There were many similarities- similar courses, cased based approach to learning, and the consensus that there is so much reading to do and never enough time. One astounding difference is that students usually do not buy their own books- the cost is prohibitive. Tuition is currently $430/semester- they use the same texts as US medical schools which can range from $30-200 per text. Here in Uganda, all texts are kept in the library and the students must share. I brought Kaaya "Robbins- Pathology" and with this, he will have more flexibility with his study time.
Regarding the practice of medicine- conventional insurance does not exist- there are private fee for service centers and government centers which are supposed to be free but one local nurse revealed that the treatment may be free but supplies and medicines must be purchased. As Kaaya said, those with serious illness and no means to pay often will just be left to die- even from a treatable ailment. Mercy killing is also an acceptable alternative.
Physicians often work with inadequate resources. Kaaya said that even gloves sometimes are not availabe. The physician must make an ethical decision- do I take care of this bleeding wound with bare hands and risk exposure to HIV and heptitis or do I let this patient bleed.
I am in the van heading over to our make-shift clinic. We are set up to see 250 today. Yesterday we made the decision to give worm tablets (albendazole and mebendazole) to all 1000 children this week. The task ahead seems daunting but we're going in with great energy and high hopes. The current nurse (self taught) Lydia will be working alongside me and the US nurses- we will be teaching one another. Lydia was thrilled with all of the supplies we brought. She has never seen a pulse oximeter or nebulizer. She is bright and eager to learn.
I'm almost at the Mbiriizi school- will update later with our experiences from day 1.
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