27 September 2016

A Blog Post by Emily

A beautiful morning in Mbarara at the Acacia Hotel

First I would like to expand on Dr. Bohan’s post from yesterday. Nick and I were assigned to the psychiatric ward, which was different than a psychiatric ward in America. The most of the patients can roam around freely and the privacy is very limited which is common throughout Uganda. The first patient that we met in the ward was a middle-aged gentleman that we met Sunday evening while we were touring the hospital. He approached our group and demanding, “you people from America! Greet me” so we obliged and asked how he was. Yesterday when we entered the ward that say gentleman greeted all of us with a “Hi, how are you?” he then joined us on rounds pretending to be a part of the team. The first patient that was presented was a woman diagnosed with HIV induced psychosis. In America we do not see this very often because HIV is not as prevalent and is typically better controlled due to easier access to medications. Our last patient was a young man who was having some type of psychotic episode. He was walking around taking things such as papers or notebooks from the pharmacy students and the other patients. He also stood on a bed and tried to climb over a half a wall. Eventually, the first gentlemen came over and sat the psychotic patient down. He sat for a few minutes before getting up and going outside to scream into the windows. This is a very unfortunate case that will hopefully be helped by the pharmaceutical management by the pharmacy students (who are geniuses by the way). After we debriefed, we had some time to exchange contact information and talk to the pharmacy students about how pharmacy is different in America. One of the biggest differences is that in Uganda community pharmacies do not have to have a pharmacist working to be open. Therefore, the pharmacists can work only a few hours a day. In America, pharmacists work 10-13 hour shifts. I think America should adopt this model (haha).

The American Team from Wilkes University and Binghamton University with the 3rd Year Pharmacy Students At Mbarara University before ward rounds

A tour of the hospital pharmacy. Note how few drugs they have. There are not many options for therapy.

Today was our second day at the Mbarara University Pharmacy School and we rounded with the 3rd year pharmacy students in the general ward and as with yesterday we split into small groups. The students presented a patient to us and then we discussed what we would like to do with the patient.

Debriefing with the 3rd year students after ward rounds.

Mike and I had a group of students in the male general ward and we saw a patient with hypertension, diabetes, dyslipidemia, peptic ulcer disease, and diabetic peripheral neuropathy. This was a very good patient to go over because there were so many disease states to discuss. We introduced the idea of using the side effect of one drug to treat other symptoms such as using metformin to help with constipation. The students knew so much about each disease state and the drug managements. They reminded me a lot about things that I had forgotten or didn’t know. Like I said, they are so intelligent and passionate for pharmacy. After rounds, like yesterday, we debriefed and reflected on our experiences.

Waiting for Grand Rounds to start in the Pharmacology Lecture Theater

Later Dr. Bohan presented about medication safety to the Grand Rounds. Medical and pharmacy students attended. The medical students expressed interest in talking with the pharmacy students during rounds to get medication recommendations from them. I think that all the students enjoyed our presentations and input in the ward rounds. I hope that they have learned from me as much as I have learned from them.

Dr. Bohan presenting the talk on Safe Medication Use

The group of participants talk with each other during the discussion part and they they shared their conversations

Dr. Bohan with Peter, one of the faculty, and Professor Jennie, the Department Head of Pharmacy

I have had a great time in Mbarara and can only hope to have the same experience as we head back to Kampala tomorrow (hopefully with less lizards).

Mike, standing, and Nick, with gloves, extracting a lizard from the girls room in Kampala