Dr Balikuddembe: An unsung hero

Gone too soon. Dr Balikuddembe. PHOTO/NET.

What you need to know:

  • Fare thee well my friend.  Dr Michael Balikuddembe, a son, a father of three, a gynaecologist and a colleague was just beginning life but it was cut short. He succumbed to cancer of the liver in September 2020.  Asa Ahimbisibwe, his close friend pays tribute.
  • Valiant: Michael was different, an eternal optimist, he believed that things would get better, he plunged himself in making sure that he would at least save one woman and baby at a time.
  • In so doing, with no protection, and with a system not well equipped, he contracted hepatitis B and, unlike most of us who worked side by side with him, he was unlucky.

Michael died on September 4, 2020. He was just in his early 40s. He died of an aggressive hepatocellular carcinoma—liver cancer. He is one of the many health workers in Uganda who gave their lives to save others, every day working under suboptimal conditions, always improvising with minimal to no resources in order to save a life, thinking to themselves, if I can at least save this one, may be tomorrow will be better. Maybe our leaders will allocate more resources  and maternal health will make it to the top agenda. 

He was a son, a father of three very young children, a gynaecologist and a colleague. His life was just beginning and it was cut short. He is not the first one to die from a preventable death in the line of fire, and he will not be the last. This is because the systems that put him in the line of exposure have not changed, and those who are in positions of affecting this change have bigger things to think about; such as making sure that Uganda becomes a middle-class income country by 2025. Investing in basic lifesaving protective equipment for the medical workers who are at risk of exposure to Hepatitis B and other blood-borne infections is not a priority. This is my opinion. 

Protective gear
When I entered medical school, I watched my senior professors operate on patients with no gloves and protective equipment. Some of these contracted HIV-Aids and died. They died to save lives. When I entered Makerere University to undertake my postgraduate training in obstetrics and gynaecology, Michael was a year my junior. Things had, and have not changed much either. We, like our predecessors, could not sit and watch mothers bleed and die at our hands, so we improvised, every second, in every way, barely with any protective gear and helped to deliver mothers. We did operations with no protection, and in due course pierced ourselves with needles operating on patients with known HIV/Aids.

I took the fight to the Ministry of Health to beg and plead for aprons (plastic sheets we placed underneath the operating gowns) to prevent our bodies from soaking with blood. I will report that a one-time batch of 20 or so aprons were bought. A win at the time. We operated with no aprons, and I cannot tell you how many times all of us would have to finish surgery on a woman with ruptured uterus and find that we were soaked in blood to our underwear. I still have nightmares about those long nights and days that lasted three years.

Dr Balikuddembe was a family man. 

We advocated for protective gear, hepatitis vaccine, gloves and sutures to save the lives that were under our care. 
Every day, our senior colleagues would tell us to ‘make do with what we had and save as many lives as we could’, and go to work we did. There was a donation of Hepatitis B vaccine during our time for a few months and for few people. And, our fight was that every health care worker and all medical students should have access to this. 

The optimist
Michael was different, an eternal optimist, he believed that things would get better, he plunged himself in making sure that he would at least save one woman and baby at a time. In so doing, with no protection, and with a system not well equipped, he contracted hepatitis B and, unlike most of us who worked side by side with him, he was unlucky. He developed hepatocellular carcinoma, a very aggressive type and this took him away, too soon from his young family. 

What is the government up to?
I am not mad, not at all. I am concerned that our government has continued to neglect its duty to protect its citizens, be those poor women who were Micheal’s patients and their doctor who gave his life trying to save them. The Ugandan government cannot go after middle income status, when its population is not healthy. If the doctors are left to die in the line of fire, one wonders what happens to the poor patients who depend on their doctors that not only treat them but also to be their advocates and voices. Uganda as a country, has a reputation of its military might and has won so many battles. It has some of the elite soldiers on the continent but I  wonder if they would ever be sent out to a battle ground without ammunition and expect them to fight and win. 

Farewell
Good bye Michael, you fought a good fight, you saved many lives of women and babies and in the process lost yours – an ultimate sacrifice. It is a sacrifice that you or any other medical person in Uganda should never have to make if our government provided the necessary protective and basic equipment to all front-line health workers. It could have been me, and it will be another person today or tomorrow. Now, all of us, medical workers, politicians and individuals, should not just say ‘sorry, he died young’, BUT we should do everything within our power to make sure that there will be no more Michaels. And some of us who were lucky to survive, should always remember his sacrifices, for he worked side by side with us.