Advanced Pharmacy Practice Experience in Uganda Fall-2016: Final Thoughts

18 October 2016

It’s hard to believe that this Global Health experience in Uganda has come to an end. The Wilkes Students and Dr. Edward Foote are now back in the USA, most likely forever changed by their experience over the past few weeks. Although this was my 10th trip to Uganda, I, too, am changed by my visit to Uganda. Every trip I learn new things and as my friendships grow and relationships deepen with my collaborators, I am privileged to learn more about the healthcare challenges they face and the difficult barriers to improvement.  But, there are many ways that pharmacy practice and safe medication use can be improved.  And I know that if the Ugandan pharmacy students, interns and Pharmacists persevere and continue to strive to learn and apply their new skills and knowledge to help patients, healthcare will improve!

Below are some final comments from the Wilkes students. They wrote these during their layover in Amsterdam earlier today.

Emily:  I am so glad to have had this opportunity to travel to Uganda. Everyone that we met was wonderful and so welcoming. It was very interesting to see healthcare specifically pharmacy in another country and to compare it to what I’ve seen. I will definitely cherish all the memories and miss all the new friends that I’ve made. I hope to someday visit Uganda again.

Mike:  This trip has been an amazing experience that I am extremely grateful to have been able to participate in. Everyone we met was very welcoming and pleasant to speak with. I enjoyed being able to partake in the culture more than I have on other trips where I was more of a tourist and didn’t have the opportunity to interact with the locals to the degree I did on this trip. It was interesting to see the challenges that face healthcare in another country and what they do to overcome those challenges. All-in-all, Uganda is a wonderful country with very welcoming people and I would love to return one day.

Jennie:  My time in Uganda has been absolutely wonderful and I am so sad that it has come to an end. When I first started telling my friends and family that I was going to Uganda, they all looked at me like I was crazy. Why would I ever want to go there? Well, I am so glad that I decided to go anyways. This trip has truly been the trip of a lifetime. I have met so many new friends and learned so much about healthcare in Uganda. I would like to thank all of our Ugandan friends for being such great hosts and Dr. Bohan for coordinating this experience. Also, thank you to all of our friends and family in the States for following our travels via the blog. Only a few more hours until we’re home!

Nick:  This global health rotation has been a profound learning and cultural experience. It is probably one of the most meaningful things I have done in my life. Leaving this beautiful country and returning home is bittersweet. I will remember the great times we had and the friends we made, but it will be nice to be home and see my family again.

Thanks to all of the people we worked with: Winnie, Gonsha, Kalidi, Professor Odoi, students at Makerere University and the Kampala Pharmacy Interns, Sam Opio from PSU, Dr. Godson and staff at Masindi-Kitara Medical Center, Peter, Prof Jennie, Noah, and Derrick and all of the students at Mbarara University, Sam, our Masindi Driver, and Haji, our Kampala driver, and Arthur from Econesttim Tours and Safari!



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The Trip Home Begins

17 October 2016

A Blog Post By Dr. Edward Foote

People view long journeys from different perspectives. Me – I tend to take a leg at a time (“let’s drive 2 hours to lunch and not think about the travel big picture”). Others like to calculate the total time traveling and then painfully countdown (on an app these days) how long it will take to get home to loved ones. I would have rather not known, but our trek will take about 43 hours, door to door.

We began our journey home leaving Para Lodge in Murchison Falls National Park in Northern Uganda at 8 AM with our trusted guide Arthur. The trip out of the park was a small safari and we saw more giraffes, antelopes, wart hogs and some elephants (from afar). After that, we drove 440 km (about 273 miles). Most of it was decent highways so we made good time (after that lunch I was talking about). To get to Entebbe International Airport we need to go through Kampala. As noted on previous blogs the traffic “jam” can be pretty bad and so Arthur made sure to leave plenty of time. Since we lucked out with the jam, we got to Entebbe at about 5 pm which too early for an 11:30 pm flight. Arthur suggested we have dinner and hang out at a local restaurant for a few hours. Arthur suggested we eat at Faze 3 which was a great suggestion since it was inexpensive and overlooked Lake Victoria. After getting through check-in and customs we are sitting awaiting our flight.

This is my last blog for the trip – the students and “Professor KarenBeth” (as everyone here calls her) will wrap up. This has been an awesome professional and personal experience. I have learned so much over the past few weeks about Uganda – from its culture, to its healthcare and stunning environmental beauty. It was a pleasure to work with the pharmacy students from Uganda but, I must say, they are no match for the four outstanding young student pharmacists from Wilkes that I had the pleasure of travelling with. Finally, big Kudos to Dr. KarenBeth on this program. It is hard to believe this was her 10th trip to Uganda. She should be very proud of her accomplishments here.

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The “Big 5” – and students saw them all!

16 October 2016

A Blog Post By Dr. Edward Foote

Our day started very early. Some coffee and cookies at 6 AM and then an early-morning safari at 6:15. Our trusted guide Arthur has been an invaluable source of information. Today, one of the rangers in the park, Andrew, joined us in our vehicle to help us track some of the most elusive and beautiful creatures in the park.

It is really difficult to describe the beauty of the African Savannah at sunrise and this picture doesn’t do it justice. Our guide told us that different animals (especially the predators) are most active in the early morning. The morning drive was a definite success!

Someone noticed that the water buffalo (usually looking at us) were staring in a more distant area. That is when Mike saw something moving in the tall grass. Our guides identified it as a spotted leopard! The leopard was walking through the tall grass so we’d only get a periodic glimpse of his head, back and tail, but what treat! Later in the drive, we came across a lion the road! Again, a relatively rare find since lions don’t show themselves like the giraffes, antelopes and elephants. Later in the trip we came across a hyena just resting in an open area. After we watched him a bit, we were able to catch a glimpse of his mate and cub! So cool!

After a nice lunch buffet we headed out for a boat trip safari. The boat set off from near out hotel and headed east to Murchison Falls, the namesake of the park. We spotted so many animals but were especially fond on the hippo’s! I think one of the things that struck us was how many animals are in this park. It was like watching a Nature special on TV (shameless plug to support your local PBS channel).

Back to the “Big 5”. The lion, leopard, hyena, elephant and the rhino are considered the “must see” for Uganda and it is not easy. The students saw them all! (And lot more).

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Goodbye Kampala, Hello Murchison Falls National Park, Uganda

15 October 2016

A Blog Post By Emily

Today we said goodbye to Kampala as we left to go on safari with our guide Arthur! It was a long drive to the park. We left at 6:30am and got into Murchison Falls National Park at 10:30am after a few pit stops. We ate lunch at a lodge that is situated on the bank of the River Nile and the views were breath taking. There were a few hippos hanging out in the Nile and sunbathing on a small island. After lunch we headed to Paraa Lodge doing a game drive on the way. You never know what to expect while you drive through the African bush. The road is very rough and surrounded by trees, grass, and bushes full of thorns. As we drove we had some vistors in our safari vehicle such as tsetse flies, which, if you did not know, bite and can bite through socks as Nick quickly found out. Arthur had warned us that sometimes elephants knock down trees into the road and that we may have to turn back if we come across this. It is a good thing that we were in a tough vehicle because we were too far too turn back when we found fallen trees. We learned that Arthur is a good off road driver.

After a few miles of driving, looking for animals, and only seeing a few antelope,“Giraffes!” Jennie exclaimed with such a childlike glee when she saw the first giraffes. We ended up seeing so many giraffes, antelopes, warthogs (“pumbaa” means warthog in swahilli), water buffalo, birds, and then finally ELEPHANTS! It was a very successful first game drive. Tomorrow morning we will go back out looking for lions especially.

When we got to the lodge Mike, Jennie, Dr. Foote, and I all enjoyed the pool especially because today was a rather warm and long day. As we were all walking back to our rooms to get ready for dinner, Mike spotted a few new friends, ELEPHANTS! There was a mother and her calf enjoying a snack right beside our lodge! It was such an awesome experience. Myself and the rest of the group are excited for whatever adventures tomorrow will bring. (Hopefully there will be more elephants.)

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Last Day at Makerere University in Kampala, Uganda

14 October 2016

A Blog Post By Jennie

Today was our last day in Kampala with the Makerere University pharmacy students and two of their professors, Winnie and Kalidi. We spent the day at Makerere University listening to the third and fourth year pharmacy students give their case presentations on the patients that we saw with them on Wednesday and Thursday at Kiruddu Hospital. The other Wilkes students and I have had the opportunity to watch third and fourth year students present patient case presentations for the past three Fridays now and it has been interesting to see how the students have developed their presentations since the first Friday that we were here.

We have truly enjoyed our time here in Kampala. We have been able to work with some awesome pharmacists and have enjoyed our time working with the pharmacy students as well. I know that I have learned so much about pharmacy in Uganda from the Ugandan students and pharmacists and I hope that we have been able to share some knowledge and tips with the pharmacy students here as well.

We thought last night would be our last night out for dinner in Kampala as we have lots of packing to do tonight before we leave tomorrow morning. However, we couldn’t resist stopping at our favorite Mexican place, ¿Que pasa?, for dinner one last time before leaving. We certainly enjoyed the food and great conversation. I think we all agree that we will miss the restaurants here in Kampala once we are home in the USA!

Although we are sad to leave Kampala and our new Ugandan friends at Makerere University, we are very excited for the weekend because we are headed to Murchison Falls National Park for a safari adventure! I’m sure we will have lots of pictures to share with you from our safari so stay tuned.

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Teaching Pharmacy Interns and Seeing Patients at a New Hospital

13 October 2016

A Blog Post By Dr. Edward Foote

We had a busy morning today. First, we walked over to Mulago hospital to make a presentation to the pharmacy interns. Our first goal was to teach the pharmacy interns about three free apps that they can download onto their phones and use for patient care. Some of the interns were ready and able to use the apps with us but we suspect others may have had difficulties due to a lack of a smart phone or internet access.

Clinical pharmacy is in its infancy in Uganda and it possible some of these pharmacy interns really don’t think they need these types of tools since they will spend most of their time dispensing. Some pharmacists are definitely making strides but the profession has a long way to go. After that presentation, one of the pharmacy interns presented a case of a patient with kidney failure. After he presented, I spent some time facilitating discussion.

After that, we headed out to Kirrudu hospital to meet with Winnie and the Makerere pharmacy students. Since Mulago hospital is under renovation, many patients were sent out to this smaller hospital. Although only several miles from us, it took nearly an hour due to traffic (“the Jam”). The hospital is fairly new and from the outside, looks nothing like the other hospitals we’ve seen since it appears, well, Western. Unfortunately, inside the same challenges for Uganda health care persist. Each floor of the hospital is 2 or 3 huge wards in which patients are cramped very close to each other. We saw two patients in the ward who had very severe anemia but the blood supply is very low so they were basically left untreated. Still, the doctors and nurses (“sisters”) who work here are quite welcoming and I think are used to having outsiders in their wards. The students did well and will be presenting their cases on campus Friday.

Our last dinner out in Kampala! We chose one of our favorites, Il Patio, an Italian restaurant. There are casinos in Uganda and Il Patio has one so we took a stroll through it. After playing some slots (they chipped in) a couple of the group tried their luck at blackjack and won! The minimum for blackjack is 5,000 Shillings (less than $2 USD) so it was fun. We didn’t stay long and headed back for some well-deserved sleep.

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Queen of Katwe

12 October 2016

A Blog Post by Nick

The other day, my professor and classmates told me that they wanted to go to see a movie here in Kampala. My response to them was, “Why? We are in Uganda for such a short period of time. We should be embracing the local culture and experiencing our surroundings. Why should we waste our time going to see a movie when we can do that back home in the States?”

They replied that the movie that they wanted to see, “Queen of Katwe,” was a true story about a Ugandan girl and that it was filmed right here in Kampala with local actors. “Wouldn’t it be a neat experience,” they said, “to see her story here in Uganda?” Interesting, yes, but they were met with much opposition before they convinced me to go to see the film with them.

As I mentioned, “Queen of Katwe” is a book and movie based on the true story of Phiona Mutesi, a Ugandan girl from Katwe, a slum in the city of Kampala, Uganda. The story shows how Phiona managed to escape poverty and to make a better life for herself and for her family by learning how to play chess and becoming a champion.

I must admit that the movie was quite good, and it was pretty cool to be able to see it in the city in which it was filmed. Having been in Uganda for nearly four weeks and Kampala for three of those, it was really neat to actually be able to recognize different places in the film. Having been immersed in the culture, we were also able to appreciate many (but not all) of the social behaviors, cultural norms, words, jokes, etc. in the movie that most people outside Uganda probably will not understand or even notice.

In addition to sharing Phiona’s inspiring story, the movie also gives a surprisingly accurate portrayal of Ugandan culture and what we have been experiencing here on this rotation. As an example, in one chilling scene, Phiona’s brother was hit by a boda boda and required surgery. The doctor explained that the hospital did not have any pain medication because they ran out, and that they would not have any more until the following day, so the child had to get the operation without any painkillers.

The movie also shows the extreme poverty that many people face here. Phiona’s family had trouble paying the rent, which was 10,000 shillings (about $3.00). Consider that we paid 15,000 shillings each just for admission to see the movie. Consider that we have been spending much more than that on our meals every day, and that is more than what they could afford for rent for the entire month. It really makes one think and be appreciative of what one has.

I would recommend that anyone who would like a glimpse of Uganda see this film. I definitely will be buying it to watch with my family when I get home.

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