How a rural hospital changed my perception
What you need to know:
- Special appreciation to the other health cadres we work with and learn from while in the wards like the nurses and midwives.
Did you know that over 60 percent of Ugandan doctors prefer working in urban areas over rural settings? The last six months have been the most rewarding of my medical career so far as I do my medical internship in a rural hospital near the border of DRC called Bwera Hospital in Kasese District. I now have a completely different attitude but first, allow me to take you a little back.
I studied at Makerere University and while there, I became the medical students’ president at the College of Health Sciences and later on at the national level. While there, we underwent a Community-Based Education and Research Programme (COBERS).
The college has over 60 sites in different parts of the country where we are posted and this programme enables the training of a health worker for the community, serving community needs, and understanding grassroots health problems affecting Ugandans.
Unfortunately, some of us naively preferred (if asked to choose) to do this “apprenticeship” from urban areas because of many reasons/excuses amongst which was the lack of accommodation services in rural settings.
After five years of studying at university, the Ministry of Health randomly deployed us and here I was, deployed in a place with no Safe Boda and Glovo networks. I was scared, confused, and not certain whether I would flourish in this new environment, new culture, and worse of all, the security threats with the uncommon ADF rebel attacks. I even reached a moment of thought to postpone my internship with the hope that “maybe next time, it will be in a closer place to the capital city.”
This is the final training part of a medical doctor during which an intern works under the supervision of seniors to get hands-on experience. Life as an intern doctor is very challenging yet rewarding.
These young health professionals are technically the first point of contact before any senior doctor sees any patient and in the rural healthcare setting, you learn by force how to use very limited resources to achieve the desired outcome.
One of my most outstanding memories of my internship is when I helped deliver a baby boy after the mother had walked very many kilometres from the mountains close to Congo and arrived while in labour. The joy and gratitude on their faces accompanied by naming the child after me was priceless.
I have seen the resilience and resourcefulness of the people at Bwera Hospital but also the gaps and needs that still exist and in my opinion, medical internship is still underrated.
To the medical students and other young health professionals in Uganda or those planning to do their internship in Uganda, I will advise you as follows.
Embrace diversity and learn to work in culturally diverse environments, learn how to adapt in resource-limited settings and I hope more of you will consider working in rural settings as it is a rewarding and fulfilling experience. I think we all need such exposure to better our lens of life, especially for the health care system of this country.
I want to reassure the public that despite the difficulties, many dedicated and passionate health professionals are doing their best to serve them with quality healthcare within government facilities. So, trust the system. Community engagement is fundamental for “Health is made at home and only repaired in hospital” as a great man once said.
To the government, do not get tired of supporting medical internship, especially with the growing numbers of interns because we need them. Identify a budget for these “public servants” and liaise in time with training institutions for proper planning.
Provide infrastructure such as accommodation for interns, especially those in security-sensitive areas like Bwera Kasese. Empower training facilities with more senior doctors and facilitate them well to supervise us better.
I thank the government, the Ministry of Health, and all administrators who make it possible for intern doctors, nurses, pharmacists, and midwives to have a great experience. Special appreciation to the other health cadres we work with and learn from while in the wards like the nurses and midwives.
I look forward to finishing my internship and working closely with global communities to further impact more lives from an international podium.
Dr Asasira Ignatius
[email protected]