Olive Kobusingye

The Patient


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people was the beginnings of formal medical training in Uganda and the region. They would soon be joined by many other doctors, both in teaching and providing medical care. While Mengo was the better established and equipped hospital initially, over time the investments at Mulago increased, especially with its role as a teaching hospital for Makerere College. By 1934 when Cook retired, the Makerere Medical School was well established and some 24 Senior African Medical Assistants had already graduated.

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      Panoramic view of Mulago Hospital 1931. Albert Cook

      Library, College of Health Sciences, Makerere University

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      Mulago Hospital Outpatient Department, 1932. In the

      background on the hill to the right is Makerere University

      College (currently Main Building, Makerere University). Albert

      Cook Library, College of Health Sciences, Makerere University

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      One of the early groups of Mulago medical trainees with the Medical

      School principal and faculty, 1931 -1935. Back row L-R: A. Mowat,

      S,W. Kalibbala, J.P. Mitchell (Medical Superintendent of Mulago, and

      Principal of the Medical School), G.K. Makoro, A.W. Williams. Seated,

      L-R: S.B. Kyewalyanga, G.N. Bogere, P.B.S. Muganwa, I.S. Kadama.

      Albert Cook Library, College of Health Sciences, Makerere University

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      Medical School class 1945 standing L-R: Raird, Muwazi,

      Williams, Onya, Makoro, Hutton. Seated L-R: T.T. Musisi,

      Latimar Musoke, Bbosa, Sewali, Lulume, Pande. Albert Cook

      Library, College of Health Sciences, Makerere University

      ***

      In June 1945 a committee set up by the Colonial Office in London, known as the Asquith Commission, tabled their report regarding medical training in Uganda. The report recommended that a 1,000 bed hospital be built in Kampala to ‘serve the people of Kampala and its environs’, and to act as the teaching hospital for Makerere Medical School. Because of the huge demand on development resources following the destruction caused by the World War, the construction was deferred, although a grant had already been announced under the Colonial Development and Welfare Act. Construction plans did not resume until 1958, when all the required resources were martialed. On 23 February 1960, Governor Frederick Crawford laid the foundation stone, and the construction started in earnest. By this time the Old Mulago Hospital facilities were so outstripped by the sheer numbers of patients that some admitted patients were sleeping on the verandas. This was phenomenal growth for a facility that started as a Venereal Disease Hospital in 1913, dealing with gonorrhea and syphilis which were rampant at the time, and only converted to a general hospital in 1923. The New Mulago Hospital was opened in October 1962.

      It was late August, 2000. Karungi swung her bag over the shoulder and looked around the room one more time. The bag contained items that had been her faithful companions the last few years. A clinical coat, a well-used stethoscope, patella hammer, a coffee mug from a conference a few years back, and a digital pointer for use in presentations. On second thoughts, she took the pointer out and placed it on the table next to the room key. One always inherited stuff from PG room6 alumni. Best to leave that for someone else. She opened the door, stood for a short while in the entrance to get accustomed to the darkness outside, and then she closed the door firmly behind her. It felt like leaving home. Karungi walked past the building that once housed the physiology lab, and that was now home to the newly created School of Biomedical Sciences. On the upper side of the uneven dirt path was a couple of old buildings – the smaller of the two had been an animal house back in the days when live animals were used in research at the medical school. The last batch of guinea pigs was eaten during the Idi Amin war in 1979, and the monkeys were set free for lack of food. Few people remembered that there was once a hippo in a special hippo pool right in front of the lab. The house now served as offices for the Department of Community Medicine. The bigger building housed the Department of Anatomy, with the famous cadaver room on the second floor, as well as histology labs and a lecture theatre. Across the parking lot on the far end was the Albert Cook Library. Karungi walked through the poorly lit parking lot down to the road that divided Mulago Hospital from the medical school, leaving the Department of Physiology to the right and Davies Lecture Theatre to the left. At the security booth that stood guard to the hospital’s administration block, she took the winding road that gave the most direct access to the Accident & Emergency Department on Level 3 of Mulago National Referral Hospital. To the right of the security booth was a rail that ran along the lower edge of the road dividing the medical school from the hospital. The rail was a key fixture in the life of medical students. Generations of students and doctors studying and working in Mulago had paid scant attention to the distinction between Mulago Hospital and Makerere Medical School, treating the institutions as one and the same. But lately there had been talk of separating the decades-old Siamese twins. The surgeons were already lining up the scalpels.

      ***

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      Dr. Emmanuel Lumu, Minister of Health, welcomes President Sir

      Edward Mutesa to the opening of Mulago Hospital, 16 October 1962.

      Extreme left is Her Royal Highness the Duchess of Kent. DS Archives

       THE SWEET & SOUR SIXTIES

      ‘Makerere, Makerere, We build for the future, The Great Makerere

      Great, Great and Mighty, The walls around thee

      Great, Great and Mighty,

      The gates beside thee.

      One day he was an ordinary physician at Mulago Hospital, teaching medical students and seeing an endless stream of patients, the next he was a cabinet minister with all the trappings that came with the title. Dr. Emmanuel Lumu, appointed the first Ugandan Minister of Health at Independence in 1962, felt like he was wearing someone else’s skin. Not that he was unaccustomed to high society. He had his friend Kabaka Edward Mutesa to thank for that privilege. The attention he got as a minister though, was different. Some days he missed his more modest position at the hospital. As a minister, he had to worry, not about the patients under his care, but about the entire country’s health system with all its warts and pimples. There were too many patients for too few hospitals and health workers, the medical school was largely dependent on expatriate staff, Kenya and Tanzania were unhappy that Makerere was not producing enough medical graduates for the whole region, and were threatening to start their own schools, and he had no predecessor to turn to for advice. Dr. H. J. Croot, who had been minister under the colonial government, was unlikely to be helpful as the conditions of work would be vastly different. He was grateful to the technical staff at the ministry who pulled together a few documents to guide his thinking. He quickly put together a team to draft the national health strategy for the newly independent Uganda.7

      ***

      The days leading to 9 October, 1962, were memorable to Ugandans for many reasons. The excitement was palpable. It was akin to the expectation of the first serious downpour after a long dry spell, only more intense. All across the country, the independence storm broke forth with loud claps of thunder and lightning. While many rural Ugandans did not fully understand the significance of what was happening in faraway Kampala, with the lowering of