Safe and Sound in Uganda: My Home Away From Home

3 September 2015:  Greetings from sunny and warm Uganda!  Despite my intial abrupt change in travel plans (see prior post), it all turned out to be an even bigger blessing in disquise than I had thought last night.  It turns out that my original flight from Pennsylvania was quite delayed as well and if I had stayed around to take that flight, I would have gotten stuck overnight in Detroit and wouldn’t have been able to arrive here until today.  As things went, the plane arrived at Entebbe Airport in Uganda just 30min late and I was greeted by the smiling Makerere University driver, Martin.  What was really nice is that most of the drivers waiting for international passengers hold signs with their names on them so the passenger knows who to go with. But for me, that wasn’t necessary. Martin has driven me numerous times now so I’m greeted as a friend instead of a welcome stranger.

View 1: Edgehouse Bedroom- See, a new TV!

View 1: Edgehouse Bedroom- See, a new TV!

My first impression upon leaving the plane was “boy, it sure is hot and humid”.  Right now should be the transition from dry to rainy season but Martin said that it has still been pretty dry. When the rains come, it cools the air down.  I was also surprised at the heat because it was so late at night and usually it can get rather cool. The normal highs are around 85-87F and normal lows are around 65F.  When its not too humid, the weather here is gorgeous.  Today, though, it did rain a little bit and when I left the campus, I was almost chilly without a sweater.

View 2 of Bedroom- note the mosquito net; the sides pull down around the bed at night

View 2 of Bedroom- note the mosquito net; the sides pull down around the bed at night

Upon arriving at the Makerere University Visiting Scholar House, commonly referred to as “Edgehouse”, I was greeted warmly by hugs and smiles from the groundskeeper and guard, Eric, and by Eva, the housemaid. They always take such good care of me when I’m here. While Eric lives on the grounds, Eva usually goes home at night but she stayed super late just to see me (we didn’t arrive there until 12:50am).  My room was already for me and there have been some welcome upgrades. First of all, they got a T.V.!  Although I do watch TV frequently when in the USA, I’ve never really missed it much while in Uganda, except for keeping up with the news around the world.  When I’m in Uganda, I keep so busy that it seems like my world is only Uganda. Over the past couple of trips I found that I could get news alerts via phone apps so I got to keep up better. This time, though, it should be easier with a Television.  I’ll also get a chance to see some of the interesting African Soap Operas that I’ve caught a glimpse of before. They have also outfitted the kitchen with a microwave and finally, they have created a raised stoop at the door so when it rains hard, the water shouldn’t run in.

View 3- the kitchen has everything I need to cook- even a new microwave!

View 3- the kitchen has everything I need to cook- even a new microwave!

After sleeping in, and a good sleep it was, my day was spent first of all, organizing my room, then meeting with Professor Richard Odoi at the University.  After a while, Cathy, the Ugandan pharmacist and faculty member who came to the USA, met me at the pharmacy school and took me to run the usual errands, Internet Phone Store for data plans for my wifi router, phone and ipad, and for groceries.  We also had a nice dinner at a local chain called “Cafe Javas”. Oh, I forgot to mention that I had African food at the School of Pharmacy. I was so hungry by then since I had no food at the house and the Matoke (mashed banana) and green pea sauce never tasted so good!!

The bathroom has a modern toilet, a nice tub with handheld shower head and best of all, really great hot water!

The bathroom has a modern toilet, a nice tub with handheld shower head and best of all, really great hot water!

Today I ran into one of the 4th year students whom I had met and worked with last year. He told me about his summer clinical experiences working at the Infectious Diseases Institute and then asked me to speak to all of the pharmacy students at a career conference being held by the upper classman this Saturday.  Since they needed a Pharmacist to talk on careers in Academia, the topic was a perfect match for me.  So, as I knew it would, my time in Uganda is starting off at full speed.  Tomorrow I will help precept the 4th year students’ oral presentation on the patient cases they worked up this week at Mulago Hospital. I can’t wait to see all of their friendly faces and find out how much they have grown in their knowledge and skills from last Spring when I gave them an OSCE assessment in May.

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Off on a New Adventure: Enroute to Uganda!

Hi! As the title states, I’m off to Uganda for my 8th trip! This time I’m traveling without Wilkes University pharmacy students so I can teach in the pharmacy program at Makerere University in Kampala, Uganda for 5 weeks. So I’m really looking forward to teaching and mentoring Ugandan pharmacy students and the Pharmacy Interns at Mulago National Referral Hospital. Those of you who have followed my journeys to Uganda will remember that I spent 3 separate months in Uganda in 2014 to help the faculty at Makerere develop a pharmaceutical care skills lab course (PCSL) where the students learn direct patient care skills such as patient counseling, how to evaluate medication regimens, and make recommendations to the hospital physicians to improve health outcomes. This is part of a larger  project to help Advance Pharmacy Practice in Uganda.  

   
Another part of the project kept me very busy all summer while I hosted 2 Ugandan pharmacists for 8 weeks in the USA to learn advanced pharmaceutical care skills with my American pharmacy students at my practice site, Wilkes-Barre General Hospital, Wilkes-Barre, Pennsylvania. I still have much more to post about Cathy Namulindwa and Gonsha Rehema’s experiences this summer and I will continue to do that while I’m in Kampala over the next 5 weeks. 

Stay tuned to learn all about the Ugandan healthcare system and the practice of pharmacy.  My hope is that you feel as if you are on this journey with me. It is sure to be full of many escapades yet to be determined. 😊

  In fact, the trip took a left turn right from the beginning. This morning, just as I was finishing up my final packing, I received a text from Delta Airlines that the flight from Detroit round be so delayed that I would miss my connection in Amsterdam to Uganda. My first fight from PA to Detroit was on time but that couldn’t help me. In fact, there wasn’t really any alternative flights available. Fortunately my brilliant husband suggested I ask Delta about re-routing me through Newark, NJ. This airport is much farther from my home but we had just enough time to make that flight, which turned out to be a blessing since it is direct to Amsterdam. Well, they are calling for boarding. I’ll keep in touch and talk to you more later. 

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Welcoming Another Ugandan Pharmacist to the USA

Pamela and KarenBeth enjoy lunch in Kampala in November 2015.

Pamela and KarenBeth enjoy lunch in Kampala in November 2015.

On July 7, 2015 the Wilkes University Community welcomed another Ugandan Pharmacist, Pamela Blessed.  Pamela was the first pharmacy faculty member I met, aside from Professor Richard Odoi, when I arrived in Kampala at Makerere University in summer 2011.  She graciously welcomed me and helped me to learn about the Pharmacy School Curriculum at Makerere.  She and I have remained friends over the years and over the past couple of years I have been trying to arrange for her to come to the USA to work with one of our own faculty, Dr. Arthur Kibbe, a renown Pharmaceutical Scientist who specializes in pharmaceutical excipients, the added starches and compounds that help a tablet containing a drug to keep its shape so it can be pressed into the tablet. He has been an editor of an internationally recognized textbook, The Handbook of Pharmaceutical Excipients, and has worked with the Pharmaceutical Industry as well as the FDA.  Dr. Kibbe was the Chair of the Pharmaceutical Sciences Department at Wilkes University since our pharmacy school started but he stepped down from that position last year and has recently retired. He is still eager to keep working in his lab, although, and his expertise is just what Pamela needs to complete her PhD in Pharmaceutical Sciences.  She has been working towards this for several years and has developed a starch from Banana that she hopes can be effectively used for the development of tablets.  One of the reasons drugs cost so much in Uganda and are in limited supply is that most of the drugs have to be imported from other countries. Unfortunately, this usually means the government buys from the least expensive source and that doesn’t always result in quality drug products. One thing that Uganda has plenty of is Banana plants!

Pamela enjoys New York City with Ms. Georgia Costalas, the Director of International Student Services at Wilkes University

Pamela enjoys New York City with Ms. Georgia Costalas, the Director of International Student Services at Wilkes University

If Pamela can successfully develop a pharmaceutical excipient from Banana, not only could it be used to help produce drug in her own country, but it could be exported and marketed to the rest of the world.  Pamela will be able to learn from Dr. Kibbe as well as use all of his laboratory equipment that she didn’t have available in Uganda.  She will be here for 6 months as she completes her research. Her research is being funded through the President’s Initiative on Banana Industrial Development (PIBID) [President Museveni of Uganda] Many thanks to her Ugandan sponsor for allowing Pamela the opportunity to work with Dr. Kibbe here at Wilkes!

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Pharmacy Interns at Mulago Hospital, Kampala, Uganda Learn About Palliative Care

Pain and Palliative Care Training for the Pharmacy Interns at Mulago National Referral Hospital

Pain and Palliative Care Training for the Pharmacy Interns at Mulago National Referral Hospital

Gonsha, one of the Ugandan Pharmacists working with me for 8 weeks at my practice site, Wilkes-Barre General Hospital, as part of an Advanced Pharmaceutical Care Training Program, is an educator herself when in Uganda, in addition to running 2 community pharmacies.

Gonsha is teaching the Pharmacy Interns in one of the Lecture Halls at the Medical School on the campus of Mulago National Referral Hospital, Kampala, Uganda

Gonsha is teaching the Pharmacy Interns in one of the Lecture Halls at the Medical School on the campus of Mulago National Referral Hospital, Kampala, Uganda

She helps to coordinate training activities and precepts weekly Pharmacy professional development sessions at Mulago National Referral Hospital for all of the pharmacy interns doing their training in and near Kampala.  I was pleased to find out that even though she is halfway across the world, she has been in close contact with the President of the Pharmacy Interns to be sure training activities are continuing to occur while she is in the USA.  A couple of weeks ago when she was conversing with David via Whatsapp (communication app for mobile phones) I said to say “hello” to him, since my Wilkes pharmacy students and I had worked with him in April.  Then I proceeded to get on Whatsapp too and have a conversation about what they are up to. I was so excited to hear that the interns were going through a Pain Management and Palliative Care training program.

Another view of the pharmacy interns being trained about Pain and Palliative Care at Mulago Hospital

Another view of the pharmacy interns being trained about Pain and Palliative Care at Mulago Hospital

This program was developed by Dr. Mhoira Leng, a Scottish Physician, who has been working in Uganda for many years now to teach healthcare providers about and provide care herself for patients suffering from chronic pain due to many conditions but especially end-stage AIDS and cancer as well as caring for the whole patient to provide other palliative care services.  I’ll refer you to my prior blog from March 2014 where I met her. http://pharmacyclassintoafrica.com/2014/03/06/hospice-and-palliative-care-in-uganda/

Hilliary and Ivan, two of the Pharmacy Interns I've worked with both at Makerere University School of Pharmacy, and now as Interns at Mulago Hospital

Hilliary and Ivan, two of the Pharmacy Interns I’ve worked with both at Makerere University School of Pharmacy, and now as Interns at Mulago Hospital

These photos were shared with me by David and he has allowed me to post them here.  He said the training was great and I told him I would be eager to see him and his colleagues using these skills when I get back. I said this somewhat in gest since I know they will apply these skills. I have been very impressed with all of the pharmacy students and interns eagerness not only to be taught but to actually put what they are learning to practice.  In return he said that they have already started using the skills and then he made the nicest comment.  He said “We are now your students.”  Wow, that just made me smile as I do think about all whom I’ve worked with in Uganda as “my students”. I feel so at home in Uganda and I not only have my Wilkes students whom I love to teach and work with but I also have my Ugandan students who I also love to teach and work with.

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Attending the AACP Annual Conference near Washington D.C.

KarenBeth Bohan presents at AACP on Uganda projects

KarenBeth Bohan presents at AACP on Uganda projects

Last week Cathy, Gonsha and I attended the annual American Association of Colleges of Pharmacy (AACP) Meeting in National Harbor, MD, near Washington D.C.  I was so happy to be able to present a talk on the work I’ve been doing in Uganda, specifically the Pharmaceutical Care Training Program in the USA (PCTP), which Cathy and Gonsha are currently part of, as well as the Pharmaceutical Care curriculum I helped to develop for Makerere University’s Undergraduate Pharmacy program with the help of the Fulbright Specialist Program grant.  The talk was well-attended and Gonsha told me afterwards that she was impressed with how engaged the audience seemed to be.

Cathy, Gonsha, KarenBeth and Dr. Kevin Rynn, Associate Dean for Clinical Affairs at Rosalind Franklin College of Pharmacy who also takes students to Uganda for experiential learning

Cathy, Gonsha, KarenBeth and Dr. Kevin Rynn, Associate Dean for Clinical Affairs at Rosalind Franklin College of Pharmacy who also takes students to Uganda for experiential learning

I was thrilled to have several people come up to talk to me about my work as well as some who are potential collaborators for the future!  It was just a big coincidence that PCTP was going on right now and that the conference was only driving distance (4 hours) from Wilkes-Barre, PA, so I capitalized on that and was able to bring along Cathy and Gonsha.  Not only were they able to attend part of the conference, my talk, and do some networking of their own, but they also had a chance to do some sightseeing in Washington D.C.

Gonsha networks at the final social event

Gonsha networks at the final social event

Cathy, Gonsha, KarenBeth, and Dr. Edward Foote, Chair Pharmacy Practice at Wilkes University

Cathy, Gonsha, KarenBeth, and Dr. Edward Foote, Chair Pharmacy Practice at Wilkes University

Cathy relaxes a bit after participating in the dancing at the final social event- the live band was terrific!

Cathy relaxes a bit after participating in the dancing at the final social event- the live band was terrific!

Jessica Koos, the Wilkes Pharmacy Librarian, with Cathy and Gonsha

Jessica Koos, the Wilkes Pharmacy Librarian, with Cathy and Gonsha

Cathy and Gonsha join Ed Foote and the gang for the annual AACP Wilkes Family dinner out.

Cathy and Gonsha join Ed Foote and the gang for the annual AACP Wilkes Family dinner out.

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3 Weeks In the USA

Gonsha, Zach, Greg, and Cathy

Gonsha, Zach, Greg, and Cathy

It has now been 3 weeks since Cathy and Gonsha arrived in the USA to participate in the Advanced Pharmaceutical Care Experiencial Training Course (APCET) and they definitely have been learning a lot and strengthening their pharmacy skills. But they have also had many other  non-healthcare related new experiences.  During their first 2 weeks here at Wilkes-Barre General Hospital (WBGH) with me, they worked alongside my two Wilkes APPE (advanced pharmacy practice experience) students, Greg and Zack, who did a great job of showing them the ropes and helping them get acclimated to the American Healthcare system and the patient care process at WBGH.

Cathy presents information about Pharmacy Education in Uganda to American pharmacy students at Wilkes (note the chocolate cupcakes-we were celebrating her birthday)

Cathy presents information about Pharmacy Education in Uganda to American pharmacy students at Wilkes (note the chocolate cupcakes-we were celebrating her birthday)

During Cathy and Gonsha’s 2nd week, they participated in the Topic Presentions by the APPE students, which is one way the students share what they have learned with others. Cathy and Gonsha prepared a talk on pharmacy practice and education in Uganda but due to time constraints, only Cathy was able to give her talk. But Gonsha will get to give her talk to the next group of students who start their clinical rotations with me next week. Below I’ll include a series of photos to give you an idea of the experiences they have had.

Gonsha and Cathy outside Walmart

Gonsha and Cathy outside Walmart

Gonsha, I’m particular, is always so excited to see American Pharmacies.  At first I thought she was just amazed at how large some of them are, but what interests her most is our signage and marketing strategies.  These aspects of the pharmacy business are much different from pharmacies in Uganda.  Gonsha owns 2 pharmacies in Uganda and I suspect she may be making notes for how she can improve her presence among the zillions of pharmacies in Uganda.

Gonsha in front of Walgreens where she received a Tdap (tetanus, diphtheria, and accellular pertussis) vaccine from a Pharmacist

Gonsha in front of Walgreens where she received a Tdap (tetanus, diphtheria, and accellular pertussis) vaccine from a Pharmacist

A pharmacy is one of the most popular and lucrative businesses in Uganda so you find them all over the place. They are mostly owned and run by business people, rather than pharmacists.  Each pharmacy owner must have a pharmacist supervisor on record but the pharmacist doesn’t have to be present and currently there would not be near the number of pharmacists required in Uganda if this were the law.  For a population of just under 40 million people, Uganda has less than 800 practicing pharmacists.  This compares to about 300,000 pharmacists in the USA for our population of about 320 million.

Gonsha and Cathy at Joel Koos exhibit for the Wyoming Valley Art League

Gonsha and Cathy at Joel Koos exhibit for the Wyoming Valley Art League

Gonsha and Cathy clowning around in the decorated hallway at St Luke Lutheran Church Vacation Bible School- the theme was Mount Everest so it was decorted like a snowy wonderland

Gonsha and Cathy clowning around in the decorated hallway at St Luke Lutheran Church Vacation Bible School- the theme was Mount Everest so it was decorted like a snowy wonderland

I took Cathy and Gonsha to Yoga at Studio B in Danville, PA. We are pictured with Becky Duignan, the owner and head instructor

I took Cathy and Gonsha to Yoga at Studio B in Danville, PA. We are pictured with Becky Duignan, the owner and head instructor

Gonsha

Gonsha

tuwanakilisha

Gonsha

Gonsha

Cathy

Cathy

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Welcome to Wilkes University & A CPR Exam

 

Cathy and Gonsha prepare to take the CPR practical exam

Cathy and Gonsha prepare to take the CPR practical exam

It’s hard to believe we are already into the 2nd week of the Pharmaceutical Care Training program for Gonsha and Cathy.  Last week involved orientation to Wilkes University and the American Healthcare System as well has completion of a few assignments to help them get prepared for working at my hospital practice site, Wilkes-Barre General Hospital.  They have also been meeting lots of new people.  Obtaining CPR certification is one of the things they had to accomplish on their first day at Wilkes, in order to complete the credentialing process to allow them to work at the hospital, as for all of our pharmacy students.   CPR stands for cardiopulmonary rescusitation which is the procedure of chest compressions and rescue breathing that can save lives.  Cathy and Gonsha completed the online knowledge component before they came to the USA but once here, they needed to take a practical examination where they had to demonstrate the technique of CPR, how to help a person who is choking, and application of the AED, automatic defribrillator device, that is sometimes needed to save a person who collapse in cardiac arrest (where their heart has stopped beating.)  This exam Wilkes University Nursing Department’s simulation suite.  This is a series of rooms that have been set up to look like hospital rooms and clinics and even includes “dummies” that the nursing and pharmacy students use to practice direct patient care skills.  Some of the dummies are hooked to computers and they can be made to answer questions that the health professions students ask.  Also, their blood pressure can be measured and other vitals obtained like heart rate and respiratory rate. This is all controlled by a computer that the Nursing Faculty cause to do what they want.  Anyway, upon entering the Sim Suite, I could tell that Cathy and Gonsha were nervous and didn’t know what to expect. Although they both knew about CPR and had been exposed to the didactic components before, they had never gotten a chance to practice on a dummy to learn the skills of CPR.  I’m proud to announce, though, that they both passed with flying colors and left the center with smiles on their faces.

 

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