PRODUCED QUARTERLY BY THE MESAU CONSORTIUM; A MEPI INITIATIVE Vol 5. No.1 January-March 2015 MESAU Newsletter MESAUNewsletter Mesau Director’s Message

Dear Reader, Interventional Cardiology Training at Case “The future we want needs to be invented; otherwise we will get Western Reserve University (CWRU) one we don’t want” Joseph Beuys. By Dr Emmy Okello (Interventional Cardiology Fellow, Case Western Welcome to MESAU Reserve University) News, a production of the MESAU consortium with Secretariat at Makerere University College of Health Sciences. I arrived at CWRU on 1st July The MESAU consortium cherishes got to meet the Case Western collaborations and networking between Reserve University (CWRU) team 2014 and attended the Fellows its member institutions augmented when they came to Uganda orientation together with the by “smart partnerships” with in country and external stakeholders under the MEPI-CVD program other Fellows including General, that promote mutual benefits and asI they provided technical support. Heart failure, Electrophysiology multi directional learning. It is only a and Interventional Cardiology and couple of months away from the end We collaborated to strengthen the of MEPI grant funding to MESAU and Rheumatic heart disease registry at started work immediately. here we stand face to face with the Uganda Heart Institute (UHI), which challenges of ensuring sustainability of The back ground above is important our educational innovations and other started as an outcome of my PhD achievements. study. because unlike many collaborations The complexities surrounding to pg 2 sustainability should not induce The team visited regularly to perform paralysis but rather stimulate our interventional cardiology procedures appetite for accelerating additional innovations based on the power we including percutaneous coronary Contents have as academic institutions. MESAU interventions and mitral balloon should examine the “Benn Principles” Pg. 3 and determine how they apply to valvuloplasty. As we worked with „Busitema University Trains the consortium and its individual them, they quickly realized that there Faculty in Tutorial Process institutional partners. Tony Benn asked was need to train interventional five questions of any institution: and Students’ Assessment cardiologists to perform these  What power have you got? procedures in the country without  Where did you get it from?  In whose interests do you having to wait for help from abroad. I „Experience in supporting the Pg. 5 exercise it? was in the second year of my general writing of the NIH MEPI grant  To whom are you cardiology fellowship then. Following accountable? application, Gulu University’s  How can we get rid of you? consultations between the Uganda first NIH Grant Application Heart Institute, Makerere University These questions can be more appropriately examined when the and Case Western Reserve University, „Meeting our health needs: A Pg. 6 concept of social accountability I was chosen as one of those to do mandate of medical schools is kept CVD awareness campaign central to defining the future of MESAU. interventional cardiology training Applying a social accountability lens to after Dr. Kayima’s one year training development of health professionals (He is currently at UHI). In 2013, I was Pg. 7 may act as a change agent for the „Clinical Observer ship at Yale future with potential to deliver high interviewed for the Fellowship by Department of Neurology quality education and graduates who Professors Daniel Simon (Chief Division respond to societal needs (Gibbs of Cardiovascular Medicine at CWRU) 2011). „Engagement with MoH and Pg. 9 and Prof Marco Costa, then Director MoE in the development of MESAU institutions are expressing of the Interventional Cardiovascular social accountability through a variety Centre for Evidence Based of approaches including emphasis Institute at CWRU. My Fellowship on working with communities started in July 2014 after completing Medicine at MakCHS through distributed community based education, research and services all relevant paper work including „Mbarara University MESAU Pg. 17 that takes place at community sites application for the Ohio State Medical Masters Fellows Graduate across the country. In addition, there License and University Hospitals is increasing emphasis on conducting regionally relevant research. Privileges.

MAKERERE UNIVERSITY 1 MESAU Newsletter MESAU Newsletter From 1 Interventional Cardiology Training at (CWRU) Busitema University Faculty of Health Sciences Trains Faculty in Tutorial Process and Students’ Assessment Willy Kisaka, Assistant Registrar, Busitema University Faculty of Health Sciences

In an effort to contribute In a quest to strengthen the discussion sessions on various towards training of high delivery of PBL, BUFHS organized assessment methods were held. quality health professionals in a two-day workshop to train the Using adult training methods, the Uganda,Busitema University faculty on the tutorial process non-residential training was highly Faculty of Health Sciences and students’ assessment with engaging with a 8.30am- 5.30 pm (BUFHS) has fully embraced funding from MESAU- MEPI. This daily program. Some of the topics the Competency Based training took place between included; How people learn and Education (CBE) Curriculum. 26th and 27th March 2015 at the PBL, The tutorial process for Pre- These competences (graduate Health Manpower Development Clinical years, The tutorial process outcome abilities) are best Centre (HMDC). HMDC is a sister for Clinical years, Competence- achieved through a learner- institution with training facilities Based Education, Skills training centered learning context. The that BUFHS can use on request. & the Skills Lab, Problem Writing, CBE is highly characterized The training was facilitated by Principles of assessment, Different Left; Dr Emmy Okello and Prof. Daniel Simon performing Coronary angiography in Cleveland-Ohio. Right; Dr Emmy Okello by use of a mixture of Prof. Sarah Kiguli Walube and methods of assessment and controlling the equipment curricular delivery including Mr. Roy Gonzaga Mubuuke; both Standard setting. tutorial teaching-learning from Makerere University College At the end of the training, that have offered to train Ugandan week and weekend or you may end should help us get our cath lab method as one of the modes, of Health Sciences. The workshop certificates of attendance were doctors, this is a hands-on training up going for a procedure every 3 better organized when I return. otherwise referred to as the was attended by 25 participants awarded to the participants. where you are treated like any hours for the 4 day call! Problem Based Learning at teaching ranks at BUFHS. The other Fellow and have to process My exposure at CWRU has enabled (PBL).This centrality of PBL purpose of the training was to Additionally, trainees expressed the right paper work, and it’s not All Fellows attend weekly teaching me learn a lot of interventional in the teaching-learning increase the competences of satisfaction with the training an observer ship where you are not conferences including cath cardiology technique and skills process makes it inevitable the faculty in the delivery and exposure and the materials allowed to touch a patient. conference on Tuesday 7-8am and in this short time that I plan to to continuously train tutors assessment of students in the provided. Worth noting though, a clinical case conference every helps patients but also bring our to impart necessary skills for CBE curriculum with particular was the recognition that success My typical day starts at 5am when Wednesday. Fellowship training in Uganda to a those who might be new in emphasis on PBL. At the end of of PBL largely depended on I wake up, pray and do some higher level. the teaching field as well as the workshop, participants were the nature of tutorial learning exercise. I then drive to hospital We also present at journal clubs improve the capacities of those expected to; explain how people problems, which should be which is about 15 minutes from and attend grand rounds where an I purpose to continue supporting already in the practice. This learn with a relationships PBL, appropriate, relevant and well my apartment. Work in the cath expert in cardiovascular diseases the department of medicine, article highlights one of the describe the tutorial process designed. Tutors pledged to lab starts at 7am and we typically usually presents on something new Makerere University, through sessions undertaken to build and explain key principles of commit more time and efforts perform 15-20 procedures every in the field teaching of cardiovascular medicine capacity in PBL at BUFHS. student assessment. In addition, in constructing good tutorial day. Each day of the week has skills to undergraduate and problems. an attending Interventional Opportunities: I have learnt a graduate medical students. cardiologist who works with the lot; by April 2015, I had done over two interventional Fellows and 526 left heart catheterizations, Appreciation: All this wouldn’t usually one general cardiology 318 right heart catheterizations, be possible without the support fellow on a diagnostic rotation. 211 percutaneous coronary from the MEPI-CVD linked award interventions, 24 fractional flow under the leadership of Prof. Nelson Monday is an interesting reserve tests, 30 optical coherence Sewankambo and Prof. Moses day because the two senior imaging tests, 25 intra aortic Kamya and the strong collaboration cardiologists Dr Simon and Dr balloon pump placements, 15 that has been built with CWRU Costa are in the Cath lab and both percutaneous left ventricular and Uganda Heart Institute. have different philosophies of assist device (Impella) placements, This collaboration gives a lot of doing the same procedure, so lots 26 endomycardial biopsies, 11 mileage to the advancement of of learning and fun. emergency pericardiocentesis, cardiovascular disease management 11 transcutaneous aortic valve and research in Uganda. I do night call for STEMI (Patients replacements and 5 mitral balloon brought in emergently for acute valvoplasties. Finally I would like to thank very heart attacks with a target to much the CWRU team including reopen their blocked arteries With the acquired skills, I am in a Dr Chris Longenecker who makes in less than 90 minutes) twice a better position to optimally utilize sure the wheels keep moving week and once a month I do a the equipment at the Uganda Heart in the background, Professors long weekend call stretching from Institute as we manage patients. I Daniel Simon, Marco Costa, Sahil Friday to Monday. have learnt organization of the cath Parikh, Hiram Bezerra, Michael One of the sessions during the training Workshop lab (human resource, equipment Cunningham, David Zidar and Photo credit: Mr. Nsimamukama Mathias Kanyeihamba Like any calls, you can have a quiet and supply management). This Najeeb Osman.

2 3 MESAU Newsletter MESAU Newsletter The Birth of Busitema Medical Students Association: A Glimmer of Hope

By Keera Fuuna Ivan and Esther (MRRH) Guest House Gardens. the association. It was a colorful Currently, we have successfully written Ochoko, BUMESA The Guest of Honor was the orange and green affair. The a few project concepts and proposals University Vice Chancellor, launch ceremony was crowned focusing on slum health, school In 2007, the idea of setting up a Professor Mary Okwakol. with joyful cake-cutting. health and cervical cancer screening. medical school in Eastern Uganda These are all in a bid to make services was penned down. Slowly but surely Each and every speaker spoke The association has given us accessible to ordinary Ugandans the seedling grew into a huge tree, with enthusiasm, love and a sense of belonging and a who are underserved. We are the Faculty of Health Sciences was passion. It was a glorious day. oneness we have always yearned indebted to the Busitema University started in Mbale district. The first The Patron of the association, for. Slowly we have achieved administration for the support and intake of medical students was in Prof. Paul Waako gave a heart- great milestones. We believe that to the MESAU-MEPI team whose August 2013. A year later a second felt speech and then invited the greater and mightier things are presence added flavour to the launch intake came on board. All went well Guest of honor who launched yet to c ceremony. though some thing was still missing. There was a gap that needed to be filled. A vivid yearning from the Prof. Nelson Ssewankambo and other MESAU- MEPI delegates immediately before the launch of the association depths of our souls; the absence of Experience in supporting the writing of the NIH an association bringing us together. MEPI grant application, Gulu University’s first From within us, Busitema Medical Students Association (BUMESA) was initiated. We were all filled with NIH Grant Application By Arnold Mindra – Grants Officer eagerness. An anxiety for its birth I knew this was going to be an successfully. filled our hearts as the days went Gulu University uphill task; and yet surprisingly by. We just could not wait for the Overall, the whole application th I was very excited to take it on. launch. A date; 25 February 2015 Following the NIH call for The first task was to finalize Gulu process for an NIH grant is was set for this event. This day will applications titled “Limited University’s registrations with rigorous and intense but once forever hold a place in our hearts. Competition: Research Training NIH which proved to be quite mastered it becomes easier and for Career Development of Junior challenging, given the mix-up in each step teaches you a lesson The morning of 25th we all awoke Faculty in Medical Education the existing registration details on or two. I have for instance learnt with happiness and anticipation. Partnership Initiative (MEPI) record. Eventually, I was helped the importance of a letter of The feeling was so good for indeed Institutions (D43)” that was by a nice lady at NIH whose support, how to formulate an we had woken up to a brand new published in October 2014; MESAU name I still struggle to recall, NIH budget, as well as how day. consortium members were strongly and I managed to complete the to go about registration with The Vice Chancellor Prof. Mary Okwakol, the Dean Faculty of Health Sciences Prof. Paul encouraged to apply in order to process and created the PI’s and NIH which expertise I am now The function started at 4:00pm at Waako and BUMESA President – Fuuna Ivan led the students in cutting the cake benefit from phase II of the grant. applying to help another Mbale Regional Referral Hospital SO’s account in eRA Commons Gulu University, being an active . Once everything was set, I consortium member get member of the MESAU consortium downloaded the application registered. This grant application took up the challenge and package which included the has also given the Faculty/ accepted to apply for this grant. form as well as information on staff at Gulu a lot of morale to engage in research. Since this I had it at the back of my mind that how to fill it in, helped in the application, a Research and being the Grants Officer, the whole drafting of the letters of support Project team has been created application process as well as that were sent to prospective at the Faculty of Medicine, subsequent communication would supporting agencies, supported which looks at relevant funding heavily depend on me, but I did the formulation and design of opportunities shared by the not know the magnitude of what the budget, filled in the grant Grants Office, discusses them was involved. This was promising application form, attached all and puts ideas together to apply to be a rollercoaster ride and it the necessary documents to for a particular grant. One grant was just the beginning! This was the application, and uploaded application has already been where I would have to prove my the budget. All these were done submitted to Grand Challenges worth! Thus began the process of during day as well as throughout Explorations, with another application with several meetings the night on the eve of the application on the way to being held and tasks allocated. submission deadline. Eventually, another funder. All this has been In a way, whatever was agreed we managed to submit our possible because of the efforts upon, always went around until it application at midday of the final of MESAU- MEPI in empowering eventually settled on me. day. I had been earlier informed that sometimes upon submission, institutions to become self- Coupled with my other there are errors that occur; but sustaining through engaging The Vice Chancellor, the MESAU-MEPI delegates, the Mbale hospital staff and Prof. Paul Waako pose for a photo with engagements as the Acting Project research and ensuring efficient students after the launch fortunately for us there were no Administrator, as well as Research errors, which was a huge relief. grants management. Ethics Committee Administrator, The application was submitted 4 5 MESAU Newsletter MESAU Newsletter Meeting our health needs: A CVD awareness campaign at a fitness Clinical Observer-ship at Yale event in Entebbe, Uganda Department of Neurology By Kenneth Ssebambulidde, Award assessed participants and the By Abdu Musubire, MakCHS MBChB IV, Paul Arinde, MBChB general public who happened to be at I, Enos Kigozi, MBChB II, Jovito the venue for CVD risk including body One of the areas identified in mass index, waist-to-hip ratio, random improving neurology services is Ojidri, Andrew Kalema, John blood sugar (RBS) and blood pressure. Baptist Kiggundu, Rhona through training. There have been Although the people who several strategies to accelerate Baingana, MakCHS participated in the fitness event and presented themselves for assessment neurology training in the sub- are a self-selected group, the picture Sahara region. These range Globally, Non-communicable diseases emerging emphasises the need for from formal training to regular (NCDs), including cardiovascular NCD awareness. Of the 44 people conferences and so on. There is disease (CVD), cancer and diabetes, who were assessed, 27 (61%) were talk of south to south and north to kill 38 million people each year. females (mean age 32 years, range south cooperation. My visit to Yale Alarmingly, almost 75% of NCD 22-47 years). Mean BMI among the Department of Neurology may thus deaths - 28 million - occur in low- females was 27.6 kg/m2 and 16 (59%) be viewed as one of the measures and middle-income countries. The were overweight or obese (BMI ≥ Female participants listen to the students attentively in enhancing neurology education The writer poses for a photo with the risk factors that contribute to NCDs 25). Only 6 (35%) of the males were in Africa. include unhealthy diets, physical overweight or obese (mean age Resident Program Director after one of having worked out for some time. of the association with “fitness” and the monthly meetings inactivity, obesity, exposure to 32 years, range 21-65 years). All of However, because it was a group thing, secondly because of the setting. As Founded in 1810, the Yale School tobacco smoke and the effects of the those we talked to have white collar we were encouraged to go”. Christine Enos, a second year medical student Among the goals was to keep a harmful use of alcohol. sedentary occupations. Christine of Medicine is a world-renowned adds, “The participation of the students said, “Having a day off school to log book of all the neurological According to the 2011 Uganda weighed 100 kg when she started center for biomedical research, was very good, I liked the combination go and participate in awareness conditions observed. This proposed Demographic and Health Survey Cheza in December 2014. Jean’s job education and advanced health of fitness and scientific stuff. The campaigns like the one we had is 40% of women 15-49 years of age involves off-station workshops and care. Affiliated institutions include schedule was then discussed with students had some good advice as absolutely exciting for every medical in Kampala are overweight or obese meetings where her diet usually the 1,541-bed Yale-New Haven the Resident Program Director in the well”. student. And the fact that we were (compared to 19% nationally, BMI gets out of hand. Fiona on the other Department of Neurology. It was going to the beach, huh! I really had Hospital—flagship of theYale ≥ 25). Additionally, overweight hand has always had fitness as part Participants were encouraged by the also agreed that we have regular to be part”. However, it wasn’t just New Haven Health System and and obesity in women in Uganda of her lifestyle, but had challenges results of the assessment. As Jean monthly meetings with the mentors fun and games: “Generally it was an one of the largest hospitals in increases with wealth index and with pregnancy-related weight gain. says, “I consciously thought about my and the Resident Program Director awesome experience, I liked the way the United States. The school’s education. Importantly, the rate of Talemwa started Cheza in December BMI and crafted concrete targets to guys turned up for assessment, and unique curriculum, known as the to discuss my progress and the overweight and obesity in women in 2014 because she was gaining weight lose weight like I now know I need to they kept us busy through out! The Yale system of medical education, challenges of the rotation. Given my Uganda increased consistently from and realised she wasn’t fit; she wanted lose 11 kg. Also I had never had my passion clients have for their health observer status, I had interactions 1995 to 2011. to be fit and healthier. blood sugar tested and had taken long promotes teaching in small having my BP measured. Being within could easily be seen in this campaign, seminar, conference and tutorial with all the different levels of Globalisation is a double-edged With that background it is not the normal range was reassuring and I liked the questions they asked physicians from residents, fellows sword: on the one hand it drives surprising that the assessment carried settings, and requires student self- I have tried to keep off sugar since during our interaction, they really to attending physicians. I was also the adoption of unhealthy lifestyles, out by the students was thought evaluation, independent thinking then”. Christine says she was happy showed that they had understood the given full access to all the academic especially unhealthy diets (fast to be opportune and was highly and investigation. and encouraged with the results of essence of carrying out BMI, RBS etc food, sugar sweetened carbonated appreciated. Talemwa says, “It came sessions and materials available to the assessment, with everything apart and the fact that they were all willing beverages) on the other hand it has as a surprise, we were not expecting The Neurology department is one the residents. I have also had one from BMI being fine. to take up the advice we offered led the middle and upper income anything like that [at the beach]. of the 33 academic departments general review meeting involving On the part of the students, this concerning their life style was very the Office of Global Health and the classes to adopt “fitness” as part Many of us were scared to have our encouraging!” Paul, a first year medical of the Yale School of medicine. It of their lifestyle. In response to weight and BMI measured; we feared campaign was different to the ones Department of Neurology midway they had participated in firstly because student adds that as a future medical is a research, teaching, and clinical the increasing demand for fitness disappointment of no change after worker, he was very glad to see the center devoted to improving the through the one-year rotation. services, many gyms and fitness participants show that much interest understanding and treatment of While here I have made a number centres have been established in their well-being, particularly their diseases of the nervous system. of observations that I feel are worth particularly in Kampala with programs cardiovascular health. He observed, The Department also has active sharing. such as Zumba and spinning. Cheza however, that the number of family is a home-grown fitness dance clinical programs at the West Haven history cases of high blood pressure Veterans Administration Medical program based on Afro-beat, hip- was high and feels that this needs hop and dance-hall created by further investigation. Center and Gaylord Hospital Training Andrew Mawejje of In Motion Dance (specializing in Rehabilitation Both participants and students There are a number of educational Studio in Kampala. The majority of are already looking forward to the services). opportunities like didactic Cheza’s clients are women who want next event in June, “although in the conferences, departmental to lose weight; many of them stay last two weeks I have slipped a bit, I began my clinical observership conferences and seminars. The on to maintain their fitness. On 28 remember they will come again in in September 2014. On my typical day starts at 7:30am with March 2015 Cheza had an outdoor June, I have to ensure I am not worse arrival, I had a series of meetings a morning report that focuses beach fitness event which was open than they found [in March]”. Enos including meeting with Directors to members of the public and this on an interesting/challenging or (MBChB II) says “And I very much look therefore provided an opportunity of Office of Global Health and the educational case presented by a forward to the one to take place in for a MESAU-MEPI CVD Linked Award Chair Department of Neurology. resident to an attending physician. June, I can’t afford to miss!” CVD awareness campaign. Students I was attached to 2 mentors that The residents are usually expected of Makerere University College of It was also suggested that a had experience in working in a in the hospital an hour earlier so Health Sciences Research and Writers’ A student drawing blood for a test from one of the fitness activity partici- partnership is established, “the two resource-limited settings, where we that they review their patients Club with MESAU-MEPI CVD Linked pant at the beach will work well together”. set up goals and schedule for my to pg8 before the morning report and the rotation through the department. subsequent activities of the day. 6 7 MESAU Newsletter MESAU Newsletter Clinical Observer-ship at Yale Department of Neurology Engagement with the Ministry of Health (MoH) and the

The morning report is followed patient satisfaction ratings. This in some of the terminal conditions Ministry of Education (MoE) in the development of Centre for by the day’s work schedule either subjective feeling I believe has like malignancies. ward rounds or clinics and the a lot it tells about the system in Evidence Based Medicine at MakCHS non-tangible areas like ethics and There is a close working morning session is concluded by By Edward Kakooza, MakCHS the resident Noon conference hospitality. I am always moved relationship between the new healthcare interventions. weaknesses; and extracting the neurology and neurosurgical clinical message and applying it to with a working lunch. After lunch, by such quotes from patients Evidence based medicine (EBM) is Contextualized health research the residents return to the wards like “I am comfortable because departments that allows for is critical to ensure healthcare the patient problem. a style of practice in which doctors With support from both the Ministry or clinics and the day is concluded am in one of the best hospitals easy coordination of care of manage problems by reference effectiveness, efficiency, and equity in the world”. It must indeed patients. There are several joint in Africa. Research publications have of Health and the Ministry of with an additional educational to valid and relevant information. Education, the Centre for Evidence session at 4:00pm on some days. motivate the health service learning and clinical discussion Unfortunately, research consistently an essential role in the scientific activities like grand rounds, process, providing a strategic Based Medicine at MakCHS will These sessions are in addition to providers here. Patients also has shown that clinical decisions address gaps around evidence report quite early in the course of specialized conferences in stroke rarely are based on the best available connection between knowledge the bedside or clinic teachings generation and its translation into medicine. Having more resources that take place during patient their illness that allows for timely and epilepsy that allow for joint evidence. Since primary care is the online and locally both at MakCHS harmonious management of essential foundation in effective policy and practice. visits. The areas of focus are: investigation and management The development of the Centre and at the Health Centers to be used hence the investigations may patients. The other areas with health care systems, it follows that by students during their Community history skills, physical examination providing evidence-based primary for Evidence Based Medicine at skills, enhancing knowledge/ look worse than the clinical close associations are psychiatry, MakCHS also benefits the Ministries Based Education Research and neuropsychology, neuroradiology care would reflect positively on the Service (COBERS) placement was diagnostic and treatment skills presentation of the patient. community’s health. for the development of varieties of about common neurological Obviously the health system in and neuropathology. Team policies. The Ministry of Health is one of the issue pointed out to According to the Ministries, evidence addressed, research training for conditions, procedural skills and a resource limited setting is so work is reflected in settings like based medicine is essential to the major regulation body of the different with issues like cash management of a stroke code medical policies in Uganda. The students especially undergraduates, most importantly for me is the produce the high quality evidence continuing medical education emphasis placed on a trainees based care system, lack of referral that is time bound with several needed to improve the quality health of the population has been teams: emergency department, one of the issues most relevant to (CME) for faculty, and also there is a attitude. Under attitude, the systems, lack of investigative of health care in Uganda and for concern that research publication ability and large patient volumes Neurology, Neuroradiology and decision and policy making. It has sustainable development of the resident must demonstrate economy and society. However, output capacity of African professional responsibility in which are compounded by late Neurocritical care all participate. been used to inform the regulation of researchers is excessively lower than essential medicines and rational drug limited availability of health services working as a team member with patient presentations. The other is unable to meet the enormous that of their western counterparts, uniqueness observed in this The hospital uses an electronic use, for training people working in this needs to be improved. other members of the Ward the health sector and for developing health needs. The role modeling, Service care team, patients and system is the amount and range medical record to document every practice, and teaching of evidence- Therefore more leadership by encounter with a patient. This has clinical guidelines. And therefore local investigators would better families. This is an inbuilt activity of sub-specialization. A patient knowledge is the most powerful force based medicine requires skills that that is demonstrated even before with a stroke due to several the advantage of ease in access are not traditionally part of medical assure that local health priorities for enlightened social transformation. are addressed in research and the joining the department where the cardiovascular factors will have of patient information in different When it is translated into evidence, it training. These include precisely a cardiologist, endocrinologist, settings. However, it may be defining a patient problem, and findings of the work are effectively residents are given an opportunity provides a solid foundation for policy communicated to policy makers to interact and participate in the physical therapist and a primary challenging how much time that is design and program implementation. what information is required to to be shared with focusing on the resolve the problem; conducting so evidence can be positioned to interview process of the resident care physician. This may have Research for health denotes the make a difference. Efforts towards many advantages but also physical patient and completing creation of knowledge that can be an efficient search of the literature; applicants to the department. selecting the best of the relevant improving access to evidence based This is also emphasized in the challenges the patient in multiple patient notes. Some physicians used to promote, restore, maintain, guidelines and summaries are complete the notes during the visit protect, or monitor the health of studies and applying rules of format of round table academic physician visits and multiple evidence to determine their validity; urgently needed. Teaching all the medications with a lot of caution but this may be challenging time- human populations. Health research students literature searching and discussions or tutorials. The other seeks to answer questions concerning being able to present to colleagues very important teaching tool is on polypharmacy and drug wise forcing some to complete the in a succinct fashion the content critical appraisal skills by feasible notes at the end of the day. health, produce evidence required to and friendly methods should be the presentation at the mortality interactions. guide policy and practice, and identify of the article and its strengths and and morbidity meetings that focus Much as many of these systems considered. not on individuals but on how to There are also challenges that may may need resources and improve systems. Training in the arise with communication in the infrastructure, we in the resource department is treated as an active setting of an educated community limited settings may need to start process and not passive where because of the amount of somewhere, in some areas like how the attending physician assumes information available on the we present and teach neurology the hot seat for most of the internet. The physician may need to students and how we approach sessions and early gives guidance to be required to spend more time our patients. We may benefit from to the trainees. The training in a session dealing in some cases interdepartmental strategies at also emphasizes the discipline with inaccurate information or the moment rather than seeing of on-urgent response to most information out of context. The one patient in two clinics like situations as demonstrated by the other are challenging situations neurosurgery and neurology. As discipline of response to pagers. that we probably don’t encounter we develop systems, we should be much in resource-limited settings; prepared for some of the situations discussions about end-of-life care that will arise like communication Clinical simply termed as the code status challenges and discussions about The focus of clinical care has of the patient that is discussed end-of-life care. We hope that moved beyond provision of high in many instances at around the our goals of improving the care quality care to a focus on patient time of admission for each patient. of patients with neurological conditions will be achieved with Meeting with Mr. Robert Odoki, Commissioner for Higher satisfaction. It is a deliberate This goes hand-in-hand with Education, Ministry of Education Uganda effort by the hospital to focus discussions about quality of life more advocacy.

8 9 MESAU Newsletter MESAU Newsletter THE 1st JOINT INTERNATIONAL STUDENTS SCIENTIC CONFERENCE (JISSC) My Satisfying Experience of Mentoring Students at Gulu By Kennedy Odokonyero, BPHARM University IV, MakCHS By Emilio Ovuga, Gulu

As Makerere University College of University Health Science Students Association (MakCHSA), we challenged ith every human ourselves to organize the first Joint endeavor having its International Students’ Scientific dark blue, and bright Conference having got a great Wsunny sides, it is time inspiration from the Joint Annual for me to reflect on my positive Scientific Conference (JASH) experiences as leader of Gulu organized by the College and MESAU- MEPI project. I have had partners. lots of exciting happy moments and experiences in the last five We put our thoughts together as years, but especially in the past pharmacy, radiology, medicine, Dr. Baryomunsi (seated 4th on the front row from the right) posing for a photo year. One striking experience has nursing, environmental health, with some of the participants been working with students. It biomedical sciences, dental, appears that nothing gives me cyto-technology and biomedical more satisfaction than sitting engineering students. The list of University and Busitema University at under the umbrella of MakCHSA, with undergraduate students on courses is overwhelming but by the the conference. Allied Health Professionals’ Council the same side of the table as we time JISSC ended on 3oth April, we and Hotel Africana. As most of us, the The conference was officially closed discuss their research ideas and had experienced the gold in this JISSC conference organizers, leave by the state minister of health Dr. research results. Research is a cocktail of courses. The experience the college, we are counting on the Chris Baryomunsi who represented core curriculum requirement in of the two-day conference, JISSC, next MakCHSA cabinet to keep the the Prime Minister Dr. Ruhakana partial fulfillment for the award right from the organizing moments fire burning and organize the second Rugunda. of the medical degree of Gulu to the end was an incredible annual Joint International Students’ University. In preparation for Prof. Ovuga helping a group pf students with their team work learning experience for us as Scientific Conference. The struggle this fulfillment students must As organizers, listening to research continues. students. This was the true story and project presentations from pass a theory paper in research of inter-professionalism from all students of different methodology in their third year. dimensions. report. At this stage I sit with my outstanding student groups courses was a dream subsequently taught himself come true. We In the fourth year, students my students and go through We started meeting as committee how to successfully publish their had presentations form their own research groups their results; students learn members of this great achievement, research results, and enroll on from dentistry, and select a suitable research how to interpret their results, JISSC, 4 months before April. I MSc program in global health pharmacy, medicine, topic to implement. Lecturers critique their own work and must confess, juggling academics, and infectious diseases. A second microbiology, are then invited to volunteer draw conclusions based on their fundraising, mobilizing for abstracts student group successfully biomedical to supervise at least one of the findings. As I interact with the and attendees across Africa was published their results in the New engineering, nursing research groups. Each research students, I realize the research an uphill challenge. We stood our England Journal of Medicine. and others in between. group must develop a full potential in some of them as ground to face the journey we had proposal that is passed by the they gradually begin to take full JISSC was a wealth The lesson arising out of my started as amateurs. A month to Department of Public Health. ownership of their work and of knowledge for experiences is for MESAU the date of the conference, it felt The students then present their answer my searching questions the attendees and Ms.Stacy making her presentation institutions to utilize the like we were pushing a rock. We respective proposals to the with confidence and without fear. indeed it was a exercise of mentorship and realized we needed guidance and Research and Ethics Committee This potential emerges through powerful testimony to student supervision from the sought for mentorship from one of of Gulu University for approval my going through students’ interprofessionalism. perspective of health research our lecturers, Dr. Freddie Bwanga. before they can implement research with the students, as I If the health sciences capacity building beginning at Well, the advice we got helped us their research. Advanced make comments, ask questions field continues with undergraduate level. Not every move a mile. Dr. Bwanga’s word undergraduate students analyze and correct their write-ups this unity, then health student will be a researcher, of wisdom gave us the courage to their data with minimal help using track changes with their care will be able to but mentorship will mine out push forward for the conference. though some seek the help of a full participation during the grow at a fast rate the potential researcher at statistician. discussions. In this way students regardless of the undergraduate level. MESAU We spread our wings as far as begin to experience a deep sense challenges. should develop strategies to we could and invited as many The point where I usually get of achievement and satisfaction students as we could both in identify and support potential We would like to thank involved is helping students to from the mentoring interaction. country and abroad. We were researchers to develop their full our sponsors: Resilient think through what they plan It is what I see happen in a so grateful to have 200 students potential as future health care African Network, MBN and intend to do and achieve student that satisfies me in my from Kampala International researchers and leaders that are Laboratories, Makerere from their research experience. role as leader of MESAU, and as University, International Health required to improve population University College of The Conference provided an opportunity to network and I then help them to think a lecturer. The leader of one of Sciences’ University, University of health in Uganda. Health Sciences, all make friends. Selfie moment with some of the delegates carefully as they prepare their Rwanda, Wilkes University, Mbarara from Rwanda student associations

10 11 MESAU Newsletter MESAU Newsletter MESAU investments in research administration and Setting up an Office of Research Administration in the Faculty management support systems begin to bear fruit

of Medicine, Mbarara University of Science and Technology By Harriet Nambooze, MakCHS institutions had in place what was had been written and fill up any required to submit applications glaring gaps. The actual electronic By Edith Wakida, Research to NIH while the other three were submission of the grant application a situation analysis and manuscript writing, responsible Manager-Faculty of Medicine, still grappling with the various wasn’t as smooth as would have consultation with the Faculty conduct of research and For close to 5 years, MESAU MUST registrations. This was so different been expected. PDF optimization Deans, Heads of Department, preparing poster presentations institutions research administrators from the time the Medical Education had to be used in order to ensure Faculty, Researchers, Principal through didactic training and and managers have been exposed Faculty of Medicine (FoM) Partnership Initiative (MEPI) that the large number of scanned Investigators, the MUST Grants research clinics. The offcie has to various types of trainings and set up an Office of Research grant was being written when letters of support from collaborating Office and other stakeholders in spearheaded the development exposures that were intended to Administration and Management only MakCHs had all the required institutions and faculty could be the University community. The of Institutional policy documents enhance their capacity in sourcing (ORA) in 2012 to provide Health registrations in place. Ultimately, accepted in the online system. core objective was to create a like the Grants management for funding opportunities, applying Sciences Research Support to its of the 5 MESAU institutions three Though the final verdict of the three better understanding of the ORA manual; Research, Innovations, for the opportunities and eventually Faculty, students and Researchers. were able to respond to this ‘limited submitted applications is yet to by clarifying its vision, mission, Management and Uptake policy managing them in a compliant funding’ opportunity. be known, we are cognizant of the objectives and core values by document; and the Centralized way if awarded. When the National ORA FoM delivers an integrated capacity that has been built over the aligning its strategy with the Institutional Research Innovations Institutes of Health (NIH) call for research support package with Though MakCHS already had its NIH years. Faculty of Medicine vision, and Management Office (CIRIMO) applications - Limited Opportunity: Research Training for Career registrations in place by the time the strategic plan contributing to the MEPI grant application was being Edith Wakida, the Grant’s Officer University research strategy. In Development of Junior Faculty in Medical Education Partnership written, the actual development at Mbarara University of Science 2013, ORA joined hands with the of the grant application was done and Technology (MUST) who DRUSSA (Development Research Initiative (MEPI) schools (D43) was announced, I saw it as a means to by staff from MakCHS with support coordinated the grant writing Uptake in Sub-Saharan Africa) from staff from the Institute of process at MUST had the following program to promote the conduct test the capacity that had been built over time. Infectious Diseases and the Johns to say about her experience; “this of relevant research in the faculty Hopkins University. This time round was an interesting experience which will ultimately inform The first thing that caught my the entire grant application process collating all that MESAU had done policy and practice. So far, gains attention as I read the funding was done by MakCHS staff with and using it to write another have been made in influencing opportunity announcement (FOA) the Grants Office spearheading the application. Working with the researchers’ decisions in was that institutions could apply budget development, populating writing team was fun, engaging, Research Uptake and community individually. Luckily enough NIH had the grant application form, at times frustrating and yet a good engagement right from proposal for the last four or so months prior sourcing for support letters, bios learning experience for me as a development. The ORA strategy to releasing the FOA been sending and assembling the supporting Research Administrator. The part I is expected to improve research us information on how institutions documents was left to a recent enjoyed the most was being able to by contributing to the stable and could apply for NIH funding which graduate of the UCF MRA program. make my maiden NIH submission predictable research funding information was subsequently The development of the concept having worked with the writing four thematic areas to develop and offer the needed research was taken up by both senior and team from concept formation to the mission, and objectives, develop shared with the MESAU network. namely: Sustainable infrastructure infrastructure which will support By the time the RFA came out, two middle level faculty. The entire end.” and facility; The Researcher; strategic directions and a strategic the researchers and ensure that team met regularly to review what Research Collaborations and framework for implementing its the research processes are in Partnerships; and Research activities. line with the requirements of Governance and Compliance. The the national research policy A new approach to training of Health Workers from the rural The stakeholders were engaged strategy is to build the capacity of and strategy. The strategy is through a participatory process Researchers, motivate and retain expected to feed into the overall areas to reduce maternal and newborn mortality and morbidity; of analysing their current research them; strengthen the existing university research strategy situation to identify the Strengths, a partnership between Makerere University Kampala, Drexel collaborations and develop that recommends similar offices Weaknesses, Opportunities and networks to attract more Research across all Faculties and institutes University Philadelphia and Rotary International. Threats (SWOT). A consideration of collaborators and partners; and as research administration and the Political, Economic, Social and establish & strengthen governance uptake management is being By Dr Mike N. Kagawa women who do great things, skills or confidence to perform life- Technological (PEST) factors that structures that create a conducive championed in the institution. not only because they can but saving interventions to the mothers affect the external environment research environment. With Rotary International (RI) is an because they care, have ventured during labour and childbirth and for medical research and research Research support at faculty Acknowledgements got to international organization of into addressing the problem of their newborns who need it. While administration was also done and level, it is easy to monitor and MEPI iRIM Supplement grant to men and women committed maternal and newborn morbidity training of health workers may not strategic choices made in defining ensure quality control, eliminate MEPI MESAU which made this to be champions of many & mortality in Uganda, through be a panacea to all the causes of the scope of work and strategic duplication and build synergy from innovation a reality in the Medical humanitarian endeavors. their global grants project also maternal and newborn mortality areas where the ORA has got a the current fragmented efforts. The School at MUST; Mrs. Mabisi They have been involved in known as the Vocational Training and morbidity, there is evidence comparative advantage to focus Research support functions are Betty and Ms. Larok Joan who humanitarian causes such as Teams (VTT). Everyday about 16 that about 15% of all deliveries on. coordinated in liaison with MUST facilitated the process; and the eradication of polio, treatment women die during childbirth in will develop a life-threatening Dean for creating a conducive of people with cleft palate/lips, Uganda. This is unacceptable and complication that requires a skilled Grants Office. ORA so far builds capacity for work environment provision of humanitarian aid to something needs to be done. birth attendant to intervene in order researchers & students in proposal A strategic planning process disaster stricken areas through One of the major contributors to for the mother and baby to survive. developemt, grant writing, was conducted following their flagship programme called these deaths is health workers It has also been demonstrated shelterbox etc. These men and who either lack the knowledge, to pg 14 12 13 MESAU Newsletter MESAU Newsletter From 13A new approach to training of Health Workers from the rural areas to reduce maternal and newborn mortality and morbidity; a partnership between Makerere University Kampala, Drexel University Philadelphia and Rotary International.

can also act as resource persons 2015 focused a lot on e-learning that have provided funding for this especially on the use of computers and received a lot of support project. A lot of networking takes (troubleshooting problems) from our American friends. Drexel place whenever the Ugandan team for other health workers as it is University is committed to continue visits Philadelphia. On their recent envisaged that they may be more supporting Makerere University in visit, it was possible to interact conversant with these technologies. the area of e-learning as they have with Rotarians from several other The students will also benefit from a lot of experience in this area. This clubs in the Philadelphia area such the mentoring visits that may be team from Makerere University has as Rotary Club of Blue Bell, Rotary done by faculty from Makerere also promised to be champions of Club of Philadelphia, Rotary Club while they are on site for their e-learning at Makerere University of West Reading Wyomissing and COBERS rotations. This project is in College of Health Sciences and many others, and to visit other line with the broad objectives of to recruit other faculty to receive institutions such as St Christopher Makerere University which include training on e-learning with Children’s Hospital, Montgomery training, research, innovation and support from Drexel University. Community College, Arbington service delivery. The partnership between Makerere Hospital, Johns Hopkins School of University and Drexel University in Nursing and Jhpiego Corporation. The collaboration between the area of e-learning will build on This kind of networking facilitated Makerere & Drexel University is what has so far been done by MEPI/ by Rotary International is another already showing promise. So far MESAU in the area of e-learning and innovative approach to building two bi-directional faculty exchange is likely to consolidate the gains so sustainable partnerships and has visits have been successfully far made. the potential to create connections concluded, several real time The Makerere University Team with the President of Drexel University at the Drexel College of Medicine Main Auditorium. Left to right: that will live on way beyond the video-linked international grand Rotary International as a partner in three years of the VTT project and Dr Rose Nabirye, Sr Dorcas Ayo, Dr Mike N. Kagawa, Mr Bob John, Dr Flavia Namiiro & Dr John A Fry (President of Drexel University) rounds have been conducted and holding the signed MOU, Dr Shannon Marquez, Dr Alleyne Gregg, Ms Harriet Obbo & Dr Owen Montgomery this project has not only provided lead to future collaborations as a Memorandum of Understanding funding for this project to take off shown by the signing of the MOU between the two Universities was but has been instrumental in linking between Makerere University that where health workers are workshops that not only escalate from various points via a local signed, among other things. The the two universities together. and Drexel University. As it is trained on newborn resuscitation, costs but are also disruptive to area network that is not entirely team from Makerere University (Dr While there are two main Rotary Montgomery Community College there is a reduction in the number continuity of service. While training dependent on the wider internet Mike N. Kagawa – Obgyn, Dr Rose Clubs that ultimately drive this was instrumental in the exposure of fresh stillbirths, meaning that materials for CPD have always been although they are also linked via N. Chalo – Dept of Nursing, Dr project; Rotary Club of Blue Bell in of the team to e-learning and is probably some of the babies are available from several sources such internet to Makerere University. Flavia Namiiro – Dept of Paed, Ms Philadelphia USA and Rotary Club of also willing to continue partnering being declared as stillborn too as WHO, Jhpiego, ALARM, Makerere, Dorcas Ayo Ekau – Dept of Obgyn Kampala North in Kampala Uganda, And how does the Makerere with Makerere University in this quickly. Taking on this cue, this Ministry of Health, etc; the challenge and Mr Bob John – Dept of ICT) there have been several other clubs endeavor. project aims to develop a novel has been a delivery mechanism University College of Health that visited Drexel University in May, both here in Uganda and in the US approach to training of health that is not very costly, can be scaled Sciences benefit? Three of the workers from rural areas away up to cover the whole country so selected health facilities in from the capital using Information that updates can be delivered in this Rotary project are COBERS Technology (IT). It is envisaged real time, is sustainable, and does (Community Based Education that if training opportunities and not disrupt service delivery. If it can Research and Service) sites where The Clinical Skills Laboratory (CSL) at MakCHS has learning materials are availed to be demonstrated that training of medical students rotate as part these health workers at or near in-service health workers can lead of their community clerkship. The helped in Family Medicine skills training their workplace, it will lead to to improved health outcomes and medical students during their improvement in their knowledge, the training materials are available, rotation will also have access to Namatovu Jane, Head of Family eliminates the anxiety of learning skills and confidence to care for the this project is coming up with an these training resources that will such an environment. With the Medicine Dept., School of Medicine, from real patients. mothers and newborns and hence innovative approach that helps be available at these sites. Plans inception of the CSL, specific clinical College of Health Sciences, Makerere reduce maternal and newborn to deliver the already available are underway to populate the demonstrations, especially with University The department of Family Medicine mortality and morbidity. Because training materials to the health external hard drives at these sites visiting Family Physicians, as well with up-to-date training resources at MakCHS uses the Mulago as Objectively Structured Clinical contemporary medicine has a workers at or close to their place of The Clinical Skills Laboratory (CSL) Hospital Assessment Center (MAC) rapidly expanding evidence base work. The installation of computers such as the Global Library of Examinations (OSCEs) are easily Women’s Medicine (GLOWM), at Makerere University College of as one of the clinical learning and conducted in a more structured and upon which health care decisions in designated spaces (computer health sciences was established with teaching sites as well as other should ideally be made, it is hoped libraries) that are accessible to all Jhpiego training materials on Basic friendly environment compared to and Comprehensive Emergency the main aim of skills training for specialized wards and community MAC. that this approach will empower health workers is now complete health professionals in training. The sites. This is a relevant approach for health workers with facilities at or Obstetric & Newborn Care (B/ at four rural health facilities with CSL is mainly used in skills training Family medicine given its emphasis Some students admitted on the close to their workplace that would CEmONC), Advances in Labour And external digital hard drives that can for undergraduate medical students on ambulatory medical care.MAC is postgraduate program especially enable them to search and evaluate Risk Management (ALARM) training store large amounts of data such and occasionally postgraduate so congested with patients and this those who did their undergraduate this evidence base and apply it to materials and many others. It is as literature, presentation slides students and faculty. The CSL does not provide an ideal learning training from other medical their practice, without necessarily hoped that students at these sites and demonstration videos. The provides an environment conducive environment. It is even worse to schools other than MakCHS are having to go for formal training will not only be able to utilize these computers are networked so that for learning clinical skills because it conduct a clinical examination in not familiar with the OSCE mode training materials can be accessed resources for learning but they to pg 16 14 15 MESAU Newsletter MESAU Newsletter The Clinical Skills Laboratory (CSL) at MakCHS has helped in Family Mbarara University MESAU Masters Medicine skills training Fellows Graduate 2015: A Shared Journey By Ampaire Lucas (M.MLS- the shoulder provided by MESAU we were able to interact with Medical and Diagnostic for us to lean on as we started lots of important people which Microbiology) our courses with rather a lot of increased on our social network, uncertainty as to how we would understood the need and how On the 31st graduation mobilize the necessary funds. to work collaboratively with ceremony, six MEPIMESAU other researchers suffice to Master’s Fellows were among The journey was rewarding mention developed skills in areas those who graduated at Mbarara and progressively positive. We like Project management, Data University entered. These jubilant were honored to attend MEPI analysis, critical thinking and graduatess included three Master site visits in Mbarara and Gulu. problem solving. of Medical Laboratory sciences Those are very memorable days. (Mr. Ampaire M. Lucas, Mr. We interfaced with various Ooooh, the mention of Mbalibulha Yona, Mr. Taremwa dignitaries from various parts of Monitoring and Evaluation Ivan Mugisha), two for Msc the globe which helped build our meetings kept everyone on Pharmacology (Mr. Twikirize confidence and strengthen social tiptoes. Thanks to Ruth Nabagala Osbert and Ms. Hanifa Nantogo) networking skills. who made it routine in our minds and one Msc. Microbiology (Ms. and we can say not only have we “What returns can we make” Atwebembeire Jenina) graduated with masters in our for the many trainings attained various disciplines but also with This award was a blessing to us in Grant writing, manuscript some principles of monitoring because without it completing writing, responsible conduct of and evaluation. research and other seminars and Family medicine postgraduate student during OSCE our Masters programs almost We were undoubtedly privileged seemed a nightmare in these workshops in which we acquired also to meet experienced financially challenging times. Knowledge and hands on skills, researchers like Prof. Nelson With the award we were able to that helped us to improve on Ssewankambo and Prof. Yuka our writing skills, learn team of assessment. We usually The CSL therefore provides an adequate environment for family move on course with minimal Munabe whose humbleness and formations in research and conduct mock OSCEs for these medicine postgraduate students who have never been exposed to economic stress. The Masters calmness challenged everyone how best to communicate in students in the CSL with the aim OSCEs to practice for the first time before their first set of exams in their degrees attained by the auspices and left each one of us inspired research? Nothing but to be of improving their confidence, postgraduate education. of MESAU is our first step into to walk their path. It was such an grateful for the opportunity. understanding of the flow of our long journey of academics. encouraging experience having Through the various workshops, OSCE, interpretation of the To this note we are grateful to to share moments with such questions, appreciation on use highly experienced people in of allocated time per station academia. and feeling of preparedness Community-Based Education, for final OSCE. Both simulated Research and Service (COBERS) At MUST, the enthusiasm and real patients are used in exhibited by the MESAU team is the CSL for these mock OSCEs. Experience: The Hunter gets Hunted one to remember. The overtly Interacting with the simulated exercised team work is an patients in a safe and conducive By Hussein Oria, MakCHS education. Prior to community architect of good leadership and environment allows the learners internships, students have an mentorship of the PI (Associate COBERS stands for Community to develop skills such as history orientation week at the university. Prof. Samuel Maling). This kept Based Education Research and taking, physical examination, During this week, students are us together as a team and we service. Its inception is premised patient communication, clinical given over-view lectures, and must admit we got better as time on the need to train a health care reasoning and professionalism. other administrative matters are went by. We are very grateful to worker in a context in which he handled including their facilitation especially Edith Wakida for her Simulated patient encounters /she will eventually work. It is for site costs and arrangements unwavering reminders that made are a powerful tool for teaching experiential training that exposes for accommodation and travel us meet deadlines as would be and assessing communication students to community practice to sites. Initially, the University set. and procedural skills. The and makes them acclimatize to invested in site identification simulated patient allows the socio-economic situation of through district entry and meeting We would like to thank the great every student to be assed in a the community. district leadership and potential minds of the PI, Prof. Nelson more standardized encounter sites’ In-charges. Using a defined Ssewankambo and his team for a The COBERS placements which increases validity of criteria, suitable sites for students’ wonderful vision and pledge that of students are done in a the assessment and also placements were identified. we shall always be part of their multi-disciplinary manner to the opportunity to receive MUST- MESAU Fellows graduate 2015 From L-R Osbert Twikirize, Hanifa vision. encourage team work across immediate feedback from both The need to retain health workers Nantongo, Ivan Taremwa Mugisha, Jenina Atwebembire, Yona Mbalibulha, different health professions the simulated patient and the is our priority goal in training Lucas Ampaire Succeed we Must and promote inter-professional tutor. to pg 18 16 17 MESAU Newsletter MESAU Newsletter From 16 Community-Based Education, Research and Service (COBERS) Experience: The Hunter gets Hunted 2014 MESAU PUBLICATIONS a health worker in a context in limited availability of health care demanded for partnership in 1. Andrew Kampikaho Turiho, Elialilia S. Okello, 10. Miriam Nansunga, Yukari C. Manabe, Paul E. Alele, which he/she will eventually work. workers in some of the most community training of students Wilson W. Muhwezi, Steve Harvey, Pauline Josephine Kasolo. Association of testosterone levels The COBERS program helps to remote areas like Karamoja and the College has proactively Byakika-Kibwika, David Meya and Anne R. with socio-demographic characteristics in a sample acclimatize the students to the sub-region. Mercycorps- a responded to the call. The requests Katahoire. Effect of School-based Human of Ugandan men. African Health Sciences 2014; rural communities and helps them US-funded organization- are only considered following Papillomavirus (HPV) Vaccination on Adolescent 14(2):348-355 understand the socio-economic operates in this region. In 2012, satisfactory assessment of sites for Girls’ Knowledge and Acceptability of the HPV 11. Nansunga M, Barasa A, Abimana J, Alele PE, determinants of health. Mercycorps contacted MakCHS suitability for students’ training. Vaccine in Ibanda District in Uganda. Afr J Reprod Kasolo J. Safety and antidiarrheal activity of Priva for partnership in students’ Health 2014; 18[4]: 45-53. adhaerens aqueous leaf extract in a murine model. In the past, the University was training/placement in Karamoja The benefits of community training 2. Orikiriza P, Tibenderana B, Siedner MJ, Mueller J Ethnopharmacol. 2014 Nov 18;157:251-6. doi: responsible for identifying suitable sub-region. Indeed, presently, and internship are enormous and Y, Byarugaba F, Moore CC, et al. (2015) Low 10.1016/j.jep.2014.09.044. Epub 2014 Oct 8. sites for students’ placement. we have two active sites there, they indeed interest key stake Resistance to First and Second Line Anti- 12. Namatovu JF, Ndoboli F, Kuule J, Besigye I. However, this trend is changing. i.e. Kotido Health Center IV and holders in health service delivery to Tuberculosis Drugs among Treatment Naïve Community involvement in health services at We now have sites that are pro- Kaabong Hospital. Mercycorps undertake the strategic partnership Pulmonary Tuberculosis Patients in Southwestern Namayumba and Bobi health centres: A case study. active and demand for students` is now in the process of building with MakCHS. The initial efforts of Uganda. PLoS ONE 10(2): e0118191. doi:10.1371/ Afr J Prm Health Care Fam Med. 2014;6(1), Art. presence on their own volition. students’ learning centres at MakCHS of hunting for COBERS journal.pone.0118191 #613, 5 pages. http://dx.doi.org/10.4102/ phcfm. This is due in part to the benefits these sites, where students sites seems to be paying off as 3. Acaku Moses, Freddie Bwanga, Yap Boum v6i1.613 the health facilities or organization will be accommodated. More the hunter, MakCHS is now being and Joel Bazira, Prevalence and Genotypic 13. Mariam DH, Sagay AS, Arubaku W, Bailey RJ, see in the community training of recently, a number of districts hunted by the districts and other Characterization of Extended- Spectrum Beta- Baingana RK, Burani A, Couper ID, Deery CB, students. One of the key result areas have demanded that students be stakeholders for enrolment of their Lactamases Produced by Gram Negative Bacilli de Villiers M, Matsika A, Mogodi MS, Mteta KA, is the reduction in waiting time for placed at their health facilities. health facilities in the COBERS at a Tertiary Care Hospital in Rural South Western Talib ZM. Community-based education programs patients at the health facilities. In These include districts of Lwengo programme. Community internships Uganda. British Microbiology Research Journal, in Africa: faculty experience within the Medical ISSN: 2231-0886, Vol.: 4, Issue: 12 (December) addition, patients’ numbers increase and Kalungu, among others. are a mainstay in improving Education Partnership Initiative (MEPI) network. Acad 4. Bashir Mwambi, Jacob Iramiot, Freddie Bwanga, when students are available at In addition, some private not community health and support Med. 2014 Aug;89(8 Suppl):S50-4. doi: 10.1097/ sites. But also a number of other health care worker retention in Marthae Nakaye, Herbert Itabangi and Joel Bazira. ACM.0000000000000330. for profit health institutions, Clindamycin Resistance among Staphylococcus factors are contributing to this underserved communities. 14. Longenecker, Chris T; Okello, Emmy; Lwabi, Peter; e.g. Save-A-Life Uganda, based Aureus Isolated at Mbarara Regional Referral observed trend. For example, Costa, Marco A; Simon, Daniel I; Salata, Robert A. in Nakasongola district have Hospital, in South Western Uganda. British Management of rheumatic heart disease in uganda: Microbiology Research Journal, ISSN: 2231-0886, the emerging epidemic of non-AIDS comorbidity Vol.: 4, Issue. 12 (December) in resource-limited settings. Journal of acquired 5. Martha Nakaye, Freddie Bwanga, Herbert immune deficiency syndromes JAIDS Journal A LIS TWG Reference Management online course to Itabangi, Iramiot J. Stanley, Mwambi Bashir and of Acquired Immune Deficiency Syndromes 2014; Joel Bazira. AmpC-BETA Lactamases among 65(2):e79-80. enhance the research capacity of students, researchers Enterobacteriaceae Isolated at a Tertiary Hospital, 15. Kamukama A, Twineomujuni E, Agaba G. Extent and faculty in the MESAU Consortium South Western Uganda British Biotechnology of Use of Aloe vera Locally Extracted Products for Journal, ISSN: 2231–2927,Vol.: 4, Issue.: 9 Management of Ailments in Communities of Kitagata (September) Sub-county in Sheema District, Western Uganda. By Alison A. Kinengyere & (CWYW) feature 6. RC Nabirye, F. Beinempaka, C. Oken, S. Groves. International Journal of Sciences: Basic and Applied Dickson Muyomba 3. automatically generate Improving midwifery care in Ugandan public health Research (IJSBAR) (2014) Volume 15, No 1, pp 1-15 references, in an output style of hospitals. The midwives perspective. International 16. Zohray M Talib, Elsie Kiguli-Malwadde, Hannah The Library and Information Science choice Journal of Health Professions (IJHP) 2014: 1: 6-13. Technical Working Group (LIS Wohltjen, Miliard Derbew, Yakub Mulla, David 7. Kamukama Adams, Twineomujuni Eliot, TWG) members from the Makerere 4. manage EndNote libraries Olaleye and Nelson Sewankambo. Transforming Agaba Gerald. Helmet use among commercial University College of Health Sciences Health Professions Education through In-Country Some of the feedback from those who motorcyclists in kawempe; a survey of knowledge, Collaboration: Examining the consortia between have developed an EndNote have attended the course includes: reference management course which attitude and practice” International Journal of African medical schools catalyzed by the Medical has been uploaded on the MESAU 1. It was a great time of learning. Sciences: Basic and Applied Research (IJSBAR). Education Partnership Initiative. Accepted for website (http://mesau.mak.ac.ug/ I got more skills to make my 8. Lusiba John K Nakiyingi, Lydia Kirenga, Bruce publication in Human Resources for Health content/online-endnote-training). research more interesting and J Kiragga, Agnes, Lukande, Robert , Nsereko 17. Aloysius Gonzaga Mubuuke, Catherine Mwesigwa, less time consuming Maria ,Ssengooba Willy, Katamba Achilles, Samuel Maling, Godfrey Rukundo, Mike Kagawa, The course which is in two parts: 2. Research work compilation in Worodria William, Joloba Moses L Mayanja-Kizza David Lagoro Kitara, Sarah Kiguli. Standardizing Power Point and a practical session, Harriet. Evaluation of Cepheid’s Xpert MTB/RIF is meant for graduate students, terms of referencing has been assessment practices of undergraduate medical Test on Pleural Fluid in the Diagnosis of Pleural researchers and faculty in the MESAU made easier. competencies across medical schools: challenges, Tuberculosis in a High Prevalence HIV/TB Setting Consortium. So far, two institutions: opportunities and lessons learned from a consortium 3. Came in timely and was very PLoS One 2014 Jul 22;9(7):e102702. doi: 10.1371/ of medical schools in Uganda. The Pan African Makerere University and Mbarara useful University of Science and Technology journal.pone.0102702. eCollection 2014. Medical Journal. 2014;19:382 have benefited from the course. The 4. It was very necessary 9. Okello, Samson; Rogers, Owori; Byamugisha, http://www.panafrican-med-journal.com/content/ Asaph; Rwebembera, Joselyn; Buda, Andrew objectives of the course are to equip ...we want to hear from you article/19/382/full trainees with skills to: J. Characteristics of acute heart failure 18. Emmanuel Mukule, Roy Mubuuke. The intricate Tell us about your experience of hospitalizations in a general medical ward in relationship between a medical school and a teaching 1. create and populate an EndNote using the EndNote online course. Southwestern Uganda. International Journal of hospital: A Case Study in Uganda. Education for Library Twit us on the MESAU Twitter handle Cardiology Int J Cardiol. 2014 Oct 20;176(3):1233- Health 2014 27(3): 249-254 @MESAUMEPI and at @makererechs. 2. make citations in a Ms Word 4. doi: 10.1016/j.ijcard.2014.07.212. Epub 2014 19. Nabatanzi R, Bayigga L, Ssinabulya I, Kiragga Your comments will enrich the course. using the Cite While You Write Alison Kinengyere (PhD) during one of the Aug 4. A, Kambugu A, Olobo J, Joloba M, Kamya MR, recording sessions 18 19 MESAU Newsletter 2014 MESAU PUBLICATIONS

Mayanja-Kizza H, Nakanjako D. Low antigen- 2014, Article ID 309106, 7 pages http://dx.doi. specific CD4 T-cell immune responses despite org/10.1155/2014/309106 normal absolute CD4 counts after long-term 28. Kabagenyi A, Jennings L, Reid A, Nalwadda G, antiretroviral therapy an African cohort.. Immunol Ntozi J, Atuyambe L. Barriers to male involvement Lett. 2014 Sep 25. pii: S0165-2478(14)00205-3. in contraceptive uptake and reproductive health doi: 10.1016/j.imlet.2014.09.016. [Epub ahead of services: a qualitative study of men and women’s print].PMID:25263953 perceptions in two rural districts in Uganda. Reprod 20. Kiguli JM, Itabangi H, Atwine D, Kibuka LS, Bazira Health. 2014 Mar 5;11(1):21. doi: 10.1186/1742- J and Byarugaba. Antifungal susceptibility patterns 4755-11-21.PMID:24597502 PubMed - in process of vulvovaginal Candida species among women PMCID:PMC3946591 attending antenatal clinic at Mbarara Regional 29. Ocan M, Bbosa GS, Waako P, Ogwal-Okeng J. Referral Hospital, south western Uganda. British Factors Predicting Home storage of medicines in Microbiology Research Journal, 2014: 5(4): 322- Northern Uganda. BMC Public Health 201414:650. 331 30. Katagwa VN, Opio RO, Niwasasira DN, Onyege A, 21. Kiguli S, Mubuuke R, Baingana R, Kijjambu S, Naisanga M, Bongomin FA, Kitara DL. Acceptability Maling S, Waako P, Ovuga E, Obua C, Kaawa- of human papilloma virus vaccination among primary Mafigiri D, Nshaho J, Kiguli-Maladde E, Bollinger school girls in Minakulu sub-county, Northern R and Sewankambo N. A Consortium approach Uganda. European Journal of Cancer Prevention: to competency-based undergraduate medical July 2014 - Volume 23 - Issue 4 - p 294-295doi: education in Uganda: process, opportunities and 10.1097/CEJ.0000000000000021 challenges. Educ Health 2014;27:163-9. 31. Ochieng J, Ibingira C, Buwembo W, Munabi I, 22. Mafigiri DK, Ayebare F, Baingana RK, Okello E, Kiryowa H, Kitara D, Bukuluki P, Nzarubara G, Sewankambo N. Medical Education for Equitable Mwaka E. Informed consent practices for surgical Services for All Ugandans (MESAU) Consortium: care at university teaching hospitals; a case in a low Development and Achievements. Acad Med. resource setting BMC Medical Ethics 2014, 15:40 2014 Aug;89(8 Suppl):S65-8. doi: 10.1097/ doi:10.1186/1472-6939-15-40 ACM.0000000000000333. 32. Muwazi L, Rwenyonyi C, Nkamba M, Kutesa 23. Odongo CO, Bisaso RK, Byamugisha J and Obua A, Kagawa M, Mugyenyi G, Kwizera G and C. Intermittent use of sulphadoxine-pyrimethamine Okullo I. Periodontal conditions, low birth weight for malaria p RKrevention: a cross-sectional study and preterm birth among postpartum mothers in of knowledge and practices among Ugandan two tertiary health facilities in Uganda. BMC Oral women attending an urban antenatal clinic et Health 2014, 14:42 doi:10.1186/1472-6831-14-42 al. Malaria Journal 2014, 13:399 http://www. 33. Ocan M, Bwanga F, Bbosa GS, Bagenda D, malariajournal.com/content/13/1/399 Waako P, Ogwal-Okeng J, Obua C. Patterns and 24. Kimbugwe G, Maghanga M, Oluka D, Nalikka O, Predictors of Self-Medication in Northern Uganda. Kyangwa J, Zalwango S, Kilizza U, Turyasiima PLoS ONE 2014: 9(3): e92323. doi:10.1371/journal. M, Ntambazi L, Walugembe F, Galiwango J. pone.0092323 (2014) Challenges Faced by Village Health Teams 34. Ssinabulya I, Kayima J, Longenecker C, Luwedde (VHTs) in Amuru, Gulu and Pader Districts in M, Semitala F, Kambugu A, Ameda F, Bugeza S, Northern Uganda. Open Journal of Preventive McComsey G, Freers J, Nakanjako D. Subclinical Medicine,2014: 4, 740-750. doi: 10.4236/ Atherosclerosis among HIV-Infected Adults Attending ojpm.2014.49084. HIV/AIDS Care at Two Large Ambulatory HIV 25. Mukunya D, Kizito S, Orach T, Ndagire Clinics in Uganda. PLoS ONE 2014: 9(2): e89537. R, Tumwakire E, Rukundo GZ, Mupere E and doi:10.1371/journal.pone.0089537 Kiguli S. Knowledge of integrated management of 35. Okello E, Beaton A, Mondo CK, Kruszka P, childhood illnesses community and family practices Kiwanuka N, Odoi-Adome R, Freers J. Rheumatic (C-IMCI) and association with child undernutrition Heart Disease in Uganda: The Association between in Northern Uganda: a cross-sectional study. BMC MHC Class II HLA DR Alleles and Disease. BMC Public Health 2014, 14:976 doi:10.1186/1471- Cardiovascular Diseases 2014, 14:28 2458-14-976 36. Nakanjako D, Katamba A, Kaye DK, Okello E, 26. Manabe YC, Campbell JD, Ovuga E, Maling S, Kamya MR, Sewankambo N and Mayanja-Kizza H. Bollinger RC, Sewankambo N. Optimisation Doctoral training in Uganda: evaluation of mentoring of the Medical Education Partnership Initiative best practices at Makerere University College of to address African health-care challenges. The Health Sciences. BMC Medical Education 2014: 14:9 Lancet Global Health, Volume 2, Issue 7, http://www.biomedcentral.com/1472-6920/14/9 Page e392, July 2014 doi:10.1016/S2214- 37. Kaadaaga HF, Ajeani J, Ononge S, Alele 109X(14)70235-9 PE, Nakasujja N, Manabe YC and Kakaire O. 27. Nakibuuka J, Sajatovic M, Katabira E, Prevalence and factors associated with use of herbal Ddumba E, Byakika-Tusiime J, and Furlan AJ. medicine among women attending an infertility clinic Knowledge and perception of stroke: a population in Uganda. BMC Complementary and Alternative survey in Uganda. ISRN Stroke. Volume Medicine 2014, 14:27 doi:10.1186/1472-6882-14-27

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