My second week in Uganda has been a whirlwind of learning experiences in the pediatric, maternity, and surgical wards.
The pediatric ward was bustling with activity. Two siblings were diagnosed with pulmonary tuberculosis (PTB), highlighting the infectious burden in the region. Malaria, caused by Plasmodium falciparum, was another prevalent condition, with one child receiving IV artesunate as treatment. I also encountered a young patient in sickle cell crisis, now on the path to recovery with ibuprofen and morphine for pain control. Another child was battling measles, serving as a stark reminder of the importance of vaccination efforts.
On the second day of my second week, the surgical ward presented a diverse range of cases. A patient with previously undiagnosed miliary tuberculosis developed a small bowel obstruction, requiring immediate resection of the incarcerated segment. Another case involved a comminuted mid-tibial fracture, complicated by fever, confusion, and persistent hiccups—raising concerns for a fat embolism versus pulmonary embolism. While many differentials were considered, the challenge lay in being over 100 km from the nearest diagnostic center offering CT imaging, along with the difficulty of distinguishing between the two diagnoses even if imaging was obtained. Limited resources, expenses, and the patient’s condition further compounded the complexity of decision-making. While encountering such challenges was discouraging at times, it was also inspiring to see the doctors actively consulting one another to ensure the highest level of care available in the facility.
In terms of procedures, I observed the drainage of a scapular abscess and assisted in a pantaloon hernia repair. During the herniorrhaphy, Dr. Peter, the on-call surgeon, took the time to explain the layers of the hernia anatomy in detail. I really appreciated the informative teaching and felt welcomed as a visiting student.
The following day, the OB/GYN clinic introduced me to the complexities of women’s health care. A first-time pregnant woman with Rh-negative blood type needed Rhogam to prevent alloimmunization. In addition to discovering her HIV diagnosis during this pregnancy, she faced the devastating loss of her baby due to fetal hydrops fetalis. Since it was her first pregnancy, the cause of fetal demise remained unclear. Another intriguing case involved a patient with vanishing twin syndrome: a monochorionic-diamniotic twin pregnancy, where one twin had demised at 17 weeks while the other continued to grow at 23 weeks. Despite her grief, I could see her determination to carry the surviving baby to term, hoping for the best possible outcome. I deeply admired the mother’s choice to live in the present for her baby.
On the fourth day of the week, I revisited some familiar faces in the surgical ward, including a child with a midshaft tibial fracture placed in a plaster of Paris (POP) cast. It was my first time assisting in an orthopedic case, so while my arms became sore from holding the leg for most of the procedure, I found it to be an incredibly valuable learning opportunity.
This week reinforced the realities of resource-limited medicine—decisions often hinged on financial constraints, patient preferences, and available interventions. Each patient had a story, and each case provided an opportunity to learn not just about medicine, but also about resilience, adaptability, and the human side of healthcare.
During the weekend, Becky from the guesthouse took us to a pineapple farm, providing a refreshing break from the hospital environment.
The sunset was beautiful, and we saw many trees, including coffee, passion fruit, bananas, and avocado. It was fascinating to see how pineapples grew directly on top of the thorny bushes. We collected three pineapples and took videos and photos of the scenery. During the walk, chickens (including blue-colored ones, which one of us had seen earlier!), goats, and cows were our temporary companions. On the way back to the guesthouse, we passed through a crowded market during rush hour. Despite the darkness, people walked in groups, sold and bought goods, and rode boda-bodas (motorcycles). It was another busy yet fulfilling
night in Uganda.