UgandAshis 15. Fort Portal – Clinical Officer School

Kampala, Uganda, June 3, 2009.

Fort Portal – Clinical Officer School

As you meander the overcrowded wards in the district hospital in Fort Portal you cannot avoid the ubiquitous red-green and blue labeled young clinical officers in training. The clinical officer plays an important role in the Ugandan healthcare system. Following some statistics to show you why:
Uganda has about 30 million people and trains about 150 doctors each year. Given the relative low salary of about 250-300 dollars per month many seek employment overseas. There is a local (rural-urban), regional (Uganda to South Africa/Cameroon) and global (Uganda to UK and USA) brain drain leading to about 75 of those doctors to leave the country. It is said there are 2000 doctors working in the whole of Uganda and about 4000 nurses (less sure about that one). This makes a whopping 1 doctor per 15000 people. Or as I just read the Netherlands trains 3000 doctors a year for a population of 17 million.

Here when you enter the district hospital we are supposed to have 40 doctors as this hospital is the referral center for 5 districts and about 1.5 million people. Reality is 10 doctors! Not bad for a 400 bed hospital where about 15 deliveries take place a day and 3 caesarean sections. As you can understand it is the clinical officers that clerk all admissions. When a case is complex the nurses and the clinical officers call for a doctor to give a consultation.

To make a living most doctors have private chambers. They receive patients there who can add to their meager income. The hospital in the afternoon will have only 1 or 2 doctors. The on call obstetrician and surgeon, sometimes a medical officer stays behind as well.

Back to the clinical officers; they get a three year theoretical and practical training. There are six schools in Uganda (3 private and 3 public). The school in Fort Portal alone churns out 123 exam candidates this year. Due to lack of funding, limited number of clinical instructors, old teaching materials and books studying is not easy for the students. There is an overhead projector for sheets but none for power point presentations.

Doing ward rounds with colleagues attracts flocks of white coats with red, green and blue labels. After seeing all patients in the early morning selected complex cases are discusses and examined with these students. Once I started doing this I was requested to meet the head of the school. This year’s group have their final examination coming up in a month’s time and can always use more clinical lecturing. If I could make them a mock exam, or better train them clinically that would be wonderful.

As I boarded the bus to Kampala I made a list of things I needed. Perhaps some of you can help. As I find many power point presentations online for clinical medicine nowadays does anyone know if there are mock exams for medical students on-line. Why reinvent the wheel when the work has been done already. The projector I am looking at is a friend’s who has borrowed to another friend who is in Gulu now.

I should be moving towards the bus now. Over the last few days I have been around Kampala to get a white coat, medical instruments, internet access, fixing my computer etcetera, etcetera. Let us hope for internet access from Fort Portal.

Namaskar,

Ashis