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| The pharmacist Richard shows An, Melanie, and Joe around First Pharmacy |
Post by Melanie Mahoney, PD4
What a week full of learning! On Monday, I went to Nakasero Hospital with Prosperity, and got to round with two physicians in the ICU and HDU (high dependency unit). We were lucky enough to spend our morning with two great physicians who were very happy to have us there and went above and beyond to involve us with questions and discussion on a plethora of topics. I learned about malaria treatment and alternatives for opportunistic infection prophylaxis while also refreshing myself on topics that will be especially important for my acute care rotation like sedation, analgesia, hypotensive emergencies, and more. Not only did I get challenged and learn about medications, but I also got to have some good discussion with the doctors about differences in healthcare systems in the United States and Uganda. I really appreciate every opportunity I get while I’m here to exchange ideas in this way.
The next day, An came to Nakasero with me and we luckily got to round with one of the same physicians in the ICU. We also reviewed a patient chart with the geriatric specialist, who was able to provide some different input than what we had learned with the cardiology specialist previously on the same case.
The past two days, Joe and I have been at the Infectious Disease Institute (IDI) while An has been at Nakasero. Yesterday we spent some time in the pharmacy observing the workflow. We were impressed by the computer system and general efficiency of the process. We also spent some time shadowing physicians in their patient visits. This led to some very intense discussion on reproductive rights. At the same time, Prosperity and An ended up having quite the debate on gay rights. As we discussed in our afternoon debrief, these can be some very difficult conversations to have and open dialogue is extremely important for progress to be made.
Another issue that has recently become much more important in the world of infectious diseases in Uganda is the current Ebola outbreak. Yesterday a 5-year-old boy died of Ebola and today, that boy’s grandmother succumbed to the disease. Ugandan health authorities are extremely concerned as these are the first cases of the virus reaching across the border from the Democratic Republic of Congo, where over a thousand people have died in this recent Ebola outbreak. When we arrived at IDI, we were asked to read and reflect on an article about the Ebola epidemic from 2013-2016 that discussed strategies for identification of patients presenting potential symptoms. The team is now reassessing these tactics and making sure they are as prepared as possible in case the outbreak reaches Kampala.
In the afternoon, we met with a physician working on preventing antimicrobial resistance throughout the country by improving access to laboratory testing, surveillance, and education. We have all seen some pretty shocking cases of patients with infections caused by extremely resistant pathogens, so we were very interested to learn how this issue is being addressed in Uganda. I really enjoyed the conversation we had with this doctor and gaining his perspective on how provider behavior can be changed for the benefit of antimicrobial stewardship.
We continued our full day with a visit to a community pharmacy in Kampala. We sat down in a meeting room with three pharmacists and had all our questions about pharmacy practice in Uganda answered. We learned that pharmacy technicians in Uganda require 3 years of education and often are very close in healthcare and pharmacy knowledge as the pharmacists who have 4 years of formal education followed by an internship year. After our discussion time, we got a tour of the pharmacy and were extremely impressed by the medication supply available (and the cheap prices!). While this pharmacy is very modern and advanced in the services it provides relative to other community pharmacies in the country, we really appreciated gaining a better understanding of the role of the pharmacist in Ugandan healthcare and seeing what a pharmacy could be like. I’m looking forward to seeing what our final week in Uganda will bring!
What a week full of learning! On Monday, I went to Nakasero Hospital with Prosperity, and got to round with two physicians in the ICU and HDU (high dependency unit). We were lucky enough to spend our morning with two great physicians who were very happy to have us there and went above and beyond to involve us with questions and discussion on a plethora of topics. I learned about malaria treatment and alternatives for opportunistic infection prophylaxis while also refreshing myself on topics that will be especially important for my acute care rotation like sedation, analgesia, hypotensive emergencies, and more. Not only did I get challenged and learn about medications, but I also got to have some good discussion with the doctors about differences in healthcare systems in the United States and Uganda. I really appreciate every opportunity I get while I’m here to exchange ideas in this way.
The next day, An came to Nakasero with me and we luckily got to round with one of the same physicians in the ICU. We also reviewed a patient chart with the geriatric specialist, who was able to provide some different input than what we had learned with the cardiology specialist previously on the same case.
The past two days, Joe and I have been at the Infectious Disease Institute (IDI) while An has been at Nakasero. Yesterday we spent some time in the pharmacy observing the workflow. We were impressed by the computer system and general efficiency of the process. We also spent some time shadowing physicians in their patient visits. This led to some very intense discussion on reproductive rights. At the same time, Prosperity and An ended up having quite the debate on gay rights. As we discussed in our afternoon debrief, these can be some very difficult conversations to have and open dialogue is extremely important for progress to be made.
Another issue that has recently become much more important in the world of infectious diseases in Uganda is the current Ebola outbreak. Yesterday a 5-year-old boy died of Ebola and today, that boy’s grandmother succumbed to the disease. Ugandan health authorities are extremely concerned as these are the first cases of the virus reaching across the border from the Democratic Republic of Congo, where over a thousand people have died in this recent Ebola outbreak. When we arrived at IDI, we were asked to read and reflect on an article about the Ebola epidemic from 2013-2016 that discussed strategies for identification of patients presenting potential symptoms. The team is now reassessing these tactics and making sure they are as prepared as possible in case the outbreak reaches Kampala.
In the afternoon, we met with a physician working on preventing antimicrobial resistance throughout the country by improving access to laboratory testing, surveillance, and education. We have all seen some pretty shocking cases of patients with infections caused by extremely resistant pathogens, so we were very interested to learn how this issue is being addressed in Uganda. I really enjoyed the conversation we had with this doctor and gaining his perspective on how provider behavior can be changed for the benefit of antimicrobial stewardship.
We continued our full day with a visit to a community pharmacy in Kampala. We sat down in a meeting room with three pharmacists and had all our questions about pharmacy practice in Uganda answered. We learned that pharmacy technicians in Uganda require 3 years of education and often are very close in healthcare and pharmacy knowledge as the pharmacists who have 4 years of formal education followed by an internship year. After our discussion time, we got a tour of the pharmacy and were extremely impressed by the medication supply available (and the cheap prices!). While this pharmacy is very modern and advanced in the services it provides relative to other community pharmacies in the country, we really appreciated gaining a better understanding of the role of the pharmacist in Ugandan healthcare and seeing what a pharmacy could be like. I’m looking forward to seeing what our final week in Uganda will bring!
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| Richard (pharmacist), Joe, Melanie, An, and Olivia at First Pharmacy in Kampala |
Thanks Melanie Nicol for sharing your experience.
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