The People Behind the Scenes

BEHIND THE SCENES AT THE PROPOSED INTERNATIONAL UNIVERSITY OF HEALTH SCIENCES

Although there have been positive moves in recent years towards tackling large-scale epidemics such as HIV/AIDS, and despite the significant involvement of NGOs and other donor organizations in the health sector, the healthcare workers crisis is not going away. This is a long-term issue, and it has become increasingly obvious within the health sector that solutions to this problems require a more ‘joined-up’ approach, which will both harness expertise across relevant sectors and work in harmony with government policy makers.

But it is not only the government and NGOs who have been involved in building capacity for healthcare and tackling the crisis in human resources for health in Africa. Some private individuals working independently, have made a significant contribution. Two such people: Dr Ian Clarke and Professor Deirdre Carabine have each been working in Uganda for fifteen years and more, and have pioneered projects in the fields of healthcare and tertiary education. In 2006 they came together to combine their expertise with a plan to establish a university of health sciences. Their combined vision is to develop a centre of excellence in training for the Ugandan healthcare professionals of tomorrow.

Dr Clarke first came to Uganda with his family in 1988 under the auspices of the ‘Church Mission Society’, an Anglican mission. This was in the immediate aftermath of the bush war in the ‘Luweero Triangle’(1981–1986). The area was known at that time as ‘the killing fields of Africa’ and many of the dead had been left unburied, leaving skulls and bones in heaps by the sides of the road. What began as a makeshift clinic under a tree grew over a period of five years into a hospital. By the time he left Luweero and CMS, Dr Clarke had established a fully-fledged Hospital: Kiwoko Hospital, which has continued to grow and now has over 200 beds, a nursing school, a laboratory technician’s training school, a large community health programme, and a community-based training centre for doctors and medical students.

Dr Clarke then moved to Kampala as a private individual where he set up International Medical Centre, a small private clinic. While his target group in Luweero had been the rural poor, in Kampala he focused mainly on the developing urban middle-income group. His rationale was that Uganda had suffered from a breakdown of its health services because of many years of dictatorship and civil war. As a result there was little on offer in terms of sophisticated medical facilities. When he had come to Uganda a decade earlier, few people had a sufficient income, but during the late eighties and early nineties he witnessed the development of an urban middle-income group. If such people were able to pay for their healthcare, Dr Clarke could then use the income to improve services available across the board. Just three years later he was able to establish a small thirty-bed hospital, following which he set up a health management organization called IAA Healthcare. The income from IAA enabled him to open a purpose-built, one hundred-bed hospital in 2005.

The hospital now not only operates on the basis of providing healthcare for patients of IAA and fee-paying patients, it also operates a charity (public) wing: Hope Ward (www.hopeward.org) which is funded through partnerships with local companies and other sponsors. With a mission to provide complex medical care for those who could not otherwise pay, this ward has focused on the treatment of such conditions as acid burns, cancer, victims of road traffic accidents, care for sufferers of HIV/AIDs, complex gynecological surgery (vesico-vaginal fistula repair), and victims of the war in northern Uganda who require reconstructive surgeries.

Dr Clarke is now CEO of International Medical Group (IMG) which as an umbrella organization for the hospital, IAA Healthcare, a nursing school, and a health management institute which mainly teaches short courses in areas related to healthcare. IMG also has a building division, specializing in the building and equipping of hospitals and clinics. The group now employs over 500 people in the hospital and its eight satellites clinics, including a clinic in Juba, South Sudan. IMG uses its structure and capacity to carry out community projects in the fields of Voluntary Counselling and Testing (VCT) for HIV, anti-retroviral treatment and community health. Through the work of Kiwoko Hospital and IMG, Dr Clarke has been at the forefront of raising standards of healthcare within Uganda for almost 20 years.

Professor Deirdre Carabine is no stranger to the establishment of educational institutions and has been a pioneer in university building for the past thirteen years. She first came to Uganda in March 1993 when she was recruited to assist in the establishment of Uganda Martyrs University. Along with her pioneer colleagues, Prof. Carabine took responsibility for the rehabilitation of what was a seriously run-down former teacher training college in Nkozi on the Ugandan equator. This hard work finally paid off when 80 new students arrived to attend lectures in October 1993. However, it wasn't all sunny days and blue skies: having lost all her worldly possessions and lecture notes in a Kenyan container heist, she had to start completely from scratch - but the University grew from her paper, pen, and infectious enthusiasm for learning. These efforts finally paid dividends as the first group of students began to pass through the University with a solid commitment to self-improvement and a veracious desire to learn.

As a committed educationalist, Prof. Carabine worked hand-in-hand with the then Vice-Chancellor Professor Michel Lejeune to ensure that their students had the same rigorous training as students anywhere else in the world. The benefits of insisting on quality and professionalism in the field of education have paid off. From humble beginnings, the university on the equator has now gained a solid national and international reputation. By the time Prof. Carabine left Nkozi in 2006, the University boasted seven faculties and a growing research profile. Prof. Carabine was instrumental in starting an Institute that offers various diploma, BA, MA, and PhD programmes attracting students not only from East Africa, but also from the US, the UK, and Europe. It is her hope that International University of Health Sciences will attain the same reputation in record time.

Dr Clarke and Prof Carabine may have worked in different sectors, but they have shared a passion for ensuring the delivery of quality essential services to Ugandans. In 2006 Prof. Carabine and Dr. Clarke realized that in partnership, they could utilise their combined experience, along with the facilities and medical expertise of IMG staff, to make a difference to the problems facing healthcare education within Uganda. This partnership bore fruit when in February this year IMG was awarded a ‘letter of interim authority’ by the Uganda National Council for Higher Education. This letter gave IMG the permission to plan for and set up a fully-fledged university. Thus, the proposed International University of Health Sciences (IUHS) was conceived.

The proposed university will hopefully open its doors to its first cohort of students in January 2008 and will initially operate from International Hospital Kampala. This newly-constructed building is excellently suited to housing a first-class tertiary education facility: the site has sufficient space for the university's lecture rooms, meeting rooms, seminar rooms, a resource center (library and computer facilities), staff and student common rooms, and staff offices. The facilities of the hospital will also be used for clinical courses (laboratories, theatres), ensuring that the expertise of IMG staff as well as that of visiting doctors/surgeons to its public wing, is used to enhance the standards of the educational provision. The current School of Nursing and the Institute of Health Management operated by IHK will together form the core pioneer faculties of the university and the university will grow to include a School of Health Policy and Planning, a School of Medicine, a School of Paramedical Studies, an Institute of Tropical Medicine, an Institute of Alternative Medicine, and a School of Postgraduate Studies and Research.

The future is an exciting one for this new university and its establishment will benefit many. The Ugandan education sector will benefit, as the healthcare professionals of tomorrow will have the opportunity to study within a new centre of excellence. The hospital and its patients will also benefit as International Hospital Kampala becomes a centre for medical research and training, attracting both talent and funding. Not only this, the Ugandan government will benefit as it becomes better placed to reach the UN Millennium Goals related to health through this increase in national medical expertise. Finally, the whole of Uganda will benefit as the number of qualified healthcare professionals entrusted with the future healthcare of the country increases to meet the need.

IUHS: Making a difference to health care in Uganda