Anyone who has had a toothache will tell you it is the worst kind of pain they have ever felt.

They will tell you it hurts in the most obscene way and all solutions involve a dentist. They will tell you how uncomfortable the dentist’s chair is, and how minutes seem like days in that dreaded chair.

What they will not tell you is the dent that visit will cause in their wallets.

A tooth extraction procedure ranges between UGX 30,000 to UGX 120,000 in most dental
clinics in Kampala. You will be fortunate to find a good dentist. He will make you feel comfortable, present all your options, explain the risks involved and assure you that this is a common, low risk procedure. He will answer all your questions, offer you leaflets on proper dental care and introduce you to dental floss.

But what happens when you have that mind numbing toothache but do not have access a dentist? When you are one of the multitudes waiting in line at a public health facility to see one dentist who may or may not be of any help?

For most, this is a hypothetical question, but for the 19.7% of the Ugandan population living below the poverty line, this is reality.

In a recent visit to Kawaala health centre III, I was saddened to find that the only dental filling machine is quickly depreciating because it has not been used in a very long time. This is not because the people of Kawempe division do not have cavities, but because the centre does not have filling materials.

This coupled with a constant lack of drugs, congestion, and shortage of medical personnel, it is absurd that this health centre serves people of about five sub counties. With a maximum capacity of 200 patients, over 600 ailing people are received every day, which prompts the provision of only outpatient care as the facility cannot accommodate any patients overnight. The maternal ward especially has only 10 beds versus the 10 -20 expectant mothers that are admitted daily.

A patient registers in a health book at the Health center in Kawala
A patient registers in a health book at the Health center in Kawaala

According to an investigation by Aljazeera, it was found that Uganda’s doctor patient ratio is about 1:24,000, One of the worst in the world. This leaves very little hope for the poor majority who cannot afford private health services and completely depend on the government health care system.

This system that allows for UGX 7 million allocation per quarter to this centre. According to the LC1 chairman of Kawempe division, this money can only sustain it for the first month, exposing it to constant drug stock outs, unmotivated medical personnel and shortage of medical laboratory equipment which creates a risk of inaccurate test results.

Despite the need and urgency of medication, the National Medical Stores has often found itself in position to destroy expired drugs not suitable for consumption. “When we have large quantities of drugs with low uptake, the shelf life of the drugs comes to an end and they expire”. Said the acting National Medical Stores (NMS) general manager in an interview by the New Vision.

As people continue to buy free medication, pay bribes to access free services and die from treatable illnesses.

The health services at private clinics however, keep getting better with advanced diagnostic and treatment techniques and technology. Drugs never run out of stock, medical practitioners are readily available with impeccable bedside manner, providing a smooth healing process. But what happens to those who cannot afford to pay consultation fee just so the doctor can confirm their illness? Are they any less of citizens? Do they not deserve access to standard medical care in their own country?

The national budget for the financial year 2016/2017 provided for a UGX 2.8 billion allocation to the Ministry of Health, as funds to cater for specialists’ wages and operational expenses in ten newly refurbished hospitals.Will this be enough to fill the gaps in public hospitals or shall people continue to suffer as a result of a broken service delivery system?