21 September 2015:

Carol, the Mengo Hospital Pharmacist, and her Interns after our discussion on Pharmaceutical Care

Until today, all of my clinical pharmacy work in Kampala has been based at Mulago National Referral Hospital and Makerere University School of Pharmacy. But after the presentation I made last week at the Pharmaceutical Society of Uganda’s Internship Supervisors meeting, I was asked to come visit Mengo Hospital, a faith-based Anglican hospital in Kampala to both give a presentation on Pharmaceutical Care to Pharmacy Interns and Physicians, as well as to advise them on the way forward to implementation of Pharmaceutical Care services. It was a lovely meeting and I seemed to hold their rapt attention. I kept thinking I was going on too long but every time I looked around the room, I saw people engaged and taking notes. This was followed by a short presentation on an antibiotic use study that one of the Pharmacists, Carol, had done to investigate potential issues where pharmacists could make a positive impact in both improving patient care and reducing the unnecessary use of antibiotics. We all had a great discussion about the challenges to implementation of PC and before I left, the interns agreed to work on 3 things over the course of this week: interacting with patients to do medication reconciliation (learning what Meds a patient was on prior to the hospital and making sure the appropriate drugs are continued), evaluating patients’ kidney function and making sure their drugs are dosed appropriately, and documenting at least 3 interventions which helped the patients. I agreed to come back on Monday to go on rounds with them and to hear how it went. I asked them to note the barriers or difficulties they have so we can address them together. The whole group seemed very enthusiastic and I’m eager to come back in a week to see their progress. Five of the interns were from Makerere and since I had the pleasure of working with them in the PCSL last year, I know how competent they are. And I’m sure the others will catch on quickly, especially as they learn from their colleagues.

Edel, KarenBeth, and Linda- some of my past Ugandan Students. We are standing outside of the women’s ward.

Earlier in the day I visited another private hospital having been invited there for a tour and to participate on rounds with 3 other interns whom I had worked with at Makerere and a 4th very competent intern whom I just met. Nsambya Hospital is also a faith-based Catholic institution and the grounds were beautiful and peaceful- so unlike the Mulago campus.

Edel, Linda and Joseph walk across the lush Nsambya Hospital Campus

It’s so exciting to see the students I’ve trained using their skills. When I asked if they liked their internship site they all agreed they did but their answers seemed a little hesitant. On further questioning, it turned out that everything was great except they wished they could participate in PC even more.

Joseph stands in one of the wards. I was pleased to see the curtins hanging around the patient beds. This isn’t done in Mulago Hospital and there is no privacy for patients. Also, I bet it helps a little with Infection Control. In the USA, private rooms are what most hospitals are moving towards to decrease the risk of transmission of infections between patients, but this just won’t be possible in Uganda.

Notice how neat and orderly the “store” is. “Store” is what Ugandans call the storeroom- where they keep their stockpile of medications and supplies. The Sister who is in charge must be quite organized.

It was a delight to see them embracing clinical pharmacy work. Although they may think there isn’t much PC going on, I know this has changed so much for the better since I started coming to Kampala. With these new Interns and the students I’m currently training, it won’t take too long to grow the pharmacy work force into one that can provide the PC and really make a positive difference in the health outcomes of patients.

Aaron, Edel, Linda, and Joseph stand outside the beautiful Catholic Chapel on the Campus of Nsambya