
Kashambya Sub-county Chairperson Elineo Bandaganiire called on the government to upgrade Kashambya Health Centre III and elevate Bucundura Health Centre II and Nyakashebeya Health Centre II to Health Centre III status.
He said the area’s mountainous terrain makes access to healthcare difficult, especially for expectant mothers, and appealed for an ambulance. Emergency patients are often transported on motorcycle taxis or makeshift stretchers, he said.
Bandaganiire said four patients recently died after failing to reach the health facility in time because their families could not afford transport.
Responding to the concerns, Baryomunsi acknowledged the poor state of the facility and said the Ministry of Health would send a technical team to assess its infrastructure needs and develop plans for new buildings.
He also said Kashambya Health Centre III qualifies for elevation to Health Centre IV because of the area’s difficult terrain and limited access to Mparo Health Centre IV. The minister pledged to engage the ministry on providing an ambulance to strengthen emergency referrals.
