Friday was our final day at Mulago Hospital in Kampala before we ventured on to Masindi yesterday. All of us have found our time at Mulago to be an extremely rewarding experience to work along side fellow pharmacy interns in a foreign country. The primary duty of pharmacy interns is to perform bedside medication dispensing to all patients on the medical ward, as well as fill prescriptions for patients prior to discharge. All of these students were knowledgeable, passionate and invested in expanding their skills as a clinical pharmacist to augment patient care. Many of the interns accompanied us on ward rounds with the medical team, something that is very hard to fit into their routine work schedule. There we witnessed them make important interventions that will surely impress other healthcare professionals and prompt them to be more inclusive in the clinical decision making process. Below are our individual accounts of our times in different wards of Mulago Hospital:

Part 1:  A Blog Post by Amanda Fenstermacher

I spent most of my time in the pediatric ward, but I also spent some time in the endocrine, oncology, and infectious disease wards. My experience at Mulago hospital is one that I will never forget. I have seen disease states that I have not had exposure to before. Most of these disease states are hardly ever seen in the United States, but are quite common in Uganda. For example, I saw a case of tetanus in a child, several cases of tuberculosis, measles, malaria, hepatitis B, Stevens-Johnson syndrome in a child, several cases of rare forms of meningitis, and many many complicated infections. What is even more astonishing is that most of the patients I saw among the wards, besides pediatrics, were mostly 40 years of age or younger. I have learned that it can be very difficult diagnosing patients due to resources available/what patients can afford, and thus it is often very difficult to appropriately treat patients, especially when there are so many drug shortages throughout the hospital.

Amanda and David start the preparations to make hand sanitizer

On one of the days I was asked to help compound 15 liters of hand sanitizer for the surgical ward. The ingredients for hand sanitizer consisted of 12.5 liters of what’s supposed to be at least 95% alcohol, ~200 mls of hydrogen peroxide, and ~300 mls of glycerol. I was also informed that the product is then tested by the World Health Organization for its sterility, which is mainly based on the percent of alcohol used.

Amanda points out how much to pour into the bucket

Adding the glycerol to the solution

Helping stir the solution

We had to use the products available to us, meaning that we did not have the proper compounding equipment/environment and we did not even know the percent of alcohol provided to us. I was surprised at the fact that they do not have something as simple as hand sanitizer easily accessible to them because we take such things for granted in the United States. I was asked how we get it in the states, and my response was that we simply just buy it.

My time spent at Mulago hospital has made me appreciate, even more, the health care we have available to us in the United States. This was definitely an eye-opening experience that made me realize (1) how good we Americans have it, (2) how resilient the human body can be in less than sanitary conditions, and (3) the need for more resources and health care providers in Uganda.