Uganda’s Arua Hospital Operating at Just 23% Staffing as Patient Numbers Soar

KAMPALA, Uganda — Arua Regional Referral Hospital, the only referral facility serving Uganda’s West Nile region, is operating with just 23% of its approved staffing complement as patient numbers continue to rise.

The hospital serves a catchment population of about 2.5 million people, including Ugandan nationals, refugees and patients crossing the border from neighbouring countries. It handles approximately 130,000 outpatients and 22,000 inpatients each year.

The staffing shortfall, hospital acting director Dr Gilbert Aniku told Parliament, is placing increasing pressure on the facility’s ability to provide services.

“Right now, our staffing using the new structure is at 23 per cent of the establishment, and this has placed a constraint on our ability to deliver services to an optimum level,” Aniku said.

He was appearing before Parliament’s Public Accounts Committee to respond to audit queries for the 2025 financial year. The session was chaired by Deputy Chairperson Sarah Lwansasula.

Maternity services bearing the brunt

Maternity care is among the services under the greatest strain.

Of the 22,000 inpatients recorded during the year under review, about 7,000 were deliveries, an average of roughly 22 births a day. About 40% of those deliveries were by caesarean section.

Aniku said the volume of deliveries was placing considerable pressure on the hospital’s human resources and infrastructure.

The hospital is, however, expected to receive some relief after Parliament allocated additional wage funding for the current financial year.

According to Aniku, the funding will allow the hospital to recruit 127 additional staff members, raising staffing levels to at least 32% of the approved establishment.

The additional personnel are also expected to support the expansion of specialised services, including intensive care, dialysis and emergency response.

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The committee also questioned the hospital over medicines worth about Shs148 million that had expired, including antiretroviral drugs and laboratory controls.

Lwansasula raised particular concerns about the condition of the hospital’s medicine store, which had reportedly been exposed to high temperatures.

Aniku acknowledged the expired stock and said some of the affected medicines, particularly antiretrovirals and antimalarial drugs, had been received through donations.

He said the hospital initially installed fans to address the temperature problem but is now installing air-conditioning systems to maintain appropriate storage conditions.

“The challenge is about the ambient temperature in the store, and we are installing ACs to maintain the temperature,” Aniku told the committee.

The air-conditioning work began after funding became available in the current financial year.

Cancer patients still have to travel for treatment

Cancer treatment is another area where the hospital’s limited capacity is forcing patients to seek care elsewhere.

Karim Masaba, an independent MP representing Industrial Division, raised concerns about the growing burden of cancer, including among children.

Aniku confirmed that the hospital is seeing cancer cases among both children and adults. Among paediatric patients, the most common cases include blood cancers such as leukaemia, as well as cancers affecting the kidney, liver and brain.

Arua currently has limited capacity to diagnose and treat cancer, meaning patients requiring specialised care are referred to the Uganda Cancer Institute at Mulago or the cancer facility in Gulu.

A planned cancer facility for the West Nile region could reduce the need for patients to travel elsewhere, but Aniku could not provide a start date for the project.

The hospital has made progress in other areas of specialised care. Its oxygen plant is operational and its CT scanner is functional.

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Dialysis services are still being developed. A facility is being constructed under the UCREP project to accommodate both an intensive care unit and a dialysis unit.

The hospital has also partnered with Kiruddu National Referral Hospital to support the rollout, with staff training expected to begin in November.

The parliamentary committee also returned to concerns about the hospital’s mortuary.

Aniku said the existing facility dates back to when Arua was still operating as a general hospital and no longer meets the needs of a regional referral facility.

Plans are in place for a new mortuary with a cold room, pathology services and facilities for post-mortem examinations. The proposed facility would also provide space to support medical students from a nearby university.

However, construction has not yet started because of the project’s significant capital requirements.

Missing Shs300 million ambulance remains under investigation

The committee also questioned the hospital about an ambulance valued at Shs300 million that was reported missing in an earlier audit.

Aniku told MPs that the matter remains under investigation.

The issue adds to the operational pressures facing a hospital already struggling to meet the needs of a large and growing population with limited staff and infrastructure.

For Arua, the immediate challenge is therefore not simply increasing patient numbers, but ensuring that staffing, medicines, specialised services and essential infrastructure keep pace with the hospital’s expanding role as the main referral centre for West Nile.