Tracing Uganda’s medical practice
Oct 01, 2007
ON October 2, 1909, Dr. Albert Robert Cook wrote to the founder of Welcome Pharmaceuticals in London about the possibility of training Ugandans at certificate and diploma levels in medical practice. In his letter to Henry Welcome, Cook said: “We have already started training and the results are im
By George Laghu
ON October 2, 1909, Dr. Albert Robert Cook wrote to the founder of Welcome Pharmaceuticals in London about the possibility of training Ugandans at certificate and diploma levels in medical practice. In his letter to Henry Welcome, Cook said: “We have already started training and the results are impressive. Uganda, with its little-known diseases, is a professional man’s paradise.â€
Close to 120 years later, that letter was not written in vain, as Ugandan doctors made the country proud on April 14, 2007 when they carried out a cardiovascular surgery, which saved the lives of two.
Mark Arinatiwe and David Kalenjera who survived Uganda’s first-ever open heart surgery at International Hospital, Kampala, are milestone pointers to the confidence Ugandan doctors continue to enjoy despite myriads of constraints.
April 14 will never go into oblivion because it is the day when Cook’s idea of Uganda as a professional man’s paradise was realised— the birth of discipline, co-operation and patience.
Most Ugandans are apt to think that cornerstones of this landmark achievement were laid 20 years ago as Dr. Ian Clarke and his colleagues have suggested, but the fact is Clarke and his colleagues sowed their seeds into a fertile ground of medical practice in a conducive climate.
Ugandan doctors have had an unimpeachable ethical discipline hinged on professionalism, career development and co-operation as forecast by Cook. In his book, My African Journey, British statesman Sir Winston Churchill, who visited Mengo Hospital in 1908, described the hospital as: “a model of what a tropical hospital for Africans ought to be....I do not know of any part of the world where missionary influence and enterprise have so beneficently exerted or where more valuable results have been achieved.â€
In a similar observation, ex-American president Theodore Roosevelt, who came to Uganda in 1909 on a hunting spree, was impressed by the standard of Mengo Hospital and the workers and on December 12, 1909, he opened the isolation ward constructed by the Cook brothers.
Dr. Edward Schnitzer, better known as Emin Pasha, who in 1840 graduated at the University of Breslau Konigsberg and Berlin, was the first doctor of scientific medicine to set foot in Uganda. He arrived at Kabaka Mutesa’s palace in August 1876 as an emissary of Col. Gordon. According to Dr. W.D Foster’s book, The Early History of scientific Medicine in Uganda, as a doctor, Pasha treated the Kabaka for an un-named sickness. Suspicious of Pasha’s drug, the Kabaka made eight chiefs to take the medication first. Had they died, Pasha would have been convicted. In Bunyoro, he carried out one of the first operations cutting an abscess — a localised collection of pus in a cavity surrounded by inflamed tissues caused by bacterial infections in one of his porters.
Though mostly involved in administrative manouvers, Pasha’s observations that hunchbacks were a common phenomenon in Bunyoro and fleas were abundant in most parts of Uganda, set a strong precedence from medical practice.
Inspired by the exploration of David Livingstone and Alexander Mackay, Dr. William Robert Felkin became the first doctor to make an attempt to study the disease in Uganda.
Arriving at Kabaka Mutesa’s Palace on February 8, 1879 as a Church Missionary Society evangelist, he was summoned to attend to the ailing Kabaka. He considered the Kabaka’s sickness serious, owing to his neglect of Pasha’s instructions. To show their sincerity to the Kabaka, Felkin and Mackay consumed the medicine before giving it to the Kabaka.
Felkin’s studies revealed the rampancy of venereal diseases, especially gonorrhea in Buganda — a fact that eventually led to the establishment of Mulago Hospital in 1924. He also discovered that there were many cases of syphilis for which the Arab slave traders were blamed. Although dysentery and cholera were uncommon, Dr. Felkin found out that smallpox and malaria were major killers and epilepsy was common among girls. He endorsed the use of quinine to cure malaria in Uganda. If Uganda became the darling of Europeans, it was the work of Dr. TH Parke who claimed that Uganda’s climate was good for Europeans, as long as they avoided marshy areas. He, however, mistakenly attributed malaria to drinking foul water.
Dr. RMG Wright, who arrived in Kampala on October 31, 1890, was the first to see the need of a hospital and started medication for money charging 10 cowrie shells, the equivalent of half a dime. In 1892, McPherson did the first chloroform-induced operation in Uganda at the foothills of Namirembe Hill.
Following the resignation of Dr. McPherson who died in New Zealand in 1935, his replacement, the infamous Ansorge was recruited by the Church Missionary Society. Outside the society, the imperial British East African Company by 1889, ran a medicinal service of which Dr. A.D MacKinnon, nephew of Sin William Mackinnon, was the first company doctor with the effect that from 1892 Uganda had never been without the services of a scientific doctor.
Dr. Robert Unwin Moffat, a nephew to David Livingstone by marriage in 1891, became the first government doctor, whose writings now preserved at Makerere University library, make basis for history of scientific medicine in East Africa.
Moffat, who had a great impact on the Uganda medical service treated more Ugandan more than any doctor at his time. Moffat wrote to the British Medical Journal protesting Cook’s thesis against the use of quinine.
In 1899, when Sir Harry Johnstone was sent to make recommendations for the administration of Uganda protectorate, Moffat recommended to move the colonial capital from Kampala to Entebbe, which Sir Harry Johnstone renamed Port Alice. Re-appointed to government service in 1903 as joint principle medical officer for Kenya and Uganda, he at resignation in 1906, supervised the construction of the first African medical hospital with 24 beds in Entebbe.
Moffat agreed to work in the remoteness of Hoima, declining the trappings of more sophisticated Kampala. His thesis on haemoglobinuric malarial fever or black water fever was very important in the study of tropical diseases, so was his new consult that malaria could be congenital (from mother-to-child).
Moffat’s studies on the relapsing fever of Uganda caused by ticks in Masindi was a major breakthrough. He was also responsible for bringing Miss Parker, the first professional nurse in government service in 1903. He, among other great achievements, introduced intravascular quinine injection for acute cases of malaria, expanded the study of parasitology in Uganda and introduced certification of deaths.
Moffat was also responsible for the initiation of the Uganda Medical Association which was taken up by his successors Dr Straththrain and Dr. Wiggins who made the first East African branch of the British Medical Association in 1913. Its first meeting was held in Entebbe in 1925 with 17 of the 25 doctors being based in Uganda.
While Moffat is credited with setting the rigid foundation and discipline upon which the pride of the medical practice lies, it was not until December 27, 1896 when Cook, the man who made an indelible mark on Uganda’s medical practice arrived.
Teamed up with Baxter and Miss Timpson, they formed Uganda’s first surgical team who on February 22, 1897 in a shed used as a dispensary, did the first operation on a camp bed. The chloroform which allowed painless operation and the corneal operations which enabled people with cataracts to see, made Africans think Cook was sent from God.
Cook kept high standards of clinical records which he indexed. For the first time in Uganda, he did haemoglobin estimation, erythrocyte and leucocyte counts. He also tested for malaria parasites, examined pus and urethral discharges.
His tradition of thorough ophthalmic examination has earned Mengo Hospital the reputation of the best eye clinic in East Africa. Apart from the landmark autopsies, Cook discovered the existence of rheumatic fever in Uganda as well as heart diseases, cerebral vascular diseases, benign and malignant tumours, hookworm anemia and diabetes mellitus. As he had observed, malaria fever remains by far, the largest killer disease to date.
In 1899, Cook was joined by his brother Dr. Jack Cook. The Cooks worked in Uganda for 20 years winning minds, bodies and souls for their political masters in Britain, setting a precedence which Ugandan medical practitioners have preserved to date. Cook resisted attempts by Bishop Tucker and Archdeacon Walker to use the acceptance of Christianity as a pre-condition to medical treatment.
Like their ancestors, Ugandan doctors have learnt to do their best with the little they have. The latest sacrifice of Ugandan doctors is the late Dr. Martin Lukwiya of Lacor Hospital in Gulu who died in the fight against the Ebola epidemic.
Like Cook, who never gave up even after his grass-thatched hospital burnt on November 28, 1903, many young Ugandan doctors have chosen to stay and serve at home, despite the meagre pay and lack of employment. Because of their hardwork and determination to learn, Ugandan doctors have received ready support from outside as did Cook, who got help from Welcome Ltd. to build a permanent hospital.
The development of asceptic surgery, technical improvement in instruments, increased knowledge of body process, development of anaesthesia and use of chemicals for pre-and-post surgeon infections could have affected the improvement of medical practice.
However, it can never be dismissed that the roots of Uganda’s first successful cardiovascular surgery can be traced to the positive impact of the first scientific doctors.
Cook’s dream of Mengo Hospital becoming a medical school of a powerful Mengo university was a driving force for the establishment of Mulago Medical School, an institution of Makerere University in whose library Dr. Cook’s works remain a priceless piece of reference.
ON October 2, 1909, Dr. Albert Robert Cook wrote to the founder of Welcome Pharmaceuticals in London about the possibility of training Ugandans at certificate and diploma levels in medical practice. In his letter to Henry Welcome, Cook said: “We have already started training and the results are impressive. Uganda, with its little-known diseases, is a professional man’s paradise.â€
Close to 120 years later, that letter was not written in vain, as Ugandan doctors made the country proud on April 14, 2007 when they carried out a cardiovascular surgery, which saved the lives of two.
Mark Arinatiwe and David Kalenjera who survived Uganda’s first-ever open heart surgery at International Hospital, Kampala, are milestone pointers to the confidence Ugandan doctors continue to enjoy despite myriads of constraints.
April 14 will never go into oblivion because it is the day when Cook’s idea of Uganda as a professional man’s paradise was realised— the birth of discipline, co-operation and patience.
Most Ugandans are apt to think that cornerstones of this landmark achievement were laid 20 years ago as Dr. Ian Clarke and his colleagues have suggested, but the fact is Clarke and his colleagues sowed their seeds into a fertile ground of medical practice in a conducive climate.
Ugandan doctors have had an unimpeachable ethical discipline hinged on professionalism, career development and co-operation as forecast by Cook. In his book, My African Journey, British statesman Sir Winston Churchill, who visited Mengo Hospital in 1908, described the hospital as: “a model of what a tropical hospital for Africans ought to be....I do not know of any part of the world where missionary influence and enterprise have so beneficently exerted or where more valuable results have been achieved.â€
In a similar observation, ex-American president Theodore Roosevelt, who came to Uganda in 1909 on a hunting spree, was impressed by the standard of Mengo Hospital and the workers and on December 12, 1909, he opened the isolation ward constructed by the Cook brothers.
Dr. Edward Schnitzer, better known as Emin Pasha, who in 1840 graduated at the University of Breslau Konigsberg and Berlin, was the first doctor of scientific medicine to set foot in Uganda. He arrived at Kabaka Mutesa’s palace in August 1876 as an emissary of Col. Gordon. According to Dr. W.D Foster’s book, The Early History of scientific Medicine in Uganda, as a doctor, Pasha treated the Kabaka for an un-named sickness. Suspicious of Pasha’s drug, the Kabaka made eight chiefs to take the medication first. Had they died, Pasha would have been convicted. In Bunyoro, he carried out one of the first operations cutting an abscess — a localised collection of pus in a cavity surrounded by inflamed tissues caused by bacterial infections in one of his porters.
Though mostly involved in administrative manouvers, Pasha’s observations that hunchbacks were a common phenomenon in Bunyoro and fleas were abundant in most parts of Uganda, set a strong precedence from medical practice.
Inspired by the exploration of David Livingstone and Alexander Mackay, Dr. William Robert Felkin became the first doctor to make an attempt to study the disease in Uganda.
Arriving at Kabaka Mutesa’s Palace on February 8, 1879 as a Church Missionary Society evangelist, he was summoned to attend to the ailing Kabaka. He considered the Kabaka’s sickness serious, owing to his neglect of Pasha’s instructions. To show their sincerity to the Kabaka, Felkin and Mackay consumed the medicine before giving it to the Kabaka.
Felkin’s studies revealed the rampancy of venereal diseases, especially gonorrhea in Buganda — a fact that eventually led to the establishment of Mulago Hospital in 1924. He also discovered that there were many cases of syphilis for which the Arab slave traders were blamed. Although dysentery and cholera were uncommon, Dr. Felkin found out that smallpox and malaria were major killers and epilepsy was common among girls. He endorsed the use of quinine to cure malaria in Uganda. If Uganda became the darling of Europeans, it was the work of Dr. TH Parke who claimed that Uganda’s climate was good for Europeans, as long as they avoided marshy areas. He, however, mistakenly attributed malaria to drinking foul water.
Dr. RMG Wright, who arrived in Kampala on October 31, 1890, was the first to see the need of a hospital and started medication for money charging 10 cowrie shells, the equivalent of half a dime. In 1892, McPherson did the first chloroform-induced operation in Uganda at the foothills of Namirembe Hill.
Following the resignation of Dr. McPherson who died in New Zealand in 1935, his replacement, the infamous Ansorge was recruited by the Church Missionary Society. Outside the society, the imperial British East African Company by 1889, ran a medicinal service of which Dr. A.D MacKinnon, nephew of Sin William Mackinnon, was the first company doctor with the effect that from 1892 Uganda had never been without the services of a scientific doctor.
Dr. Robert Unwin Moffat, a nephew to David Livingstone by marriage in 1891, became the first government doctor, whose writings now preserved at Makerere University library, make basis for history of scientific medicine in East Africa.
Moffat, who had a great impact on the Uganda medical service treated more Ugandan more than any doctor at his time. Moffat wrote to the British Medical Journal protesting Cook’s thesis against the use of quinine.
In 1899, when Sir Harry Johnstone was sent to make recommendations for the administration of Uganda protectorate, Moffat recommended to move the colonial capital from Kampala to Entebbe, which Sir Harry Johnstone renamed Port Alice. Re-appointed to government service in 1903 as joint principle medical officer for Kenya and Uganda, he at resignation in 1906, supervised the construction of the first African medical hospital with 24 beds in Entebbe.
Moffat agreed to work in the remoteness of Hoima, declining the trappings of more sophisticated Kampala. His thesis on haemoglobinuric malarial fever or black water fever was very important in the study of tropical diseases, so was his new consult that malaria could be congenital (from mother-to-child).
Moffat’s studies on the relapsing fever of Uganda caused by ticks in Masindi was a major breakthrough. He was also responsible for bringing Miss Parker, the first professional nurse in government service in 1903. He, among other great achievements, introduced intravascular quinine injection for acute cases of malaria, expanded the study of parasitology in Uganda and introduced certification of deaths.
Moffat was also responsible for the initiation of the Uganda Medical Association which was taken up by his successors Dr Straththrain and Dr. Wiggins who made the first East African branch of the British Medical Association in 1913. Its first meeting was held in Entebbe in 1925 with 17 of the 25 doctors being based in Uganda.
While Moffat is credited with setting the rigid foundation and discipline upon which the pride of the medical practice lies, it was not until December 27, 1896 when Cook, the man who made an indelible mark on Uganda’s medical practice arrived.
Teamed up with Baxter and Miss Timpson, they formed Uganda’s first surgical team who on February 22, 1897 in a shed used as a dispensary, did the first operation on a camp bed. The chloroform which allowed painless operation and the corneal operations which enabled people with cataracts to see, made Africans think Cook was sent from God.
Cook kept high standards of clinical records which he indexed. For the first time in Uganda, he did haemoglobin estimation, erythrocyte and leucocyte counts. He also tested for malaria parasites, examined pus and urethral discharges.
His tradition of thorough ophthalmic examination has earned Mengo Hospital the reputation of the best eye clinic in East Africa. Apart from the landmark autopsies, Cook discovered the existence of rheumatic fever in Uganda as well as heart diseases, cerebral vascular diseases, benign and malignant tumours, hookworm anemia and diabetes mellitus. As he had observed, malaria fever remains by far, the largest killer disease to date.
In 1899, Cook was joined by his brother Dr. Jack Cook. The Cooks worked in Uganda for 20 years winning minds, bodies and souls for their political masters in Britain, setting a precedence which Ugandan medical practitioners have preserved to date. Cook resisted attempts by Bishop Tucker and Archdeacon Walker to use the acceptance of Christianity as a pre-condition to medical treatment.
Like their ancestors, Ugandan doctors have learnt to do their best with the little they have. The latest sacrifice of Ugandan doctors is the late Dr. Martin Lukwiya of Lacor Hospital in Gulu who died in the fight against the Ebola epidemic.
Like Cook, who never gave up even after his grass-thatched hospital burnt on November 28, 1903, many young Ugandan doctors have chosen to stay and serve at home, despite the meagre pay and lack of employment. Because of their hardwork and determination to learn, Ugandan doctors have received ready support from outside as did Cook, who got help from Welcome Ltd. to build a permanent hospital.
The development of asceptic surgery, technical improvement in instruments, increased knowledge of body process, development of anaesthesia and use of chemicals for pre-and-post surgeon infections could have affected the improvement of medical practice.
However, it can never be dismissed that the roots of Uganda’s first successful cardiovascular surgery can be traced to the positive impact of the first scientific doctors.
Cook’s dream of Mengo Hospital becoming a medical school of a powerful Mengo university was a driving force for the establishment of Mulago Medical School, an institution of Makerere University in whose library Dr. Cook’s works remain a priceless piece of reference.