I spoke to two women at a private hospital in Kampala, Uganda to find out why they had come, whether they were happy with the services they had received, and if not how they wished their problems to be addressed.
Mother experiencing pain after delivering 2-months-ago
A 29-year-old woman who delivered at the health facility 2-months-ago had returned with symptoms of vaginal discharge and discomfort, dyspareunia [pain during and after sexual intercourse] and bleeding.
The woman had received an episiotomy [surgical cut to aid labour] during childbirth. The doctor said she had come back to the health facility with a reddish mass in her vagina following the episiotomy. Her episiotomy had healed but granulation [fibrous-like clotting] was present and she was experiencing pain even on slight pressure. His advice was for her to undergo surgery at a cost of $40 USD.
The mother complained about this, saying: “This was a problem that arose from an episiotomy. Wasn’t this the midwife’s mistake? I do not know what causes this granulation after an episiotomy, but I have been told the granulation takes place at the point at which they start stitching and the point where the end the stitches. Is this an oversight, omission or commission on the part of a physician? Why did it happen to me and not many other mothers who were stitched?
“The time I should have reported for the post natal review, that is one week after the delivery, the granulation they tell me had not yet appeared. My major problem is why should I pay again for what could have been a problem arising from the physicians fault? I do not begrudge the hospital, but we need mechanisms that ensure that such mistakes are not made deliberately to make us pay. This is a private facility and I do not know how they make money and profits.”
A baby with tongue tie
Another mother I spoke to had brought in her baby due to tongue tie, a condition where the bottom of the tongue is attached to the floor of the mouth, which restricts the ability to freely move the tip of the tongue. The cost of this surgery was $10 USD.
The mother’s complaint was as follows: “This baby was delivered from this private hospital, but we went with the baby home. And it is [only] after two months that we discovered that this baby had this problem of tongue tie. We were actually told by a traditional birth attendant, who checked the baby’s mouth. When we came back to the hospital, the doctors also confirmed that the baby has tongue tie.
“Isn’t the hospital capable of finding out this problem immediately the baby is born? This could be an oversight or omission on the part of the health workers. When I came back I had to pay again for consultation and the surgery, yet the cost could have been covered at the time I delivered this baby. Why should I pay again?
“Secondly, the time of waiting for the surgery is too long. We were told to report at this facility at 7.30 am but it is now 11.30am. This is too much time for waiting.”
The hospital declined to give an official comment. However, one doctor I spoke to there told me that granulations should be detected when a mother is properly reviewed after delivery. But he told me that detecting tongue tie is not part of standard childbirth hospital protocol.
Patients prefer services from private hospitals because they expect that those services are better than government funded facilities. It is therefore unfortunate to see patients unsatisfied with the quality of care in private health facilities.