Reflections on Doctoring: Finding Joy and Healing in Africa

**By Una Lee, MD**

It was my third trip to Mbarara, a bustling city in rural Southwest Uganda and home to a regional hospital. Visiting the first time as a UCLA fellow and then as an attending surgeon, the people and places had never left me. I felt excitement but also a new responsibility: this time I would serve as trip medical director for Medicine for Humanity, a nonprofit organization dedicated to improving women’s health through direct care and education, in partnership with the Mbarara University of Science and Technology. The mission had grown, but it felt like a homecoming – a connection I needed more than I knew.

Una plus three

 From left: Wai Lee, MD; Una Lee, MD; Carli Hoaglan, MD and Brooke Reagan, surgical tech; overlooking Lake Mburo National Park, Uganda.  

The visiting team included three Virginia Mason colleagues: Brooke Reagan, surgical technician; anesthesiologist Carli Hoaglan, MD, and urology fellow Wai Lee, MD. We and our UCLA counterparts became a well-oiled machine from the moment we met, organizing 22 bagged loads of medical supplies and gear. The Virginia Mason team moved into a university provided house, and soon we would familiarize ourselves with the local food, sights, smells, as well as traditions like mid-morning tea with chapatti and samosas. We would also come to know operating rooms stripped to the basics. Sometimes the power would go out and we would keep operating with flashlights and cell phones to illuminate the surgical area.

Our mission was two-fold: to collaborate with and teach Ugandan surgeons, and to provide fistula surgery to the region’s women in need. It is a sad but common story that many young Ugandan women suffer traumatic childbirth. Because of prolonged labor and the lack of access to health care, the baby’s head causes severe damage to the pelvic floor, resulting in constant urinary and/or bowel leakage. Surgical repair is the only way to restore function and enable these women to return to their lives and communities.

“Every member of our surgery, anesthesia and operating room teams worked with a common purpose and a joyful attitude, helping us accomplish so much with so little.”
— Una Lee, MD

Radio announcements were made of our medical team’s arrival, bringing local women by way of compact “boda boda” motorcycles, busses, and on foot from area villages. The women are poor and often work as sustenance farmers. Many have lost their babies, spouses or families in the aftermath of their birth-related injuries. Every member of our surgery, anesthesia and operating room teams worked with a common purpose and a joyful attitude, helping us accomplish so much with so little. It was invigorating to work with such an amazing team of people – American and Ugandan – from sunrise to late into the night.

Una in surgery

Dr. Lee teaching Ugandan and American residents and fellows in the Mbarara University of Science and Technology operating room.

Medicine for Humanity (MFH) programs go far beyond visiting medical teams, providing dedicated year-round gynecologic and fistula care. Local Ugandan gynecologist Dr. Musa Kayondo leads the collaborative which provides ongoing training, patient care and prevention efforts. Aided by the visiting teams, more than 800 surgeries have been completed since 2009, with a newly established fellowship program that will train surgeons to repair fistulas and serve in other areas where there is great need. Last year, MFH also helped build the 50-bed Center for Gynecologic and Fistula Care to support medical education and the community.

During the two-week mission, our team focused on doctoring, operating and teaching, without the barrage of other pressures and demands that would normally fill our workdays. We arrived in Uganda to offer surgical care and education, but through the process of talking, laughing, sweating, celebrating life, and grieving loss together, we realized the Ugandan people were giving us more that we could ever give in return. With each smile, hand held, or moment of recognition of our shared human experience, we were restored. Our patients – Sylvia, Jovia, Hope and so many more – beamed with beauty, strength, and optimism. Our hearts were filled with gratitude for these brave women and our Ugandan colleagues for teaching us these simple truths.

My time in Uganda changed me. I felt the true joy of being a doctor and a teacher. I was humbled by the privilege of helping these women on their path to healing.  And now, back in my regular life as a physician in Seattle, I am approaching each patient with the joy and openness that I learned from the Ugandan people.

Ugandan women

 Grateful postoperative patients in the Medicine for Humanity fistula ward, Mbarara Regional Referral Hospital.

 


Una and teamUna Lee, MD, is board certified in Urology and subspecialty certified in Female Pelvic Medicine and Reconstructive Surgery at Virginia Mason.


To learn more visit Medicine for Humanity, and give them a follow on Instagram and Twitter. You can also follow Dr. Lee on Instagram and Twitter.

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