Back to Masindi…FINALLY

After 2 years of being thwarted by COVID, our residents, fellows and faculty were able to return to Masindi, Uganda to provide patient care and a long-delayed ultrasound training. PGY3 Will Fraser shares his experiences in Masindi…

Arriving in Masindi brought us into a world in and of itself. From the vibrant colors of the clothing to the impressive hand manufactured furniture that lined parts of the main road throughout the city, it was clear that we were surrounded with a hardworking and passionate culture. Our first introduction to the medical system was at One World Health’s self-sustaining hospital, Masindi Kitara Medical Center (MKMC). A testament to the hard work of the area’s physicians and staff, the hospital functions as an affordable tertiary care center with an operating theater, obstetrics and medicine ward. The clinical staff ranged from physicians to clinical coordinators and nursing and with every person I interacted with, it was clear that there was a uniform pride and desire to learn in order to improve the lives of their community.

After touring the main hospital, we were able to return to the hotel and inventory our supplies for the next five days of work in the community. As my first medical trip in Africa, I was excited but still not quite sure of how the clinics would run or how we would be received in the communities we would travel to. The next morning assuaged any feelings of apprehension when we arrived at a church approximately an hour outside Masindi where we were greeted by a line of two hundred people waiting to discuss their symptoms, many who had never met with a physician or nurse before. Immediately upon arriving, we got to work. With the help of the locals, we were able to arrange the inside of the church to accommodate a triage section, a physician section, a pharmacy station, a reading glasses zone, and even an examination table where we could utilize point of care ultrasound (POC) for bedside echocardiograms, obstetric screenings, and various other point of care diagnostics. The day flew by. We treated over 250 people, including our translators who graciously helped us throughout the day, and learned a significant amount about Uganda and its rich culture.

The next day, we travelled to a village with a more remote commute. I had the opportunity to ride in the van with our local outreach team and they showered me with information of the surrounding villages, farmlands, major exports and even the major slang. I learned some surprising terminology– like the fact that “malaria” and “syphilis” meant fever and rash, respectively. I then spent an inordinate amount of time attempting to learn some of the different animal names in Swahili and the 90-minute ride to the next village passed in a flash. Again, we were greeted by over 200 people. The day was split with a lunch time break where one of the translators graciously swapped lunches with me and I was able to enjoy some matoke (steamed bananas), “irish” (potatoes) and chicken. The day once again passed quickly, and we were able to see and speak with everyone who came and wrap the day up with a nice dinner at the hotel in Masindi with the whole group.

The clinics continued through Friday. Through the week, we examined over 1000 patients, educated on nutrition and medicine, and were educated on local traditions, languages, and lifestyle. We had multiple cases where we utilized the tertiary care centers in both Masindi and Kampala, and we were able to arrange transport for patients who would have never otherwise had the opportunity to be treated with a higher level of care.

Transitioning from work to relaxation, we then packed up some essentials and took the vans to Murchison Falls National Park for a safari. Expecting to possibly see a giraffe and have dinner beside the Nile, I was blown away when we were greeted by an African Elephant, within an arm’s reach of a lion, surrounded by Giraffes, watched by hippos and trailed by pumba (the Swahili translation for warthog – Disney was teaching while entertaining). The safari was so much more than I had expected and would have been an incredible trip in and of itself.

Arriving back in Masindi, we prepared ourselves for 3 days of ultrasound teaching. With the goal of establishing a readily available POC ultrasound program with the ability to upload and review images in real time, the opportunities are vast in an area without an accessible CT scanner and limited radiographs. The staff learned quickly and the physician on staff was able to convey how useful the technology could be, especially for fetal heart rates, sometimes difficult to detect manually. Ideally, we’ll continue this project and see if it makes a clinical impact in the upcoming months.

As we said goodbye to our fellow Richlanders, I stayed back with a coresident and conquered one more Ugandan goal… rafting the Nile. A daunting experience after seeing the animals that frequent the Nile during our safari, we booked the excursion and quickly found ourselves rafting through the Nile rapids. We did flip the raft, but no harm done, and we were able to see the beautiful landscape of some of the Ugandan villages where life is nourished from the river.

The trip to Uganda was an incredible experience. Given the opportunity to see the success that an NGO can have in creating a functional and sustainable healthcare system and meet some of the incredible people living and working in Uganda was an unparalleled opportunity, as well as some of the most fun I have ever had.

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