A day in the life of a Ugandan doctor

An eight-year-old girl has been brought to Mulago National Referral Hospital. She has not been feeding but her stomach keeps bulging.
For the past two and more hours, we are in a queue of about 40 parents and children seated at one of the paediatric wards.
Some of the children have been sick for days, even weeks, without medical attention, and today their parents somehow believe a chance before a doctor will start a healing process.

Two men who seem to be chatting freely emerge from one of the rooms. The faces in the queue light up, but it is short-lived as one walks on and the other only gets back in with a child.
He later comes out with the same child smiling, as if to assert hope that regardless of how ill some of these children are, the process to heal was on.

Yet for Dr Joel (not real name), this is not even close to how his work starts. In fact, this particular stint at the paediatric ward is the third trip he is making to this particular ward and it is only 2pm. He started the day at the trauma ward
The young doctor notes that saving lives and empowering patients not to give up is almost his second nature.
In fact, even as he wakes up at 5am, some of the many things always on his mind are the last critical patients he saw.

By 5.30am, he is already on the road or risks getting stuck in the early morning traffic in Nakawa, Kyambogo and Kyadondo that lie in between his workplace and Kireka where he stays.
“At times, to be at work in time, you can’t avoid hoping on a boda or using special hires,” he says.

But for a job that almost directly works with calamity and outbreaks – one that has to always be called on in case of a crisis, he says there is no two days that are the same for a doctor.
“Each day, I have to make rounds in three different wards, but I never do this in a particular order,” he says, noting that on some days one ward may need more attention than the other.
The wards, he says, usually attract 1,200 people a day. These are meant to receive services from usually 18 assigned doctors and about 26 interns and at times specialists from elsewhere too come in – these are spread in all the three wards.

He, however, notes that since many doctors would rather be at private hospitals which are well paying, the number of doctors available is usually low.
“Because of this, the workload increases since the number of patients never slows yet doctors leaving the duty station to make money elsewhere is always increasing.”

Although, even with the dynamics of the profession, some things, he notes, are more constant. For instance, he goes through a comprehensive clerking process of documenting patients’ history first thing daily.
“There are chances you know some patients since they were admitted days back and you’ve interacted, but then there are those new ones that probably came in the night while you were off duty and for some reason, because they see you’re a doctor, they believe you must know everything happening to them,” he says.

But after the clerking, what follows is a restless up and down stroll within the wards. Naturally, the paediatric ward is often busiest and he notes that unlike paediatric wards in private hospitals where the main cases are simple infections, in public hospitals, admitting a child suffering from something no one has heard of is always on the cards.

But he notes that handling patients is always never an easy thing, some caretakers get agitated on busy days and may for instance try to talk to you ‘in all sorts’ of languages to get help quicker than everybody else.
“Some of these things can be tempting but it’s the humanity that comes in, it is hard helping one patient while ignoring one mourning right behind you,” he says.

On a busy day like this one, he says many of them never get a lunch break but briefly leave their duty station to go grab a meal.
Today, he will be taking tea and Irish potatoes, a meal he says he likes but is also affordable – daily, he has to budget for breakfast, lunch and dinner, yet when the day becomes busier, lunch is often foregone.
“On such busy days, numbers vary but in paediatrics, one could handle a minimum of 30 cases,” he says.

For the time he has worked, he says he has had both good and bad fortune while in practice. For instance, he notes that he has been at the ward when there is an excellent supply of equipment and has been there when there is almost nothing.
“The supply here is almost periodic, there are times it good and others when it is really bad that you even end up investing your own money to make things work,” he says.

At the moment, he earns Shs1m “which does not reflect the amount of work we do, nor the number of patients we handle and worse, it is not enough to take care of a family with the expenses involved.”
His day, he says, must end at 3pm although most of the times because of the large numbers of patients, he ends it at 5pm or even later.

DOCTOR’S DEMAND
As part of their demands, the doctors want government to review their salaries which will see an intern doctor earn Shs8.5million as opposed to the current Shs960,000 before tax.
They also want a medical officer or teaching assistant to be paid Shs15 million and accorded a two-bedroom house and a 2.5cc vehicle.
They want a senior consultant doctor or professor to be paid Shs48m plus allowances. They want this to be accompanied by a five-bedroom house, 4.0cc vehicle, and three domestic workers.
The doctors also want salaries for nurses and midwives enhanced to about Shs6.5 million besides a three-bedroomed house, 2.0cc vehicle and one domestic worker.