By S. U. Thoronka………………………
The Auditor General’s report on the Accounts of Sierra Leone for the year ended 2014, has disclosed that there was inadequate supply of essential equipment and other facilities at the Princess Christian Maternity Hospital (PCMH).
The auditors observed the unavailability of equipment in the laboratory to be used by medical staff to diagnose different ailment on patients and these included: Automated bio-Haematology, Peritoneal port, oxygen concentrators, Ultrasound scanning machine reagent and large sterilizer drum.
At the theatre, the auditors also discovered that essential equipment which will enhance safe surgery such as Laparoscope, Laparotomy, Large sterilizer drum and Caesarean section set were insufficient.
In the exercise of their mandate, the auditors noted that there was lack of professional health workers with appropriate technical skills and inadequate infrastructure to support clinical activities. The laboratory in the hospital according to the report was being shared by another tertiary hospitals and this situation affected the timing and service delivered to patients, the auditors noted.
The report noted that the hospital lacks sufficient storage space to keep drugs and other supplies received from the Central Medical Stores. Interview conducted by the auditors with the patients in the wards revealed that there was no running tap water in the wards, patients or their relatives had to fetch water elsewhere.
The auditors also discovered poor monitoring and supervision of contract cleaners in the hospital. The private contractor providing cleaning services at the hospital was not monitoring and evaluated by the Environmental Officer to ensure that the hospital was properly and regularly cleaned. There was inadequate control of the management and distribution of free health care drugs.
The hospital according to the report did not maintain a database of patients who benefited from the free health care drugs and that the distribution and utilization of free health care drugs and consumables were not monitored and documented.
At the hospital pharmacy, the auditors discovered that physical stock count was not conducted quarterly or annually by the pharmacist and that weekly reconciliation between physical stock and records were not performed by an independent officer. The report further disclosed that documents such as sales day books, receipts books were not maintained to show the movement and sale of drugs; and revenues collected were not banked daily or the next working day.
The report noted that drugs were supplied to the hospital using the push system which was not required by pharmacists; as a result some drugs supplied had expired since they were not frequently required. According to the report, interviews conducted by the auditors with the patients in wards revealed that, drugs prescribed by medical specialists such as Fefol tabs, Ampiclox, vitamin ‘A’ tabs and many more were not available at the hospital pharmacy, these drugs had to be bought from pharmacies outside the hospital.
It was also observed that records management at the stores was a problem that is to say, store records such as bin cards maintained by the store keeper were not updated daily to reflect the movement of store items. In addition, physical count of stock revealed that actual stock counted did not agree with stock recorded on the tally card.