OFFICE OF THE AUDITOR GENERAL

THE REPUBLIC OF UGANDA

REPORT OF THE AUDITOR GENERAL

ON THE FINANCIAL STATEMENTS OF MOROTO REGIONAL REFERRAL HOSPITAL

FOR THE YEAR ENDED 30TH JUNE 2016

TABLE OF CONTENTS

Table of Contents LIST OF ACRYNOMS ...... 2 REPORT OF THE AUDITOR GENERAL ...... 3 1.0 Introduction ...... 5 2.0 Audit Scope ...... 5 3.0 Audit Procedures Performed ...... 6 4.0 Entity Financing ...... 6 5.0 Findings ...... 7 5.1 Categorization of findings ...... 7 5.2 Summary of Audit Findings ...... 7 6.0 Detailed Audit Findings ...... 7 6.1 Unaccounted For Funds ...... 7 6.2 Under Staffing ...... 8 6.3 Delayed Procurement of Oxygen Plant ...... 8 6.4 Salary Arrears ...... 9 6.5 Missing Procurement Files ...... 9 6.6 Diversion of regional medical equipment workshop funds ...... 9 6.7 Nugatory Expenditure ...... 10 6.8 Shoddy work on Completion of 3 Semidetached Staff Housing Unit ...... 10 6.9 Non Disposal of Expired Medicines...... 11 6.10 Delayed Disposal of Obsolete Assets ...... 11 Appendix i Unaccounted for Funds ...... 13 Appendix ii under Staffing ...... 14 Appendix iii Salary arrears FY 2015-2016 ...... 15 Appendix iv Missing Procurement Files...... 15 Appendix v Payments made under Moroto hospital Regional workshop programme ...... 15 Appendix vi Nugatory Expenditure ...... 18 Appendix vii Payment for completion of 3 Semi-detached Staff Housing Unit ...... 19 Appendix viii Non Disposal of Expired Drugs ...... 19 Appendix ix Delayed disposal of assets ...... 20

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LIST OF ACRYNOMS RRH Regional referral hospital ICT Information Communication Technology ISSAI International Standards of Supreme Audit Institution MoESTS Ministry of Education Science and Technology and Sports MoFPED Ministry of Finance Planning and Economic Development NMS National Medical Stores PFMA Public Finance Management Act 2015 PPDA Public Procurement and Disposal of Assets UGX Uganda Shillings URA Uganda Revenue Authority VAT Value Added Tax WHT Withholding Tax MoU Memorandum of Understanding GoU Government of Uganda PDE Procurement and Disposal Entity

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REPORT OF THE AUDITOR GENERAL ON THE FINANCIAL STATEMENTS OF MOROTO REGIONAL REFFERAL HOSPITALFOR THE YEAR ENDED 30TH JUNE 2016

THE RT. HON. SPEAKER OF PARLIAMENT

Introdution I have audited the accompanying financial statements of Moroto Regional Referral Hospital for the year ended 30th June 2016. These financial Statements comprise of the statement of financial position as at 30th June 2016, statement of financial performance, statement of chnages in equity, cash flow statement together with other accompanying statments, notes and accounting policies.

Management Responsibility for the Financial Statements Under Article 164 of the Constitution of the Republic of Uganda, 1995 (as amended) and Section 45 of the Public Finance Management Act, 2015, the Accounting Officer is accountable to Parliament for the funds and resources of Moroto Regional Referral Hospital. The Accounting Officer is also responsible for the preparation of financial statements in accordance with the requirements of the Financial Reporting Guide, 2008, and for such internal control as management determines necessary to enable the preparation of financial statements that are free from material misstatement whether due to fraud or error.

Auditor’s Responsibility My responsibility as required by Article 163 of the Constitution of the Republic of Uganda, 1995 (as amended), and Sections 13, 16 and 19 of the National Audit Act, 2008 is to express an opinion on these statements based on my audit. I conducted the audit in accordance with International Standards on Auditing. Those standards require that I comply with the ethical requirements and plan and perform the audit to obtain reasonable assurance whether the financial statements are free from material misstatement.

An audit involves performing audit procedures to obtain evidence about the amounts and disclosures in the financial statements as well as evidence supporting compliance with relevant laws and regulations. The procedures selected depend on the Auditor’s judgment, including the assessment of the risks of material misstatement of the financial statements, whether due to fraud or error. In making those risk assessments, the Auditor considers internal controls relevant to the entity’s preparation of the financial statements in order to design audit procedures that are appropriate in the circumstances, but not for the purpose

3 of expressing an opinion on the effectiveness of the entity’s internal control. An audit also includes evaluating the appropriateness of accounting policies used and the reasonableness of accounting estimates made by management, as well as evaluating the overall presentation of the financial statements.

I believe that the audit evidence I have obtained is sufficient and appropriate to provide a basis for my qualified opinion.

Part “A” of my report sets out my qualified opinion on the financial statements. Part “B” which forms an integral part of this report presents in detail, all the significant audit findings made during the audit which have been brought to the attention of management.

PART “A” Basis for Qualified Opinion

Un Accounted for Funds A sum of UGX. 107,675,473 remained unaccounted for at the time of audit. Consequently, I was unable to confirm that the funds were utilized for the intended purposes.

Qualified Opinion In my opinion, except for the possible effects of matters described in the Basis for Qualified Opinion paragraph , the financial statements of Moroto Referral Hospital as at 30th June 2016 are prepared, in all material respects, in accordance with the Section 51(3) of the Public Finance Management Act 2015.

Other Matter I consider it necessary to communicate the following matter other than those that are presented in the financial statements. Under Staffing

The Hospital has an approved staff structure of 395 positions. However, out of the 395 approved posts only 162 (41%) positions are filled leaving 237 (59%) posts vacant. Understaffing adversely affects service delivery.

John F.S. Muwanga AUDITOR GENERAL 15th December, 2016

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PART "B"

MOROTO REGIONAL REFERRAL HOSPITAL DETAILED REPORT OF THE AUDITOR GENERAL FOR THE FINANCIAL YEAR ENDED 30TH JUNE 2016

1.0 Introduction In accordance with Article 163(3), of the Constitution of the Republic of Uganda 1995 (as amended), I am required to audit and report on the public accounts of Uganda and of all public offices, including the courts, the central and the local government administrations, universities and public institutions of the like nature and any public corporation or other bodies or organizations established by an Act of Parliament. Accordingly, I carried out the audit of the Moroto Regional Referral Hospital to enable me report to Parliament.

2.0 Audit Scope The audit was carried out in accordance with International Standards on Auditing and accordingly included a review of the accounting records and agreed procedures as was considered necessary. The audit was carried out with regard to the following objectives:- a. To verify whether the financial statements have been prepared in accordance with the requirements of the Public Finance and Accountability Act 2015, and fairly present the income and expenditures for the year and of the financial position as at the end of the year. b. To verify whether all the entity’s funds were utilized with due attention to economy and efficiency and only for the purposes for which the funds were provided. c. To verify whether goods and services financed have been procured in accordance with the PPDA Act 2003. d. To evaluate and obtain a sufficient understanding of the internal control structure of the entity, assess control risk and identify reportable conditions, including material internal control weaknesses e. To verify whether management of the entity’s funds was in compliance with the Government of Uganda Financial Regulations. f. To verify whether all necessary supporting documents, records and accounts have been kept in respect of all activities, and are in agreement with the financial statements presented.

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3.0 Audit Procedures Performed The following audit procedures were undertaken:-

a. Revenue Obtained all schedules of all revenues collected and reconciled the amounts to the cashbooks and bank statements of the entity.

b. Expenditure The payments vouchers of the entity were examined for proper authorization, eligibility and budgetary provision, accountability and support documentation.

c. Internal Control System Reviewed the internal control system and its operations to establish whether sound controls were applied throughout the period.

d. Procurement Reviewed the procurement of goods and services under the various departments during the period under review and reconciled with the approved procurement plan.

e. Fixed Assets Management Reviewed the use and management of the assets of the entity during the period under review.

f. Financial Statements Examined, on a test basis, evidence supporting the amounts and disclosures in the financial statements; assessed the accounting principles used and significant estimates made by management; as well as evaluated the overall financial statement presentation. 4.0 Entity Financing Moroto Regional Referral Hospital is financed by grants (Conditional and Unconditional) from the Central Government, and Non Tax Revenue. During the year, the district received grants totalling to UGX 3,292,187,755 from the Central Government and UGX 204,846,237 as donation from Foreign Government realising a total revenue of UGX 3,497,033,992 constituting 98.5% of its approved budget estimates of UGX 3,549,968,000.

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5.0 Findings 5.1 Categorization of findings The following system of profiling of the audit findings has been adopted to better prioritize the implementation of audit recommendations:

N Category Description o 1. High significance Has a significant/material impact, has a high likelihood of reoccurrence, and in the opinion of the Auditor General, it requires urgent remedial action. It is a matter of high risk or high stakeholder interest. 2. Moderate significance Has a moderate impact, has a likelihood of reoccurrence, and in the opinion of the Auditor General, it requires remedial action. It is a matter of medium risk or moderate stakeholder interest. 3. Low significance Has a low impact, has a remote likelihood of reoccurrence, and in the opinion of the Auditor General, may not require much attention, though its remediation may add value to the entity. It is a matter of low risk or low stakeholder interest.

5.2 Summary of Audit Findings No. Finding Significance 6.1 Unaccounted for funds High 6.2 Under Staffing High 6.3 Delayed Procurement of Oxygen Plant High 6.4 Salary arrears Moderate 6.5 Missing Procurement Files Moderate 6.6 Diversion of regional medical equipment’s workshop funds Moderate 6.7 Nugatory Expenditure Moderate 6.8 Shoddy work on Completion of 3 Semidetached staff Housing Unit 6.9 Non disposal of expired drugs Low 6.10 Delayed Disposal of Assets Low

6.0 Detailed Audit Findings This section outlines the detailed audit findings, management responses thereof and my recommendations. 6.1 Unaccounted For Funds Paragraphs 217(a) and 214(a) of the Treasury Accounting Instructions 2003, require that advances to be accounted for without delay and the approving officer to make sure that the concerned staff has settled any old advances before authorizing new advances within 60 days.

However, a total to UGX 107,675,473 remained unaccounted for at the close of the financial year as shown in appendix i.

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Consequently, I could not confirm that the funds were utilized for the intended purposes.

The Accounting Officer promised that all accountability will be obtained.

I advised the Accounting Officer to ensure that funds are properly accounted for.

6.2 Under Staffing The Hospital has an approved staff structure of 395 positions. Out of the approved structure only 162 (41%) positions are filled leaving 237 (59%) positions vacant as shown in appendix ii.

Understaffing negatively impacts on service delivery.

The Accounting Officer explained that efforts are being made to narrow the gap in staffing of the hospital.

I advised the Accounting Officer to liaise with the line Ministries of Health and Public Service to ensure that the critical positions are filled.

6.3 Delayed Procurement of Oxygen Plant During the financial year under review, the hospital planned to construct and install an oxygen plant. The contract was awarded to Biomed Systems Ltd to supply the oxygen plant. It was observed that the procurement did not take place and on 16/06/2016, the entity transferred UGX.392,857,000 meant for the oxygen plant to Naguru Referral Hospital but the plant was not in place by the time of audit.

The Accounting Officer explained that GOU provided funding for oxygen plants to all Referral Hospitals and the various Hospital directors met at the Ministry of Health under the leadership of the former Permanent Secretary and agreed to do a joint procurement with Naguru Referral Hospital being the leading Agency. An MOU was signed between the Moroto Regional Referral Hospital and Naguru Hospital.

The delayed procurement and installation of the plant hinders effective service delivery.

I advised the Accounting Officer to liaise with Naguru Referral Hospital to ensure that the oxygen plant is procured.

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6.4 Salary Arrears Section (B - a)(25) of the Public Service Standing Orders 2010, states that salary arrears that accrue to a public officer within a financial year shall be paid through the payroll within the same financial year.

However, the hospital had salary arrears totalling to UGX.8,747,911 from financial 2015/16 and prior resulting from errors, underpayments and non-payments as shown in Appendix iii.

Non-payment of employees negatively affects service delivery and employee performance.

The Accounting Officer explained that management has taken action by submitting requests for payment to Ministry of Finance, Planning and Economic Development.

I advised the Accounting Officer to follow up the requests with the Ministry of Public Service to ensure that the arrears are paid.

6.5 Missing Procurement Files Section 41 of the PPDA Act, 2003, stipulates that all PDEs should maintain procurement records for all procurements undertaken in a manner specified by the Act.

However, the hospital failed to avail procurement files for procurements totalling to UGX.285,462,042 as shown in appendix iv.

I was unable to confirm whether the procurements were conducted in a transparent and competitive manner.

The Accounting Officer promised to avail the procurement files.

I advised the Accounting Officer to ensure that the procurement files are in place.

6.6 Diversion of regional medical equipment workshop funds According circular number ADM 100/244/15 issued to all regional referral hospitals by Ministry of Health on 14/01/2014 directing that funds allocated under Programme 03 (Regional Maintenance) are ring fenced and should not be reallocated to other activities under any circumstance.

However, a review of the financial statements revealed that out of UGX.124,700,000 released for regional medical equipment maintenance only UGX.87,836,527 was

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utilized on the equipment and a balance of UGX.36,863,473 was diverted to unspecified activities without seeking approvals as shown in appendix v.

The Accounting Officer explained that the funds were used for cross-cutting issues like expenditure on fuel , motor vehicle maintenance, stationary and procurements

I advised the Accounting Officer to ensure that refunds are made to the specified programme.

6.7 Nugatory Expenditure Regulation 9 (2) of the Local Governments Financial and Accounting Regulations, 2007 requires the Accounting Officer to reduce cases of apparent waste, extravagant administration or failure to achieve value for monies.

It was observed that UGX.9,810,000 was utilised for a procurement process of an oxygen plant which was later halted after only advertising and receipt of bids resulting in wasteful expenditure as shown in appendix vi.

This was due to change of the procurement responsibility from Moroto hospital to Naguru hospital.

The Accounting Officer explained that Naguru Hospital was chosen as the lead agent to procure and install the oxygen plants on behalf of all the 14 regional referral hospitals and this led to the cancellation of the procurement process by the hospital.

I advised the Accounting Officer to ensure that due care is exercised in such circumstances to avoid nugatory expenditure.

6.8 Shoddy work on Completion of 3 Semidetached Staff Housing Unit During 2014/15, a local firm was contracted to complete the 3 structures at a cost of UGX 119,621,014.The contract start and end dates were 6/11/2014 and 31/12/2015 respectively.

It was observed that the construction was not completed at the expected date. During the financial year under audit, UGX.81,342,401 was paid as shown in appendix vii. Out of the amount paid , it was observed that UGX.17,700,000 was paid for shoddy work as shown below:-

S/no Item Amount UGX Remarks 1 3 Water harvesting tanks 15,420,000 were poorly fitted on a weak and (of 5000 litres each) broken base.

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2 Plastic water pipes 700,000 not properly fitted as pipes were not buried to the ground and others broken with sewage spilling in the compound exposing 3 Lightening arrestors 1,080,000 broken from the roof and not functioning. 4 Compound land scaping 500,000 Not done Total 17,700,000

The hospital may not have got value for money spent.

The Accounting Officer promised to engage the contractor to rectify the defects.

I await management action on this matter.

6.9 Non Disposal of Expired Medicines Section 1.1.1 (f) of the Memorandum of Understanding (MoU) between the Government of Uganda (GoU) and the National Medical Stores (NMS) requires the Ministry of Health to communicate mechanisms of reducing expiries, carry out periodic collection and disposal of expired medicines from the districts and health facilities in collaboration with Ministry of Local Government and National Medical Stores. It was noted that expired medicines and sundries worth UGX 6,477,212 had not been collected for disposal for over 1 year as shown in Appendix viii. This creates a risk that the expired medicines may end up on the market and be misused.

The Accounting Officer explained that waste and expired drugs are handled by Green Lebel, a company contracted by Ministry of Health to collect hospital waste.

It is advised that the relevant authorities ensure that the expired medicines are disposed off promptly to avoid misuse.

6.10 Delayed Disposal of Obsolete Assets According to section 34 (1) of Public Finance Management Act,2015 , an Accounting Officer shall be responsible for the management of asset and inventories of the vote.

However, inspection of documents and assets of Moroto hospital revealed that the hospital did not dispose off assets that were recommended by board of survey at the end of financial years 2010/11 and 2011/12 as shown in appendix ix.

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The delays to dispose off the assets may lead to further deterioration of value.

I advised the Accounting Officer to ensure that the items are disposed off.

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Appendix i Unaccounted for Funds

Invoice No Date Details of payment Payee Amount Remarks To facilitate Q1 Audit Not accounted for. No RB/08/15/ 19- exercise, perdiem for Masette Samuel acknowledgement from 65C Aug-15 Internal Auditor Wataka 1,500,000 beneficiary (Musana) Not accounted for. No RB/08/15/ 20- Stationary for Q1 for the Masette Samuel acknowledgement from 65A Aug-15 internal Auditor Wataka 250,000 beneficiary (Musana) Facilitation to Accountant General F/Y 14/15 draft Not accounted for. No RB/08/15/ 20- financial statements for Masette Samuel evidence of submission of 71 Aug-15 approval Wataka 330,000 statements. No GRN,No Uganda Medical acknowledgement receipt RB/08/15/ 12- Purchase of new stabilizer Equipment & of the funds. Procurement 39 Aug-15 for x-ray machine Dental supplies 3,150,000 guidelines ignored. Payment for various Uganda Medical RB/11/15/ 17- regional workshop Equipment & No DN, No GRN, 108 Nov-15 maintanace spares for Q2 Dental supplies 15,868,000 Procurement doubtful RB/12/15/ 23-Dec- Payment for empting the My Garage 230B 15 Toilets Investments Ltd 16,000,000 Missing Voucher RB/12/15/ 23-Dec- Payment for plumbing tools Elbro Enterprise 234 15 and materials and Contractors 2,500,000 Missing Voucher RB/01/16/ 08-Jan- Payment of lockable Credus U 007 16 Hospital Notice Board Limited 9,578,000 Missing Voucher Payment for Electricals for RB/01/16/ 08-Jan- the Hospital as per the Credus U 007D 16 attached invoices Limited 1,549,000 Missing Voucher Part payment for repairs on Hospital fleet of motor RB/03/16/ 04-Mar- vehicles as per invoice Mago Elgon 116 16 No.416 attached Motors (U) Ltd 4,000,000 Missing Voucher Payment for repair/servicing of the RB/4/16/8 27-Apr- Hospital fleet as per the Mago Elgon 3 16 attached invoices Motors (U) Ltd 5,775,000 Missing Voucher Part payment for repairs on Hospital fleet of motor RB/03/16/ 04-Mar- vehicles as per invoice Wamuco Motors 117 16 No.78938 attached (U) Limited 9,953,875 Missing Voucher Payment for repair/servicing of the RB/4/16/8 27-Apr- Hospital fleet as per the Wamuco Motors 2 16 attached invoices (U) Limited 5,119,598 Missing Voucher RB/08/15/ 26- For vehicles and Generator Elgon Springs 78B Aug-15 for Q1 (U) Ltd 1,250,000 No fuel order forms. RB/08/15/ 26- For vehicles and Generator Elgon Springs 77B Aug-15 for Q1 (U) Ltd 2,000,000 No fuel order forms. RB/08/15/ 26- For vehicles and Generator Elgon Springs 78A Aug-15 for Q1 (U) Ltd 1,000,000 No fuel order forms. RB/08/15/ 26- For vehicles and Generator Elgon Springs 78C Aug-15 for Q1 (U) Ltd 2,000,000 No fuel order forms. RB/08/15/ 26- For vehicles and Generator Elgon Springs 78D Aug-15 for Q1 (U) Ltd 250,000 No fuel order forms. RB/08/15/ 26- For vehicles and Generator Elgon Springs 78 Aug-15 for Q1 (U) Ltd 4,500,000 No fuel order forms. Not accounted for.No fuel order forms, no RB/11/15/ 02- Payment for fuel for Elgon Springs consumption schedule. No 36A Nov-15 generator (U) Ltd 2,000,000 acknowledgement receipt Not accounted for.No fuel RB/11/15/ 03- Payment for fuel for Elgon Springs order forms, no 36B Nov-15 Generator (U) Ltd 2,000,000 consumption schedule. No

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acknowledgement receipt Not accounted for.No fuel order forms, no RB/11/15/ 03- Payment for fuel for Elgon Springs consumption schedule. No 36C Nov-15 Generator for Q2 (U) Ltd 1,000,000 acknowledgement receipt Not accounted for.No fuel order forms, no RB/11/15/ 03- Payment for fuel for Elgon Springs consumption schedule. No 36D Nov-15 Generator for Q2 (U) Ltd 5,000,000 acknowledgement receipt Payment for generator fuel Not accounted for. No fuel RB/03/16/ 15-Mar- as per the request and Elgon Springs order forms, No 120 16 authority to pay (U) Ltd 5,000,000 consumption statement. Payment for fuel to run the No fuel order forms, No RB/04/16/ 26-Apr- Hospital Generator & Elgon Springs consumption schedule, No 64D 16 Ambulance for Q4 (U) Ltd 526,500 acknowledgement of funds. No fuel order forms, No Payment for fuel to run the consumption schedule, No RB/04/16/ 26-Apr- Hospital Generator & Elgon Springs acknowledgements of 64 16 Ambulance for Q4 (U) Ltd 2,732,500 funds. No fuel order forms, No Payment for fuel to run the consumption schedule, No RB/04/16/ 26-Apr- Hospital Generator & Elgon Springs acknowledgements of 64C 16 Ambulance for Q4 (U) Ltd 750,000 funds. Payment for generator/ambulance fuel Not accounted for. No fuel 10-Jun- as per the approved Elgon Springs order forms, No RB/06/08 16 request attached (U) Ltd 1,000,000 consumption statement. Payment for Hospital ambulance and Generator Not accounted for. No fuel RB/06/16/ 14-Jun- as per the attached Elgon Springs order forms, No 13 16 approval (U) Ltd 500,000 consumption statement. Payment for fuel to run the Generator and Hospital Not accounted for. No fuel RB/06/16/ 14-Jun- Ambulance as per the Elgon Springs order forms, No 12 16 approval (U) Ltd 593,000 consumption statement. Total 107,675,473

Appendix ii under Staffing

POST Approved post filled Vacant %Filled % Vacant Hospital Director 1 1 0 100% 0% Sn. Consultants 4 0 4 0% 100% Consultants 12 1 11 8% 92% Medical Officer Special Grade 12 0 12 0% 100% Medical Officers 10 6 4 60% 40% Snr. Dental Surgeon 1 1 0 100% 0% Clinical Officers 12 9 2 75% 17% Dermatologist 1 0 1 0% 100% Anaesthetic Officers 7 3 4 43% 57% Orthopaedic Staff 12 8 4 67% 33% Princ.Orth.Off 1 0 1 0% 100% Physiotherapy Services 4 0 4 0% 100% Ophthalmic Staffs 4 1 3 25% 75% Radiographer 6 1 5 17% 83% Laboratory Staff 14 5 9 36% 64% Princ.Lab.Tech. 1 0 1 0% 100% Dental Staff 6 1 5 17% 83% Pharmacy 9 4 5 44% 56% Psychiatric Cl.Staff 9 6 3 67% 33% Prin. Psych Cl. Off 1 1 0 100% 0% Theatre Staff 5 1 4 20% 80% Sen. Theatre Attendant 2 0 2 0% 100% Other Professional 6 2 4 33% 67% Nursing Dept. 131 57 54 44% 41% Nursing Officer Nursing 34 20 14 59% 41%

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Nursing Officer Mid 20 7 13 35% 65% Enrolled Nurses 40 18 22 45% 55% Enrolled midwife 20 7 13 35% 65% Nursing Assistants 20 17 1 85% 5% Finance & Admin 43 15 26 35% 60% Procurement Unit 2 1 1 50% 50% Maintenance Unit 5 1 4 20% 80% Support Staff 58 26 32 45% 55% Drivers 7 3 4 43% 57% Cooks 5 2 3 40% 60% Porters 5 3 2 60% 40% Attendants 21 9 12 43% 57% Total 395 180 217 46% 55%

Appendix iii Salary arrears FY 2015-2016

S/N Name Title Ipps Period Net Pay Reasons For Arrears 1. Turyamwijuka Enrolled 992427 2015/2016 1,499,619 Did not have supplier Number Robert Nurse 2. Amony Judith Theatre 822358 2015/2016 1,633,218 Un applied not created on the Assistant master data. 3. Lalango Fiona Medical 992502 2015/2016 1,780,065 Not created on the master data Officer May – June and no supplier number. 4. Moru Andrew Nursing 729396 2015/2016 834,490 Un applied. Cham Assistant Feb – June (5 months) 5. Aciro Julia Sen. Clinical 729511 Jan. 2014 878,324 Non-payment error Officer 6. Odonga Simon Nutritionist 798863 Sept. 2015 967,101 Non-payment Sept 2016. 7. Atube Christine Nursing 729469 April, May and June 436,720 Under payment. Assistant 2014/15 (5 months) 8. Eriechu Richard Accountant 869673 March 904,603 Missed salary March 2016. 9 Asire Toma Nursing 729610 Salary for 6months 1,418,045 Non-payment. Officer 10 Akol Joyce Nursing 824378 Feb 2015 241,415 Underpayment. Assistant Total 8,747,911

Appendix iv Missing Procurement Files.

Contract Details Contractor Contract Sum (UGX) Computer servicing and repairs Not availed 4,000,000 Vine Initiative Ltd, Supply of printing stationary & Pema Ltd and Credus photocopying Uganda Ltd 29,000,000 Computer and ICT supplies Not availed 6,500,000 Property expenses (Engraving) Not availed 15,000,000 Rent from private entities Not availed 21,600,000 Supply of fuels, Lubricants and oils Not availed 71,640,000 Supply of tyres Not availed 30,000,000 Maintenance-Civil Not availed 25,000,000 Repairs and servicing of vehicles Not availed 72,217,000 Supply of detergents and infection control Fancy services 10,505,042 Total 285,462,042

Appendix v Payments made under Moroto hospital Regional workshop programme

Invoice Num Date Unit Details of payment Payee Amount RB/01/16/24 13-Jan- Regional workshop- Payment for regional workshop Aj Phoenix Limited 13,583,000

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5B 16 Moroto spares for Q2 19- Regional workshop- RB/08/15/41 Aug-15 Moroto Travel to Arua for a workshop Lokut Lino 220,000 RB/09/15/17 18-Sep- Regional workshop- Payment for spares for Medical 0D 15 Moroto workshop Lokut Lino 738,000 RB/11/15/40 02-Nov- Regional workshop- Payment for air time for Q2 /A 15 Moroto Hospital workshop department Lokut Lino 40,000 RB/11/15/35 02-Nov- Regional workshop- Payment for travel to tokora for A 15 Moroto repairs Lokut Lino 165,000 12-Nov- Regional workshop- Payment of perdiem and transport RB/11/15/82 15 Moroto during official Lokut Lino 165,000 RB/11/15/11 18-Nov- Regional workshop- Payment to cater for bulbs & 4 15 Moroto other electricals Lokut Lino 660,000 RB/11/15/11 18-Nov- Regional workshop- Payment of transport to Tokora 4A 15 Moroto for official duty Lokut Lino 90,000 RB/12/15/20 09-Dec- Regional workshop- Payments for travel for routine 07E 15 Moroto repairs Lokut Lino 715,000 03-Feb- Regional workshop- RB/02/16/31 16 Moroto Payment of electricals Lokut Lino 70,000 Regional workshop- Payment for allowance for 04-Feb- Moroto Hospital contract committee RB/02/16/53 16 member for one sitting Lokut Lino 80,000 Regional workshop- Payment of Electricals, including 13-Feb- Moroto cables for H/D and PHAs office as RB/02/16/82 16 per the receipt 025 attached Lokut Lino 102,000 15-Feb- Regional workshop- RB/02/16/96 16 Moroto Payment for assorted Electricals Lokut Lino 350,000 Regional workshop- Payment of perdiem & transport Moroto for training in Gulu where he was RB/04/16/17 23-Apr- Nominated to attend as per the A 16 approval attached Lokut Lino 590,000 Regional workshop- Payment for Electricals for various 25-Apr- Moroto offices on the AMDM block as per RB/04/16/61 16 the approval Lokut Lino 405,000 Regional workshop- Payment of perdiem & transport RB/04/16/22 27-Apr- Moroto to the above while proceeding to B 16 Gulu for training Lokut Lino 15,000 Regional workshop- Payment of evaluation bids for Moroto Oxygen plant Payment to cater for oxygen activities, borrowed for item-223005 (Electricity) in Q3 26- from Oxygen plant. Now refund to RB/05/16/86 May-16 item224001(oxygen Lokut Lino 160,000 28-Oct- Regional workshop- Payment for vehicle servicing & Mago Elgon Motors RB/10/15/14 15 Moroto repair (U) Ltd 4,675,000 RB/01/16/00 05-Jan- Regional workshop- Payment for routine Mago Elgon Motors 1 16 Moroto servicing/repairs of Hospital fleet (U) Ltd 4,774,277 Regional workshop- Payment for repair/servicing of 27-Apr- Moroto the Hospital fleet as per the Mago Elgon Motors RB/4/16/83 16 attached invoices (U) Ltd 5,775,000 19- Regional workshop- Makombe willex RB/08/15/40 Aug-15 Moroto Travel to Arua for a workshop tingu 400,000 26- Regional workshop- Perdiem for various officers to Makombe willex RB/08/15/75 Aug-15 Moroto various health facilities tingu 2,480,000 RB/09/15/17 18-Sep- Regional workshop- Makombe willex 0 15 Moroto Payment of air time for modem tingu 200,000 RB/09/15/17 18-Sep- Regional workshop- Makombe willex 0A 15 Moroto Payment for stationary tingu 9,500 RB/09/15/17 18-Sep- Regional workshop- Payment for perdiem for field Makombe willex 0B 15 Moroto work tingu 277,750 RB/09/15/17 18-Sep- Regional workshop- Payment for the stationary and Makombe willex 0C 15 Moroto workshop tingu 490,000 02-Nov- Regional workshop- Payment for air time for Q2 Makombe willex RB/11/15/40 15 Moroto workshop department tingu 120,000 11-Nov- Regional workshop- Payment for perdiem and Makombe willex RB/11/15/66 15 Moroto transport to Kabale for Regional tingu 1,320,000

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workshop managers meeting RB/12/15/20 09-Dec- Regional workshop- Payments for travel for routine Makombe willex 07 15 Moroto repairs tingu 800,000 rb/12/15/20 09-Dec- Regional workshop- Payments for travel for routine Makombe willex 07A 15 Moroto repairs tingu 1,500,000 Regional workshop- Payment for allowances for Makombe willex 04-Feb- Moroto Hospital contracts committee tingu RB/02/16/51 16 member for one sitting 80,000 04-Feb- Regional workshop- Payment for repair of medical Makombe willex 04-Feb-16 16 Moroto equipment in the Hospital tingu 200,000 13-Feb- Regional workshop- Payment for equipment repairs Makombe willex RB/02/16/70 16 Moroto and servicing for Q3 tingu 2,300,000 Regional workshop- Payment for repairs at the Makombe willex 13-Feb- Moroto Hospital theatre as per the tingu RB/02/16/76 16 Equipment breakdown report 274,000 RB/03/16/10 01-Mar- Regional workshop- Payment of perdiem as per the Makombe willex 1 16 Moroto requisition and authority attached tingu 300,000 Regional workshop- Payment of assorted spares for Makombe willex RB/03/16/10 01-Mar- Moroto repair at Tokora Health centre as tingu 2 16 per the authority attached 2,400,000 Regional workshop- Payment of assorted spares for Makombe willex 01-Mar- Moroto repair of LAB freezer as per the tingu RB/03/16/99 16 authority attached 2,260,000 Regional workshop- Payment for perdiem and fuel for Makombe willex RB/03/16/10 02-Mar- Moroto regional workshop meeting to tingu 4 16 take place in GULU 1,188,000 Regional workshop- Payment for laboratory fridge Makombe willex RB/03/16/11 14-Mar- Moroto spares as per the attached tingu 9 16 authority 1,020,000 Regional workshop- Payment for spares to repair a Makombe willex RB/03/16/17 21-Mar- Moroto theatre machine as per the tingu 8 16 request and approval attached 1,995,000 Regional workshop- Payment for spares to repair Makombe willex Moroto Kotido HCIV Blood Bank fridge as tingu RB/03/16/17 21-Mar- per the request and approval 9 16 attached 2,090,500 23-Apr- Regional workshop- Travel to kotido to do some Makombe willex RB/04/16/30 16 Moroto repairs tingu 457,500 23-Apr- Regional workshop- Travel to kampala to deliver the Makombe willex RB/04/16/31 16 Moroto workshop vehicle for repair tingu 500,000 23-Apr- Regional workshop- Payment for airtime for voice calls Makombe willex RB/04/16/32 16 Moroto and internet tingu 200,000 23-Apr- Regional workshop- Payment tor fuel for the generator Makombe willex RB/04/16/33 16 Moroto and mobile vehicle tingu 2,595,000 Regional workshop- Payment for spares under the Makombe willex 10- Moroto workshop as per the approval tingu RB/05/16/09 May-16 attached 500,000 Regional workshop- Payment for perdiem and Makombe willex 18- Moroto transport while for meeting in tingu RB/05/16/83 May-16 Mbale Hospital 1,020,000 Regional workshop- Payment for spares on oxygen Makombe willex 18- Moroto connectors as per the approval tingu RB/05/16/84 May-16 attached 504,000 26- Regional workshop- Payment of allowances for Makombe willex RB/05/16/91 May-16 Moroto evaluation of Oxygen plant bids tingu 160,000 RB/10/15/28 23-Oct- Regional workshop- G 15 Moroto Payment Electricals Ongom Gildo 800,000 RB/10/15/28 23-Oct- Regional workshop- Payment of perdiem and transport A 15 Moroto to purchase electrical materials Ongom Gildo 155,000 RB/11/15/40 02-Nov- Regional workshop- Payment for air time for Q2 /B 15 Moroto workshop department Ongom Gildo 40,000 Regional workshop- Payment of perdiem & transport 11-Nov- Moroto to kabale for regional workshop RB/11/15/70 15 meeting Ongom Gildo 605,000 RB/12/15/20 09-Dec- Regional workshop- Payments for travel for routine 07B 15 Moroto repairs Ongom Gildo 220,000

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RB/12/15/20 09-Dec- Regional workshop- Payments for travel for routine 07C 15 Moroto repairs Ongom Gildo 330,000 23-Apr- Regional workshop- Payment for traveling for RB/04/16/37 16 Moroto equipment maintenance Ongom Gildo 715,000 Regional workshop- Payment of transport and Moroto advertising the Hospital during the 26-Apr- visit to Gulu for a senior staff RB/04/16/75 16 wedding Ongom Gildo 500,000 Regional workshop- Uganda Medical 12- Moroto Purchase of new stabilizer for X- Equipment & Dental RB/08/15/39 Aug-15 ray machine. Supplies 3,150,000 Regional workshop- Payment for various Regional Uganda Medical RB/11/15/10 17-Nov- Moroto workshop Maintenance spares for Equipment & Dental 8 15 Q2 Supplies 15,868,000 23-Apr- Payments for support supervision RB/04/16/46 16 MRRH around Karamoja region Nyeko John Filbert 1,640,000 23-Apr- Payments for support supervision RB/04/16/47 16 MRRH around Karamoja region Mawa Geoffrey 1,480,000 Payment of perdiem & for driver RB/04/16/01 22-Apr- during support supervision of Ongom Olero 0 16 MRRH workshop activities in the region Johnson 1,320,000 Total 87,836,527

Appendix vi Nugatory Expenditure

Invoice No Date Details of payment Payee Amount 17- Payment of perdiem and fuel to MOH for MOU RB/09/15/147 Sep-15 regarding Oxygen plant Nyeko John Filbert 195,000 17- Payment of perdiem and fuel to MOH for MOU RB/09/15/147A Sep-15 regarding Oxygen plant Nyeko John Filbert 30,000 17- Payment of perdiem and fuel to MOH for MOU RB/09/15/148 Sep-15 regarding Oxygen plant Mawa Geofrey 360,000 17- Perdiem for three days to MOH with the H/D on Omugetum Paul RB/09/15/150B Sep-15 the MOU for oxygen plant Settimo 165,000 17- Payment of perdiem and fuel to MOH for MOU RB/9/15/146 Sep-15 regarding Oxygen plant Nyeko John Filbert 550,000 17- Payment of perdiem and fuel to MOH for MOU RB/09/15/146A Sep-15 regarding Oxygen plant Nyeko John Filbert 475,000 03- RB/02/16/009 Feb-16 Payment for travel for oxygen plant meeting Nyeko John Filbert 580,000 03- Omugetum Paul RB/02/16/009A Feb-16 Payment for travel for oxygen plant meeting Settimo 165,000 22- Payment of perdiem and transport to kampala RB/04/16/008 Apr-16 Naguru oxgyen plant evaluation meeting Mawa Geofrey 360,000 23- RB/04/16/41 Apr-16 Payment for advertising for oxygen plant Alionzi Charles 490,000 23- Payment of perdiem & trspt to Biomedical Masette Samuel RB/04/16/015 Apr-16 Engineer c/o masette samuel Wataka 640,000 23- Payment of pedierm & trspt Naguru Hospital RB/04/16/27 Apr-16 kampala for meeting regarding OXYGENPLANT Mawa Geofrey 960,000 26- Payment to cater for oxygen activities,from Masette Samuel RB/05/16/85 May-16 borrowed amount Wataka 520,000 26- Payment of allowances for evaluation of Oxygen RB/05/16/86 May-16 bidsPayment to cater for oxygen activities Lokut Lino 160,000 26- Payment of allowances for evaluation of Oxygen RB/05/16/87 May-16 bidsPayment to cater for oxygen activities Lekuru Joyce Judith 160,000 26- Payment of allowances for evaluation of Oxygen RB/05/16/88 May-16 bidsPayment to cater for oxygen activities Kabitanya Lukia 160,000 26- Payment of allowances for evaluation of Oxygen RB/05/16/89 May-16 bidsPayment to cater for oxygen activities Alionzi Charles 160,000 26- Payment of allowances for evaluation of Oxygen RB/05/16/90 May-16 bidsPayment to cater for oxygen activities Mawa Geofrey 160,000 26- Payment of allowances for evaluation of Oxygen MAKOMBE WILLEX RB/05/16/91 May-16 bidsPayment to cater for oxygen activities TINGU 160,000 26- Payment of allowances for evaluation of Oxygen Keem Jackson RB/05/16/92 May-16 bidsPayment to cater for oxygen activities Moding 160,000

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26- Payment of allowances for evaluation Eng.Mary Masette Samuel RB/05/16/93 May-16 Musoke C/o Masette S. of Oxygen bids Payment Wataka 200,000 17- Payment of administrative costs from oxygen MRRH Delegate RB/06/16/100 Jun-16 plant as per the attached approval Development 3,000,000 Total 9,810,000

Appendix vii Payment for completion of 3 Semi-detached Staff Housing Unit

Invoice no Date Details of payment Payee Amount 17- Part payment for the construction of Apel Engineering RB/11/15/105A Nov-15 staff Houses Company Limited 33,267,429 26-Apr- Second payment for the three staff Apel Engineering RB/04/16/54 16 housing units as per certificate no.02 Company Limited 48,074,972 Total 81,342,401

Appendix viii Non Disposal of Expired Drugs

Date entered into the Cost per No Drugs/Medicinal Supplies Quantity Expiry Date expiries book unit Total cost 1 ACETYLSALICYLIC ACID 300 MG 7000 31-08-2015 30-08-2015 5 37,800 2 ATENOLOL 100 MG TABLET 3000 31-01-2015 30-01-2015 20 60,600 ATORVASTATINE 10MG 3 TABLETS 150 31-01-2016 31-01-2016 670 100,500 4 CAPTOPRIL 25 MG TABLETS 6000 31-08-2015 09/01/2016 28 168,000 CARBAMAZEPINE 200MG 5 TABLET 2000 30-06-2016 07/06/2016 64 128,000 6 CARVEDILOL 6.25MG TABLET 440 30-07-2016 31-07-2016 783 344,652 DIETHYLCARBAMAZINE 7 TABLETS 1000 30-04-2016 05/05/2016 82 81,900 8 HALOPERIDOL TABLETS 5MG 7000 31-03-2016 21-04-2016 14 100,100 9 IMIPRAMINE 25 MG TABLET 1000 30-04-2016 05/05/2016 32 32,400 10 LISINOPRIL TABLETS 10MG 3200 30-04-2016 05/05/2016 318 1,017,600 11 LITHIUM CARB. 400MG TABS 200 31-01-2016 29-02-2016 346 69,200 PHENYTOIN SODIUM 100MG 12 TABLET 17000 31-03-2016 06/06/2016 21 353,600 13 PREDINISOLONE 5MG TABLET 6000 30-09-2015 05/10/2016 25 148,200 TRIFLUOPERAZINE 5MG 14 TABLET 1000 31-01-2016 06/01/2016 87 87,100 ANTI D IMMUNOGLOBULIN 250 15 UNITS VIAL 8 31-05-2015 31-05-2016 143,800 1,150,400 ATRACURIUM 10MG/ML 2.5ML 16 INJECTION 50 30-06-2016 30-06-2016 7,650 382,500 17 BUPIVACAINE INJ 0.5% 350 30-11-2015 30-11-2015 0 0 DEXAMETHASONE 4MG/ML 18 1ML,2ML AMPOULE 720 30-06-2016 30-06-2016 618 444,960 FLUPHENAZINE 25MG/ML 19 INJECTION 40 30-11-2015 22-01-16 1,820 72,800 HYOSCINE BUTYL BROMIDE 20 20MG/ML INJECTION 20 30-09-2015 15-03-2016 1,600 32,000 21 LIDOCAINE HCL 2% INJECTION 7 28-02-2016 16-09-16 2,400 16,800 PROPOFOL 10 MG/ML, 50ML 22 VIAL 15 31-01-2016 31-01-2016 14,100 211,500 VITAMIN B COMPLEX INJ 2ML 23 AMP 300 31-01-2016 30-06-2016 110 33,000 CODEINE PHOSPHATE 30MG 24 TABLETS 63 30/09/2016 30/09/2016 18,650 1,174,950 PHENYTOIN SODIUM 100MG 25 TABLET 17 30/06/2016 30/06/2016 13,450 228,650 TOTAL 6,477,212

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Appendix ix Delayed disposal of assets

Item Qty Reference Item Qty Reference Generator make 1978 1 Board of survey report Fridges 3 Board of survey 2010/11 report 2011/12 Deep freezer 1 Board of survey report Baby weighing scale 2 Board of survey 2010/11 report 2011/12 Weighing scale heavy 1 Board of survey report Chairs with cushion 3 Board of survey duty 2010/11 report 2011/12 Computer model 3259- 1 Board of survey report Deep freezer 1 Board of survey 200200 2010/11 report 2011/12 Motorcycle Jialang UG 2 Board of survey report Generator 1 Board of survey 0610M and Chanqoi 2010/11 report 2011/12 Iron sheets 25 Board of survey report Electric Oven 2 Board of survey 2010/11 report 2011/12 Filling cabinet 1 Board of survey report Auto claves ( small, 6 Board of survey 2010/11 medium and big report 2011/12 each 2) Sterilizing drum 11 Board of survey report Suction pump 2 Board of survey 2010/11 report 2011/12 Steriliser 1 Board of survey report Electric Steriliser 2 Board of survey 2010/11 report 2011/12 Wooden doors 9 Board of survey report Vehicle tyres 23 Board of survey 2010/11 report 2011/12 Weighing scale 1 Board of survey report Filing cabinets 2 Board of survey 2010/11 report 2011/12 Incubator 1 Board of survey report Metallic cupboards 5 Board of survey 2010/11 report 2011/12 Beds 50 Board of survey report Bicycle ambulances 3 Board of survey 2010/11 report 2011/12 Microphone 1 Board of survey report Beds 60 Board of survey 2010/11 report 2011/12 Radio Osaka 1 Board of survey report Nissan Pick UP UG 1 Board of survey 2010/11 3843M report 2011/12

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