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Musomesa: Uganda Part V

March 27, 2019

(Luganda translation: Teacher)



Although it was not an initial reason for my pursuit of medicine, being able to teach my patients and my peers quickly became a large motivating factor in my quest to becoming a physician.  I have always enjoyed relaying what little knowledge I have acquired to my peers and being able to present what may have seemed to be difficult and complex material in a more easily digestible and understandable form.  Even during my time in medical school, I served as a peer tutor which allowed me not only to gain a better mastery of the material for my own self, but it allowed me to help assist those coming behind me gain their own mastery of the same material.  Therefore, during this past residency interview season, it was easy to remark that I look forward to stepping into a teaching role as I help educate the medical students and eventually my future co-residents. 


Coming to Uganda, I did not expect to be further thrusted into role of an educator.  Though I did expect to provide some occasional insight to how certain things work in the States and how we might approach treatment of certain patients, I did not expect to be giving Health education talks to the members of the community or Continued Medical Education (CME) talks to our entire hospital staff.  Nevertheless, the ability to provide health education is something that I am relatively well-versed in as a result of my prior job experiences.  However, I still was not prepared to have people already looking to me as the source of their information on potentially how to shape the way they approach certain diseases, assessments and treatments.  You can tell me all you want that I am basically a doctor, so I should be prepared for people looking to me for this information, but I still feel very far from having that same confidence in the information that I may share. 


I now feel very fortunate to have been provided multiple opportunities to share and educate both the community as well as the hospital staff.  Being able to share information to both pregnant mothers, post-partum mothers and women in general was truly the most impactful to me.  As a future OB/GYN and self-proclaimed “champion of Women’s Health”, being able to educate and speak to the Ugandan women was a truly special moment for me.  Although the realization that women’s health issues span all continents was something that I knew prior to coming here, I was still not prepared for the degree to which certain things that we considered preventable (ie Cervical Cancer) provide so much morbidity and mortality worldwide and how a little education can provide meaningful results.  I like to think that my ability to dispel some urban legends or debunk misinformation was beneficial to the some of the women that I have encountered, and that they now feel somewhat more empowered to take care ownership of their own health and will share with their own family and friends.  Additionally, my journey into become a true health educator did not stop with the community but also trickled down to my colleagues in the hospital.  This past week I was given the opportunity to do a CME talk on Diabetes, another topic that is actually near and dear to my heart. During some of my time in both outpatient and inpatient, we would have Diabetic patients who would come in with complications and complaints as a result of years of poorly controlled blood sugars.  After doing some research, I found that there has been a 3% increase in the prevalence of Diabetes in Uganda over the last few years.  Furthermore, it is suspected that the prevalence rate is actually higher, but unfortunately many are not seeking care largely because they are not able to afford it.  After learning how our clinical officers educate and treat Diabetes and my own observations about the diet and lifestyle habits of the Ugandan people, I was able to utilize information from both to provide education and recommendations about signs, symptoms, diagnosis, treatment and management.  I was happy that I was able to give this talk at the end of my time here in Uganda (insert sad face) because I was able to take what I have learned about the Ugandan culture and make my talk a direct reflection of all that I have learned regarding their way of life.  I also think that my hospital family was similarly appreciative of that aspect of my talk.


The importance of being able to provide some degree of education while traveling abroad is immensely important.  I do not consider myself a teacher, but I do understand that I am called to teach through medicine, and it is imperative that I remain open to when those opportunities arise.  In the arena of Global health this is even more crucial to the sustainability of the assistance that we provide.  As we learn so much from our colleagues both in and outside of the hospital in Uganda and whatever countries we may find ourselves practicing medicine in, we understand that we are only just there to help and to not provide some sort of a savior complex.  Our assistance is appreciated but many times not necessary, however, where we can actually leave a lasting impact and provide some further sustainability with our recommendations is by teaching and educating our fellow colleagues in their native countries.  Our contributions to their learning must always come with humility, sensitivity and understanding of the country’s culture, but if done so with these things in mind, can provide important information and alternate ways of treating and managing patients that may not have been considered. 



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