It wasn’t the way patients are cared for that first struck Dr. Wincey Katagira as different, but the patients themselves.
“Here more patients really are advanced in age. I remember my first month the youngest person I saw was 74,” says Dr. Katagira. “I rarely see a 74-year-old patient back home unless they have something different, maybe advanced pneumonia or malignancy.”
Dr. Katagira is a medical learner from the East African nation of Uganda. He recently wrapped up a four-month residency at Niagara Health’s St. Catharines Site as part of the International Outreach Program (IOP), a charitable organization overseen by St. Joseph’s Healthcare System in Hamilton. Run in conjunction with McMaster University, four medical schools in Uganda and the Ugandan government, the program is designed to give Ugandan healthcare professionals experience in a Canadian hospital that can be applied in their home country.
“The experience system-wide I think was different. I appreciated the difference in culture,” says Dr. Katagira. “Ward management is very different compared to home. Here there is really a team.”
The Ugandan partnership was launched 22 years ago under the direction of Dr. Peter Kagoma, Niagara Health’s Head of Academic and Education Centre. Born in Uganda, Dr. Kagoma completed his medical schooling in the United States and the Caribbean before completing his hematology training at McMaster. Once he was established, he wanted to find a way to give back to his birthplace.
“The feeling is amazing,” says Dr. Kagoma. “You can see these people growing, being mentored and then they become leaders.”
Initially, the program brought Ugandan doctors to Hamilton hospitals but over the years has expanded to other Ontario cities, including Brantford and Cambridge. Dr. Katagira, who is a fourth-year resident in internal medicine at Makerere Medical School in Kampala, is the first Ugandan international resident at Niagara Health.
“Coming here I had set out a few objectives of my own, and I am glad to say I have achieved all of them,” says Dr. Katagira. “I think the biggest achievement I have gotten is acquiring skills in my area of interest and that is respirology.”
Specifically, Dr. Katagira is interested in the care given to sleep apnea patients as there is little equipment in Uganda to help with treatment. With less technology and laboratory resources to work with than their Canadian counterparts, doctors in Uganda rely more on family history and physical exams when making a diagnosis.
“Here (in Canada) tests and diagnostic equipment play a larger role in ensuring accurate diagnoses,” says Dr. Katagira.
Dr. Kagoma refers to the differences in diagnosing patients as high-touch and high-tech. Each has its own benefits and Dr. Kagoma says both countries can learn from one another.
“We want to marry the two,” he says. “When you do that, both systems rise up.”
When Dr. Kagoma first began designing the program, he knew it had to be different from other developing nation partnerships, which typically invited visiting doctors to observe medical practices in North America, but not participate. He wanted to ensure that physician learners were able to gain hands-on training that would be directly applicable upon return to Uganda.
“Right now there are a lot of people waiting for me back home,” says Dr. Katagira. “They’re looking forward to first of all, hearing what I have learned…and also to try and see how I can bring what I have learned from here and make the clinical experience as well as the teaching experience richer.”
It was also important for Dr. Kagoma to establish a partnership that was beneficial to everyone involved, including the Canadian institutions. He says by bringing physicians like Dr. Katagira to Niagara Health, local doctors get the experience of interacting with international learners who provide services to patients as part of their training. As well, Niagara Health physicians and staff involved with teaching international learners will potentially have an opportunity to travel to Uganda to visit various medical schools and conduct seminars.
“None of the people involved in this program are paid,” says Dr. Kagoma. “We have an extensive staff of teachers, professors and administrative leaders who do this on a volunteer basis.”
In just over two decades, Dr. Kagoma estimates the program has brought over 150 Ugandan doctors to Canada. Many of these individuals are now in leadership positions in their home nation. He says the program is having a big impact on the healthcare system in Uganda.
“We all pray and hope that the people we teach will become bigger than us because we all stand on the shoulders of giants,” says Dr. Kagoma. “If you stand on the shoulders of somebody, you see higher and further and actually go a longer distance. So that’s what you hope for and I’m very proud of that.”