The unsung heroes of the Heart Institute of Mulago

By Betty Aol Ocan

For a long time, Ugandans have known the National Referral Hospital, Mulago as a death trap of sorts.

Sometimes, the news of one having a patient in Mulago Hospital sends some chills in the spine of many.

Indeed, the reason private hospitals have flourished in Uganda in the last few decades or so is partly due to the high ineffectiveness of Mulago hospital. However, there is a unit in the Hospital which is rising from the limbo. It is the Heart Institute. 

Founded in 1988 and operationalized in 1996, the Heart Institute is coming of age although in the most difficult of circumstances.

In the recent past, the institute has acquired a few machines with which they are performing miracles.  

The Executive Director, Dr. Omagino John seems to provide excellent leadership to his staff at the Institute. His inspirational character, both in speech and touch makes for some enthusiasm in the crowded, tiny rooms.  

The standard description of the qualifications of the staff there, particularly the doctors, is "super specialists". This, according to him is due to the extent of training they undergo to qualify to work in the institute. 

"By the standard of Public Service, a doctor is a medical professional with a first degree and a Master upgrade."

According to Omagino, that is where they start at the Institute. "We look for brilliant doctors from the district hospitals and take them for further training of 3 - 5 years, that's when you qualify to work here."

"Our nurses are at Bachelors and Masters levels," he said. Many of them undergo extensive training from within the institute before being deployed. Others are sent out for specialised training. 

Yet the working conditions in the institute are not pleasing at all. The congestion levels alone are alarming. Given the sensitivity of Heart-related operations, which is the business that takes place there; common sense dictates space, aeration, tidiness, and freshness. None of those though. The gallant staff at the institute struggle so hard to achieve a semblance of a tolerable environment of work for them to be effective.

They have to squeeze up their systems, machines, and tools to fit all that they have in place. The space between those items for their maneuver continuously threatens the success of their work. 

In the midst of that though is the visible passion with which the medics in the institute work. They are quick and alert but also, quite clearly, without the matching vibrancy. 

According to Dr Lwabi Peter, the head of the Paediatric Cardiology Division in the Institute, they only need some inspiration. 

"All we need is just to be motivated and empowered." This probably explains the dim vibrancy in the Institute.

Cardiology is one of the professions whose pay is most internationally benchmarked and at least regionally standardised. In Kenya and Rwanda, a consultant cardiologist earns about USD 10,000 as opposed to Uganda's about USD 1,200 pay. 

According to the head of the Heat Institute in Mulago, Dr. Omagino, a senior cardiologist at the institute earns about USD 1,000 while a junior one earns below USD 1,000. 

Considering the nature and length of training the medics undertake to qualify to provide service at the institute; appreciating the intricate specialty of their work in the already difficult medical profession and juxtaposing it to their earnings; I can draw only one conclusion: Ugandan patriots work at the Heart Institute of Mulago.

But our praise for them alone will not improve anything. You do not select the best of brains you have in the country, subject them to the most intense of training and pay them in such an ordinary manner. This is an abuse of what is supposed to be our special strategic interest.  

However, in spite of the work condition, lives are being turned around at the Heart Institute of Mulago.

Some of the cardiology cases being handled with accomplished effectiveness at the Institute are Open Heart Surgery, a procedure where the chest is opened and the heart itself also opened. 

The other is closed heart surgery where only the chest is opened without opening the heart. And also cardiac catheterisation, a modern heart treatment procedure where blood vessel blockages are opened by means of inserting very tiny tubes in the vessels to open them. 

The head of the Institute, Dr. Omagino says the success rate of the operations is 80%. 

"What we are aspiring, for now, is achieving organ transplant capabilities," he said. 

As a result of the exceptional work of medics at the Institute, one of the consultant cardiologists, Dr Okello Emmy has been nominated for an award by the Fellow of Cardiologists of the United States of America (USA). 

But there is a lot to be improved at the Institute including making new considerations about the retirement age of a cardiologist. Given the length of training one takes to qualify as a super specialist to practice cardiology, the age of 60 years is so soon for retirement. 

According to Dr. Omagino, "all over the world, cardiologists master their discipline at around the age of 60". 

Given the consideration for a fairly higher retirement age like for the Justices of the Supreme Court and politicians who actually have none, cardiologists too should be considered for higher retirement age because their degree of specialty and training are not easy to attain. 

Government must consider prioritising developing the Heart Institute to attain international standards because beyond helping Ugandans, it has the potential of attracting major medical tourism into the country.  

The writer is the Leader of Opposition in the Parliament oh Uganda.