Our Busiest Medical Clinic Yet – 6/24

As you know, we have been supporting Dr. Franklin to build a hospital outside of Kampala. During this same time, another group from the United States was helping to build a hospital in Eastern Uganda and needed some expertise to help get their hospital up and running. They ended up meeting Dr. Franklin and he had the opportunity to help with their hospital. Although Dr. Franklin hasn’t started a hospital before, he is a visionary and a leader and is extremely hard-working and has taken to the challenge with vigor. Dr. Franklin wants nothing more than the success of their hospital in Eastern Uganda, and hospitals and clinics across Uganda. His motivation is trying to bring health equity to all.

When we arrived at the new hospital in Tororo, the clinic was up and running. We keep track of the number of patients seen and when we arrived, Dr. Franklin and his team had seen about 20 patients so far. Staffing this clinic consisted of 8 physicians, three dentists, one optometrist, three lab techs, and 5 pharmacists. We had a fully stocked pharmacy and diagnostic tests including standard lab work, Xray and Ultrasound.

The clinic was a bit chaotic due to the sheer volume of patients. We did our best to triage patients as they came in. The patients we served at this clinic had a high burden of disease. This is similar to what we have seen at other clinics in underserved areas in Uganda. I’ve seen so many diseases here in Uganda that I’ve never seen in the United States and only read about.

Over the past 10 years we have noticed that some parts of Uganda have a very low prevalence of hypertension while other parts have a very high prevalence. The first 10 patients I saw all had hypertension and diabetes. Hypertension and Diabetes are extremely common in the US and make up a significant part of my practice in the United States. However, the focus in Uganda has historically been on infectious diseases, with many providers receiving less training of treating non-communicable disease. However, there is an epidemiologic trend across many developing countries where infectious diseases are decreasing and non-communicable diseases like hypertension and diabetes are rising. This will continue to be an important area to address in the future.

In addition to hypertension and diabetes, we saw a number of malaria cases. We also saw multiple patients with previously undiagnosed cancer, heart conditions such as severe aortic stenosis (a disease of the aortic valve in the heart) and many other conditions. Although it can be challenging for patients to receive a new diagnosis, it is also be very beneficial in helping patients understand their symptoms and get treatment to help them feel better. During these clinics we also see a number of “walking well” patients. These patients are overall healthy and come in asking for a checkup. This is a great thing because an ounce of prevention is worth a pound of cure.

While I was seeing patients, John Rackleff helped the dental team. Although better known for his financial expertise, John has become quite adept at working with the dental team. They had over 50 extractions and provided preventive care and education to many other patients. Laura Naumes helped in the eye clinic with the optometrist. I estimate that their team saw over 200 patients. Gina Bonsi helped in the pharmacy with the team, making sure that all of the patients got their medications and knew how to take them properly.

Around 7 PM there were still about six patients coming back from the lab or x-ray. The other physicians had to leave, so I stayed to see the last few patients. Although it was a tiring clinic, it was a joy to know that we were able to serve so many people.

At the end of the day, we saw 550 patients. The community was extremely grateful. It is my sense that this hospital is going to be a huge success and was desperately needed in this community. We drove to our hotel and had a late dinner and recapped the highlights and lowlights of the day. Tomorrow we will be driving back to Kampala and are looking forward to a stop in the Mabira Forest.

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