Monday, 11 June 2018
I’m in Kampala now! I had a wonderful night and breakfast at the Entebbe Airport Guest House last night. I awoke to sunshine and beautiful gardens. After eating a delicious plate of fresh fruit- papaya and watermelon- and freshly squeeze passion fruit juice, eggs and bacon, yes, I said bacon, I awaited the arrival of my driver, Haji.
We left Entebbe around 10:30am and reached Kampala in about an hour later. I was surprised to see that the new Airport Road is kind of open for business. It made the drive so much faster. The reason I said “kind of” is because it will be a toll road and the ability to charge tolls isn’t quite finished. I was amazed at how similar it looks to American toll roads. There is even a service plaza for easy access on the road. But although it isn’t officially open, no one is preventing cars from driving on it. It was a bit scary at times, though, because cars get confused about what direction to go on it. There are actually 2 one-way roads—one to the airport and one to Kampala. Luckily, there is very little traffic and Haji just scooted out of the way when a car came towards us head on in our lane. We reached Kampala without incident and I checked in to my Kampala hotel: The Mulago Guest House. I really like the staff here and the rooms are clean and safe. It is also very close walking distance to the hospital where I will be spending a lot of time. It is a benefit not to have to walk across town on the busy, traffic-jam filled roads.
Winnie came to meet me for lunch and right away she noticed the Executive Medical Director of Mulago National Referral Hospital was having lunch and brought me over to meet him. We spoke briefly, but in those few minutes he had nothing but great things to say about Winnie’s pharmaceutical care work in the Neurosurgery Ward and he spoke longingly of having many more clinical pharmacists working at the hospital. The main issue is lack of advanced training for pharmacists in Uganda. The only degree offered now is the Bachelors of Pharmacy and that does not provide enough clinical training for the provision of advanced pharmaceutical care. I have helped to develop and teach pharmaceutical care skills in the Bachelors program but it is still basically just an introduction. The entry level pharmacy degree in the USA evolved to become the Doctor of Pharmacy degree 15 years ago. Beginning with the graduates in 2003, every pharmacy program offers a Doctor of Pharmacy degree. Much study and debate went on before this was enacted but the decision was out of necessity—the USA healthcare system really needed pharmacists that could provide advanced medication management and work as an integral part of the healthcare team to help improve patient outcomes and ensure safer and more effective medication use overall. The desire of such a level of practice in Uganda is present—many pharmacists, especially the newer trained pharmacists, aspire to directly impact patient care and make lasting improvements in the healthcare of Ugandans. But, the training opportunities just aren’t available quite yet. This is something I want to explore more. The answer, at least for most Ugandans, isn’t for them to go out of country to enroll in a Pharm.D program. There are very few of these outside of the USA and those in the USA are impossibly expensive for a Ugandan. I’m not sure they really need a full PharmD education. Their undergraduate degree is quite extensive in terms of pharmacology (how drugs work in the body) and pharmaceutics (how to make drugs into products patients can take like tablets…). In fact, I am always impressed at the level of knowledge of the Bachelors students. They just need more therapeutics (how to use drugs to treat diseases in patients), drug information skills (how to find evidence-based medical information at the point of care), and lots of hands-on mentoring while they practice their skills with real patients. This may require a couple of years of training, but not to have them repeat courses and take a full 4-year Doctor of Pharmacy degree.
After lunch, Winnie took me over to meet with the staff of the International Students Office at Makerere University Medical School. This is the office that arranges and supervises medical, nursing, and pharmacy students and residents who come from all over the world to learn while working with medical practitioners in Uganda. It was nice to be warmly greeted and meet up with Susan and Phionah again. They remembered me from my past visits. Part of my goals for this visit to Uganda, in addition to the research, is to investigate possible opportunities for Binghamton Pharmacy Students. After talking with Susan and Phionah, I can definitely see there are numerous possibilities.
I decided to call it a day a bit early so I can hopefully, get a really good and long night’s sleep to ward off any remaining jet lag. Today I have felt very well—just a bit tired. Greeting so many people I know already kept me going. Good night for now. I will be up super early for a 7am meeting with the Executive Medical Director of Mulago. I’m accompanying Winnie and a pharmacist from the Infectious Diseases Institute to a meeting about what can be done about the horrible situation of antimicrobial resistance here.
I enjoyed watching these monkeys play around my balcony this afternoon. They are cute but I can’t get any really good pictures because I’d have to open the glass doors and they would come right into the room through the grating.