IMPACT OF HARD TO REACH AREAS ON SERVICES IN UGANDA

Terrain affecting Kabarole’s health and education services

BY FELIX BASIIME

& GEOFFREY MUTEGEKI
(Link: http://mobile.monitor.co.ug/News/-/691252/1290200/-/format/xhtml/-/10chkuq/-/index.html)

KABAROLE: Despite the presence of four hospitals and several health centers, majority of the rural people in Kabarole district are not accessing health services due to the geographical set up of the area.

The most affected are the hard to reach and hard to stay areas on the slopes of Mount Rwenzori and in the slippery areas east of the district.

The areas include Rwimi, Kabonero, Katebwa, Bukuuku, Kicwamba and Kasenda and parts of Hakibale sub counties.

The areas are hard to reach in a sense that it is difficult to realize infrastructural development, like roads, buildings and safe water.

Due to the steep, rocky or slippery terrain, these areas are at times cut off from the rest of the district especially in rainy seasons where there are at times landslides and or collapsed bridges hence affecting the government services.

The district vice chairman, Mr Moses Ikagobya admits that the terrain of the district has affected health and education sectors.

He observes that one of the health centres in Kibiito Sub County had failed to be constructed after more than five contractors abandoned work.

“At Rwagimba health center III, we had 5 contractors all abandoning the contract, every material to use required to be carried on the head through River Rwimi because there is no road in the area due to the steep terrain. The project was costly and time consuming” Ikagobya says.

He adds, “To take a bag of cement to Rwagimba, we had to divide it into four portions so that people could easily carry it”.

Ikagobya says that even after construction of some health centers and schools, it is hard to maintain staff at these facilities as they ran away soon and abandon work due to difficulty of staying there, no roads or means of transport.

Ikagobya adds “Most workers do not want to stay in these areas but go there for experimental work”

Due to these problems, better human resource is not attracted from outside the district to the rural areas of Kabarole forcing the district administration to hire the local people who at times are not qualified for the jobs.

“Health workers who are qualified do not prefer working in these areas which leads to many children in these areas suffering from diarrhea, pneumonia, and malaria” Ikagobya says.

Health workers are responsible for holding regular health education sessions on varying topics and conducting home visits and public facility inspections, active participatory vaccination campaigns, child health days, bed net distribution, and disease surveillance, but this is less or not done in some areas of the district due to the terrain.

“In some schools we hire school drop outs especially senior four leavers are the ones who teach in some schools in the hard t reach and hard to stay areas” says Ikagobya.

The district administration has tried to attract workers to these areas in vain.

Apart from the terrain problem, lack of electricity and other social amenities like shops in some rural areas and the weather in the district being generally cold are other challenges affecting human resource in the district.

In some places, the government has constructed schools and hospitals but there are no staff quarters.

The district leadership wants government to include Kabarole on the list of the “Hard to reach and hard to stay districts” so that when sending funds for infrastructure development, it is considered separately.

“Money needed to construct one school in the hard to reach area can be used for two schools in a town set up” argues Ikagobya.

Residents of Bunyangabu County have always petitioned government over poor services in their area.

“At Rwagimba Health Centre III, health workers report at work after midday and leave shortly after. As a result, many lives have been lost,” part of their petition handed to the district chairman in 2010 read.

Mr Joshua Bulimbenda, the LC1 chairman for Bulyambaghu, says when people fall sick, they use traditional stretchers to carry them to health centres because of the terrain, no ambulances can reach there.

The residents say they have resorted to carry their sick to Rwagimba hot springs for treatment. The hot springs are just a stone’s throw from the Rwagimba health centre III but health workers rarely go there.

                       Fact box (Source: Kabarole district 5 year development plan (2011-2016)

Kabarole District lies at an altitude of 1300 – 3800 meters above sea level. The district has a total area of 1,814km² of which 1,569 km² is covered by arable land and 198km² is covered by open water and wetlands.

The district has a ragged mountainous relief (Rwenzori Mountain) and undulating rolling slopes towards the low land. It is covered by black loams over red sandy clay loams (volcanic soils) and red sandy loams occasionally under laid by soft laterites on the top layer in most parts of the District.

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Rwagimba Health centre III is on the steep slopes in Kibiito is virtually without health workers