Leaving

Pediatric Hospital Care in Uganda

Scott Nabity, MD, MPH

Resident in Medicine-Pediatrics at MGH

PGY 4

Leaving

February 3, 2017

When the time comes to head back to the U.S., I feel both positivity and regret.

The positive excitement largely represents the longing I feel for the return to comforts of home, familiarity, friends, and family. It also comes from reflection on the contribution, regardless how small, my interactions may have had on the work of frontline Ugandan clinicians. Regret, conversely, seeps from a place where not giving enough and missed opportunities reside. While the clinical need appears endless, we are not interminable beings, and sustainability requires some attention to self. Choosing impact rich activities helps, too.

Teaching session for staff at a district health center

During my last trip to MUST, I was given the opportunity to break away from the main hospital and see the workings of one district health clinic. In exchange, I was asked to given an educational lecture, a simple but brilliant arrangement. I talked about pharyngitis, something the clinic staff had asked to learn about. They simplified a complex health system for me and walked me through some clinical decision pathways where only clinical impression is at play. While I’d also spent an afternoon of clinical work in the hypertension clinic, I surmise the lasting effect of a few hours of educational swappery far outlasts the impact of a few blood pressure measurements and med changes. I hope I added something to the armory of the bright Ugandan clinicians I interfaced with then. They had clearly taught me more about how to navigate an environment where resources are limited.

The MGH-MUST Global Health Collaborative is an established, multifaceted, long-term investment in research and education. Over the course of three years, the collaborative provided me freedom to better identify sustainably oriented opportunities in such settings, even when strictly short-term in contact and scope. Because we often arrive focused on hard outcomes – abstracts written, research studies funded, gadgets produced, procedures performed – the simplicity of exchanging information as the desired outcome can fall aside. Hard outcomes are important, but so are the soft ones. I’m fortunate to have had the privilege to learn about choosing wisely.