Jitka Škovránková, the head of a Czech hospital in Uganda

Jitka Škovránková

The Archdiocese Caritas Prague is one of the three biggest charity organizations in the Czech Republic. Every year, it spends some 70 million crowns, or almost 5 million US dollars, on various projects around the world in countries such as Belarus, India, Zambia and Uganda. Our guest today in One on One is Jitka Škovránková who has recently returned from Uganda where she headed the project of a Czecho-Slovak hospital in the town of Buikwe.

“I was the hospital administrator, that’s the official title. I was a representative of the major donor for the hospital, the Archdiocese Caritas Prague. The position involved running the hospital, financial issues, administration, employees, paying the salaries, getting drugs, blood, oxygen; basically running the hospital and maintaining its functions.”

How did Caritas first get the idea of opening a hospital in Uganda?

“The Archdiocese Caritas Prague has been running a child sponsorship programme in Uganda since 2001. This project provides education for children through the sponsorship of Czech donors. Later, they started adding more development projects to support whole communities and the families of the sponsored children because we believe that we have to support whole communities, not only individual people but rather whole families. Later, more agricultural, income-generating projects were implemented, and finally Caritas Prague decided to add on the health care project. The construction of the hospital began in 2005 and it concluded two years later; the hospital opened in February 2007.”

What kind of hospital is it? What type of care does it provide?

“It’s a general hospital. It has the four usual departments – a paediatric ward, a general ward, a maternity ward and a surgical ward. It of course has an outpatient department where you can come to see a doctor with minor problems. The hospital also has a lab, and it runs some specific programmes, such as nutrition and vaccination programmes as well as an outreach to the rural areas to reach the very poor.”

Do you get Czech doctors to work there or do you rely on locals?

“We cooperate with St Elisabeth University in Slovakia and since the beginning we’ve had around four or five Slovak or Czech doctors present there at all times. We always try to have all the important areas covered – we have a gynaecologist, a surgeon, an anaesthesiologist, an internist and a paediatrician.”

How does general health care in Uganda stand compared to health care in more developed countries?

“In general, there are three types of health care providers in Uganda. Some of them are governmental, which does not really work. They are only sponsored globally which means they run specific programmes and turn the entire health care into ARVs and other global initiatives fighting tuberculosis, malaria and HIV. It’s very specific and unreliable. Another type is private hospitals which are rare and of course you have to pay a lot of money, and the third official part is private non-for-profit hospitals which originated as the old Christian missions back in the 19th century. We are part of this type of hospital. These hospitals cover almost a half of health care in Uganda. According to the statistics, almost 50 percent of Ugandans have no access to health care, especially in the north that has been affected by an armed conflict, but there is fact a big tradition of local healers and herbalists.

Jitka Škovránková  (left) observes a surgery in the hospital in Buikwe
They have always been there. They traditionally attend births, they are spiritual healers who talk to gods, pray, sacrifice animals, and so on. I would say that on the one hand it’s fine that the herbs are so strong, but on the other hand it’s dangerous because we had cases of children whose bodies had ornaments cut with knives, and we also had people who died after eating some herbs. So this is the situation in Uganda but the statistics say that there is about 290 Ugandans per a traditional healer and 20,000 Ugandans per one western-style doctor. And the majority of the people still go to a traditional healer first.”

That might be one of the reasons why Uganda has had such a serious problem with HIV infection. What’s the situation like there now?

“Right now, the official numbers suggest that the rate has dropped significantly. But it’s also known that President Museveni set the rate quite high at the beginning of his era and now he says it dropped so much because his campaign has been successful. The official numbers are now around 6.8 percent of HIV prevalence. I can say that our laboratory tests showed that something between one third or one half of the tests are positive. It’s definitely more common in rural areas, and the highest prevalence is on the islands of Lake Victoria. The local communities there are very traditional and health care practically doesn’t exist there. They are fishing communities where the men have quite a lot of money; they drink alcohol too much and so on, so HIV is very common especially on Lake Victoria. So I would say the numbers are much higher than the official statistics.”

The United States has sponsored abstinence-only programmes to combat HIV in Uganda. Do you think these programmes work?

“That’s the famous PEP-FAR funding coming from the Bush administration. I don’t know if they really work but you can see both approaches in Uganda. We as a Catholic hospital cannot promote condoms or birth control pills and things like that but we in fact incorporated a former governmental health centre, and we have to run all the governmental programmes which also include family planning and condom distribution. So we, coming from the Czech Republic, are not as strict about abstinence-only programmes as they perhaps are in the West. And although we cannot really promote it in Uganda, we somehow do.”

You spent a year in Uganda – are you going back?

“Well, I just came back recently, so I don’t now yet. I am still working for the hospital from Prague, we are working on getting some grants from the Ugandan government and I’m preparing all the reports… I don’t now yet, I’m not sure.”