Vivian, Pharmacy Intern, and Jeff

During our stay at Mulago I have spent most of my time in Ward 4A, infectious disease. The infectious disease ward is a little more chaotic than the other floors at the hospital. The ward is very crowded, patient beds are very close together and there are even more patients on the floor. The male and female patients are housed on opposite sides of the ward with the all the critical patients are in the middle. At least once a day there is some sort of screaming outburst, mostly because a patient has passed away. Unfortunately, death is very much a part of 4A. The doctors care for their patients and do everything they can to save them but many of the cases are very complicated.

I’ll explain a little as to why the cases are so complicated. Around Uganda, Mulago has a reputation that “you come here to die.” Due to this reputation, many patients wait as long as possible to come to the hospital because they are afraid if they go there they will die. When they finally do come to the hospital, many of their diseases have progressed far past treatable stages. They remain in the hospital with the doctors doing their best until they pass away because they waited too long to come in. This adds another death at Mulago and perpetuates the reputation Mulago has. I have seen the doctor’s work and I know they are dedicated medical professionals but they are limited by the culture and perception of the hospital. This is what makes the infectious disease ward so prone to deaths.

I saw many interesting patients while doing rounds. They have many infectious diseases that you don’t commonly see in the United States. I was able to see patients with conditions like meningitis, tetanus, hemorrhagic fever, and tuberculosis. One day a woman came in, jumped out of bed, and immediately fell to the floor dead. Patients like that made daily rounds completely unpredictable.

I worked closely with the pharmacy intern in Ward 4A, Vivian. She was very helpful and we were both able to teach each other so much about medications and pharmacy practice in our countries. Everyday we would dispense medications to all of the patients in the infectious disease ward. We would also make interventions when patients were prescribed inappropriate drugs, doses, or regimens by talking to doctors and getting things switched.

I included a picture of Vivian and I. My time in the infectious disease ward was both startling and informative and I know I won’t be forgetting this experience anytime soon.