Dear Governing Council of Mengo Hospital,
Thank you for the survives you offer to Uganda. There is no doubt about the commitment and passion of the men and women manning that hospital. I am so very proud of them. However, I would like to bring to your attention a very unfortunate event that made Jesus weep. Jesus wept, not 2021 years ago but yesterday 19th July 2021, in the compound of Mengo Hospital when an indigent child, Musa aka Moses, a homeless juvenile was brought to Mengo Hospital.
Acting on the principle of reliance, a homeless child, carried another homeless child to Mengo Hospital, after being referred from a small facility, but Mengo Hospital management- relying on the policies they claimed you set, refused to admit him for emergency care before we could deposit Two Million Uganda shillings. Jesus wept, as that boy was wheeled away from a hospital.
The boy was in very critical condition and required the ICU Facility. Musa but known by friends as Moses, had fallen in a sand pit filled with water and almost drowned. Street children with whom he lives picked him and conveyed his almost lifeless body to a clinic in Masanafa from where I picked him and took him to another Clinic in Nakulabye, where they examined him and advised he immediately be rushed to Mengo Hospital as he was in need of ICU facilities.
The homeless young man, who was accompanying this little boy arrived in Mengo, and your team ruled that he needs to immediately be admitted in ICU but that he would need to deposit 2 million shillings before they could provide emergency care.
The young man called me and I asked to speak to a member of staff of the Hospital. The member of staff I talked to on phone insisted that it’s the hospital policy to pay a deposit before ICU admission and that they will not admit him until we deposit 2 million shillings.
I pleaded with him, explaining how the patient was homeless. I begged to be given time to mobilise resources as the boy receives care but my pleas fell on deaf ears. He told me the best they can do is refer him to ‘a cheaper option’- Kirudu or Kawempe Hospital. A cheaper Hospital!!
Governing Council, I believe that Mengo Hospital lived short of its identity and did not bear witness to the Love of Christ when it refused to admit a homeless child to at least be stabilized before making a referral to Kuridu Hospital.
I cannot register it in my mind that the indigent cannot find help in the compound of Christ. This act is a clear portrait of the unfortunate departure of our Hospital from the Vision of its founders and the entire Body of Christ.
As a Private BUT Not for Profit Hospital, that also, directly and indirectly, benefits from resource allocations from Government, there is an implied consensus that the Hospital is important to the public and it is logical for the people to support it to maintain an acute care infrastructure. This is why you receive support from Government and other entities.
Public resources to Mengo Hospital are not only limited to resources from Government but other donations and support offered by other entities, which believe that the Hospital has a Christian Mission and welcomes all, as Jesus did…and that even the indigent like Moses can seek refugee and be treated without being told to find a cheaper option.
Members of the Governing Council, as you strike a balance between meeting the overhead costs and providing care to all, it is my prayer that you remain true to your Mission as a Christian Hospital. Jesus wept that a hospital that prides itself in being a ‘Christian medical witness’ whose mission is to ‘To provide quality, holistic, patient-centered, evidence-based health care services and medical education bearing witness to Jesus Christ’ could dump a patient- a homeless boy because he was not liquid enough to receive the Love of Christ. Where is the church in that Hospital?
I am appalled by the sickening policies that have unfortunately made Doctors act against their code of ethics- to turn away a patient in need of emergency care on account of their inability to pay. I am aware that Doctors, like all professionals ‘do not owe a duty to exercise their particular talents, knowledge, and skill on behalf of every person they encounter in the course of the day …and that is only with a physician’s consent, whether express or implied, that the doctor-patient relationship comes into being and that even on the basis of the law of contract, both parties must assent to the creation of a relationship’ BUT I think for a Christian Hospital, there is a moral duty for physicians and hospitals to provide emergency care.
I think this act constituted a breach of the Hospital’s moral duty of care for the patient. It is my opinion that the policy should be revised to provide for circumstances, like in the case of a homeless child, where the Hospital should have a duty to accept a person in need of emergency treatment.
Mengo Hospital as a Christian Mission Hospital has a well-established custom of providing emergency care to the public and it’s on this premise that other medics referred the homeless child to this Hospital, relying on that custom and knowing that this child would receive emergency care.
That above needs to be understood. Why did they refer this child to Mengo? The concept of reliance! It would be a disaster for the public to start to think that Mengo Hospital is for the rich and that its emergency services are no longer available for the general public, or worse for the indigent. That act was a sickening departure from our norms as a Christian Mission Hospital to turn away Moses.
By making such disheartening policies, we compromise the ethical duty for physicians to provide assistance to individuals requiring emergency care. I believe that physicians should be able to provide whatever appropriate assistance to any person with an urgent need for medical care.
By accepting a patient, in which case we establish a physician-patient relationship and in which case the patient starts to rely on you, and then deciding to reject him and send him away because he cannot deposit 2 Million shillings borders on criminality or in the least, anti-Christian mannerism.
The medics, knowing what they know, did not convey this boy to Case Clinic/Hospital or IHK, but they referred him to Mengo because there is a public perception that this is a public or people’s hospital where care comes first, then money follows.
If it is now settled custom that Mengo Hospital is no longer for the poor or ordinary people, let it be said and put in writing, warning the Public that all cases coming for emergency care must report with 2 million shillings. This ‘warning’ will leverage the expectations of the public and also convey the new identity of the Hospital to the Public. For now, there is a reliance principle by which patients, rich or poor, are conveyed to Mengo Hospital.
It is also my opinion that given that Mengo Hospital, in one way or another, receives support from public funds; whether conveyed by the Government of Uganda or other entities, in form of training of members of staff, subsidies, and tax exemptions of medical supplies or wages for some staff, there should be a public policy consideration when making decisions to dump patients.
All hospitals that benefit from the public purse should be duty-bound to stabilize and provide medical screening examinations for each patient who comes to the facility for emergency care, regardless of the patient’s ability to pay. I believe this is the spirit by which these grants and aid are given to a private Hospital. If Mengo Hospital should become a hospital for the rich, it should not receive any form of aid from the Government or other faith-based entities.
I am not of the view that failure to provide emergency care should expose individual physicians to direct liability but the Hospitals that make such sickening Policies must not benefit from the public purse.
You have provided good services to the Public and this legacy should not be destroyed. The church must be present in the actions of the Hospital. The Love of Christ must be the guiding principle in the delivery of services at Mengo Hospital.
As an Anglican faithful, I am very disappointed at the manner in which this matter was conducted and it is my hope that this is the last case that Mengo turns away. Mengo Hospital should not join the train of most private for-profit Hospitals whose Mission is different. Trying to mimic the acts of Private-For-Profit Hospitals is careless and goes against public policy considerations against which aid is provided to Mengo Hospital.
Governing Council Members, I would appreciate any consideration you could give to this matter. However, should you find my suggestion and prayer too heavy to consider, I will be pleased to take other measures to make the Hospital find reasonable accommodation for my suggestion.
As you sit to make these policies, please remember the doctors and nurses who interface with a dying patient, and have to look in their deep-set eyes, and say NO, I can’t serve you because you have are poor. I have no ill feelings towards any medic in Mengo…as I am aware, they have to act within the policies you make. I am simply asking that as you sit in your AC furnished board rooms to make these policies, you remember the Doctors and Nurses, who have to look a dying patient in the eyes and say, ‘No, I won’t serve you because you have no money.’ Remember the Doctors and Nurses who interface with the community and have to sleep with a hurting conscience.
Mengo Hospital receives so much help from so many well-wishers in and outside Uganda and this kind of Policy has no place in our hearts as users but also contributors to the services of the Hospital. I await to hear your action on this policy as I explore other means of bringing this matter to the attention of other stakeholders near and far, by whose gifts and donations the Hospital stands.
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