Rugarama Hospital is a private, not-for-profit hospital situated in Kabale, a southwestern district of Uganda just north of Rwanda. The district population is over 500,000. The under-five mortality rate in Uganda is at 99 deaths/1,000 live births (2010) and the maternal mortality also remains at 430 deaths/100,000 live births (2008). Most women die as a result of infection and hemorrhage, while others have obstructed labor and cannot get a caesarean section.
Until February 2011, Kabale District had only the Regional Referral Hospital offering emergency maternal care services. Bearing in mind the challenges common to all government facilities, it goes without saying that the Kabale maternal and child health situation could only be worse than the stated national situation.
Rugarama Hospital realized the need to establish emergency maternal care services as far back as 2004, however due to limited resources this dream went many years unrealized. Several attempts to start were made, but with key components lacking, they were always fruitless. However, there was a ray of hope in April 2010 when officials from Direct Relief visited the Hospital with an intention to improve maternal and child health services in Kabale. It was on May 24, 2011 that there was a communication from Direct Relief as such “Direct Relief was committed to health system strengthening in Kabale in the years ahead, and to that effect was prioritizing establishment of Emergency Obstetric theater, based at Rugarama hospital.”
The district has since constructed a second operating theater and there has been tremendous improvement in maternal and child health service utilization at Rugarama Hospital. For the years 2008, 2009 and 2010 the total number of deliveries at the hospital was 55, 82 and 212 respectively. However with the introduction of emergency maternal care services by Direct Relief support the total number of deliveries of 2011 were 453 and already in the first quarter of 2012 deliveries are already 90 in total. Nearly 1/3 of the deliveries are by caesarean section. On August 5 2011, this was realized and there was an official handover of theater equipment required to establish emergency maternal care services.
In addition to theater equipment, Direct Relief supported Rugarama Hospital in establishing the second blood bank in the district and also a number of oxygen concentrators for use in the hospital neonatal unit that takes care of both neonates and premature babies- the only one in the region.
All these interventions have greatly improved both maternal and neonatal outcomes at the hospital and in the district at large. The hospital is committed to putting the donated equipment to the intended purpose as it seems the only appropriate appreciation to Direct Relief for the offer.