THE REPUBLIC OF UGANDA MINISTRY OF HEALTH STATEMENT ON INVESTIGATIONS INTO THE DEATH OF FOLLOWING A NEUROSURGICAL CAMP AT MENGO HOSPITAL Hon. Sarah Opendi Minister of State for Health – General Duties February 7, 2018

PATIENTS

STATEMENT ON INVESTIGATIONS INTO THE DEATH OF PATIENTS FOLLOWING A NEUROSURGICAL CAMP AT MENGO HOSPITAL In November 2017, the media was awash with claims that Mengo Hospital had organized a neurosurgical camp where 30 patients died after the surgery, and that the team that conducted the surgeries were not qualified. Subsequently, I directed the Uganda Medical and Dental Practitioners’ Council (UMDPC) to investigate the matter and provide a report. The Council constituted a team of specialists who comprised the following: 1. 2. 3. 4.

Ass. Prof. Okullo Joel Dr. Mijumbi Cephas Dr. Kituuka Olivia Dr. Nakibuuka Jane Mulago

5. Dr. Katumba Sentongo 6. Ms. Nanvule Doreen

Chairperson Senior Consultant Anesthesiologist President, Association of Surgeons of Uganda Consultant Pysician/Head General ICU, National Referral Hospital Registrar, UMDPC Legal Officer, UMDPC

The findings are as follows; i.

ii. iii.

iv.

v. vi. vii.

viii.

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The visiting team of neurosurgeons had held 11 similar neurosurgical camps at Mulago National Referral Hospital (10) and one at Mbarara Regional Referral Hospital (September 2016). The Mengo camp was intended to work on complex neurosurgeries which would otherwise have been referred abroad. Council noted that all the health care workers involved in the neurosurgical camp were qualified and were duly registered by their respective regulatory councils. These included Neurosurgeons, Intensivists, anesthetists, nurses, biomedical engineers/technologists and allied health workers. Thirty-one patients (31) out of 145 were screened using a three tier system by local and foreign doctors. (i.e by the Mengo Hospital team, Uganda Neurosurgical team, and International Neurosurgical team from Duke University) Overall there was adequate preparation for the camp. Council established that equipment and supplies were adequately provided in the theatre, ICU and High Dependency Unit for the neurosurgical camp. All the 31 patients were operated successfully with no adverse events. However, 5 patients died following complications in the late postoperative period. The mortality figures were comparable to those experienced in earlier neurosurgical camps conducted in Mulago NRH and Mbarara RRH. The Theatre, ICU and High Dependency Unit (HDU) were deemed microbial free before commencement of the neurosurgical camp.

ix.

x.

Frequent entries and exits by the ICU team to assist in collecting the postoperative patients from theatre and numerous visitors to the ICU posed an Infection Prevention and Control (IPC) challenge. The team noted weaknesses in documentation in the patient files.

Therefore, it is not true – as alleged by some media houses - that all the 31 patients worked on died. The investigative team therefore recommends that; i. ii. iii. iv.

Documentation in all operational areas should be done clearly and concisely. Re-constitute and urgently operationalize the Infection Prevention and Control Committee of Mengo hospital. Mengo Hospital should ensure continuous training and retention of ICU and HDU staff. Mengo Hospital neurosurgical unit should be further developed and accredited as a training site for neurosurgery

The Ministry of Health appreciates Uganda Medical and Dental Practitioners’ Council for the thorough investigation and comprehensive report on this matter.

For God and my country.

Hon. Sarah Opendi Minister of State for Health (General Duties) 7th February 2018.

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