This academic year, Uganda continues to be the flagship site of the global health program with sites at Makerere University College of Health Sciences and Mulago Hospital. Altogether, the sites hosted six medical students, two resident physicians in pediatrics and family medicine, seven attending physicians in pulmonary-critical care, infectious disease, pediatrics, and obstetrics and gynecology, and a multi-disciplinary team composed of nursing and respiratory therapy. These participants not only provided direct patient care and medical education in collaboration with their Ugandan counterparts, but also partook in community service projects, cancer outreach and research.
Dr. Sam Luboga and his family continue to provide an embedded homestay that is one of the unique hallmarks of the site. Their generous support truly contributes to the richness of the overall experience. In return, a pair of global health scholars from Uganda travelled to the United States, where WCHN and UVM hosts provided extended clinclinical and research opportunities to these two promising young faculty, assisting in capacity building with our Ugandan partners.
A major change this year was the shift in the primary base from the Uganda Cancer Institute to Makerere University College of Health Science and Mulago Hospital. This transition allowed participants to take full advantage of the established curriculum and educational structure organized by Makerere University's international office. Next step will be an expansion in the upcoming year to include two rural sites outside the capital.
Solidifying the Homestay Model
With over fifteen program participants staying with Dr. Sam Luboga, the homestay model has become a cherished part of the Uganda elective. Students and faculty are given the interpersonal support they need while learning firsthand about the culture and environment they are visiting. This year, dinnertime lectures were formalized into a curriculum covering both cultural and sociopolitical topics as well as Ugandan history.
STAR International Surgical Teaching Camp, June 2014
Surgical Training and Research International (STAR ) was pleased to be able to put on the first successful surgical teaching camp with the Department of Obstetrics and Gynecology at Mulago Hospital. The mission of the camp was to combine delivery of surgical equipment and training for Residents, or Surgical House Officers (SHOs), in order to increase the number of Ugandan women treated for gynecological issues and improve the efficiency and complexity of surgeries performed. These efforts towards capacity building will ultimately give Ugandan health care providers more resources and improved management to care for the women of Uganda.
The preparation for the camp required many hours of labor by all members involved. STAR International raised approximately $12,500 through an online start-up website, and was extremely pleased to receive an additional $10,000 from Danbury Hospital and Western Connecticut Health Network. In partnership with organizations like the Afya Foundation, Americares, Cooper Surgical and Medline, we were able to purchase a four hysterectomy sets, a LEE P and suction machine, many disposable goods for the operating theater, medications, and several other supplies.
Team members personally invested their time and money to come to Mulago Hospital to put on the teaching camp:
- Dr. Robert Samuelson, Residency Program Director and Vice Chairman of OB/GYN and Director of Minimally Invasive Surgery, Danbury Hospital
- Dr. Sung Lee, Medical Director of the Women's Health Center, Seifort and Ford Community Health Center, Danbury Hospital
- Dr. Ellen Brand, Senior Anesthesiologist with Obstetrical Expertise
- Dalia White, RN , CNM , Expert Certified Surgical Technician
- Dr. Karina Haber, Chief OB/GYN Resident at Danbury Hospital and Founder of STAR International
- Dr. Corrie Miller, OB/GYN Resident at Danbury Hospital and Co-Founder of STAR International
Upon arrival at Mulago Hospital, STAR was pleased to have the support and partnership of Dr. Byamguisha and the entire Department of Obstetrics and Gynecology at Mulago. Dr. Esau Wasswa was instrumental in orchestrating the logistics of the camp, and identified priority patients for surgery and gathered SHOs to participate with us in the camp. His efforts were greatly appreciated.
The camp lasted from 8am to 8pm for 7 days. Various types of procedures were performed. All procedures were performed with Senior Consultant from Danbury Hospital, a Mulago SHO and a Danbury Hospital SHO. Approximately 26 procedures were performed over the five days, including six Hysterectomies, eight ovarian cystectomies or salpingoopherectomies, five ectopic pregnancies, and four pelvic abscesses. There was joint effort with General GYN Operating Theater Staff and STAR International Staff to sterilize instruments, transfer patients, turn-over rooms, and recover patients after surgery. STAR International followed patients post-operatively on the wards, doing dressing changes and administering pain medications. Upon completion of the camp, two hysterectomy sets, a LEE P machine, suction, and various other surgical supplies were donated to the Mulago Department of OB/GYN .
Anesthesiology SHOs and students also had the opportunity to learn additional skill during the Surgical Teaching camp. Dr. Ellen Brand enjoyed teaching multiple SHOs throughout the week with Dr. Chintu. Several anesthetic medications and instruments were donated to the department as well.
STAR International was extremely pleased to be able to work with Mulago Hospital in this endeavor. Several lessons can be learned for future collaborations. First, participating SHO's would receive the most benefit if they were selected by administration to participate in the camp consistently throughout the entire week. It would be beneficial for the department to choose 2-3 SHOs who have performed well throughout their training and allow them to opportunity of being able to operate with the visiting senior surgeons. This would also allow these particular SHOs to focus on improving skill over several cases instead of many SHOs seeing a glimpse of 1 or 2 cases.
Another suggestion for future improvement to surgical teaching camps is having a designated operating space, as this would lead to improved patient care. Often scheduled cases were delayed for more emergent surgery, which is a known issue at Mulago Hospital. Yet being able to focus on surgical technique and complex procedures will benefit SHOs in their future practice.
The goal of the surgical teaching camp was to expose Mulago SHOs to the various ways OB/GYN physicians perform their trade around the world. We hope that by spending time with STAR International, the next generation of healthcare leaders in Uganda will advocate for their patients, practice what is best for their patients' health, and encourage change in the health care system of Uganda. It was an absolute privilege to be able to care for the patients of Kampala, and work alongside outstanding Ugandan physicians all week long. STAR International is extremely thankful for the opportunity to help serve the women of Uganda and we desire to return to help carry on this good work.