Dialysis is not a rocket scientist’s procedure.Extreme caution and great knowledge are essetial in carrying it out though. There is nothing medical that Mulago will not do if the right personnel is trainned for the appropriate equipment/procedure. Mulago is doing well on removal of prostates, using one of the most non invasive surgical methods(forget those bloody laporatomies for prostatectomies) I have known in modern medicine. Dr. Kagwa, who trainned in the US is a real shinning star on this one. He will do dialysis in a heart beat if the equipment is in place. Remember so much has been done with olden equipment and obsolete medications( for the west).Prioritising in health investments should not be embattled at all as health is the pivot of our lives.
On the issue of man power,according to the original plan, Mbarara University was to start and help the already trained allied health professionals to upgrade into medicine mostly, Medical Assistants now called Clinical officers like their compatriots in Kenya and TZ. But the plans changed when Museveni came onto the political scene. The unfinished university buildings were suddenly occupied by fresh students whom Makerere medical school could not take due to different reasons, space, level of passing etc. In a heartbeat, Cuban doctors were brought in to teach the fresh medical students. This has in the long run become a good thing, but at the same time, there has been a tremendous loss of manpower to be tapped into by not facilitating further education for people who are already in the system.
Nursing is still looked upon in Uganda and yet revered in the US. Bottom line is that the practice of medicine in general is simply based on patient care which is done by a team (forget the hard academic hassles). Many times doctors will do work that one would consider fit for a nurse and a nurse will act as a doctor in times of emergency. A case in point is airway management, say in case of an accident and someone sustains a head injury, is unconscious, bleeding from the nose and mouth and probably through the ears(bad stuff here). Do you think a nurse at site will stand with arms akimbo saying, OK, this is a doctor’s case, may be a neurologist to see so I will not secure the airway?
NO, unless she is in the US where legalities and red tape are the order of the day. Remember the first caesarean section was done by a midwife. She managed to save the baby but the mother died. This mentality of overlooking nursing should stop and the nurses be allowed to study more and become nurse practitioners as they do here in the US so that quality care to patients could extend to remote areas of the country as the nurse practitioners would be allowed to open up private clinics just like their colleagues in the US. I am sure they would be able to determine the types of cases and emergencies they would handle and be able to refer the rest in time.
I just remembered the Lines of patients on Rubaga Road that used to zigzag into Dr.Mumpi’s clinic. This was real madness, as one doctor or medical assistant could not accurately investigate, diagnose and treat diseases of all those many people that flocked into his clinic every day. Something has to be done by the government of Uganda to improve the quality of health care as well as improving the training standards of the medical personnel. Buying new text books, introducing high tech equipment and supplying ample sundries for practical work for the students will greatly improve our people’s health. But how will this be possible if the financial resources are wasted on non priorities like buying new presidential jets or when our people have been told not to pay graduated taxes, so that they keep in a happy state(euphoria) , happy enough not to disagree with a selfish Museveni who hates and fears democracy?
One is tempted to bet that the books some people used at the Albert cook Library in the 70s, the Cunninghams, the Gray’s Anatomy, Nzarubara’s book on surgery are still the same volumes that fill that beautiful library annexed to a perennially blocked private place, while the modern world is writing new books with new information almost every day! This is our Uganda and its president of 23 years.
Ugandan resident in New York/UAH member