Ugandan celebrity chef @mama_d256, an iconic figure in the country’s culinary world, beat pre-eclampsia to deliver twins on July 19, 2025, at TMR Hospital, a private hospital — her go-to health facility for years.
“As of midmorning on Friday the 18th, I was just an expectant mom, eagerly waiting to receive my twins on September 3rd. Little did I know the universe had a completely different plan,” Mama D wrote in a tweet.“Crashing kidneys, dangerously low blood supply, and severe pre-eclampsia flipped my world upside down. I spent hours in ICU at TMR Hospital, my go-to health facility for years.”
“There, I received the absolute best care without paying a single coin, as it should be for any emergency case in Uganda. My life was saved. My babies were saved too though they remain in the Neonatal Intensive Care Unit (NICU), fighting bravely to stay with us. As of this hour, I’ve been discharged. It was the hardest thing leaving them behind, but I know they are in the best hands.”
Ugandan women face a higher risk of dying from pre-eclampsia
Pre-eclampsia is a common pregnancy complication characterised by the sudden onset of high blood pressure. Studies show that women in developing countries are 300 times more likely to die from the condition.
In Uganda, 368 women die from pregnancy and childbirth-related causes per 100,000 live births. Hypertensive disorders, including pre-eclampsia and eclampsia, are the second leading cause of maternal death after postpartum haemorrhage.
National study shows gaps in emergency care for pregnant women
A 2025 national evaluation examined emergency care for severe pre-eclampsia across 75 maternity facilities in Uganda. About 25% of facilities failed to provide correct emergency treatment, and 21% could not deliver or refer eclamptic cases within 12 hours.
Key barriers included lack of staff training, absence of clinical protocols, insufficient antenatal education, weak postnatal monitoring, and care that was not woman-centered. Most of these gaps are considered fixable through better clinical governance and tailored national training programs. You can access the full study here: Variations in Emergency Care for Severe Pre-eclampsia in Uganda: A National Evaluation Study (AJOG Global Reports, Feb 2025).
Stigma, myths, and delayed diagnosis fuel danger
The cause of pre-eclampsia remains unclear, though it is believed to run in families, suggesting a genetic link. It has no local language equivalent and no reliable screening test. It is detected only through persistent high blood pressure and protein in urine.
Dr. Annettee Nakimuli, head of the Department of Obstetrics and Gynaecology at Mulago National Referral Hospital, said at least four women die from pre-eclampsia every day at Mulago. The condition accounts for 8% of all admissions of pregnant women there.
“Pre-eclampsia presents with signs like swelling of the body but the women generally have no pain,” Nakimuli said. “It is surrounded by myths — some believe it is witchcraft or happens only during twin pregnancies or when expecting a baby girl. It’s also labelled a ‘disease of cheating women.’”
Nakimuli added that all women are at risk, but especially those under 19 or over 40, and those who conceive through in vitro fertilisation (IVF).
The cost of survival: 18 million shillings and counting
According to Mama D’s posts on social media platform X, she had set aside three million Ugandan shillings for her pregnancy, expecting a normal delivery. But the pre-eclampsia diagnosis threw her plans into chaos. She thereafter turned to her social media friends for help who raised some money.
“My bill has been cleared by the generous @UOXUganda and I can’t thank you guys enough for the love and support. My twins remain in the NICU and there’s still need for financial help as the bill is still growing, but fortunately, the doctors will advise of the way forward after 72 hours,” she said.
At one point, her bill at TMR Hospital had reached 18 million shillings (about USD $5,000). Although she was discharged from TRM, the total cost remains unknown. In her post she said she was later transferred to Mulago Specialised Women and Neonatal Hospital, another private hospital. Her twins remain in the Neonatal Intensive Care Unit (NICU), with a reported cost of 250,000 shillings (USD $70) per day for their care.
Earlier this year, Members of Parliament raised concerns over exorbitant fees charged at Mulago Specialised Hospital’s private wing. https://www.parliament.go.ug/news/3637/stop-charging-high-fees-mulago-specialised-hospital
Private hospitals also continue to charge exorbitant costs that remain unaffordable by many. The problem is some of these hospitals have been given loans from the IFC/World Bank to create equity but many of them instead continue to charge exorbitant fees that make services unafforable to the citizens.
Who benefits from World Bank and other donors financing of private hospitals?
Uganda’s healthcare services are delivered through both public and private sectors. However, the role of the private sector is expanding rapidly, largely due to inadequate public healthcare financing and pro-private policies endorsed by the government and international bodies such as the World Bank.
The private sector now provides 53% of healthcare services, compared to 37% by public facilities. The remaining 10% of the population relies on traditional healers. During the COVID-19 pandemic, private hospitals faced heavy criticism for overcharging patients, especially for oxygen and ICU care, drawing condemnation from civil society.
Despite these criticisms, several of these private hospitals benefited from loans provided by the World Bank’s International Development Association (IDA) under the Private Sector Window (PSW). These funds were channeled through the International Finance Corporation (IFC), the World Bank Group’s private-sector investment arm, to address the pandemic’s economic and health crises. Other donors continue to fund private sector hospitals which understandably charge very high fees. Maybe to repay the loans.
The question now is whether continued financial support to private healthcare facilities through the IFC and other donors is justified — and whether it contributes to widening health inequities in low- and middle-income countries like Uganda.
Again shouldn’t this financing be channelled to the public sector. Granted they are the private sector arm wanting to make profits from their loans but clearly they are widening health access. Shouldn’t the funders also ensure that no mother fears for her life or her baby’s survival simply because she can’t afford care—whether in a private or public hospital? The loans, are meant to save lives, not trap families in medical debt!
