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Uganda, Lacor

Uganda, Lacor

Canadian Surgeons Visiting Lacor Hospital, Gulu, Uganda
Before 2002: Dr. R. Taylor
2002: Dr. Eric Webber, Paediatric Surgeon, Vancouver, BC
2003: Dr. Brian Ostrow, General Surgeon, Guelph, Ontario
Dr. William Fitzgerald, General Surgeon, St. Anthony, Newfoundland
2004: Dr. Barb Leblanc, General Surgeon, Guelph, Ontario
2005: Dr. Barb Leblanc, General Surgeon, Guelph, On.
2006: Dr. Robert Schwarz, Urologist, Halifax, Nova Scotia February
Dr. Nicholas Baumann, General Surgery Resident, McMaster University,
Hamilton
Dr. B. Leblanc, General Surgeon, Guelph – Nov-Dec
2007: Dr. B. Leblanc – October/November
2008: Dr. Ghee Hwang – General Surgeon – February/March
Dr. Steven Untracht – March/May – USA
Dr. B. Leblanc – Sept/Oct –
Dr. Bernard Lawlor – October/November
2009: Dr. Ghee Hwang – March/April
Dr. Barbara Leblanc
2010:  Dr. Bernard Lawlor, Dr. Ghee Hwang

Dr. Ghee Hwang is now the Co-ordinator of the CAGS-Lacor Project on behalf of the CAGS International Surgery Committee.
He is seeking volunteer surgeons who can contribute 4-6 weeks at the St. Mary’s Hospital in Gulu, northern Uganda.
The security situation has improved, there is a new medical school, and a need to develop a stronger collaboration in surgical and nursing training.
If you are interested, contact Dr. Ghee Hwang – gheehwang@shaw.ca

St. Mary's Hospital, Lahor

St. Mary’s Hospital, Lahor,  

Lacor/ Gulu visit April 2014

This had been quite a busy visit and we managed to accomplish a fair bit.

(1) Run the CNIS sponsored Structured Hernia repair course

(2) Run the CNIS sponsored Essential Surgical skills Course for the final year students of Gulu University  Medical school

(3) Run 2 perioperative nursing courses a) Safe Surgery Save Lives b) Essential Theatre nursing Skills taught by our team of Canadian nurses (a continuation of previous years’ activities)

(4) Discussion with Dean of Medical Faculty Gulu University with regards to help with their new MMed postgraduate surgical training program. What form of assistance will need further discussion.

(5) Preceptor 3rd year surgical resident from MacMaster University …Elena Parvez

 

Update January 2010

This collaboration has been operational since 2002 with one or two CAGS surgeons visiting the hospital/year. Drs. B. Leblanc (6 visits) and Ghee Hwang (2 visits) have been the most frequent visitors and have participated in 3 ESS courses in collaboration with CNIS. CNIS’s objective is to run two courses/year.  Ghee will supervise an ESS course in March 2010 and Dr. B. Lawlor, who has visited Lacor in the past, will be on hand to be certified as an ESS provider. It remains to be determined if he will manage the fall ESS course. Dr. Hwang has developed a members’ project through CNIS which will bring OR nurses from Canada to assist in OR nurse training at Lacor. Dr. Ghee Hwang has agreed to take over from Dr. Brian Ostrow as Lacor co-ordinator.  The committee is very grateful to Brian O. for his years of service in this role.

CAGS Visiting Surgeon Partnership with 
Lacor (St. Mary’s) Hospital, Northern Uganda

UPDATE April 2009

ward-web

“The usual activities are helping do the list in the OR with interns or medical officers.  The kind of surgery is truly general and you do do what you are comfortable with.  It ranges from the routine hernias and thyroidectomies, to prostatectomies, amputations, skin grafting and the not so occasional open head injuries.  Sepsis is a huge problem and gas gangrene, pyomyositis, psoas abscesses, necrotising fasciitis and variety of odds and sorts of abscesses.  Tetanus continues to be a problem and just last week there were 4 patients with tetanus in the ICU” (from Dr. Ghee Hwang’s report)

UPDATE September 2008

Colleagues: The Uganda project facilitates visits by Canadian surgeons to Lacor Hospital in Gulu, northern Uganda.  It has an ongoing need for participants.  The visit is primarily service-oriented and a minimum 2 month commitment is requested in order to make the visit beneficial to the hospital.  Lacor Hospital is very used to visitors and makes an excellent and supportive first step into a commitment to international surgery. Financial support for the visit is coordinated through Canadian Network for International Surgery (CNIS) and involves primarily tax receipts for out of pocket expenses. There is a specific need for certified Essential Surgical Skills instructors for twice yearly courses that are held in Gulu in cooperation with CNIS.
Interested surgeons should send their CVs to Dr. Brian Ostrow at brian@bookshelf.caward2-web

Lacor Hospital, located in outside of Gulu in northern Uganda is one of the premier regional hospitals in Africa. Founded in 1959 by the Comboni Brothers from Italy, it has developed and expanded through the work of the late Canadian surgeon, Louise Teasdale and her husband Piero Corti. It has operated continuously throughout the various conflicts and chaos of Ugandan history and today functions as a 500 bed non-profit charitable institution providing humanitarian and medical care to the people of northern Uganda.

CAGS/Lacor Collaboration
In 2000 a partnership between CAGS and Lacor Hospital was established to allow volunteer surgeons to visit and work in Lacor. Since this time 17 visits by Canadian surgeons have been arranged. All have acknowledged the profound personal and professional value of the experience, which is also greatly appreciated by our Ugandan colleagues. Visits vary from 6-8 weeks; they may be shorter for surgeons with specific specialties. A new responsibility is teaching medical students from the Gulu Medical School.  Visiting Canadian surgeons can participate in this when possible. An agreement  with CNIS provides a tax-receipt for the costs of the visit. Welcoming accommodation is provided by the hospital. This program is an excellent initiation for Canadian surgeons to the very different world of African surgery. It allows individual surgeons, by contributing their experience and skills, to assist in the development of surgery in Africa.

If you are interested in volunteering to work at the hospital, contact Dr. Brian Ostrow at brian@bookshelf.ca. or 1-519-821-4625.

History of Lacor Hospital
In 1959 a small medical dispensary was begun in Lacor as an outgrowth of a nearby Italian mission of the Comboni Fathers. In 1961 Dr. Piero Corti (Italian pediatrician) and Dr. Lucille Teasdale (Canadian surgeon) joined the staff and the dispensary developed progressively into a hospital and has continued to grow in response to the enormous need of the area. By 1970 it was already recognized as a teaching/training institution and by 1980 young Ugandan doctors were beginning to join the staff. Dr. Teasdale died in 1996 as a result of HIV/AIDS infection acquired during her years of surgery. Dr. Corti died in 2003.

During the past 30 years Uganda has seen much social upheaval and civil war with consequent strain on its medical services. Lacor Hospital operated continuously during these years providing humanitarian as well as medical assistance to the population. As a result it has received national recognition. A recent external review commissioned by the Ugandan Ministry of Health of all service/teaching hospital facilities of the country reported that St. Mary’s Hospital had the most stable and functioning infrastructure to be found. In 2000 the hospital battled an Ebola outbreak. Relative peace has prevailed in the area since 2006 with the development of a peace talks between the Ugandan government and the rebel group.

The hospital has almost 500 beds and runs 130% occupancy. It serves a population of one-and-a-half million and is the regional referral hospital for the northern districts.  In 2005/06 the hospital saw 250,000 out patients, admitted 35,000 and carried out 400 major surgeries. The buildings are of cement, brick and plaster and are in good repair. The hospital has its own water supply and it is reliable. It can also use the town’s water supply if ever necessary. The electricity, 220 volts, is quite regular, although needs updating. It also has its own back-up generator.
There are separate buildings, connected by walkways for surgery, medicine, gynecology, pediatrics and maternity. Separate wards also exist for infected cases, both surgical and medical and for child welfare – which is a special nutrition center. The wards are somewhat crowded, with the high occupancy, although there is still room to get around, and they are quite tidy. As anywhere, there is a nursing shortage, although their numbers are helped by the presence of student nurses. Please see www.lacorhospital.org for further information on its history and activity.

Ugandan Context
Uganda has a population of 22 million. There are fewer than 1000 doctors in the country, giving a doctor to population ratio of 1 to 25 000. There are about 70 specialists in Uganda and most of these are located in the two major urban centers, Kampala and Mbarara. Because of the inadequate resources and infrastructure, many specialists have left Uganda. There are three medical schools, the older ones in Kampala & Mbarara and a new one recently opened in Gulu. They graduate a combined total of 120 doctors per year.

Life expectancy at birth is 40 years; under-5 mortality is 140 per 1000; maternal mortality is 1200 per 100,000 live births. About 60 hospitals of various capabilities exist throughout the country of which some 15 are designated “regional” where some basic surgery can be done. A major portion of Uganda’s population is simply without access to surgical care, and it will be years before this changes.

The community of Lacor is located just outside the city of Gulu in northern Uganda. Gulu is about 300 km north of the capital, Kampala, and these cities are connected by a paved road.

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