Auma’s 26 years of working in the emergency ward

Career paths are in most cases individual decisions, but parents’ influence cannot be ruled out. Some do it without even noticing, while others make an effort to shape their children’s careers through work, ethics or family values.

Winfred Auma, a clinical officer based at the accident and emergency department of Masaka Referral Hospital, is one of those who drew inspiration from her mother. 

Auma’s mother, Rose Nekesa, got up every morning and found her way to her workstation in Lwakhakha, where she was working as a midwife. Nekesa’s works laid a firm foundation for Auma’s career life.

“It was magical watching my mother treating people. She conducted deliveries successfully and mothers went home smiling with their babies. I used to see her as a semi-god including other health workers. That is why I chose medicine,” explains Auma, who has grown to love and appreciate medicine.

Horning skills

The year 1996 was a turning point for Auma. This is when her journey in medicine took a major step after graduating with a diploma in Clinical Medicine and Community Health from Mbale School of Clinical Officers.

Auma joined the Ministry of Education at Bubulo Girls School before being transferred to Ministry of Health. The next step of her pathway led her to Mbarara University of Science and Technology, where she was awarded a diploma and a convocation prize in Emergency Medicine as a specialty, among the pioneers in 2019.

For more than a decade, Auma has horned her skills and capacity as a clinical officer dealing with emergencies, saving lives in the greater Masaka region.

According to Auma, this is a role that calls for tolerance, patience, discipline, integrity, working long hours and most important of them of all, passion for medicine. “I examine, treat accident emergencies and outpatients, perform minor surgeries and mentor health workers in the field,” she says.

Auma believes that having a community with credible emergency response skills is one of the biggest assets of any society.  This is why she strives to train more health workers in basic emergency care services, ambulance drivers and first aid respondents. She also trains medical and clinical students or interns in medical research and proposal writing.

In December last year, Auma was at the forefront of training 200 people including cyclists, police officers, army men, bankers, teachers among others in first aid response knowledge.

“A knowledgeable community in offering standard first aid skills reduces unnecessary morbidity and mortality among its people.  It saves lives because the first attention a causality gets is important,” she emphasises.

The golden hour

Accidents occur anywhere and in cases where there is no medical personnel at the scene, someone has to step in with a quick clinical decision to keep the patient alive until medical help arrives.

In most rural areas across the country, accident scenes happen miles away from the nearest health centre and when victims are not given adequate first aid, there are high chances of losing life. With more training programmes, Auma believes more lives will be saved.

“My dream is to see many people embracing emergency medical services. People will learn to save lives using the golden hour,” she says.

Auma also acquired further training in South Korea at Yonsei University Hospital in Emergency and Pre-hospital Care, thanks to an opportunity from Korea Foundation for International Healthcare (KOFIH).

Upon her return, she joined the KOFIH Global Almuni (KGA), which continues to empower local healthcare system in Uganda. Auma is one of the 75 Ugandan health experts that have gained medical skills from the programme since its inception in 2019.

What it takes

Auma’s work puts her in harm’s way of all sorts of emergencies that come with unique challenges. Blood, fractures, trauma, shock and respiratory issues are a package she wakes up to everyday. She compares her daily routine to that of sportsmen and soldiers because of the workload.

“We walk a lot, stand for long hours. In the emmergency department, you cannot afford delays.  Every minute counts,” she says.

“It is a calling not a duty. We work as a team, share extensive knowledge and skills with team members. For instance, you do not need to look for cadres in time of emergencies. You are required to resuscitate a patient as you contact seniors.  We are called to save lives at all costs,” she adds. Auma says her kind of job presents an overwhelming number of patients including mass causalities at times. “We never know how the day will go. Sometimes I am on duty and 20 emergency cases are brought to hospital. Of course, I do not work alone but that calls for us to be swift in order to save lives,” she adds.

Near death experience

In mid-2021, machette wielding assailants bijambiya terrorised greater Masaka with day and night attacks. Many lost their lives while a significant number were severely injured. Majority of those nursing injuries ended up in Auma’s care. The sight of fresh wounds and victims in insurmountable pain was not new to her, but there was more to it this time around. Auma’s team feared for their lives as suspicious characters surrounded the unit in which they went about their business. There was fear that the attackers were back to finish off the victims.

Another nervy experience for Auma came when the then presidential candidate Robert Kyagulanyi, known by his stage name Bobi Wine’s supporters, raided Masaka Referral Hospital.

A section of the crowd announced how government medical facilities were deliberately denying Kyagulanyi’s supporters medical help. “The hospital management had to call for help from Kasijjagirwa barracks to boost security. I was afraid of being assaulted or killed while on duty,” she recalls. 

Called to serve

Life as a clinical officer can also be frustrating, especially when there are insufficient medical tools to get the job done yet a life is on the line in most cases. “The most challenging bit while at work is dealing with new patients with different ailments using inadequate medical supplies or equipment because of big numbers of patients on limited budget plans and staff,” says Auma.

Despite all the shortcomings, Auma has made a tremendous contribution to Masaka Referral Hospital in 2010. “I have been part of the great team that has lobbied for improved service delivery,” she says.

Not even the limitations her job presents can drain her resolve to save lives. Her desire to learn something new in medicine every day and save lives makes her believe God had chosen her for this job.

Research

Working in a hospital setup for long hours, pressure situations and deadlines can be stressful. Auma says in such environments, one needs all the possible support. Seeking for help, talking to more senior officers are great ways to get through the day.

 Apart from listening to gospel music, exercising, parenting and weekend family outings, Auma also spends her free time reading and researching.

She watches American medical drama television series Grey’s Anatomy and Emergency Room, which perfectly relate with her work as a clinical emergency officer.

Be of service

Auma also keeps reading about emergency medical services for updates and new developments. She does not want to be left behind in the ever evolving world of medicine.

After dedicating 26 years of her life handling emergency cases and saving lives, Auma appeals to women to strive to leave an indelible mark, be of service to people, be trustworthy, and have empathy if they must succeed in the careers. Even after all that experience, Auma feels there is still a lot out there for her. From gaining more skills and mentoring many health professionals and passing on knowledge to people, she plans to pursue a bachelor’s degree in Emergency Medicine.

Her goal is to become part of the policy makers in emergency medical services and fight to improve the working standards of health workers.

Emergency services association

One of her biggest concerns is that many road accident victims, especially on highways do not get first aid on time. “I want to form an emergency medicine services association and open up trauma or emergency care centres on dangerous highways in central and eastern Uganda,” she dreams.

Minister of Works and Transport Katumba Wamala last year released a report during the Uganda Road Safety week with worrying statistics.

Statistics

A total of 3,633 people died in road accidents in 2020 according to the report. The figure was an increase from those seen in both 2018 and 2019 when 3,194 and 3,407 people, respectively, succumbed to road accidents, according to government statistics.

Auma believes those numbers can reduce significantly if the casualties get emergency help on time. That can only be achieved by setting up more facilities or educating the general public on the benefits of having a clue on how to react in case of a health emergency.

It is 26 years and counting but retirement is the last thing on her mind. Auma dreams of a Uganda that fully embraces emergency medical services, where everyone is able to save a life even in the absence of health worker.