The Uganda Heart Institute's unsung miracle workers

May 06, 2020

Who were these unsung miracle workers at UHI at Mulago who did the successful operation? Where did they acquire their lifesaving skills?

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 The story that caught my attention recently was about Uganda children stranded in India after heart surgery.  Stories of Uganda children going to India for heart surgery are not new. Since the mid-2000 generous donations sent Uganda children with heart problems for successful operation at Amrita Institute of Medical Sciences in Kerala and Narayan Health in Bengaluru, among others. 

 
The reason the story piqued my curiosity was because three weeks ago, my mother, Mama Alici Oloya, was treated at Uganda Heart Institute (UHI) at Mulago Hospital. I came away with a whole new level of respect for the work happening in Mulago today. A bit of context here.  Several years ago, Mama Alici had a heart procedure completed in San Diego, California that gave her a heart pacemaker.  Plans were already underway to bring her to the US to ensure the device was still working properly.
 
But coronavirus intervened.  Mama Alici was stuck in Gulu. Sometime in April, she started getting sick and was admitted. Despite the best care her situation was not improving. She was not eating and, worse, the body began to swell. When I called, she did not recognise my voice.  The situation was dire. My brother Dr. Richard Oloya based in Canton; Ohio discussed treatment with doctors in Gulu by phone. Her situation was fast deteriorating, Dr. Pebalo Francis Pebolo of Gulu Regional Referral Hospital told him.  Dr. Pebolo suggested it could be a heart problem.
 
A close relative in Kampala suggested consulting a heart doctor at UHI in Mulago.  The name given was Dr. Emmy Okello.  He is an interventional cardiologist.  Born, bred and educated in Uganda, he completed his medical studies at Mbarara University of Science and Technology. He then travelled to Wuhan University in China for Masters of Medicine in Internal medicine. On returning to Uganda, he enrolled at Makerere University where he completed his PhD in medicine. A fellowship in Cardiology at Case Western Reserve University in Ohio completed the educational journey. 
 
Yup, he is a doctor's doctor.  From a distance, on the phone with my brother, Dr. Okello diagnosed what was wrong with Mama Alici in Gulu. The old pacemaker was no longer doing what it was supposed to do. My mother was experiencing heart failure and a procedure was needed immediately to save her life. As required under the current coronavirus lockdown law, arrangements were made for an ambulance to bring the old lady to Kampala. At Mulago, she was admitted.  A couple of days later, Dr. Okello assisted by three professionals took an hour to carry out the procedure that implanted a permanent pacemaker. 
 
And, just like that, Mama Alici began regaining her bearing, to eat and talk.  She returned to Gulu and travelled to Kampala last Tuesday for another checkup. The verdict: Her heart is humming merrily on.
 
For me, that was not enough. Who were these unsung miracle workers at UHI at Mulago who did the successful operation? Where did they acquire their lifesaving skills?  Finally, I connected with Dr. Okello by phone, and for one hour I interrogated him for information. What the doctor told me shocked me pleasantly.  Every information made my chest swell with pride. 
 
Under the leadership of Executive Director Dr. John Omagino, himself a senior cardiac surgeon, UHI has quietly made serious strides in heart patient care. Divided in four departments—adult cardiac surgery, pediatric cardiac surgery, adult cardiology and pediatric cardiology—it takes care of 90% of adult cardiac procedures and 85% of procedures in children. The team consisting of six cardiac surgeons, 12 adult cardiologists, six paediatrics cardiologists and six anaesthesia and critical care doctors and 66 cardiac nurses, carries out an average of 10 heart procedures a week. Success rate is comparable or better than in some hospitals in America and Europe. 
 
There was more.  Dr. Okello told me that the cardiac catheterisation theatre laboratory for pinhole surgery where my mother was treated has some of the best equipment in Africa, matched only by South Africa and Egypt. Did you know that? No, I did not. 
 
And Dr. Okello was only get warmed up. The ensemble of brainpower that runs UHI received training over the last two decades from the best hospitals around the globe and were mentored by top cardiac doctors including from Italy, India, South Africa and the US — not forgetting Canada, of course (I have to throw that in there for good measure). 
 
So, what is the problem, I asked, why are our children still going to India for heart treatment when the world ought to be beating a path to Uganda? Only two things are needed to elevate UHI to a global status with a reputation to match, Dr. Okello told me. The first on the list is more space. Currently, with very limited space for admission, UHI takes only so many patients at once. A backlog is a reality. The Ministry of Health is working to give more space in the newly renovated Mulago Specialised Hospital. My take — MoH do it already, don't just talk about it. 
 
Better still, the Government is apparently looking for funding to build a state-of-the-art heart institute.  Now in my not so humble opinion, that sounds like the future of UHI. For a number of reasons, it is the best option. There will be plenty of space to take on the heavy caseload of heart patients in Uganda. The most exciting part of it is turning Uganda into the gateway for heart care in Africa. You build it and they will come from all over the world—Lagos, Cairo, Antananarivo, Lilongwe, Ouagadougou, you name it.  
 
The second obstacle is really a question of will.  Currently the same heart procedure costs a cool $5,000 to carry out in Uganda and $3,000 in India. Even after adding airfare, accommodation and food, relatively speaking, it is cheaper to do the operation in India.  This is not acceptable when we have the brain to carry out the same procedure in Uganda. The answer to affordable healthcare is medical insurance — everyone pays a little bit into a communal pool and, when needed, a person can dip into it for these expensive procedures. Everyone wins and, more importantly, it does not break the bank to carry out heart surgery. 
 
Look, my ignorance about the capability of UHI would have persisted were it not for the topnotch care my mother received last month at Mulago Hospital. Now I know better and, yes, Mama Alici will get her regular checkup in Uganda not America. The professionals are, after all, only four hours away at Mulago Hospital. Now what we need is more technology, training of new heart doctors and above all, space to care for our heart patients—my mother included. Globally, Uganda is already known for world-class peacekeepers. Now let's add to the positive reputation by investing heavily in heart care.
 
 
Twitter: @Opiyooloya

 

 

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