Complicated surgeries: Has Uganda come of age?

When Can. Francis Mweheire's children told him that they had found a urologist at the Uro Care Hospital in Nansana, Wakiso district who can conduct an operation on him, he doubted the hospital's capacity to treat his condition.

He had developed enlarged prostates and had difficulty passing urine. The problem started during the lockdown and the family was trying to find a quick way to fly him out of the country.

It is during this period that a well-wisher told the family about the clinic.

His response was: "Nansana, of all places!"

"That area is known as a hub for criminal activities and I was shocked that my family had decided this is where I should go for an operation," Mweheire told New Vision.

SURGERY |

After careful consideration, he accepted the proposal and went to the hospital on September 19. He was examined by Dr Stephen Watya, the chief executive officer of the hospital, and was recommended for surgery.  Watya is an experienced surgeon in urology. The procedure was successful and, today, Mweheire is full of praise for the hospital.

"It was one of my best experiences in life. He (Watya) paralysed my lower part of the body. I could see what they were doing on a screen. He was showing me what he was cutting. He told me there was no cancer. Two days after the operation, I started urinating normally," Mweheire recounts.

Watya says his hospital can carry out any high-level surgery that many people travel to undergo abroad.

Another patient at the hospital, who preferred anonymity, told New Vision that he was asked to pay $18,000 (about sh66.8m) for treatment in the US and $4,500 (about sh16.7m) in India, exclusive of the air tickets, meals and accommodation. However, at this hospital, he has undergone surgery at a lesser cost.

These two are just a few of the many people who have undergone successful surgeries in the hands of local specialists.

Other major surgeries

In 2007, Uganda had a major surgical operation that involved a 44-man team of Ugandan and American experts. The specialist surgeons carried out a successful open-heart surgery. Before the surgery, the family needed $15,000 (about sh55.7m) to have the operation done in India.

At the Uganda Heart Institute (UHI), the surgery was conducted free of charge.

This week, a team of 20 medical experts at Mulago Hospital conducted a successful operation on Siamese twins, who were conjoined at the pelvic bone. The twins are now recuperating and feeding well.

This complex surgery, if referred overseas, would cost about sh470m, according to Dr John Sekabira, a senior consultant paediatric surgeon who also led the team that worked on the Siamese twins. It was also done for free by the hospital.

Despite these landmark achievements, Ugandans in need of specialised medical care have continued to seek treatment in countries, such as India, South Africa, Dubai, USA, Turkey, and Kenya.

The finance ministry notes that the country loses over sh450b to medical tourism, annually. The health ministry puts the figures being spent annually on sending ministers, Members of Parliament, and senior government officers abroad for treatment, at sh30b.

HAS Uganda come of age?

"Certainly, Uganda has come of age. We can now do a lot. We have specialised surgeons. We even have those specialised in newborn surgery," Dr Richard Idro, the president of the Uganda Medical Association, said.

He said the country now has, among others, spinal, heart, neuro, cardiovascular surgeons and specialist anaesthesiologists. He added that there are also good structures in place to support any complex case.

According to medical experts, Uganda now has all it takes to conduct any surgery and there is no need for one to travel overseas.

Dr Justine Onen, a neurosurgeon, who was part of the team that worked on the conjoined teams, said he has successfully worked on patients who, after failing to raise the needed funds for overseas treatment, resorted to local hospitals.

He notes that when tabulated, the cost spent on air tickets, feeding, and accommodation in India, minus the cost of surgery, can cover the total amount demanded by hospitals in the country.

"We have human resources and modern structures to handle complicated procedures. I do not see why someone should go abroad for treatment. Treatment abroad is expensive, compared to what we charge here," he says.

Prof. Francis Omaswa, a seasoned cardiovascular surgeon and the executive director of the African Centre for Global Health and Social Transformation (ACHEST),  said the country has the best specialist surgeons, paediatricians, and specialists in internal medicine in  East Africa.

"The surgery on twins is an indication that Uganda has a crop of leaders capable of taking us further," he said, noting that when given enough support, in terms of good pay, these medics can do.

He observed that the country has highly trained medical specialists, who are well organised and great team players. He said this could be the reason why such a complex procedure was successful.

Dr John Omagino, a thoracic and cardiac surgeon as well as the executive director UHI, said the Siamese twin surgery is a demonstration of the country's capacity and a confirmation of the availability of the right human resource to move the country ahead.

"There is no need to go abroad. All we need is the facility, which we have. What is remaining is to pay the medics better so that they can concentrate," he said.

Better pay

President Yoweri Museveni, in his congratulatory message to the medics at Mulago Hospital, said: "This is why I advocate better pay for our scientists."

However, Omagino said the President needs to move from just recommending pay and making directives to ensure that these recommendations are implemented.

He said, to motivate the young crop of highly trained medics, the Government needs to give attractive terms to not only recruit, but also retain them. He notes that at UTI, they no longer refer patients abroad since all conditions can be successfully addressed at the institute.

We can handle, says minister

Dr Jane Ruth Aceng, the health minister, said the health system is well equipped to conduct surgery on any form of abnormalities.

She allayed fears that such a success could attract many people with abnormalities and thereby overwhelm the few medics.

"Yes, we can handle the complicated surgeries. These abnormalities do not come like these communicable diseases. They happen occasionally. So, our scientists can handle them," she said.

Dr Rosemary Byanyima, the deputy executive director of Mulago Hospital, had earlier told New Vision that when such successes are recorded, the workload tends to increase since many people start seeking services from local hospitals.

She vouched for increase in human resource, especially anesthesiologists, since complex surgeries take a lot of time and requires many specialists. Therefore, having more human resource helps address other needs while such a team is at work.