By Mulengera Reporters
Responding to initial media reports indicating that everything that can go wrong at a private not-for-profit health facility has happened to Catholic Church-owned St. Francis Nsambya Hospital, Ugandans have taken to social media to register their dismay while calling on President YK Museveni to intervene.
One of the oldest hospitals in Uganda, Nsambya Hospital (which millions of Catholics have always loved the way they love themselves) has clearly fallen on hard times largely due to the break down of corporate governance practices, financial scandals, procurement fraud and power struggles; all of which have over the years combined to breed despicable inefficiency.
The chaos at scandal-riddled Nsambya Hospital has been fermenting under the leadership of Dr. Andrew Sekitoleko as the Chief Executive Officer and Dr. Freddie Sengooba (who has since been replaced by Dr. Sentongo Katumba) as the Governing Board Chairman. Nsambya Hospital is one of the many Catholic Church-owned social services delivery entities over which the Archbishop Paul Semogerere-led Kampala Catholic Archdiocese has supervisory authority, including having four representatives on the Governing Board.
Because of the general feeling that, because of the vast goodwill from millions of loyal Catholics things always get along, there has always been a near unanimous consensus that such entities don’t have to be ran very efficiently and viably to thrive and remain in operation.
This inefficiency syndrome is a problem afflicting many Catholic Church-run business entities including Centenary Bank where one doesn’t have to be a very prudent CEO or MD to appear to be delivering results-and making money for the shareholders. There are many things top executives get away with and it continues to be business as usual at for instance Centenary Bank, which their contemporaries at other purely commercial banks can’t. The good will of the Catholics, who will stick around regardless of the apparent service inefficiencies, has always provided a firm fall back position-and this is well accepted wisdom across the banking industry in Uganda.
That same complacency hasn’t spared St. Francis Nsambya Hospital whose top leadership has over the years prioritized and concentrated on putting up glamorous buildings which helped to cajole the public into believing all is well, whereas not.
Available literature contained in multiple audit reports shows that the massive physical infrastructure expansion (which exposes top executives to billions in procurement kickbacks-related opportunities) was over the years prioritized at the expense of making the appropriate investments in the relevant ICT systems/automation, adequately investing in staff welfare, staff retention and human capital development. The Board also hasn’t been able to exercise the appropriate oversight role over the deeply fractured management of the hospital.
The latest forensic report by Ernest & Young shows that as of last February, St. Francis Nsambya had accumulated debts worth Shs49.3bn against a projected income or revenue of 11.1bn during the same auditing period. The Shs49.3bn, which the CEO Dr. Andrew Sekitoleko admits can only be paid through external help, comprises of billions in accumulated staff salary and gratuity arrears covering several months. Staff salaries always come several months later, if they ever come at all. The ICU isn’t functioning that well anymore.
Suppliers of essential medicines and badly-needed hospital equipment have gone unpaid for months. Billions in the staff SACCO too haven’t been spared the misappropriation which years of mismanagement and breakdown of corporate governance practices has permitted. Instead of prioritizing staff welfare and ensuring that the medical team members are adequately remunerated and on time, for years the top management curiously prioritized paying consultancy fees for the top-notch personnel who only come once in a time, and strictly on appointment.
The neglected core medical staff team members have been left with no option but to consequently become demotivated and disillusioned to the extent of being rude to patients who can only access the Nsambya facility after paying through the nose. The lack of morale among core medical staff team members explains why Nsambya is among the most sued health facilities in Kampala as aggrieved patients often have their cases mismanaged and thereby resorting to litigation.
The end of February HR department report to the Board indicated the extent to which senior medical staff departures had become a problem for Nsambya Hospital. It’s the reason management had to improvise by increasingly relying on medical interns who end up mismanaging patient cases because of inexperience and thereby exposing the institution to endless litigation.
Between January and December 2025, a total of 52 very senior medical staff had quit the job protesting general poor staff welfare and the hospital’s failure to pay them their monthly salary on time. There was no money to invest in staff retention, even when patients are charged highly and the recovery of unpaid medical bills is viciously enforced like St. Francis Hospital Nsambya is a military barracks!
In what shows the extent to which corporate governance practices have broken down at Nsambya Hospital, the Governing Board in January 2024 got involved into the purchase of the new online billing system called Hospedia (aka Navision ERP), which clearly is a management procurement function. A nugatory expenditure of Shs750m was incurred onto that unhelpful software procurement.
Dr. Sentongo Katumba has had to be recruited to serve as the new Board Chairman but knowledgeable insiders are doubtful if that alone will be mitigation enough to save the sinking titanic, which St. Francis Hospital Nsambya has become. As of 2021, the Board endeavored to rescue the situation by sourcing Shs10.3bn which was injected into the Hospital to ameliorate the financial situation but the crisis only got worse. It’s increasingly predictable that the reputation of the 440-bed Catholic Church hospital is going to suffer irreparable reputational damage.
Cases of staff indiscipline have also been rampant yet management, guilty of salary arrears stretching into months, hasn’t been able to assert itself enough so as to decisively crack the whip against such errant staffers. In a bid to pay themselves, some of the exploited medical staffers have resorted to stealing the hospital’s essential medicines from the pharmacy to sell and get money to be able to fend for their families.
A pharmacist can boldly tell patients to go buy medicine from outside while declaring the available stock in the dispensary to be his. In another instance, a staff member, who had gone unpaid for months, was authorized to take out 10 bottles of Albumin 20%-100ml injection for the treatment of his ailing mum and ended up taking 324 bottles worth Shs118m, yet the 10 bottles that had been authorized had been valued and recorded at only Shs3.5m!
Equally protesting salary arrears stretching months back, an electrician recently vandalized the hospital’s main theatre air conditioning system and went on to remove all the compressors to be able to sell and use the proceeds to keep thriving while waiting for his remuneration payment.
A previously relieved senior management official incited and legally aided a medical records officer to sue the hospital for Shs240m in damages. Some insiders say that Nsambya Hospital’s financial squeeze is partly attributable to failure or refusal by some of the health insurance companies and large corporate clients to promptly pay for the received medical services on time. Whatever the case, no prudent patient should consider seeking healthcare from a hospital engulfed into such a toxic environment because the outcomes are clearly predictable. (For comments on this story, get back to us on 0705579994 [WhatsApp line], 0779411734 & 041 4674611 or email us at mulengeranews@gmail.com).
