Modern Day Slavery of Postgraduate Medical Doctors in Uganda (Video by MUK postgraduate doctors)

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• published: 21 Nov 2016
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The plight of Senior House Officers in Mulago Hospital By Prince Kakungulu Edward Back in 2012, while I was attending to patients in one of the private hospitals in Kampala, a mother walked in at 3:00 am with her child who had an exacerbation of Asthma (severe allergic airway disease). She requested to see a pediatrician (a specialist doctor for babies and children), to her dismay there was none at that time and out of frustration she asked, “But how are these specialists made?” Specialist doctors in the making are referred to as Senior House Officers here in Uganda (and in Ireland, and formerly in the UK and other countries whose education systems are similar to the UK)while in the US they are called Medical residents. They are postgraduate students in a university training to acquire a master’s degree of medicine in any of the many fields that includes Surgery, Obstetrics and Gynecology, Pediatrics, Medicine, Psychiatry, Ophthalmology, Ear, nose and throat, Anesthesia, Orthopedics, Neurosurgery among others. All Senior House Officers come back to specialize with too much experience in Health care provision and Administration. Personally I graduated from Gulu University having trained at Gulu Regional Referral Hospital, St. Mary’s Hospital Lacor plus attending community based learning in Anaka Hospital in Amuru District. I completed a year of internship in Hoima Regional Referral Hospital and Jinja Regional referral Hospital before I took on a contract job with Uganda Cancer Institute. At Uganda Cancer Institute we treated all kinds of tumors including Breast cancer and cervical cancer in women, prostate cancer in men and blood cancers known as leukemia in in children. I terminated my contract two years later to join postgraduate training in General Surgery at Makerere University. Many of my colleagues have been District Health Officers and Hospital administrators and some have even completed postgraduate training in other fields such as Business, Law and Public health. Our training is one of apprenticeship, we learn on job, the training is full time, rigorous and we are usually few in each field given the bulk of resources and time it takes to train one Senior House officer. We work 24hrs a day, teach undergraduate medical students, supervise intern doctors, clinical officers, Medical officers and we report to the consultants. Part of my work is to understand the ailment of a patient, provide emergency treatment that often at times includes cardiorespiratory resuscitation in case the persons heart has stopped, making sure he/she is breathing, provide supplementary oxygen if necessary replace blood and body fluids if insufficient. The next step is to wheel the patient to the operating theatre and to correct that problem that led to a change in the patient’s health. This may require doing a laparotomy (opening up the abdomen), fixing a fracture ( from the many bodaboda accidents, ), drain a blood collection from the skull and the like. In pediatrics the Senior House Officers have the responsibility of saving lives of innocent babies who are brought to the hospital with severe malaria, convulsions , reduced amounts of blood in their bodies (anemia), and those that can hardly breathe either due to allergic airway diseases (asthma) or having swallowed food and it gets logged in the airway or drunk poisonous substances such as paraffin Specialist trainees in obstetrics and gynecology attend to our mothers in labor perform caesarean sections (C-section) and make sure that both mother and baby are safe. Such work is on the hour, even when one is to put down his head for a moment, the phone is never to be off. You can be called upon by the patient, caretakers, relatives, junior doctors and consultants. Suffice it to say We are at the centre of health care delivery, to say the least. There is no room for error.. Beyond Mulago hospital we and our lecturers engage in medical camps to provide free health care to the hard to reach communities. I have been to Kitgum Matidi, Patongo prisions in Pader district, Amuru Health centre, Rukungiri town, Rubuguri in Kisoro District on the border of Uganda and Congo, Mubende, Kiganda and Ntwetwe health centres in Kyankwanzi  for such healthcare camps. At the Kyankwanzi health camp which was the most recent,  we had a Surgical camp and operated on over 300 people. We are soon heading to Kiruhura for yet another camp. Postgraduate training also catapults one to becoming a scholar engaging in research to innovate homemade solutions to address challenges in treating tropical diseases that selectively affect Africans. Such diseases include HIV and HIV associated Cancers, Sickle cell disease,  tunga penetrans also known as jiggers, Buruli ulcers among others. Most of this research is funded by the students themselves. Training can be challenging with many of our colleagues taking twice the duration necessary to complete, a number drops out before completion and some are d