18 October 2015: I’ve been back in the USA for just 2 weeks now but my Ugandan friends, pharmacists and pharmacy students are never far from my thoughts. This past trip was incredibly successful and rewarding for me and I hope, also for the students and pharmacists I worked with. From their comments and emails, I think this was a mutually beneficial experience! Although I won’t be back to Uganda until April 2016 when I arrive with my Wilkes Pharmacy students, until then I will be busy working on spreading the news about the progress of teaching students and pharmacy interns the skills to provide pharmaceutical care that can help improve safe medication use and the health of patients. I also am very proud of the positive changes that are occuring within the practice of pharmacy in terms of the implementation of clinical pharmacy services and direct patient care.
During the last part of my stay and work in Uganda, Professor Richard Odoi, whom I’ve collaborated with on my “Uganda Projects” for the past 4 years, went to the International Pharmaceutical Federation (FIP) meeting in Dusseldorf, Germany. We had a poster accepted which he was able to present for us on this work called “Development and Evaluation of a Pharmaceutical Care Skills Course for Ugandan Pharmacy Students to Bridge Didactic Learning and Clinical Application with Assistance of a Fulbright Specialist”.
He was excited to tell me how well received it was and about the great interest from other participants.
I am currently at the American College of Clinical Pharmacy Meeting in San Francisco (ACCP) which has a Global focus this year and has many international participants. On Sunday there were presentations on the advancement of clinical pharmacy practice in Singapore, China, Philippines, Saudi Arabia, and Europe and I was highly impressed with their progress! Uganda still has very far to go but I think little by little, they are making strides in the right direction. Sometimes it can be hard to see improvments when there are still so many issues to address and so many patients that need help but I have to keep reminding myself of two things. First, one of my favorite sayings is “Two steps forward and One step back is still forward progress” and second, I try to remember the story about the starfish. It goes something like this: One day 2 people were walking on the beach and hundreds of starfishes had washed up on the shore and were going to die from being out of the water. One of the people kept picking them up and tossing them back into the ocean but the other person questioned her effort. “why are you throwing the starfish back into the ocean? There are so many, you can’t possibly make a difference.” The woman replies “Well, I made a difference for this one, and this one, and this one….” So, although we can’t fix all of the problems at once, all we can do is the best we can at this point in time and helping address the medication issues for one person at a time is making a difference for that one, and that one and that one…
I think the most important roles I play when I am in Uganda is to inspire and mentor Pharmacy Students, Interns, Pharmacists, and Faculty in the ways they can positively impact patient care. The people I work with are extremely bright, but they live in a resource-poor environment where the drugs that are supposed to be available often aren’t and it is really hard to address drug therapy problems when the necessary drugs aren’t there. And it can be very frustrating to work within a system that doesn’t reward a good work ethic and when you are the only person who seems to care about the patients and is willing to stay late to do whatever is necessary. In fact, it is easy to get caught up in the ways of most people who work for the government system and who are under-appreciated. It is not only that their salary is extremely low, but also they are seldom given positive reinforcement for the good things they are able to accomplish. I’m hoping that by sharing the work I’ve been doing in Uganda, I can interest other American Pharmacists and Pharmacy Faculty into joining my project. The more people that can be involved and who can work together on the same project will help to make a bigger difference, faster.
One of the posters I presented at this meeting was about the Fulbright Specialist Program and how this short-term funded exchange was able to support my work on developing a Pharmaceutical Care Skills Lab for Makerere University to help students learn how to educate patients, how to evaluate medication regimens to identify and solve drug therapy problems and how to communicate their findings and recommendations to other healthcare providers.
The other poster was on the program I developed to bring Ugandan pharmacists to the USA to train with me at my hospital to teach them these same skills so they could bring them back to Uganda to teach others.
Another opportunity I was able to participate in at this ACCP meeting was an informal pre-meeting of Pharmacy Faculty and Pharmacists who have been involved with Global Health Experiences. It was convened by Dr. Tina Brock from University of California-San Francisco on behalf of a small group of people who had envisioned developing a small discussion group. The group was called “Apoteko”, which means “Pharmacist” in Esperanto. (For those who aren’t familiar with Esperanto, as I was not, it turns out that this is a made-up language meant to help people communicate thoroughout the world with a politically-neutral language. Apparently, there are about 2 million people who are able to converse with it.) It was great to be able to talk about our projects in a small group setting. Tina also brought in a physician who has spent much of his time working in global health both in the USA with the Navaho Nation and in Haiti after the earthquake and more recently in Liberia during the Ebola epidemic. His talk was truly inspiring! There were a lot of young people at this meeting both young faculty, pharmacy residents and some 2nd year pharmacy students from UCSF that are really interested and passionate about global health. Their energy is catching and makes me realize that if we reach out to the young and up and coming pharmacists, they will be there to help continue our projects. In my age group, not that many are interested in global health but it is amazing how many young people today are service-oriented and specifically are interested in working to help improve patient care in the developing world. Below are a series of photos from the event.