The Ugandan Medical Safari... Part I

Going to Uganda as a young medical graduate with a lot of enthusiasm to serve offered me an immense opportunity to grow as a doctor. There was plenty of work to do and a lot to learn at the same time. Soon after I was exposed to the patients there with routine and casualty duties I realized that I was inadequately prepared to handle them efficiently. The internship training period we had in India was not properly utilized, as the young medical doctors would feel elated, having finally qualified after slogging for so many years of rigorous theoretical education. Also, working as a House Surgeon did provide ample chance to handle patients but in that particular specialty only in which you are posted. 

The work in Ugandan hospitals in the seventies expected you to handle cases on your own especially while on emergency duties. This was really a very challenging task and required a sound practical knowledge and grit to tackle the patient.

Here, I found that the young Ugandan doctors were bolder and better prepared as they had already been exposed to cases like minor simple fractures, obstructed Hernias, hydrocoele, minor amputations, D and C, Caesarian sections etc. while in medical school. They would approach such cases with more confidence, whereas in our case we were rather timid or just not able to deal with the problem at hand. This was due to faulty or inept practical training and lack of serious attention to acquire skills on the part of interns or both. However, it was imperative to acquire greater practical skills in order to fit into that medical setup where medical facilities were few and there was a dearth of the specialists as in Uganda of those days.

In such situations, we had to handle the cases with our utmost and sincere abilities, and despite the challenges, the results were 80-90% good. It was sometimes a do or die situation: in case we didn't try to handle a complicated case, there were greater chances of fatality. Referring patients to higher centers was not always feasible most of the time due to lack of transport or fuel, or the sheer distance, or all the factors combined. If one took the plunge, generally the outcome, would be rewarding and greatly encouraging. I stayed in Uganda for 11 years and worked in hospitals like Tororo, Kapchorwa, Mubende, Hoima, Masaka and Mulago in Kampala. This gave me ample clinical work to practice my skills, learn on the job and draw a great satisfaction at the same time. Unfortunately this sojourn of mine (1970 to 1981) happened to coincide with the tyrannical and murderous regime of Idi Amin, a very trying period especially for Ugandans.