From a Leprosarium to a Surgical Center of Hope

NAME: Katherine Albutt

PROGRAM: General Surgery

PGY: Research Resident (currently completing second year of research)  

Several weeks ago, I had the privilege of visiting Kumi Hospital in eastern Uganda. This site visit was part of a larger nationwide project designed to assess and improve surgical capacity in Uganda through collection of core surgical indicators at public, private, and not-for-profit hospitals around the country. Having travelled extensively within the country and completed site visits at more than 30 hospitals, I thought I had a pretty reasonable grasp on the hospital system and surgical infrastructure in the country, particularly as Kumi Hospital was the penultimate site visit. But Kumi Hospital was unlike anywhere else I have been in Uganda, or elsewhere in the world.

Kumi Hospital is located down a very long bumpy dirt road in eastern Uganda, approximately 300 km from Kampala. Founded in 1929 in response to the need for specialized work among leprosy patients, it was originally founded as a leprosarium. For many leprosy sufferers at that time, Kumi Leprosy Centre became the only place where they could live in community without being rejected, despised and discriminated. In the 1970s, a move was made to stop segregation in line with changing attitudes. At Kumi, much needed care, treatment, and rehabilitation continued to be provided for Leprosy sufferers. But in 1985, war and conflict took hold of the region and Kumi suffered total collapse in terms of both infrastructure and services. You can still see the scars of this war as you walk around the hospital today. By the end of the war in 1992, the building and campus had been extensively vandalized and later turned into a camp for internally displaced persons.

But in 1997, Kumi experienced a revival as it was transitioned and transformed into a general hospital. It has since undergone major structural development as well as upgrading of facilities and infrastructure. Currently, the hospital has a 350-bed capacity and is able to provide a wide range of integrated services including medical, surgical, obstetrics, and other specialized services. Throughout this transition, the hospital has maintained its referral status for leprosy in Uganda and a quick walk through medical records reveals the scores of leprosy patient records.

Today, Kumi Hospital is a preferred destination for the poor, and a centre for hope and healing for many. About 3,000 operations are performed at Kumi each and every year. The man at the helm, a humble hospital director and trained general surgeon, has revolutionized care delivery at the hospital. He told us: “Some patients can pay, some can’t pay, sometimes people have been brought here, they have been run over by the bus, with fractures, we treat them, the time they come because they are bleeding, they are in pain… and then there is a patient left with a bill of 3 million… Those who can’t meet their bill we put them under the compassionate fund… So instead of the escaping the hospital or shunning the hospital, they come, we treat them, then we pay for them. Yeah, we don’t turn anybody away.” For him, this work is a calling. “I’m happy to be here, because if we can’t improve this place, then no one will come and improve this place.” For the people of Kumi, what was once a center for the stigmatized and segregated has become a symbol of hope for the entire community and the preferred destination in the region for many forms of medical and surgical care.