Butabika patients battling side effects due to cheap drugs

"I was first diagnosed with mania in 2002 as I was joining University. I was taken to Butabika and put on treatment. I was on that medication for a year," he said.

According to Mugonyi, when he joined university he stopped his medication because it could cause drowsiness.

"I used to take my drugs in the night but waking up in the morning was difficult. I used to wake up at midday and try to go to campus but it was too hard. I wanted to sleep all the time," he said.

Mugonyi says that due to the side effects of the drugs, he decided to leave campus and stay home.

"I wanted to be an electrical engineer and work for telecommunication companies like MTN. That was my dream but I failed to achieve it because I failed to attend classes due to feeling sleepy all the time," he said.

Mugonyi is not the only patient at Butabika National Mental Referral Hospital to complain about the side effects of the medication. The problem is attributed to the use of cheap drugs.

According to the hospital administration, they have been dispensing cheap drugs that that present side effects and alter the physical ability of patients to function when they swallow them.

One such drug is largactil.

It is one of the drugs the hospital relies on mostly to treat mental illnesses for more than 50 percent of the patient population.

Despite its side effects, the hospital procures the drug because of the limited resource envelop from government to benefit all patients.

Dr. David Basangwa, the Executive Director Butabika Butabika National Mental Referral Hospital, said the hospital operates on a budget of 600 patients yet it has 1,000 patients at the moment.

He explained that due to the funding gap, they are forced to prioritise on what conditions to treat and which drugs to use.

The hospital prioritizes the procurement of drugs like largactil, which can treat a number of mental illnesses. 700 of the 1000 mental patients currently at the hospital are treated using largactil.

100 patients are being treated for Schizophrenia, 300 for mood swings, 100 for paranoia and another 200 for alcohol & drug abuse.

Dr. Basangwa said that while cheap drugs like largactil are effective in treating mental illnesses that they are prescribed to treat, they present a number of side effects that affect the quality of life of the patients.

Due to side effects like heavy sedation caused by the cheap drugs, most patients cannot fully perform.

"When a student takes these drugs they cannot go to school and study or a person cannot even work when they are on these drugs. They are slow," Dr. Basangwa said.

Alternative drugs that present less or no side effects in patients are available on the market.

Olanzapine can be used to treat the same illnesses that largactil treats. However, due to the lack of money, procuring drugs like olanzapine is impossible, according to Dr. Basangwa.

"On the open market, a one month dose of largactil for one patient costs Shillings 5,000. Olanzapine on the other hand costs Shillings 200,000. With our funds, we cannot afford that," he said.

According to Dr. Basangwa, they have been buying cheap drugs since 2012 when they started experiencing an increase in the number of mental ill patients.

"Before we used to get a budget of Shillings 1.2 billion that was enough to cater for 600 patients. Five years, later we still get the same money for 850 in-patients. So we have had to cut corners to make sure that all Ugandans get the care," he said.

Dr. Basnagwa said ideally in situations when they face drug shortages, they would expect family members to step in but the case is different at Butabika.

"Our biggest challenge is that most of our patients do not have relatives who attend to them. They are bought in by police and there is no way you can ask someone like that to buy drugs for themselves due to a shortage," he said.

Dr. Hasfa Luswata, the Mental Health Focal person at the Ministry of Health, said the shortage of funds at the facility is an issue beyond the ministry's reach.

According to Dr. Basangwa, Butabika National Mental Referral Hospital needs twice its current annual budget allocation of Shillings 12 billion to be able to procure drugs like olanzapine.

Butabika National Mental Referral Hospital was founded in 1955. It has a capacity of 900 beds.

Currently, the hospital has 200 out patients and 850 in-patients.