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Reflections On Time Well Spent In Uganda

“If you have come here to help me, you are wasting your time.  But if your liberation is bound up with mine, then let us work together.” – Lilla Watson, Australian Aboriginal activist

By: Harry Chen, M.D., September, 2018

It was about this time one year ago that my wife and first set foot in our new home in Mbarara, in Southwestern Uganda.  We had just finished an abbreviated Peace Corps orientation in Washington DC and Kampala, Uganda and were deemed “ready to go.”  Though we have been back in the U.S. for a couple months, the memories are fresh and our arrival in Mbarara sometimes still seems like yesterday.

I was participating in the Global Health Service Partnership (GHSP), a collaboration between Peace Corps and SEED Global Health, designed to build local capacity in Africa in Medicine and Nursing.  My placement was at the Mbarara University of Science and Technology (MUST). MUST was starting the first Emergency Medicine Residency (Masters in Medicine in Emergency Medicine) in Uganda and providing academic structure for the GEC’s Emergency Care Practitioner Program (Diploma in Emergency Medicine). Both of these programs are essential pieces to creating a much needed and effective Emergency Care System in Uganda.

“Looking back, it’s not hard to pick out the high and low points of a most extraordinary adventure.”

 “Deer in the headlights” would be an apt description of me during the first few weeks, whether it was learning to navigate the randomness and shortcomings of the health care system, the unbelievable pathology and too frequent deaths or just figuring out how to get by in daily life. I was fortunate to have my wife, who was in a different Peace Corps program, to share the process of adjusting to the surprises, challenges – and delights – of life in Uganda and five stellar Ugandan residents and a wonderful medical partner to help on the health care front. In Uganda, medical school is five years right out of high school followed by a year of internship.  After internship, most physicians go out and work in clinics or hospitals before further training.

Our “pioneer” group of residents all had three to five years of clinical experience prior to joining us. Thus, they were seasoned clinicians, primarily in need of technical guidance and mentorship. They were hard-working, unpretentious and kind in addition to being skilled and knowledgeable physicians. While critical thinking and problem solving seem to be challenges for medical students in Uganda, a few years out in the real world does wonders in this regard.  One lesson they taught me was the power of a diverse group. They were all so different from one another but worked together constantly to learn, teach, care for patients and consider more systemic change. As several observers commented, we became like a family.

“International development is a dicey endeavor; it can be hard to know who is helping who, who is driving the bus and if you are making a sustainable difference.”

 Lilla Watson, an Australian Aboriginal activist spoke about it in a way that resonates with me. “If you have come here to help me, you are wasting your time.  But if your liberation is bound up with mine, then let us work together.” By that measure, the ten months I spent teaching and mentoring Uganda’s future leaders in Emergency Medicine was truly an example of shared liberation – mine was to teach and theirs to learn. I am grateful for the chance to fulfill a lifelong dream, to live and work in a developing country, to learn about and live humbly in a different culture and to have an opportunity to make a difference on multiple levels.

Uganda is a beautiful country with spectacular scenery and wildlife. We explored only in-country during our first eight months and had plenty of wonderful trips. We normally think of Africa as hot but where we lived, the “Land of Milk and Honey,” it was hilly and green, with temperatures in the 80s during the day and 60s at night.  We were so close to the equator that day and night were precisely 12 hours long, and the only seasons were “dry” and “rainy.” While we were awed by the beauty of the country, Uganda’s people are its true gem. They were warm and welcoming to us, at times to a fault. The standard greetings were genuine and required before getting down to any business. Ugandans are impressive in their ability to embrace the vicissitudes of life in stride; that’s no small feat based on what we saw of the everyday difficulties and struggles almost everyone faces.

So how does this sound to you? If you’re an EM doc and this is appealing, I’d ask you to consider spending a semester or two in Uganda.  While the GHSP, the Peace Corps program I was in, has ended, SEED Global Health is continuing to support medical and nursing education in Uganda. You can find out more about the program here- SEED Global Health Educator.
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