Wednesday, June 6, 2018
Greetings! I have good news—I’m on my way back to Uganda this weekend for my 12th trip! I know it’s been over a year since I’ve written but my friends and students in Uganda are never far from my thoughts. I’ll be coming by myself, no pharmacy students this trip, to conduct research with a faculty colleague from Makerere University in the Neurosurgery Ward of Mulago National Referral Hospital. Winnie Nambatya is a clinical pharmacist who received her Bachelor’s of Pharmacy degree from a university in Cuba. I met her years ago when she was working with the Pharmaceutical Society of Uganda (PSU) to promote clinical pharmacy and pharmaceutical care. She eventually went to a university in South Africa for her Masters of Clinical Pharmacy degree and now she teaches at Makerere and works with the physicians and nurses in the Neurosurgery Ward to ensure safe and effective medication use. Through her experiences, she has noticed that patients may not be getting optimal results from a drug that is being used to prevent seizures in neurosurgery patients called Phenytoin. This is a drug commonly used throughout the world but in the high-income countries, therapy with this drug is always monitored by obtaining drug blood levels, which is called therapeutic drug monitoring (TDM). By using TDM, we can make sure the drug concentration is high enough to prevent seizures but not too high as to cause adverse effects. Unfortunately, TDM is expensive and not possible in most developing countries, like Uganda. Our goal with this research is to conduct a retrospective medical chart review to systematically characterize the use of Phenytoin at Mulago to learn how the drug is being administered and how the patients are responding. Obtaining this baseline data will help us develop a plan to optimize the therapy with Phenytoin to achieve the best patient outcomes.
In addition to research, during this trip, I’m hoping to catch up with many friends and colleagues. I’ve found a few old photos of some of them. As always, I look forward to sharing my journey with you so stay tuned…
For those new to the blog, here is a brief synopsis:
I am a pharmacy faculty member with a passion to use my knowledge and skills to help others. My initial foray to Uganda was for the purpose of helping to assess the water, health and sanitation project of an NGO, The Water Trust, in Masindi, Uganda in summer 2011. Even before that trip, I began to collaborate with Professor Richard Odoi at Makerere University School of Pharmacy to develop a global health experience for advanced pharmacy students in Uganda. I always wanted this project to be sustainable and as beneficial to Uganda as to me and my American pharmacy students. Working with Professor Odoi over these past 7 years and with the help of a Fulbright Specialist Grant in 2014, I have been able to assist in the development and implementation of new curriculum to teach pharmaceutical care to Bachelor’s of Pharmacy students. We also conceived the plan to develop a Masters of Clinical Pharmacy program which is in the curriculum approval process at Makerere University. (The draft of this curriculum was developed by Dr. Darowan Akajagbor, a prior faculty member at D’Youville School of Pharmacy.) Over the past 7 years I have also been able to conduct pharmaceutical care conferences in Mbarara, at the Mbarara University of Science and Technology (MUST) and for pharmacists of the Pharmaceutical Society of Uganda. Simultaneous to my work in the pharmacy education system in Uganda, my students and I have also work with the medical staff of Masindi-Kitara Health Center (MKMC) in rural Uganda to improve the safe use of medications. MKMC is part of OneWorld Health, an NGO in Charleston, SC, who works with communities in Uganda and Nicaragua to develop sustainable healthcare facilities. My students and I attend multidisciplinary patient rounds with the MKMC providers, look up the answers to drug information questions, and prepare educational presentations to provide continuing development. The following key blog posts would be a good way to learn more about my endeavors:
https://pharmacyclassintoafrica.com/2015/10/20/spreading-the-news-about-advancing-pharmacy-practice-in-uganda/ (examples of presentations about my previous work- includes research posters)
https://pharmacyclassintoafrica.com/2017/04/13/healthcare-challenges-at-mulago-hospital-a-meeting-at-makerere-school-of-pharmacy/ (this post talks more about the concerns regarding the use of Phenytoin)
https://pharmacyclassintoafrica.com/2016/05/02/ponderings-at-the-end-of-my-9th-trip-to-uganda/ (a blog post that highlights the multifaceted nature of the healthcare challenges in Uganda)