(The Fulbright Program is designed to improve intercultural relations, diplomacy and competence between people in the United States and other countries. This is the first of three stories about American Fulbright Scholars serving with Uganda Christian University.)

By Patty Huston-Holm

“The heart of man plans his way, but the Lord establishes his steps.” Proverbs 16:9

Uprooting from a developed to developing country shouldn’t be an overnight decision.  For Dr. Ladavia Just of North Charleston, South Carolina, it wasn’t.

Sitting barefooted in her Kampala, Uganda, home while her three children were in their new school and juggling phone messages about her husband’s American-to-Uganda air travel snafus, she reflected on her path across the ocean to serve with Uganda Christian University (UCU).  The three-year discernment journey started in February 2016 with UCU’s Vice Chancellor, the Rev. Canon Dr. John. Senyonyi, visiting South Carolina. This connection was followed by Ladavia’s two exploratory trips to Uganda before a Fulbright Scholarship award to do nine months of work related to Dr. Ladavia’s expertise in pharmacy.

Dr. Just is teaching pharmacology courses for second-year students at the UCU School of Medicine that is located within Kampala’s Mengo Hospital. She also has been tasked with helping to lay the foundation for a new pharmacy program at UCU’s School of Medicine. In addition, she will conduct research assessing the feasibility of increasing access to heath care using telemedicine in refugee settlements.

“When I look at the needs of Ugandans, the list is overwhelming,” she said. “I wondered how I could possibly have made a ripple of an impact. Now as I consider the fact that I have been practicing as a clinical pharmacist for the past decade, coupled with my background in postsecondary education and health administration, I realize there is a ripple that has my name on it.”

That ripple became a wave with “first God nudging me very subtly” before the giant push with her husband, Jason, agreeing to hold down the fort with his work at the Medical University of South Carolina while his wife and three daughters took up a year’s residency in Uganda.  The couple agreed that having their twins, Jamie and Jael, age 9, and Jada, 14, engaged in the international experience, including school in Uganda, would be a plus.

Here’s some of what Dr. Ladavia Just knows as it relates to the need she might fill in Uganda:

• In the United States, the career path to become a pharmacist involves at least two years of undergraduate study, four years of graduate-level study, and two exams. There are 144 accredited programs with the more than 300,000 pharmacy graduates (2016) making more than $100,000 a year. These American pharmacists give advice on wellness, educate on drug benefits and side affects and administer certain vaccinations. Throughout the country, citizens can access a licensed pharmacist about every two miles (3.2 kilometers).
• In Uganda, which is about the size of the state of Oregon, you can become a pharmacist following a four-year program, followed by a one-year internship, in four locations – one in the north, one in the west and two centrally located. While institutions offer lower levels (certificate, diploma) of programs related to pharmacy work in Uganda, the best comparable solution to supplementing health care in this country is the licensed pharmacist, making 4 million shillings ($1,085) a month. Except for the injection role, they operate much the same as those in the Western world. But there are are not enough of them.

As quoted in May 2019 by Uganda’s Daily Monitor newspaper, 20 percent of the just over 1,000 Ugandan licensed pharmacists are working or getting further education out of the country. And 90 percent of the rest are working in private pharmacies that the most economically vulnerable, particularly the rural poor that make up 80 percent of Uganda’s population, cannot access.

According to Samuel Opio, the Pharmaceutical Society of Uganda secretary, Uganda needs five times more than the 150 pharmacists who graduate each year.

“If you look at Uganda’s 42 million population as a while, the number of ‘in country’ pharmacist ratio is roughly 1 per 60,000 people,” Dr. Ladavia said. “The Ministry of Health has indicated a goal of 1 per 20,000 over the next decade.”

The pharmaceutical issue in third-world countries goes beyond access data. It’s also about substandard drugs.  In June of 2019, the Ugandan National Drug Authority estimated that 10% of all medications provided in the country are counterfeit.  Ineffective ingredients (sugar, powder, chalk, etc.) in these fake drugs can be deadly.  In July of 2019, the Ugandan government was exploring a relationship with MediConnect block chain technology to alleviate the problem.

While considering assistance to start a UCU School of Medicine pharmaceutical school at some point, providing this information to the university’s medical students will assist in not only added knowledge but also with reinforcing ethical and Christian practices in Ugandan health care, according to Dr. Ladavia.

Dr. Edward Kanyesigye, Dean of the UCU Faculty of Health Sciences (including the medical school) cites Dr. Ladavia’s practical and teaching experience as an asset to UCU as well as her highly relational personality.  In Uganda’s community-based culture, the American pharmacist had the added advantage of being able to build sustainable relationships.

An added uniqueness with Dr. Ladavia is her African-American heritage. Most Westerners working in Uganda are Caucasian. This ethnic unfamiliarity results in many locals mistaking her for Ugandan until she starts to speak. She recalled one restaurant experience in Kampala with white-skinned Americans.

“My friends, Amy and Jayne, were given menus, and I was not with the assumption that being Ugandan, I would get my food from the local buffet, “ Dr. Ladavia recalled, smiling.  “When hearing my American accent, the wait staff quickly apologized and brought me a menu. But the rest of the lunch was spent with curious stares of other (Ugandan) diners.”

Heritage, Dr. Ladavia believes, will be another asset to her teaching in East Africa. While teaching basic principles of pharmacology, the nervous system, chemotherapy and other drug-related topics, students and staff will expand their cultural, racial and ethnic awareness by learning who she is and what she believes.  If the subject of slavery comes up, she welcomes the conversation.

“I want them to understand and learn from me, ” Dr. Ladavia remarked from her home in Kampala, shortly after moving in. ““Already, I have learned so much from them.”

She has learned how to go to the market, to enroll her children into an international school with children from 35 countries, to find a place where her children can see a movie, to drive a car on rugged streets and around bodabodas (motorcycles) that don’t follow traffic rules, and to buy and keep four rabbits for her girls to have as pets.

“Ugandans are wonderful, friendly people,” she said. “I know that God is using me for His Glory and placing His children from here in my path.”

+++

To support Uganda Christian University’s School of Medicine and other programs, go to www.ugandapartners.org and click on the “donate” button, or contact UCU Partners Executive Director, Mark Bartels, at mtbartels@gmail.com.

+++