By Eric Cher Wei Liang, Class of 2014
Being the first medical student to do an overseas elective in Uganda, Duke-NUS has provided tremendous support in making this intention a reality. I had the privilege of doing my elective in Orthopedics Trauma at Mulago Hospital, the national referral and teaching hospital in Uganda.
Outreach program into the neighborhood
Orthopedics Department, Mulago Hospital
With Dr. Titus Beyeza, Head of Orthopedics, Mulago Hospital
Africa has one of the world’s highest road traffic mortality rate and in Uganda, road traffic accidents account for more than 49% of the total injuries seen at the casualty unit. With less than thirty orthopedics surgeons serving the country, most of the musculoskeletal conditions were handled by trainee residents and orthopedics officers.
Traffic in Kampala
During my elective, I rotated through two of the primary orthopedics trauma wards; the casualty department where most of the trauma cases were seen as well as outpatient consults including general orthopedics and clubfoot clinic.
Clubfoot shoe braces used in specialized clubfoot clinics
As a medical student, I was given ample opportunities to participate in all aspects patient care, ranging from ward work, to being a primary assistant during surgeries and triaging patients as they arrive at the casualty department. Due of the severe shortage of healthcare providers, students played a significant role in the delivery of patient care. The doctors and nurses at Mulago Hospital were incredibly helpful when it comes to teaching students and have no qualms about letting us perform procedures under supervision. Very quickly, I started getting used to the rhythm of things and was able to independently handle simple conditions as such toilet and sutures of large lacerated wounds, abscess drainage and preliminary management of both close and open fractures.
Casualty department – OT and treatment room
It was here, where I did my very first manipulation of a dislocated shoulder and performed my first external fixation as the 1st assistant surgeon. With these levels of responsibilities, it very quickly dawned upon me the importance of being proficient and confident with my work. As a student, we need to be mindful of our limitations, and moving forward to become a doctor, we must be aware of our professional boundaries.
Mr Musumba, an experienced orthopedics officer
With Dr. Willis, Intern, doing ward work
With the doctors at Casualty Department
With the interns at Casualty Department
Living in a house filled with like-minded people, I had the opportunity to work and learn alongside both medical and nursing students from all over the world. Educated through different healthcare system and having gone through various volunteering experiences, our individual passion for humanitarian served as a common denominator, creating the perfect environment for ideas to propagate. Being in Africa isn’t without its fair share of fun. While visiting the safaris and sightseeing weren’t part of my primary agenda, I had the chance to visit one of a nearby island (Banda Island) with a group of international friends. Located more than 4hrs boat ride away from the main city, the beauty of the crystal clear blue water, together with the rustic campsite right next to the beach painted a scenic view of calmness and mesmerizing nature.
With locals and international students at EdgeHouse
Great Ugandian Friends from Edge House
While resources at the hospital may be limited and technologies may not be at the forefront, the experience gained is something words cannot quantify. There were countless learning opportunities and hands-on practices, not to mention the tremendous sense of satisfaction working in such an environment. When it comes to research, there are no other place that is in need of more creativity and innovations to solve the nation’s long-term healthcare problems. Rather than spearheading breakthrough technologies and medical advances, some of the simplest engineering designs and clever use of local resources are what’s most in need here.
The international exposure gained after being here in Kampala has made it obvious the different spectrum of healthcare challenges faced by many developing nations. There are indeed multiple avenues available to help these communities, but at the same, one has to think beyond satisfying an individual’s passion and look at problems and solutions from a macro landscape. The cross cultural experience of interacting and working with the local community has given me a small glimpse into a different realm of medicine, providing new insights and perspectives into how I want my personal and professional life to be as a doctor.
With Dr. Amuron Naomi, Ortho SHO(Resident)
I hope that through this experience, more students would be encouraged to partake in such overseas clinical electives during their medical education, and subsequently as a physician.