I had the privilege last summer of doing my elective in Kagando Hospital. Having never been to Africa I had no idea what to expect but I can assure you, my whole experience went far beyond any expectations I may have had.
I flew from London via Ethiopia to Kampala and then embarked on a days worth of travelling across Uganda through Queen Elizabeth National Park. Eventually arriving at Kagando – my home for the next 5 weeks. The hospital has a compound for staff to stay – so don't need to sort accommodation or travel to/from the hospital. I awoke the next morning with the sun shining to be greeted with the Rwenzori mountain range which separates Uganda from the Democratic republic of Congo (DRC).
Word of warning – if you like your luxuries – don't come! You are in the sticks. Prepare to slum it in true African style. No Internet – no AC (didn't really need it) – no decent shops near by. HOWEVER there was electricity most of the time, a proper toilet, a comfy bed and decent (cold) shower. Food is included in accommodation so 3 meals a day are provided. Highlight of the week was the local market – chance to buy a pineapple!!Kagando is made up of a hospital, school, nursing and midwifery training college and church which has links with an orphanage and prison, so plenty to keep you busy. The hospital holds 250 patients, but 300 is a more realistic number. There are 6/7 doctors in the hospital alongside nurses, clinical officers and overseas visitors. There is an OPD, paediatric, O&G, surgical, male medical and female medical wards as well as a TB and leprosy ward.
A typical day began at 8am with Chapel – lasting 30mins with a time of worship, preach and prayer. Everyone works on 'African time' – meaning ward rounds can start whenever – usually shortly after chapel!
My personal interest was in O&G so I spent 4 of my 5 weeks there. It's all hands on deck if you are eager and willing. There's a lack of staff and often too many patients. I learnt a lot on my first week, that old phrase of 'see one, do one, teach one' was rather applicable! By the 2nd week I was seeing post op women with another medical student, and most likely starting antenatal ward rounds also. Common tasks would be to examine the women, order some investigations, prescribe drugs and do discharges. The Pinnard stethoscope became my best friend! Sounds overwhelming but you get the hang of it with a little help from oxford handbook and the BNF alongside the senior doctors who I always ran things past!
My afternoons were variable – sometimes popped to theatre to see what was going on but often I headed to Outpatients. It's an equivalent to GP / A&E and chance to see LOTS of pathology. All acute patients will come here to be admitted (babies, RTA victims etc) malaria, typhoid, HIV and psychosomatic illness is rife. Your clinical skills will be put to the test as there isn't an extensive amount of investigations available but you can order some basic things – bloods, X-ray, USS.
As mentioned earlier you can use your afternoons to go and visit the orphanage, do prison ministry, go to the school, do HIV outreach clinics, assist in theatre, walk to Kagando village. Kasese town is 45 mins away by car where you will be able to use the internet, pick up some chocolate, have a nice meal and a few drinks. There is a lot to see and do in south west Uganda so make use of the weekends. Lake Bunyoni was a favourite of mine!! Mid week some of the staff have a time of fellowship which was another highlight of mine, definitely worth getting along to.
The good bits
- Fantastic clinical opportunities if you are willing to get involved
- The staff and patients are amazing
- Beautiful location
- Lots to do at the weekends
- The fruit is amazing!!
The bad bits
- Communication from the hospital wasn't extremely good before going out there, but they were expecting us when we arrived! Pheww
- Local food can get a bit monotonous
- Educated people in Uganda speak English but lots of locals only speak tribal languages, nurses can always translate but it can get slightly frustrating
Would recommend this elective 100%, however apply early as there it was a full house when I went so it is popular with overseas students. Chance to travel afterwards; I went to Kampala, Zanzibar then travelled to Kenya.