By Patty Huston-Holm
Uganda Christian University’s (UCU) two lecturers with PhDs in nursing have reasons for their academic journeys not unlike those acquiring advanced degrees in other career fields. The passion for learning often starts with an interest through role model observations followed by personal growth and then understanding and application of how additional knowledge and skill improve people, organizations and systems.
This is especially true in health care, according to Dr. Elizabeth Namukombe Ekong and Dr. Faith Rosemary Sebuliba Kasumba. They hold a half dozen each of nursing credentials including master’s degrees from UCU and doctoral degrees from other countries. They teach students pursuing bachelor’s and master’s degrees under the UCU Faculty of Public Health, Nursing and Midwifery.
“At the bachelor’s level, you are learning how you can improve yourself,” Elizabeth said. “At the master’s level, you enhance that while knowing more about policies and practices. With a PhD, you go deeper in questioning to solve problems, improve health, save more lives.”
Acquisition of these capabilities is especially critical for nurses and even more so for developing countries like Uganda. The World Health Organization reports the 27.9 million nurses globally reflects a shortage of 13 million nurses. According to the World Bank, there are 1.6 nurses and midwives per 1,000 people in Uganda, compared to nearly 12 per 1,000 in the United States.
On a July 31, 2023, morning when UCU nursing students were on a full break from classes or engaged in practical experiences, the university’s two nursing PhD holders shared their recollections about early experiences with health care that led them along their career paths. They elaborated on the value of advanced degrees in nursing.
Faith and Elizabeth received their doctoral degrees from Texila American University (Guyana, South America) and the University of Central Nicaragua, respectively. Both are married to medical doctors. Dr. Thomas Sebuliba has been the husband of Faith for 34 of his 37 years as a practicing physician; they have three children. Elizabeth likewise has three children with Dr. Ekong Joseph, who has been a doctor for 18 of their 24 years of marriage. The husbands had some influence on the wives’ advancement in nursing but not all, especially at the onset.
For Faith, her health care interest can be pinpointed to an injured ear at age five when living in the Fort Portal, western Uganda region.
“I pricked my ear,” she recalled of how she tried to imitate adults cleaning their ears with match sticks. “My siblings and I dared each other to see who could go the deepest, and I won.”
The damage put Faith in a hospital, now known as Mulago National Referral Hospital in Kampala, for two months. During a series of surgeries leading to full recovery, she was surrounded by caring, nurturing nurses. It was them as well as a “retired nursing officer” cousin who started her direction to become a nurse.
On the opposite side of the country, Elizabeth was likewise young and watching happenings around a health facility in eastern Uganda’s Kamuli District.
“I was fascinated to see people go in a place sick and come out well,” she said. “I was surprised that somebody could identify your problem and help you get better…By the time I was in secondary school, I was looking for a profession where I could do that.”
When considering higher education options and given the choice between being a doctor or nurse, Elizabeth and Faith chose nursing that would allow them closer contact with patients. While their education journeys after high school are roughly eight years apart, both Elizabeth and Faith started out as midwives – an occupation in 2023 that, according to the Uganda Nurses and Midwives Council chaired by Elizabeth, is occupied by around 70,000 men and women.
“To smile at a baby was pure joy,” Elizabeth said of her midwifery practice at Mulago. “I’m still passionate about newborns and identifying and helping mothers at risk.”
While helping mothers deliver their babies, Elizabeth and Faith worked at deepening their health care knowledge with the growing realization of the need to pass on what they learned. They began to understand the value in stretching the knowledge and curiosity of the next generation of nurses in their country.
“Until 1993, nurses were only at the diploma level here,” Faith said. That year, she recalled, Makerere University started a bachelor of nursing program that interested her but she couldn’t begin because of child rearing responsibilities while her husband was getting surgical training in Zimbabwe. She got a couple more diplomas before getting her bachelor’s degree at UCU in 2007.
Elizabeth, who got her UCU Bachelor of Nursing Science in 2008, also started to see the importance of teaching others while continuing her own learning. Like Faith, she worked her way up from tutor to lecturer. As teachers, they share both the academic and practical sides of nursing.
“I’ve seen a critically ill person, not able to talk or open the eyes and then functioning after treatment,” Elizabeth said. “As I am enlightened with deeper understanding and ownership, I pass that on to students.”
Faith and Elizabeth cite Dr. Karen Drake, emeritus professor of nursing, Bethel University (St. Paul, Minn.), as their mentor. Karen, who holds a PhD in educational policy and administration, has been a practicing nurse since 1968, including at the side of her late husband in East Africa; as well as a nurse educator at UCU for more than a decade.
The difference among bachelor, masters and doctoral degrees is primarily critical thinking and problem solving, according to the two UCU nursing doctoral holders. Those with undergraduate degrees are primarily applying what they have been told while those with advanced degrees are more likely to keep questioning.
“Many times, people say the PhD is for the sake of self-actualization,” Elizabeth said. “I don’t see it that way. I see it about more help for the patient, better services, improved policies and processes.”
For Faith, her advanced degree has reinforced the “importance of collaboration for change” with increased confidence and a “spirit of inquiry.” One area in need of louder, more informed voices is mental health that is “highly stigmatized” in an ill-informed East African culture that may label mentally ill people as “possessed,” she said.
In addition to what their advanced degrees offer for their students, Faith and Elizabeth are frequently at the table for policy and research discussions and conference presentations. Topics have included early postnatal care improvements, work-based learning, menstrual hygiene among adolescents and technology learning and application.
“We need to have nurse leaders at various levels,” Elizabeth said.
In addition to their on-paper credentials and reputations as esteemed lecturers and nurse practitioners, Christian walk is critical to UCU’s two PhD holders.
“God has called me to do this,” Elizabeth said. “My model is Jesus Christ.”
“It’s a calling,” Faith concurred, admitting that she initially didn’t want to teach but a higher power nudged her there. “When I feel almost like giving up, I know who is my strength. God is my strong foundation.”
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