Experience of Our Medical Students
Letter from Evan Taylor
March 2012
Staring out the bus window as we travelled southwest from the Ugandan capital Kampala, the infrastructure began to drop off noticeably. The paved roads became narrower, electric lines became fewer, and by the time we were bouncing down the rutted dirt roads past Rukungiri town, the only lights we could see were the kerosene lamps hanging in the windows of the houses and shops and the stars overhead.
In 2011, early rains had not only affected the harvest cycle, but they had turned the dirt road to Kisiizi Hospital into a muddy mess. As we rounded a turn, still kilometers away from the hospital, the fully loaded bus slid, spun, and finally became impossibly stuck.
In the evening gloom, the passengers and prospective patients dismounted. On the side of the road, Jessica and myself, as two newly arriving American medical students, had our first taste of Kisiizi kindness. “Are you heading to the hospital?’ asked an elderly man, standing next to us in the darkness. ‘Well, we are trying to,’ I replied, ‘but we don’t really know how we are going to get there.’ ‘’I’ll call the hospital and have them send a car,’ he reassured us. (The next day, as we were warmly welcomed into the family of Kisiizi staff and nursing students during morning sermon, we realized our benefactor was none other than Father Patrick, Kisiizi’s head chaplain).
30 minutes later, we gratefully threw our bags in the back of the Landrover and, along with the 8 hospital employees who had been on the bus (unbeknownst to us), we piled into the vehicle and set off for the final leg of our journey. Churning our way through the mud, we rounded the final hill and began our descent into the valley in which Kisiizi sits. In a corner of the country hours away from the closest town connected to the national power grid, Kisiizi Hospital’s 7 wards were lit up brightly, serving as a beacon for the entire region. It was clear we were heading to a very unique place.
During our 8 weeks there, we were to discover that Kisiizi hospital is exceptional in many ways- although it is on the other side of the country from the populous capital, Kampala, Kisiizi is only the second institution with a mental health ward in the country. While rotating on the unit, the head psychiatric nurse Sister Nancy showed us a box of chains that the hospital staff had removed from mentally ill patients brought to the hospital in chains. Their exhausted family members had been left with no other options except to bind them. Under Sister Nancy’s care and the proper medical management, however, many individuals that have lived with serious mental illness for years have been able to walk out of Kisiizi as free, functional members of society. The chains that represent the depth of their illness now function only as souvenirs.
This is the paradox of Kisiizi Hospital: despite its rural location and impoverished patient base, thanks in part to its devoted supporters Kisiizi Hospital is able to provide an extraordinary level of care. With its’ x-ray and ultrasound machines, innovative home-made health insurance plan, and team of highly skilled doctors, surgeons, and midwives, the hospital provides an amazing level of medical care to a mainly rural patient population that would have no other care available to them.
This last point is especially key: as we learned during our time there, despite Uganda’s improvements over the last 20 years, most rural Ugandans still live in immense poverty. This was particularly apparent in the malnutrition wing of the pediatric ward: while the nurses at Kisiizi are able to provide the swollen, protein-deficient infants with a lifesaving, nutrient-rich formula during their stay at the hospital, out behind the malnutrition unit the babies mothers’ were cooking the same nutritionally incomplete meal of pounded banana porridge that rural Ugandans have been eating for generations. This ‘matoke,’ Uganda’s staple food, might fill bellies, but it provides little in the way of protein that growing children so desperately need. The problem is not simply a matter of education either: when asked about her access to protein, one local woman told me that her family can afford to eat meat only once a year, on Christmas.
It is realities like this that make the Kisiizi staff’s job so incredibly difficult, both technically and emotionally. Day after day, a staff of 6 doctors, with the assistance of nurses and midwives, attend to hundreds of rural patients. To be a doctor at Kisiizi is to be a highly educated individual who has devoted oneself to practicing rural medicine almost as far away from the capital as one could get in this country. Likewise, to be a patient at Kisiizi is to receive compassionate care at a hospital that is able to do more for its patients than it should in all rights be able to.
As medical students between our first and second year of medical school, Kisiizi hospital provided an amazing learning experience. The guidance we received from the Ugandan doctors, nurses, and midwives was irreplaceable. Likewise, the amount of medicine we were able to absorb was immense- watching surgeries, participating in deliveries, learning procedures, and having access to experienced clinicians as they talked through their thought process regarding cases that we would likely never see in the U.S. was an amazing learning experience. I for one will never forget seeing Dr. Gabriel, the hospital’s skilled surgeon, remove the leg of a 10 year old boy diagnosed with osteosarcoma (a type of bone cancer). The skill he showed during that operation was matched only by the courage and stoicism of the boy and his family during and after the operation.
But the hospital doesn’t just provide medical care--- through its sponsorship of local orphans, affiliated school of nursing, free distribution of lifesaving HIV/AIDS medication, and pre-natal service outreach in local villages, Kisiizi hospital has truly created a community to serve the people of local Uganda. In a part of the country without electricity, the hospital’s hydroelectric dam and generator provides power not only to the wards (surgical ward and theater, maternity, medical ward, pediatrics, isolation ward for infectious disease, mental health ward, and outpatient), but also sends electricity for miles in either direction.
It was a privilege to learn from the doctors and patients at Kisiizi. In an area of the world where the government provides almost no services, Kisiizi Hospital has taken on the role of protector and community fixture. During my interviews with them many of the patients stated that they had tried to go to government hospitals but were turned away when the clinic had run out of medicine, healthcare workers, or both. The one refrain I heard repeated over and over was that Kisiizi was better than government hospitals because at Kisiizi, people cared. While the American system might outstrip Kisiizi in the technology and outcomes we can provide for our patients, I have no doubt that we could learn a lot from this outstanding Ugandan hospital and its dedicated healthcare providers.
‘Please help us support this hospital as it strives to support Ugandans’
Evan Taylor
University of Colorado School of Medicine Class of 2014
Letter from Evan Taylor
March 2012
Staring out the bus window as we travelled southwest from the Ugandan capital Kampala, the infrastructure began to drop off noticeably. The paved roads became narrower, electric lines became fewer, and by the time we were bouncing down the rutted dirt roads past Rukungiri town, the only lights we could see were the kerosene lamps hanging in the windows of the houses and shops and the stars overhead.
In 2011, early rains had not only affected the harvest cycle, but they had turned the dirt road to Kisiizi Hospital into a muddy mess. As we rounded a turn, still kilometers away from the hospital, the fully loaded bus slid, spun, and finally became impossibly stuck.
In the evening gloom, the passengers and prospective patients dismounted. On the side of the road, Jessica and myself, as two newly arriving American medical students, had our first taste of Kisiizi kindness. “Are you heading to the hospital?’ asked an elderly man, standing next to us in the darkness. ‘Well, we are trying to,’ I replied, ‘but we don’t really know how we are going to get there.’ ‘’I’ll call the hospital and have them send a car,’ he reassured us. (The next day, as we were warmly welcomed into the family of Kisiizi staff and nursing students during morning sermon, we realized our benefactor was none other than Father Patrick, Kisiizi’s head chaplain).
30 minutes later, we gratefully threw our bags in the back of the Landrover and, along with the 8 hospital employees who had been on the bus (unbeknownst to us), we piled into the vehicle and set off for the final leg of our journey. Churning our way through the mud, we rounded the final hill and began our descent into the valley in which Kisiizi sits. In a corner of the country hours away from the closest town connected to the national power grid, Kisiizi Hospital’s 7 wards were lit up brightly, serving as a beacon for the entire region. It was clear we were heading to a very unique place.
During our 8 weeks there, we were to discover that Kisiizi hospital is exceptional in many ways- although it is on the other side of the country from the populous capital, Kampala, Kisiizi is only the second institution with a mental health ward in the country. While rotating on the unit, the head psychiatric nurse Sister Nancy showed us a box of chains that the hospital staff had removed from mentally ill patients brought to the hospital in chains. Their exhausted family members had been left with no other options except to bind them. Under Sister Nancy’s care and the proper medical management, however, many individuals that have lived with serious mental illness for years have been able to walk out of Kisiizi as free, functional members of society. The chains that represent the depth of their illness now function only as souvenirs.
This is the paradox of Kisiizi Hospital: despite its rural location and impoverished patient base, thanks in part to its devoted supporters Kisiizi Hospital is able to provide an extraordinary level of care. With its’ x-ray and ultrasound machines, innovative home-made health insurance plan, and team of highly skilled doctors, surgeons, and midwives, the hospital provides an amazing level of medical care to a mainly rural patient population that would have no other care available to them.
This last point is especially key: as we learned during our time there, despite Uganda’s improvements over the last 20 years, most rural Ugandans still live in immense poverty. This was particularly apparent in the malnutrition wing of the pediatric ward: while the nurses at Kisiizi are able to provide the swollen, protein-deficient infants with a lifesaving, nutrient-rich formula during their stay at the hospital, out behind the malnutrition unit the babies mothers’ were cooking the same nutritionally incomplete meal of pounded banana porridge that rural Ugandans have been eating for generations. This ‘matoke,’ Uganda’s staple food, might fill bellies, but it provides little in the way of protein that growing children so desperately need. The problem is not simply a matter of education either: when asked about her access to protein, one local woman told me that her family can afford to eat meat only once a year, on Christmas.
It is realities like this that make the Kisiizi staff’s job so incredibly difficult, both technically and emotionally. Day after day, a staff of 6 doctors, with the assistance of nurses and midwives, attend to hundreds of rural patients. To be a doctor at Kisiizi is to be a highly educated individual who has devoted oneself to practicing rural medicine almost as far away from the capital as one could get in this country. Likewise, to be a patient at Kisiizi is to receive compassionate care at a hospital that is able to do more for its patients than it should in all rights be able to.
As medical students between our first and second year of medical school, Kisiizi hospital provided an amazing learning experience. The guidance we received from the Ugandan doctors, nurses, and midwives was irreplaceable. Likewise, the amount of medicine we were able to absorb was immense- watching surgeries, participating in deliveries, learning procedures, and having access to experienced clinicians as they talked through their thought process regarding cases that we would likely never see in the U.S. was an amazing learning experience. I for one will never forget seeing Dr. Gabriel, the hospital’s skilled surgeon, remove the leg of a 10 year old boy diagnosed with osteosarcoma (a type of bone cancer). The skill he showed during that operation was matched only by the courage and stoicism of the boy and his family during and after the operation.
But the hospital doesn’t just provide medical care--- through its sponsorship of local orphans, affiliated school of nursing, free distribution of lifesaving HIV/AIDS medication, and pre-natal service outreach in local villages, Kisiizi hospital has truly created a community to serve the people of local Uganda. In a part of the country without electricity, the hospital’s hydroelectric dam and generator provides power not only to the wards (surgical ward and theater, maternity, medical ward, pediatrics, isolation ward for infectious disease, mental health ward, and outpatient), but also sends electricity for miles in either direction.
It was a privilege to learn from the doctors and patients at Kisiizi. In an area of the world where the government provides almost no services, Kisiizi Hospital has taken on the role of protector and community fixture. During my interviews with them many of the patients stated that they had tried to go to government hospitals but were turned away when the clinic had run out of medicine, healthcare workers, or both. The one refrain I heard repeated over and over was that Kisiizi was better than government hospitals because at Kisiizi, people cared. While the American system might outstrip Kisiizi in the technology and outcomes we can provide for our patients, I have no doubt that we could learn a lot from this outstanding Ugandan hospital and its dedicated healthcare providers.
‘Please help us support this hospital as it strives to support Ugandans’
Evan Taylor
University of Colorado School of Medicine Class of 2014
Letter from Yihan Lin
March, 2012
When I first stepped into Africa, I imagined that it would be like the many pictures that I had seen previously: scorching deserts and thin, emaciated children. I thought that even with my limited knowledge, surely there was something that I could contribute to people that were so lacking in basic necessities. However, my time in Africa drastically changed the way I thought of developing nations, and also the way in which I plan to contribute to the world of global health in the future.
The first way in which my time in Kisiizi changed me is how I thought of the burden of disease in Africa. The staff in the medical field is every much as brilliant and dedicated as the staff in the United States, but the difference that exists lies in the lack of resources - and what a huge difference this makes. Even the most brilliant surgeon cannot effectively operate when they are so lacking in staff and so overwhelmed with patients that they cannot get enough rest in between surgeries. The most brilliant hospitalist with knowledge of the latest medical literature and treatments cannot save a patient if the hospital cannot afford the drug that is specified in the medical textbook. The state of health in Africa is not a problem with the doctors or the patients, but that of resources, including time and money. After being in Africa, I was able to understand that this inequality was unacceptable, and that we must all do our part to bridge this inequality.
The next way in which Kisiizi has influenced me is the way I have learned how to contribute to global health. One of my most memorable moments in Kisiizi hospital happened on a Sunday morning. A week before this, we had found a whole carton of donated medical supplies from the States left to the wayside, because there was no one that was able to spare time away from patients to sort through the massive carton. Many medicines had expired as a result of this, and many valuable supplies were going to waste. Therefore, it was our mission to build a storeroom so that medical supplies would be easily accessible to the staff and be put into good use for the patients. We had cleared an entire room for this project, then purchased/measured/cut wood so we could build shelves to organize these medical supplies. That Sunday morning, we had used our day off to wake up early in the morning, and were using hammers and nails to build our shelves. To my surprise, one of the sister nurses of the hospital came in and was quite firm with us, telling us that we were not allowed to be working on a Sabbath. Initially, I could not believed that we were being reprimanded for trying our hardest to get something that would be of their benefit. However, I quickly realized the that I was very ignorant in thinking this. Who am I to decide what I think is better for someone? All I can do is help in a way that is the most beneficial to them. This was an important lesson that I will carry with me to use in all my future endeavors.
Africa is a beautiful country, with the the most wonderful people. Dr. Dave and Chris Hibbard have established a great working relationship with the hospital, and have developed a very sustainable project that continues yearly.
I hope that you will consider donating and help this great cause!
March, 2012
When I first stepped into Africa, I imagined that it would be like the many pictures that I had seen previously: scorching deserts and thin, emaciated children. I thought that even with my limited knowledge, surely there was something that I could contribute to people that were so lacking in basic necessities. However, my time in Africa drastically changed the way I thought of developing nations, and also the way in which I plan to contribute to the world of global health in the future.
The first way in which my time in Kisiizi changed me is how I thought of the burden of disease in Africa. The staff in the medical field is every much as brilliant and dedicated as the staff in the United States, but the difference that exists lies in the lack of resources - and what a huge difference this makes. Even the most brilliant surgeon cannot effectively operate when they are so lacking in staff and so overwhelmed with patients that they cannot get enough rest in between surgeries. The most brilliant hospitalist with knowledge of the latest medical literature and treatments cannot save a patient if the hospital cannot afford the drug that is specified in the medical textbook. The state of health in Africa is not a problem with the doctors or the patients, but that of resources, including time and money. After being in Africa, I was able to understand that this inequality was unacceptable, and that we must all do our part to bridge this inequality.
The next way in which Kisiizi has influenced me is the way I have learned how to contribute to global health. One of my most memorable moments in Kisiizi hospital happened on a Sunday morning. A week before this, we had found a whole carton of donated medical supplies from the States left to the wayside, because there was no one that was able to spare time away from patients to sort through the massive carton. Many medicines had expired as a result of this, and many valuable supplies were going to waste. Therefore, it was our mission to build a storeroom so that medical supplies would be easily accessible to the staff and be put into good use for the patients. We had cleared an entire room for this project, then purchased/measured/cut wood so we could build shelves to organize these medical supplies. That Sunday morning, we had used our day off to wake up early in the morning, and were using hammers and nails to build our shelves. To my surprise, one of the sister nurses of the hospital came in and was quite firm with us, telling us that we were not allowed to be working on a Sabbath. Initially, I could not believed that we were being reprimanded for trying our hardest to get something that would be of their benefit. However, I quickly realized the that I was very ignorant in thinking this. Who am I to decide what I think is better for someone? All I can do is help in a way that is the most beneficial to them. This was an important lesson that I will carry with me to use in all my future endeavors.
Africa is a beautiful country, with the the most wonderful people. Dr. Dave and Chris Hibbard have established a great working relationship with the hospital, and have developed a very sustainable project that continues yearly.
I hope that you will consider donating and help this great cause!