Friday, April 23, 2015
Today was our last day at Masindi-Kitara Medical Center (MKMC) and tomorrow we are embarking on our Safari to Murchison Falls National Park. It has been a wonderful two weeks at the clinic working with the competent clinicians and other medical staff. They have warmly welcomed us into their lives and shared their experiences with us. We have all gained a better understanding of the healthcare challenges facing Ugandans. We have learned not only about the diseases but also about the barriers to treatment.
For example, today I learned that many Ugandans don’t really understand the disease, Cancer, and we were asked to consider doing some educational programs about this next year. It is really hard for them to understand that cancer of the breast is different from cancer of the lung and why some cancers can be treated and others don’t respond well to therapy. Also, cancer doesn’t always cause pain so women who have breast lumps often don’t seek care until the cancer has spread greatly because initially it doesn’t affect their ability to continue on with their normal life. As I mentioned in a previous post, we have learned that many patients don’t understand the concept of chronic diseases that need medications every day for the rest of their lives to prevent complications and illnesses. In this resource-poor environment, many people just live day to day and crisis to crisis and have no capacity to plan for the future.
But, we also have learned how much families care for each other. When someone is sick, the entire family may come to stay at the hospital. And when bills need to be paid, the family at large will chip in to cover the bill. As I have kept all I’ve learned with me over the years as I practice in the USA, I hope the students and resident with me will also ponder their experiences and let them shape the way they care for patients as well as the way they think about the U.S. Healthcare System. We are so fortunate to have the opportunities afforded us in terms of healthcare services. Even patients without any insurance or those with poor insurance are able to access care. No one will be turned away and the variety of testing available to determine the problem is amazing. But as we have seen here, tests are not always necessary to provide good patient care.
A good clinician can listen to their patient’s story and use their astute clinical assessment skills to determine the problem and devise a solution. It is great that in the USA we have more lab tests and radiology test to diagnose diseases, but I think these are often overused. We could all learn a lot from the clinicians at MKMC and in Uganda, in general.