The planning

We began our search for elective locations in January 2018; once we had decided on Africa as a general destination we narrowed it down to a few countries - Uganda included. From there we contacted lots of different hospitals, and then waited for their response.

Almost immediately we heard back from Enoch and David at CFYDDI, the organisation responsible for the Kasangati Health Centre elective. From the word go they were extremely helpful and very friendly, and sent us a very detailed elective guide with everything we needed to know about Uganda, Kasangati, CFYDDI and the elective programme.

One of the biggest draws to this elective was the cost and how CFYDDI used the money. The elective programme that Enoch and David have set up has all the advantages of going on an organised elective, with accommodation, food, airport transfers and contact with the hospital all arranged, but without the admin fees you must often pay with bigger companies. As if the low cost wasn't enough, CFYDDI use the money that elective students pay to fund their various projects, such as their school and community library.

The hospital

Kasangati Health Centre IV is a small rural hospital with a busy maternity unit, one theatre, HIV clinics three times a week, an outpatient department and an inpatient ward (which has around six male beds, six female beds and six paediatric beds). 

The hospital is a level four government funded hospital, which means it has a functioning operating theatre. The government funding extends to paying the staff's wages and to a small selection of drugs (contraception, antiretrovirals and some antibiotics); anything else required to treat the patients must be provided by the patient - this includes gloves, cannulae, catheters, sutures and giving sets.

We spent the majority of our six-week placement in maternity as we found this to be the busiest and most rewarding department to work in. Monday, Tuesday and Thursday mornings were for general antenatal clinics, with Wednesday and Friday mornings hosting an antenatal clinic for those pregnant women with HIV.

Our days would typically start at around 9.30am, when we would help in the antenatal clinic by taking the blood pressures and weights of the waiting women, or by palpating their abdomens to assess the stage of the pregnancy. Once the clinic was done for the day we would either find ourselves helping to deliver and receive babies in the labour room, discharge women from the postnatal ward or assist the student nurses with the family planning clinic.

Most days there was also the opportunity to go to theatre with the resident doctor or one of the visiting doctors; these surgeries were usually C-sections, but there were occasionally other general surgical cases such as hernia repairs or hysterectomies. We would tend to head home at around 3pm, but it depended on how busy the department was.

Spare time in Uganda

Despite spending six full weeks at the hospital, we still had plenty of time to travel and explore Uganda at the weekends. We travelled to the capital Kampala twice; the first time we explored the Gaddafi Mosque, the Kasubi tombs and the largest church in the city before heading to Acacia Mall (a shopping mall aimed at expats) where we enjoyed an up-market dinner. Our second visit took us to a craft market aimed at tourists but selling beautiful souvenirs, and we spent a couple of hours exploring this before heading back to Acacia Mall for another tasty dinner.

On another weekend we travelled to Jinja to go white-water rafting on the River Nile - something I would recommend! We went with Nile River Explorers and had an incredible day out on the river, and then chose to stay at their river camp for the night in tents overlooking the Nile. We enjoyed Jinja so much that we returned to the camp the following weekend for a couple of days of relaxation. The highlight of our trip had to be our journey to Murchison Falls where we did a three day Big-5 safari.

Highlights and reflection on the experience

The elective was honestly the best six weeks of my medical school life, and I learned an incredible amount from the staff at the hospital. The differences between the health centre and English hospitals has made me appreciate the NHS so much more.

The highlight of my elective was watching and helping the midwives resuscitate a baby who was born not breathing. Forty-five minutes passed before the baby made any respiratory effort of its own. The perseverance and skill displayed by the midwives was incredible, particularly given the lack of any real resuscitation equipment. Thankfully the baby survived and was transferred to a larger hospital for more specialist care.

My take home message would be that this elective is the one to pick if you want a family feel to your trip. Enoch and the team will make you feel as though you are part of their family, and that you are always welcome back!