How different is paediatrics in Uganda compared to the UK?

How different is paediatrics in Uganda compared with the UK?  That question has a very obvious answer.....or does it? 

It’s a question we had asked ourselves prior to coming and one that is actually much more difficult to answer than we first thought.  The differences are obvious.  The lack of doctors (approximately 400 medical students qualify to be doctors each year in Uganda compared with 7,500 in the UK).  We could do something very similar with nursing numbers.  We can talk about the fact a child can receive a maximum of 5 litres of oxygen or that compatible blood isn’t always available.  We could point out that investigations here are a luxury, not a necessity. We could even mention that the incubators and warmed using light bulbs (often broken or in need of replacement) and a complex system of moist napkins are used to control humidity. 

These are a few of the many differences, but there are lots of similarities.  It may seem odd that we could then say that paediatrics in Uganda and the UK are similar, but let us explain.   The most important first: it’s paediatrics.  Yes it’s a statement of fact, but it is important to realise that no matter where in the world you are, when children become unwell they present in the same ways.  Newborn children in Uganda still most commonly have problems with breathing and infection when first born.   Is the treatment different?  No!  Not at all- give them support to help them to breathe and treat the infection.  Of course, the antibiotics you use may differ slightly, but the problems, assessment and treatment are almost identical. 

A view of the main hospital

Moving on from newborns, let’s talk about children.  What are the most common reasons that children present to hospital in the UK?  Gastroenteritis, breathing concerns and fevers.  In Africa?  That’s right- gastroenteritis, breathing concerns and fevers.  How do you manage these conditions – appropriate fluids, oxygen/antibiotics/support and treat the cause of fever (usually antibiotics/antimalarials).  The availability of support differs, but the patients themselves are more alike than they are different.  There are diseases specific to tropical regions, the most prevalent of these being Malaria, but in general the children present with similar symptoms.  The big differences are that the children often present later (distance to nearest health advice) and with co-morbidities, most commonly malnutrition.

So, we have mentioned a few of the similarities of UK and Ugandan paediatrics and it is these underlying principles of paediatrics that, with some adjustment, have allowed us to work in Uganda.  However, we have still had to go back to school and learn tropical medicine. We will talk more in the next blog about the challenges we have faced, from understanding the Ugandan culture to improvising when the equipment we would usually use is not available. 

Happy Easter everyone!

Colin and Jess