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MBARARA UNIVERSITY OF SCIENCE & TECHNOLOGY, SCHOOL OF MEDICINE


 “If you can do one thing, help me retain my best and brightest.”
- Vice Chancellor Frederick Kayanja,
Mbarara University of Science & Technology
 
Currently, Uganda has fewer than 30 ENT surgeons and 34 ophthalmologists serving a population of 33.4 million. In crowded clinic waiting rooms, children represent the majority of the patients that inundate the staff at Mbarara Regional Referral Hospital (MRRH) in southwestern Uganda. Suffering from the usual maladies of childhood – but at greater rates – these children often require common ENT procedures – tonsillectomy and adenoidectomy, foreign body extraction, excisional biopsies. Other times they require more than what the current otolaryngologists and ophthalmologists are able to provide – either because of training and equipment limitations, or because of advanced presentation. 
Preventable ear disease is a major cause of hearing loss for Ugandans, 11% of which suffer from hearing impairment that often affects speech and language development and can impact educational opportunities, economic livelihood, and social well-being.  Similarly, despite the high incidence of visual loss in southwestern Uganda, the majority of cases, cataract and refractive error, are treatable. High rates of HIV/AIDS and tuberculosis further complicate the disease spectrum ENT surgeons and ophthalmologists see, where environmental conditions including pollution; unsafe drinking water; bacterial, fungal, and viral infections; and high numbers of individuals living with HIV and TB result in numerous, otherwise rare, ENT and ophthalmic manifestations.  
Mass. Eye and Ear Office of Global Surgery and Health has been invited to partner with the Mbarara University of Science and Technology (MUST) School of Medicine and MRRH to develop and advance their current postgraduate training programs in ophthalmology and otolaryngology, improving both capacity and capability. Newly rehabilitated in October 2012, including a brand new Training Eye Hospital, the hospital has the physical infrastructure but not the faculty or equipment resources to address the ENT and ophthalmology needs of its ever-growing patient population.  
The MGH Center for Global Health has had a long and successful partnership with MUST that has expanded from AIDS/HIV research to include microfinance and medical device innovation in addition to a Global Primary Care Residency Program and various other health-related programs.  This long-term partnership has provided opportunities for mutual learning and benefit as well as a solid base for future collaborative endeavors.  Most recently, MUST invited MGH to help develop their subspecialty departments, including otolaryngology and ophthalmology, prompting the inclusion of the Mass. Eye and Ear.   
As a point of stability and relative economic prosperity in an area of conflict and rampant poverty, 70% of patients seen at MRRH come from outside of its intended catchment area and even outside of Uganda itself, including refugees fleeing South Sudan and the Democratic Republic of the Congo. These numbers, coupled with the third-highest birthrate in the world, dramatically raise the stakes for improving MRRH’s ability to care for its patients and decrease the numbers of referrals to the already overwhelmed National Referral Hospital in Kampala, a distance away that too many families find to be insurmountable. 

UGANDA

A landlocked nation framed by Lake Victoria to the south and ringed by mountains, Uganda’s lush equatorial plateau and wooded hills are broken occasionally by swampy lowlands and semi-arid regions. Uganda is neighbored by Kenya to the east, South Sudan to north, the Democratic Republic to the west, and to the south Rwanda and Tanzania. While English is the official language and the language of education, Uganda is a multilingual nation, home to 40 indigenous languages in addition to Swahili and several imported dialects.

Emerging from decades of civil war following its independence from Britain in 1962, Uganda has enjoyed a recent history of peace and steady economic growth. Despite the eighteen-year brutal insurgence of the Lord’s Resistance Army led by Joseph Kony that led to the displacement of almost 1.5 million people in northern Uganda, the country has been at peace since 2008. Although one of the poorest countries in Africa, Uganda has built one of the fastest growing economies in sub-Saharan Africa, bolstered by a period of peace and sound economic development policies. Economic growth, low inflation, and a steady reduction of poverty have made Uganda a stable center for a more troubled region, but a third of the population still lives on less than US $1.25 a day.  Decimated by earlier civil war and handicapped by poverty, Uganda’s healthcare infrastructure has only recently begun to see improvement. Heavily impacted the HIV/AIDS epidemic (7.3% HIV prevalence), Uganda has been a major location for infectious disease-related global health activity. 

 

Page updated: June 28, 2013