AJ Bear on Rounds

One of the things on my wish list whilst in Uganda was to visit both the tertiary hospitals as well as the local referral hospital that are government funded. I always find it interesting to visit hospitals in different countries to compare and look at best practices.  The discussions with the physicians reinforce to me our common goals of patient care and comfort.

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Mulago hospital in Kampala is a tertiary hospital and I was able to visit the outpatient pediatric unit run by family physicians. We saw many infants and children – mostly with communicable diseases. What struck me most was the limited amount of investigative tools that were accessible, compared to what is available back at home. Treatments were frequently presumptive in nature. I also had the opportunity to talk to the medical residents and family medicine staff and give a CME on MSK disorders. I was quite surprised to hear that there are only 70 family physicians in Uganda which has a population of 42 million. The majority of medical students become specialists and the primary objective is not on preventive medicine. It is my belief that an increase emphasis on well trained Family Physicians will help decrease the burden on the health care system. (but I might be a bit biased based on my chosen field of medicine!)

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Rounds at Buhinga hospital in Fort Portal on the men’s medical ward was also an eye opener. The ward is an open unit with about 30 beds. The patients that were admitted were a mix of both non communicable diseases (NCDs) as well as communicable diseases (CDs), but isolation rooms are not available. Uganda is facing the unenviable state of having increasing NCDs without a significant reduction of CDs. Access to diagnostic testing – both lab as well as radiological imaging, is quite restricted, and one has to be a very astute physician indeed to work in a hospital setting with such limited access to diagnostic testing. When I get back to my hospital in Canada, I am going to get down on my knees and kiss the floor and I will be considerably more gracious with the radiologists when they are not able to expedite procedures in what I consider “a timely manner.”

Looks like I am going to eat a lot more humble pie when I get back to work.

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