Dr. Richter writes: “I recently traveled to Uganda for a two week urology camp at three hospitals in the Mbale region. The focus was on general urology where nearly 40 surgeries were performed, among them TURPs, TURBTs, urethroplasties, and VVF repairs.
This was my second visit to Mbale where I had the privilege of working with Dr Fred Kirya and his staff. Dr Kirya serves a patient population of approximately 7.5 million at three different hospitals. In addition he performs vesicovaginal fistula camps in remote areas of Uganda as well as South Sudan. As Dr. Kirya is quite fascicle with urethroplasties and VVF repair, our focus from a training standpoint was endoscopic cases, especially TURP. As we all know, open Prostatectomy is associated with longer operative time, greater blood loss with increased risk of transfusion, and longer hospital stay. By the nature of the Ugandan healthcare infrastructure, patients who have open prostatectomy typically stay in the hospital for two weeks, while we were able to discharge the patients managed with TURP in 2-3 days. The ability to efficiently do transurethral cases can be a force multiplier in a region that is already starved for medical resources, both human and capital. This is an ideal platform for the IVUmed teach one reach many philosophy.
As was my experience last year, my biggest takeaway is that although the goal is for the urologist representing IVUmed to provide the teaching, without question I can say that I learned more from the host urologist and staff than they did from me. As a result I will be a far more effective surgeon in my home community. The surgeons are very talented and are able to perform complicated surgeries with a handful of suboptimal instruments with a choice of maybe 10 types of suture. When one considers the multiple instrument sets in perfect condition and upwards of 300 varieties of suture to choose from, their abilities are all the more impressive.
While being faced with a critical lack of resources, the staff in Mbale is skilled, creative, and resourceful in a way that is hard to understand without seeing, and is simply inspiring. Many of these practices would not be suitable in the United States, but in the context of the current Ugandan health care system, they are a necessity. It provides a great perspective for all of the perceived difficulties that challenge us in the United States and an appreciation and how fortunate we are. Among the many challenges, the operating room is hot and humid, the equipment suboptimal, and one most do for one’s self as the surgeon what would be performed by multiple people. Power would go out at times. In one instance because it was at night someone used their phone flashlight to provide vision until the power came up a short while later. At times there were even two operations going on in the same room. Yet through all of this, I believe quality care and surgery are delivered.
Uganda is a country blessed with stunning physical beauty that is well matched by the kind and gracious nature of its people. A warm welcoming environment was provided for me in Mbale, and I have been able to create relationships that are best described as friendships that I hope will last a lifetime.”
Thank you Dr. Richter, for volunteering your time and expertise to change the lives of people all around the world.
Are you interested in volunteering with IVUmed? Visit us here to find out how! https://www.ivumed.org/how-you-can-help/upcoming-volunteer-opportunities/