MBA Student's Journey to Kawolo Hospital: Kawolo, Uganda

December 7th, 2010: Journey to Kawolo Hospital; Kawolo, Uganda
Nadia Abuzaineh and Adam Wolf

After spending several days exploring the wide landscape of urban hospitals in Kampala, Uganda, we journeyed out to Kawolo Hospital, a truly rural 100 bed hospital about 45 kilometers outside of the city center in Kawolo. The drive in and of itself was quite a journey as we quickly realized that a drive that would normally take about 20 minutes, would instead take over two hours due to the extremely poor road conditions.
Upon arriving at the hospital, which was situated directly off of the main road into Kampala, we found a collection of buildings which appeared to be abandoned. There was no one in any of the administrative offices and all we heard was the heart-wrenching scream of what appeared to be a young child in extreme pain. We were shortly approached by a young woman who helped us locate the one doctor on call.
We then met Dr. Julius Kizito who, after training at Markere University in Kampala, returned to his hometown to work as one of the three doctors at Kawolo. Despite having over 100 beds, serving over 300 patients a day, and performing over 15 major surgeries daily, the hospital only had 3 doctors, an astonishingly low number for the medical needs of the area. We also learned that one doctor had been offsite on training for over a month, leaving just 2 doctors to cover the immense medical and surgical load. When asked what drove him to return to Kawolo, Dr. Kizito simply said, “this is my hometown; I always knew I would come back.”
In an effort to learn a little more about the types of needs at Kawolo, we learned that roadside and vehicle related injuries and fatalities were by far the predominate medical issue treated at Kawolo. After hearing this and experiencing the driving conditions first hand, one can’t help to wonder if the burden on the medical field could be reduced to a great extent by simply installing more stoplights and putting a greater emphasis on vehicle safety.
As we turned our discussion to some of the preliminary suggestions we had developed to increase the surgical capacity in rural areas, Dr. Kizito was excited to hear about a substitute surgeon program we had been developing. Although in the past surgeons in Kampala were mandated to serve in rural areas for several weeks a year, this program had been cut due to a lack of funding. As a result, when one of the three doctors was away for training or family matters at Kawolo, the entire burden feel on the remaining doctors. With a program where a substitute surgeon could be sent to handle the duties of the missing doctor, Dr. Kizito was optimistic that this would increase the quality of care not only by increasing capacity, but also by reducing the fatigue of the doctors who remained at Kawolo.
After our 2 hour journey back to Kampala, although we were certainly impacted by the extremely poor conditions at Kawolo, we were excited to hear that one of the recommendations we had been working on, the substitute surgeon program, would be of great benefit to a hospital like Kawolo. It was then off to sleep before an early morning flight to Nairobi, Kenya.