Kagando Hospital is run by the Anglican Church of Uganda; set in a beautiful part of the country in the foothills of the Rwenzori Mountains. There are 220 beds. In the last 10 years there has been considerable expansion with the help of Tear Fund, the British High Commission, various International Charities with support from Mission Partners - C.M.S. and A.I.M. The medical staffing consists of 2 surgeons, 2 physicians, an anaesthetist and a physiotherapist. There was an adequate complement of nurses as essential basic care was undertaken by the patient's relative or attendant. The Outpatient Dept. was staffed by Medical Assistants with doctors seeing the more complicated cases. Outreach work in local Health Centres was being implemented when staffing permitted. There was a basic Pathology and X-ray service.
I was assigned as an extra 'pair of hands' to the Paediatric Unit for 3 months as this was the busiest area of the hospital. The atmosphere was very positive and friendly and I was quickly accepted as part of the medical team. As a retired G.P. I had a lot to learn about tropical paediatrics as well as re-learning the technique of IV cannulae, lumbar puncture and chest aspiration in small children in addition to the incision of abscesses. I was not involved in major surgery.
The most common illnesses encountered were malaria, measles, meningitis and malnutrition together with TB and AIDS related complex. Children with severe anaemia and cardiac failure frequently needed blood transfusion. An epidemic of measles also put a great strain on the resources. On the whole, the supply of drugs was adequate, but certain expensive antibiotics were hard to come by.
My biggest problem was the language barrier but the nurses were most helpful in translating from Lukonzo (local dialect) into English.
Whilst I was at Kagando, the district was subjected to intermittent attacks by terrorist groups called A.D.F. rebels. Their incursions produced an influx of refugees coming to the safety of the hospital compound where they could be protected by detachments of the Ugandan Army. This situation resulted in more illness and poverty amongst the displaced local population. There were times of particular tension when the staff were concerned for the safety of the hospital but it was not felt that we were in any personal danger in recent months. The Christian emphasis in the hospital was very evident and this was reflected in the quality of care. Mornings began with communal staff prayers and the hospital Chapel was well attended by the staff and local people.
The Bakonzo are cheerful and stoical in the face of illness. I often felt frustrated that we could not do more to help them. So many conditions could not be treated due to a lack of money or resources. At Kagando although there were cases of AIDS they were not so common as in other parts of Uganda probably because of its remoteness.
Kagando will still need doctors and surgeons as Mission Partners for the foreseeable future. The Church of Uganda is finding it difficult to maintain the existing staffing levels out of its own resources even with some Government help. A surgeon and an anaesthetist to replace Andrew and Sarah Hodges would be a priority. An additional physician or paediatrician would be useful.
On a personal note I found the climate quite agreeable, not too hot by day and cool by night. Accommodation was provided by the hospital but I was responsible for my own housekeeping which was inexpensive. Kagando has running water with flush toilets and electricity which works most of the time. Leisure opportunities include the Queen Elizabeth National Park close by and pleasant walks to local villages. There is an enthusiastic Badminton Club.
I would thoroughly recommend any retired doctor who feels a call to do something interesting and useful to give this type of short-term placement a try. One needs to be prepared to learn and be adaptable and to accept the Ugandan way of life, the motto of which is "Everything is possible but it may take a little time"!
I was assigned as an extra 'pair of hands' to the Paediatric Unit for 3 months as this was the busiest area of the hospital. The atmosphere was very positive and friendly and I was quickly accepted as part of the medical team. As a retired G.P. I had a lot to learn about tropical paediatrics as well as re-learning the technique of IV cannulae, lumbar puncture and chest aspiration in small children in addition to the incision of abscesses. I was not involved in major surgery.
The most common illnesses encountered were malaria, measles, meningitis and malnutrition together with TB and AIDS related complex. Children with severe anaemia and cardiac failure frequently needed blood transfusion. An epidemic of measles also put a great strain on the resources. On the whole, the supply of drugs was adequate, but certain expensive antibiotics were hard to come by.
My biggest problem was the language barrier but the nurses were most helpful in translating from Lukonzo (local dialect) into English.
Whilst I was at Kagando, the district was subjected to intermittent attacks by terrorist groups called A.D.F. rebels. Their incursions produced an influx of refugees coming to the safety of the hospital compound where they could be protected by detachments of the Ugandan Army. This situation resulted in more illness and poverty amongst the displaced local population. There were times of particular tension when the staff were concerned for the safety of the hospital but it was not felt that we were in any personal danger in recent months. The Christian emphasis in the hospital was very evident and this was reflected in the quality of care. Mornings began with communal staff prayers and the hospital Chapel was well attended by the staff and local people.
The Bakonzo are cheerful and stoical in the face of illness. I often felt frustrated that we could not do more to help them. So many conditions could not be treated due to a lack of money or resources. At Kagando although there were cases of AIDS they were not so common as in other parts of Uganda probably because of its remoteness.
Kagando will still need doctors and surgeons as Mission Partners for the foreseeable future. The Church of Uganda is finding it difficult to maintain the existing staffing levels out of its own resources even with some Government help. A surgeon and an anaesthetist to replace Andrew and Sarah Hodges would be a priority. An additional physician or paediatrician would be useful.
On a personal note I found the climate quite agreeable, not too hot by day and cool by night. Accommodation was provided by the hospital but I was responsible for my own housekeeping which was inexpensive. Kagando has running water with flush toilets and electricity which works most of the time. Leisure opportunities include the Queen Elizabeth National Park close by and pleasant walks to local villages. There is an enthusiastic Badminton Club.
I would thoroughly recommend any retired doctor who feels a call to do something interesting and useful to give this type of short-term placement a try. One needs to be prepared to learn and be adaptable and to accept the Ugandan way of life, the motto of which is "Everything is possible but it may take a little time"!
