This in not an official U.S. Department of State (DOS) blog and the views and information presented are my own and do not represent the Fulbright Program or the DOS.
Wednesday and Thursday were spent learning all about the Hospice and Palliative Care services available in Uganda. I owe this fabulous experience to the Pharmacist and Physician team from Beth Israel Hospital, New York City who has joined me this week in Uganda. Ebstesam Ahmed, Pharm.D. “Sammi” is a Clinical Pharmacy faculty member at St. John’s University in NY specializing in Pain Management and Palliative Care Medicine. Jenna Butner, M.D. is Family Medicine Physician who is doing a Fellowship in Palliative Care Medicine. As mentioned in the March 3 post, Sammi is interested in developing a project to help Ugandan pharmacists get more actively involved in Palliative Care for patients. She and Jenna know first hand how beneficial it is to have pharmacists on the interdisciplinary care teams of those who are helping to ease patients’ pain and provide supportive care for those near the end of life. (although that is only the tip of the iceberg of what they do, as I have learned this week 🙂 Anyway, I would have never met the wonderful people from Hospice Africa Uganda led by Dr. Anne Merriman, recent Nobel Peace Prize nominee, or the Mulago Hospital Palliative Care Team, led by Dr. Mhoira Leng, a guru in the world of international palliative care in which she has worked for the past 20 years, or even explored this new opportunity for pharmacy practice in Uganda if it hadn’t been for Sammi’s email to me back in Fall 2013 and her passion to jump right in, fly to Uganda with only a month’s notice and discover the possibilities.
Wednesday we went to the Hospice Africa Uganda (HAU) Center in Kampala where we started the day with morning prayers and then were given a very detailed tour of the facility by Tracy, which included an introduction to every single person who worked there. Everyone was so gracious, welcoming, and friendly, and it really made me aware of how important people and relationships are to those in Africa. If this center was in America, we would have had a fine tour but the focus would be on the facilities and equipment and introductions would probably be made to only those whom we might work with.
This center serves as an international training center for healthcare workers all over Africa and beyond who want to learn about Palliative Care Medicine and Hospice and it is this training that enables nurses in Uganda to prescribe morphine for pain control as they work to improve the lives of patients. The site also has a small outpatient clinic but most of the clinical care is done during home visits- more on this tomorrow since that was what we did today. The center also houses a morphine oral solution manufacturing operation, which provides ALL of the morphine for the entire country of Uganda. We were able to observe the process of making morphine since we lucked out and came on one of the days they were doing so. I’ll save that for another post.
The second half of the day was spent talking with Dr. Mhoira Leng, the Head of Palliative Care at Makerere University and Medical Director of Cairdeas International Palliative Care Trust, Scotland. We met in a lovely coffee cafe, Endiro Coffee, and spent a few hours discussing all that Dr. Leng has done to improve patient access to Palliative Care and pain medicine both at Mulago National Referral Hospital in Kampala as well as in many other countries worldwide. She uses and advocates a multidisciplinary team approach but admits that the pharmacist role is noticeably absent. We brainstormed about some ways that Sammi could help to train pharmacy interns and come here herself with her pharmacy students to model this type of practice. In addition, I realized that Pain Management and Palliative Care would be a great topic to suggest to Makerere University School of Pharmacy as the basis of the clinical skills course I am going to help them develop. We all left this meeting excited about the future possibilities of this collaboration and the positive impact it can potentially play in improving patient quality of life.