Deadly medical technology

By Nicole Namubiru

If more attention is given to advanced technology, there will be fewer unnecessary deaths, experts say

Despite a slight increase, the allocation to the health sector in this year’s budget has not impressed sector enthusiasts. While it increased from Shs 1.1 trillion to Shs 1.2 trillion, the sector allocation reduced from about 7% to 5% a percentage of total budget – miles away from the World Health Organization (WHO) recommendation of a minimum of 15% of the total budget.  Sector enthusiasts argue that one of the consequences of inadequate funds is failure to acquire advanced medical technologies that are so critical to health service delivery in other countries.

A WHO Global Health Expenditure Database published by Eucomed found that between 2000 and 2008, medical technology reduced hospital stays by an average of around 13% in developed countries including Belgium.  The study showed that the advancement in the medical technologies of these countries matched their low levels of deaths due to diseases.  Although there hasn’t been a similar study for Uganda, health experts contend that the failure to invest in advanced medical technologies have had adverse effects on the health services that are delivered in Uganda.

Dr. Anthony K. Mbonye, the director of health services at the health ministry, knows why Uganda has not acquired critical modern technologies. “We do not have advanced technologies in our hospitals because we are minimally funded,” Mbonye told The Independent.  Medical technology, according to the WHO, constitutes medical equipment, drugs, vaccines and supplies.

Mbonye said of these technologies, what Uganda lacks most is diagnostic equipment though hopefully this could change soon. “We are discussing with some investors from Turkey and Italy to provide equipment like CT scans, Linear Accelerator machines among others,” Mbonye said, adding that though some donors such as the GAVI Fund have injected money into the health sector, it is still not enough to provide for all the critical modern medical equipment.

Yet, worldwide, there has been great advancement in medical technology, which Ugandans should benefit from, according to Dr. Ian Clarke, the executive director of the International Hospital Kampala.

For instance, he says, there have been huge advancements with TB medications, yet Ugandans patients are still being treated with the older routines.

But for Clarke, Uganda’s problem goes beyond limited funding.  “There is limited medical expertise in Uganda to handle high tech machinery,” he says. “Maintenance for this equipment is also expensive. This makes it hard for most hospitals here to have them.”

That means that even if the sophisticated medical equipment were to be brought in, the deficiency in expertise to use it appropriately would hinder its effectiveness to help patients.

But Dr. Mbonye says they are working on devising a solution.

“Our ongoing discussions with international investors from Italy and Turkey involve having them train Ugandans on how to operate high-tech machines,” he says.

Until that happens, the shortage in medical technologies continues to pose a severe problem to many people’s lives. What medical technology does is that it improves the ways of administering medication and thus increases the chances of survival. For instance, if one had to swallow ten tablets for an ailment, they would instead swallow one tablet. This could go a long way to reducing skipping the drugs, which leads to resistance, plus avoiding some of the side effects of taking too many drugs.

Additionally, instead of undergoing an open surgery that would leave one with severe wounds to nurse for a long period of time, advanced technologies can enable a surgeon to perform minimally invasive surgery that would leave a small wound that can heal in only a short while.

Modern technology is helping to save lives of cardiovascular patients. According to the WHO Global Health Expenditure Database, which was published by Eucomed, the use of coronary stents – artificial tubes used in cases of coronary heart disease to keep the arteries open – has halved the number of patients dying from heart attacks or heart failure. Patients with an Implantable Cardioverter Defibrillator (ICD) – a small device implanted for those at risk of sudden cardiac death – now have a 98% chance of surviving a cardiac arrest, compared with only 5% without the implantable device.

The dire lack of such a technology has left the poor Ugandans exposed to unnecessary deaths from cardiovascular diseases.

A similar situation faces cancer patients. A source at the Mulago National Referral Hospital revealed that cancer patients are being treated with a cobalt machine. This is outdated technology in many countries as it scatters radiations beyond the cancer-affected tissues to other healthy tissues.

This thus means that even the healthy tissues of a cancer patient will be affected by radiation. This is just one of the many disadvantages of old technology.

There are now better technologies on the market like the Linear Accelerator.

According to Intermountain Healthcare, the Linear accelerator technology is incredibly important because cancer tumors and lesions don’t stay in the exact same place after each radiation therapy session. When a patient gains or loses weight or experiences other physical changes, organs can shift even slightly. So it’s imperative that before each treatment, physicians can identify exactly where cancerous cells end and healthy cells begin. Most importantly, this technology does not scatter radiation to the healthy tissues.

Experts say the use of Linear Accelerators in the treatment of cancer is not yet available in Uganda.  This means that all cancer patients in Uganda, if not flown out of the country, would have to undergo the available old technology for cancer treatment.

This thus inevitably reduces their chances of surviving cancer, and if they do, they must succumb to the effects of radiation on their other otherwise healthy tissues.

Experts however say that Uganda has acquired some advanced technologies but they insist that policy makers must improve the situation by availing more funds for better technologies and the provision of training expertise in order to modernize health service provision to the Ugandan population.