Richard Feinmann, chest physician, Uganda
Chest physician Richard Feinmann is volunteering in Uganda, where life expectancy is just 51 and over a third of the population live in poverty. Here Richard describes the challenges facing patients and why exposure to these challenges is so crucial for UK health professionals.
I hadn’t realised VSO would want people of my age. All my VSO contacts went overseas straight out of university, so I was a little tentative when I contacted VSO and said, “I’m an old git, I have reasonable health and these talents, are you interested?” And I really did expect them to say no but was pleasantly surprised. So here I am and I think it’s the best decision I ever made.
Here at International Hospital Kampala I’m called “Doctor Richard”, which is quite nice in a way – all the doctors are called by their first name. It’s a private hospital but has a charity wing, Hope Ward, which is where I work. It’s for people who can’t afford healthcare. There are a lot of people in Uganda with no money. If you don’t have money, you can’t get transport to the hospital or clinic. And even if you do get there you don’t have money to pay for drugs to get you better. The Ugandan government does provide free drugs for HIV, TB and malaria but they often run out. Sad stories of patients selling their HIV drugs to buy food are all too true.
Making sustainable changes
A lot of patients, particularly those with HIV and TB, come to us quite late and we really think they’re going to die. We feed them up with this disgusting stuff called millet porridge and they get their drugs and within a fortnight they’re up and about. It’s remarkable. There are not always successes, but people often bounce back when you just don’t think they will. So it’s a really rewarding job, but we’re only scratching the surface.
The doctors here are very hard working and very bright, but they don’t get a lot of support and every day they’re seeing things they’ve never seen before. So it’s good to supervise them on the ward rounds, to say, “why did you do that? Had you thought of doing it this way?” I work with the nurses too. Before they just weren’t used to being asked for their opinion, but now they’re so forthcoming. It’s very satisfying for me to see them change and their standards improve. To make all this sustainable I’m about to start working alongside a Ugandan specialist physician who will take over my role. It’s really important to have a figurehead, a key person who will teach and work with nurses when I leave.
I think it’s absolutely key for health workers in the UK to have exposure to Africa. If you haven’t, you just can’t imagine what the difference in healthcare is. It has been a real eye opener. I think every doctor should experience it if they can.