(What’s an average day like for a UCU medical school student? This two-part story is designed to provide some insight. Today is focused on one year-three student.)
By Patty Huston-Holm
It’s Monday morning in the 35-bed Nassolo Ward at Mengo Hospital on Cathedral Hill Road, Kampala, Uganda.
At 8 a.m. Linda Obukor Ojore, 22, talks to a woman slightly older. Writing carefully in block letters, Linda, wearing a white coat emblazoned with her name and the Uganda Christian University (UCU) logo, records answers to questions about the woman’s sick child who nearby sleeps with a breathing tube through his nostrils and saline solution entering his body intravenously through his wrist.
“His third admission,” Linda writes about the boy, aged four-and-a-half years. In blue ink, she documents that the child recently has been to other hospitals with symptoms of vomiting and convulsions and one diagnosis of malaria that does not appear to be a reason for any illness now.
“He has no ‘hx’ (history) of chronic illness, no asthma or epilepsy,” she writes as the mother speaks in English and the father, silent, stands nearby, and as both parents show a phone video of the boy walking days earlier. Linda speaks English and Acholi dialect, but only English here.
“No drug or food allergies,” the mother says, and Linda writes.
On this day, 18 beds in Nassolo Ward are filled with children intermittently crying and being entertained with cartoons and happy-and-you-know-it and Jesus-loves-me songs from parent phone screens. Most days, the 35 beds above a tending parent who sleeps and prepares food on the floor are not enough, according to Dr. Rhoda Mayega, a doctor for 15 years and now also mentoring UCU School of Medicine students in their third, as with Linda, and the final, fifth year of studies.
“We have one nurse for all of these,” Dr. Mayega said. “In the section with babies under 28 days, we also have only one nurse.”
From her office near where Linda documents a year-three course-required case study, Dr. Mayega described equipment health care deficiencies including heart/blood pressure monitors, syringe pumps, throat scopes, CPAP (continuous positive airway pressure) breathing machines and X-ray, radiology diagnostic equipment.
“We have no ventilators,” she said. “Even mattresses and clean sheets are scarce.”
Next to where Linda recorded a male child’s condition, a father held his sick baby girl as a worker sanitized and flipped the child’s mattress, soothing clean sheets and a pillowcase for her return with a blanket the daddy brought. Above the beds were the words “Let the little children come to me.”
Linda continued writing.
“He has minimally improved … prior to discharge,” she penned. This referenced the boy’s condition before referral to Mengo Hospital. This is one of Linda’s course-required case studies. The parents know she’s a student and approve.
Placing her stethoscope in a large pocket of her jacket, Linda thanked the parents
and walked into a nurses’ office, where she further transcribed her notes – this time in red ink – that she would use when giving her oral report before a doctor and her classmates.
Thirty minutes later, huddled within earshot of the parents and still-sleeping child, as well as her classmates who stood in a half circle and near a water bottle filled with disinfectant, Linda spoke, seriously and appreciatively, accepting corrections to her report from Dr. Joseph Ssali.
At one point, he asked her to describe a convulsion, casually referenced as “fits,” in more medical terms. In another part of a 45-minute session, Dr. Ssali asked students to define hypoglycemia, a low-blood sugar condition with shaking and dizziness among symptoms.
“All of us have to have two cases right now,” Linda explained when leaving the ward for a lecture. “What I did this morning is what I need to do with one more patient. We learn from the doctors, from each other and even the patients.”
Most of the doctors at Mengo, including the UCU School of Medicine dean, Dr. Gerald Tumusiime, were trained through Makerere University, which has had a medical school for 100 years, compared to the six years since the five-year program was launched at UCU. The UCU School of Medicine collaborates with Mengo, a private, non-profit local referral hospital. Makerere gives its medical students hands-on experience with Mulago Hospital, which, as a national referral institution, has more specialized medicine in such areas as neurology and cardiology. The two hospitals are 4.9 kilometers (3 miles) apart.
UCU is the newest medical school in Uganda. It was launched in 2018 with nearly 100 current alumni in a country with one doctor per 25,000 people. The World Health Organization recommends one doctor per 1,000 people.
Linda, who was born near Mbale and attended primary and secondary school in Kampala, wants to be among UCU’s July 2027 class with a Bachelor of Medicine and Bachelor of Surgery degree. Linda and more than 40 classmates are half-way to that goal, which is followed by Uganda’s one-year, required internship.
“I can’t remember not ever wanting to be a doctor,” she said.
When walking across the street from the children’s ward and passing a vendor selling juice and blankets, Linda reflected that her “desire to help people” may have started when her younger brother had congenital heart failure. He had to be flown for surgery in Germany because it wasn’t performed in Uganda.
At 10:30 a.m. in a small room near the UCU School of Dentistry laboratories, Linda and two dozen classmates prepare to share definition, frequency, symptom and cause information and answer Dr. Mayega’s questions about two unhealthy bodily functions – vomiting and diarrhea. Two classmates provide discussion points via a WhatsApp PDF that all students view from their phones or laptop device screens.
“What is the difference between acute and chronic?” Dr. Mayega asked. “What might be symptoms of an electrolyte imbalance? What might be the cause of blood in the stool? How can you determine dehydration without equipment?”
The definition of acute is symptoms less than two weeks; chronic is more than two weeks. Confusion, dizziness, skin color may indicate an imbalance of minerals or electrolytes. Blood in feces could indicate E.coli or salmonella. Without a watch, the medical professional can check the hydration-related responsiveness of color returning to skin with a three-second count.
“Mango one, mango two, mango three,” Dr. Mayega said as students squeeze a finger with the opposite hand to determine color response in three seconds.
“This is harder than I expected,” Linda said. “But being able to relate what is in the classroom to patients is rewarding.”
At 12:30 p.m. and before dashing to a canteen for a snack or lunch prior to afternoon studies, Linda, who has her current sights on pediatric medicine, added that time with doctors and the Christian-based emphasis at the hospital and university is likewise a positive with getting her degree from UCU. In addition to the financial challenges that most students face, one barrier has been seeing people die.
“I watched four people die – three adults and one child,” she said. “I had to realize that doctors can’t save everybody, and that dying is part of life. I will do what I can.”
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