KAMULI MISSION HOSPITAL
8th to 22nd May 2016
Further to the kind help and support of the Rotary Doctor Bank and advisors, I have had a ‘flying visit’ to Kamuli Mission Hospital, East Uganda, using 2 weeks annual leave from my GP partnership post in Sevenoaks. It was a receptionist at our surgery who had been to a Rotary Doctor Bank fundraising dinner that first gave me the connection.
I was impressed by the hospitable friendliness of Ugandans and the helpfulness of KMH staff to a newcomer. They have considerable experience of international volunteers and were most welcoming of yet another one.
I am grateful for the knowledge and imparted wisdom of other international visitors at KMH at the time of my visit, including several final year medical students, on the brink of their first UK posts in a couple of months.
Most of my time was spent on the medical ward (particularly the first week when the doctor covering the ward was away) and outpatients, with an occasional venture into the paediatric unit. I encountered some illnesses that I have only previously known about in textbook form. Limited resources are available at the hospital particularly in terms of tests and investigations and treatments are often limited by funding availability, but I remain in awe of how much is done within those limitations. Sad cases occur of course but some outstanding results also.
I was able to spend some time with the Clinical Officers (who have three years of clinical training) in outpatients and to see the range and sometimes severity of the illnesses that they manage. We had some interesting interactive clinical discussions.
I attended the Continuing Medical Education events which are a useful forum for dissemination of knowledge. Some of the medical students had prepared a presentation on the role of nutritional aspects and needs of inpatient care. They had also very usefully researched some data and guidelines on fluid requirements for babies and children, in addition to doing an audit on the use of and value of intra-operative pain relief. Instigated by various previous and present clinicians, local and visiting, a range of guidelines have been fixed to office and consulting room walls, a pragmatic way of making the information accessible. It was heartening to see these guidelines being referred to whilst patient care was being managed.
It was good to have the opportunity to go with the village health clinic team as they travelled to one of their usual clinic venues. The clinic was in fact held with the use of benches and chairs in the shade of a few trees. Baby and child growth was charted, immunisations were given and recorded on parent-held records, malaria was tested for and treated, and a health education talk was given. I can see a place for supporting this clinic perhaps with an enhanced health education syllabus and perhaps aided by laminated visual reference cards. Taking more medical care out with the village clinics would have a resource implication and perhaps the best role might be to continue a primarily preventative approach.
My time at KMH has been very short and my reflective thoughts are from the tiniest of glimpses of the work at Kamuli Mission Hospital. A challenge that they handle well is that rather than being overwhelmed by the magnitude of what you can’t do, they focus on areas that you can contribute to and influence. That is an approach that the late Mother Theresa had in her work and seems apt to recall as KMH had its foundation from Catholic nuns.
I am most grateful to the Rotary Doctor Bank and to KMH for the opportunity. As I return into my NHS work, I am reminded that where resources are more limited there is need and value in very careful clinical assessment and careful thinking. The process is an informative challenge that would benefit any situation.
Dr Andrea Taylor.