The Inadequacy of Donating Medical Devices to Africa (My Article at The Atlantic)

(Via The Atlantic)

Part of Bwindi Community Hospital's medical device graveyard

Part of Bwindi Community Hospital’s medical device graveyard

Mulago National Referral Hospital, the keystone of Uganda’s system of public hospitals, is located on top of an ochre hill overlooking the capital city of Kampala. The sprawling six-story hospital has spawned an ecosystem of restaurants, guesthouses, and—in a macabre combination of remarkable efficiency and casual indifference—multiple coffin sellers.

It’s named after omulago, a plant that once grew on the same hill and was used in traditional Banda medicine to ward off spirits. The hill offers only Western medicine now, and throngs of Ugandans can be found waiting for treatment and standing vigil by loved ones, with babies secured on their backs by flowerykitenge.

Mulago’s Neonatal Intensive Care Unit is a cramped, 20-by-30-foot rectangle. On the day I visit, it’s crowded with about 50 newborns in hospital beds and mothers’ laps. Justine, one of the two NICU nurses on shift, said it was a light day: “50 to 60 babies is the lowest—you will find 70 or 80 at times. We put them on chairs.”

The premature and low birth weight babies lie cordoned-off from the rest in a narrow space where 20 incubators are arranged like Tetris pieces; most were donated by NGOs and bilateral agencies like USAID. Many lay open, and the silence is interrupted only by the cries of newborns; no sound emanates from the machines.

They aren’t on.

“They’re old, so they break down soon,” Justine informs me matter-of-factly as we survey the carnage. 13 of the 20 incubators are broken.

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