Buluba Hospital, July 2018.

My name is Gregory Kenzo Saito and I am a Canadian emergency physician and family physician who has had the opportunity to visit St. Francis Hospital Buluba again this year. As mentioned in previous reports, St. Francis Hospital Buluba is a community hospital located in the Mayuge District of Eastern Uganda (between Jinja and Iganga, on the northern shores of Lake Victoria). Founded originally to treat leprosy patients, it has now evolved into a non-profit district hospital serving a predominantly rural population. Interestingly, the hospital continues to care for a fair number of leprosy patients, and diagnoses of new leprosy cases continue to be made on a regular basis.

This year I arrived in Uganda in late June to visit for a month. Given my familiarity with the hospital from the previous year it was easy to hit the ground running and I soon felt like I had never left. This time I decided to focus my efforts on the children’s ward and the outpatient “Doctor’s Office.” Last year I realized that these were the areas where I could make the most impact. Again, the nurses on the children’s ward were incredibly helpful in translating Lusoga to English for me in order to communicate with patients and families. I am also very thankful to Rose, one of the nursing assistants in “Doctor’s Office,” who helped me tremendously as my translator.

Since my last visit to Buluba, the hospital has hired two new medical officers, Dr. Emmanuel Wasede and Dr. Solomon Mwase. Both are young and enthusiastic doctors who now work alongside previous veteran medical officers, Dr. Henry Kalende and Dr. Patrick Ndoboli, whom I knew well from last year. I also met the new administrator, Sister Mary, who helped me settle in quickly and feel welcome. Additionally, I was happy to work with many of the same nurses, clinical officers, and other staff that I met last year. Impressively, despite the relatively high burden of disease and healthcare challenges in this setting everyone has a very positive attitude.

The children’s ward kept me quite busy during my time here and I helped to manage patients with childhood medical conditions common in the rural East African setting. The most common illnesses included malaria, diarrheal illnesses, respiratory infections, sepsis, and unfortunately a few cases of severe acute malnutrition. Similar to last year I was also able to participate in “outreaches” where I joined a team of 8-10 hospital workers and visited isolated and underserved neighbouring communities. There, the team performed immunizations, tested for HIV, distributed ARVs (antiretrovirals), and carried out basic outpatient medical assessments. I was able to visit both the Lawanika and Walumbe communities with the team.

This year I especially took note of the hospital’s dedication to medical education and continuous quality improvement. Jonah, one of the clinical officers, organizes weekly CME (continuous medical education) events on Wednesday mornings. On the maternity ward, regular neonatal rounds are held to discuss improvements in the management of the neonates and to learn from challenging cases. It was also enjoyable to be able to help teach some of the visiting clinical officer students on the children’s ward. For those that are not familiar, clinical officers in Uganda complete a 3 year program and serve as vital frontline clinicians in both the inpatient and outpatient settings. During my time here, a paediatrics resident named Dr. Clare Nakubulwa, also visited the hospital to give a presentation on paediatric pneumonia and to perform a paediatric quality of care assessment of the hospital. Visiting clinical officers from both South Sudan and other parts of Uganda were also hosted in order to complete a leprosy training program.

During my downtime I was to be able to enjoy the tranquil, peaceful natural countryside around the hospital, to catch a few world cup games on television, and to visit Kampala to see a jazz concert. Once again this year, as I am sitting in the airport in Entebbe now writing this report, I am wishing I could stay longer and looking forward to be able to volunteer again in the near future. I am very grateful for the support of the Rotary Doctor Bank and for again making this experience possible. Thank you in particular to Dr. Rogers Kabuye and Dr. Jim McWhirter for assisting with the placement and coordinating my medical license. On one of my last days here it was great to be able to personally meet Jim and Rogers in Kampala to update them on my experience.