You see, they would come and knock on my door, I would spend the day working and then come home to a line-up of patients. It started in my office at home... I simply could not ignore the need. So we started St. Stephens.His young protege gives us a tour of the small but clean and organized hospital, we all agree we'd rather deliver here than as part of the mass of humanity at Mulago. Sam's hair is now mostly white, his smile gentle and his laugh genuine. His clerical collar (since he has also trained as an Anglican priest) seems to make him even more approachable instead of unattainable and intimidating. He has 'adopted' over a dozen children, mostly from his siblings who have passed away, from AIDS and other life circumstances. I have no doubt he has made more of an impact on this community than the most well-published of academic general surgeons could ever hope to.
4. Jean Chaimberlain - They told me she was a spit-fire but I must say seeing is believing, (I briefly may have even mistaken her passion for hypomania at one point). An obstetrician originally from Ontario, she has dedicated her life to developing a Masters of Public Health in Maternal Mortality at Uganda Christian University where currently professionals from across East Africa are being trained. I felt privileged to meet some of her students and was blown away by their dedication and passion, some were government health officials, nurses, social workers and business people who all work full time in addition to taking the course. She makes no excuses. Not for her faith, nor for the relentless drive she has to affect change in a world where a woman dies needlessly every minute of everyday from a pregnancy related cause.
3. Veronica Najjuma - She must be nearly 60 but to me her wrinkled face seems ageless. Rarely without a smile, always some type of floppy hat on her head as she sets out into her community of Kisenyi with a message. Whether related to cervical cancer or a town meeting, she spreads the word with determination. She's a village chairperson and one of the research assistants that I've written about previously. In January of this year, I visited Kisenyi again, but this time with an entourage from UBC. Among them, the head of gyne oncology, the Canadian infectious disease in pregnancy guru and of course my fearless research supervisor herself! I have worked with these attendings in a very different context than the dust and garbage that surrounded us in the slum.
Veronica had been charged with a tour of Kisenyi which she took seriously. First to the houses that had been burned down just three days before, two children had died. The wooden shacks are crowded so close together that the fire had destroyed a dozen houses within only a few square meters. Next she lead us to the brothels. We sat in a tiny courtyard, crowded on tiny wooden stools as Veronica chatted with these women about HPV self-collection. To be there, having my attendings, a group of driven women who are leaders in their fields, sit and witness the stories of a group of women so different from themselves, some of the most marginalized, was a powerful and moving experience. They had recently been involved in an HIV microbicide trial and were wary of pelvic exams, saying speculums had caused HIV in some of their friends. Veronica engaged them in conversation, her openness drawing them in.
2. Florence Mirembe - aka The Queen of Africa. Previously the head of the department of Obstetrics and Gynecology. She may have done more than any other woman in Uganda to forward women's health. She is a trained obstetrician-gynecologist and a long-standing professor at Mulago Hospital. I remember going to morning rounds before I had met her and leaning over to ask one of the junior doctors in a whisper what her name was. He looked back at me incredulously, "that is Prof Mirembe!" She certainly had a presence in the room, admonishing the interns and registrars to higher standards
"you knew she had a previous Ceasar when she came in in labour, and now you have risked her life and taken her baby's life from her because you waited for her uterus to rupture before going to theater!"No apologies, just pure passion, decrying the injustices of a system without resources. How can a woman who has not only lived through the dark times of Idi Amin but also witnesses unspeakable tragedy at the loss of women's lives not have become jaded? Not have come to lower her standards of care? How does she maintain that fiery compassion in the twilight years of her career when she could be relaxing a bit more? I have trouble not getting jaded and I'm only partway through residency!
1. Allan Ronald - In all honestly I didn't fully realize who was coming over for dinner, over the past two weeks we had innumerable meetings with a variety of phenomenal individuals and names were all starting to blend into each other. So Allan Ronald took me off guard. He is humble to a fault, down-playing his involvement in a massive HIV trial currently taking place. He is somehow able to connect personally with everyone in the room, he leans forward engaging me in conversation, interested in what my plans are. Then, looking me straight in the eye puts the entire responsibility of saving the world squarely on my shoulders. "You need to change how CIDA works, you need to transform the way health research and development are done, its up to driven young people to do it."
As it turns out Allan Ronald has not only received the Order of Canada and been inducted in to the Medical Hall of Fame, but he is the foremost infectious disease physician and microbiologist in Canada and was at the forefront of developing the infrastructure for the hundreds of thousands of Ugandan's who have received antiretroviral medication. He is a leading HIV researcher who spent 30 years involved in research in Africa. Sadly, I heard he has been diagnosed with advanced stage cancer, something you would not have know by the hope and inspiration oozing out of his every word as we sat and discussed international development over dinner. Everyone was a bit starry-eyed as he left that night.
The Top Five have left me humbled, inspired and unapologetic about what drives me. As the slog of residency continues, the day to day of baby-catching, sleepless nights, coffee-jittered days. The endless learning of surgical techniques and the challenges of clinical decision-making threatens to convince me that all there is to my vocation is getting babies born safely and hysterectomies done properly. Not to sound cliche, but these individuals, all in different ways, have been a thundering waterfall on a parched and disillusioned soul, overwhelmed by hope in the face of a much greater need than someone with painful periods wanting a hysterectomy.
OB/GYN Residency
