This document provides information about a medical student's four month elective at Kitgum General Hospital in northern Uganda. It describes the hospital's departments and opportunities for student involvement in ward rounds, community visits, and other activities. The student reflects on having gained medical skills and confidence while also learning about the local culture and language. Challenging experiences, such as cases of gender-based violence, led the student to reflect on attitudes and compassion. Overall, the elective provided an educational experience that broadened the student's horizons.

1. GULU UNIVERSITY
FACULTY OF MEDICINE
DEPARTMENT OF PUBLIC HEALTH
FOURTH YEAR ELECTIVE PROGRAM
JUNE - AUGUST 2013
KITGUM GENERAL GOVERNMENT HOSPITAL
NORTHERN UGANDA
Student
Mr TURYASIIMA MUNANURA (TMK)
tumiek@yahoo.com or
tumiek2000@gmail.com
……………………………………
Site Supervisors
Dr OKELLO GEOFREY
Dr AKENA GEOFREY
……………………………………………….
……………………………………………....

2. My medical elective was undertaken at Kitgum General Hospital (KGH). KGH is a
government hospital set in Kitgum City of Northern Uganda, and with this comes a
very different spectrum of patients compared with Gulu University Teaching
Hospital.
The Hospital has 6 main units that students can be involved in: Female and Male
medical and surgical units, Paediatrics and Maternity. There is also a TB ward,
Outpatients department, Community team, Physiotherapy department, Rehabilitation
and nutrition department and the HIV/AIDS programme to keep you busy!
There is a doctor or senior clinical officer based on each of the main units that
students can attach themselves to. They are all keen for you to be involved and
become part of the team. The average day varies depending on which doctor you are
with but generally it begins with ward rounds at 8:00am. This is followed by break tea
at 10:15am finishing around 11:00am. Then it is the clinicians’ time to disperse again
to their various departments where patients are reviewed, treated or admitted
according to their clinical presentation.
Lunch is a personal business, so everyone gets lunch at their own time and
convenience within or outside the hospital between 1pm and 2pm. There are a variety
of restaurants and hotels that are pocket friendly around the town for one to quench
their thirst.

3. In the afternoon students continue to work on the wards, join one of the other
departments or do community visits for STI tutoring, AIDS counselling and
immunisations. The evenings are a time for relaxation, football, clubbing, playing lots
of cards or seeing friends! At the weekends there are opportunities to explore Kitgum
or neighbouring villages and towns.
I have had the most wonderful time here in Kitgum. The staff and nursing students
from the nearby nursing school make you feel very welcome. Most of the patients
speak the local language “Acholi” and the nursing students are excellent at helping
you get through the language barrier, (although translating some systemic
examination through a translator is fun!!)
My time here has challenged me medically, personally and socially. My medical skills
have greatly improved and confidence in my abilities, although sometimes shaken, is
now much stronger. The senior staff are always on hand to offer advice and help with
any decisions, but one of the more enjoyable things is that you have far more
autonomy than a medical student would at our teaching Hospitals Gulu Regional
Referral or Lacor (even if this can be daunting at times!) There is also plenty of
opportunity to increase your portfolio of skills such as an Orthopaedic department,
minor/major surgeries, cardiopulmonary resuscitation (CPR) and building
management plans.
My colleague reviewing
patients during a general ward
round on the Paediatrics ward.
The common conditions are
malaria and respiratory tract
infections (RTIs); however i
noticed marked number of
sickle cell disease (SCD)
which is not the case in Gulu.
Hospital.

4. Personally my time here has led me to reflect on my attitudes and interactions with
those around me. The language and cultural differences have made me far more
patient and compassionate with the people i meet and have come to learn that people
in the north are good and caring to strangers.
There have been some difficult times as well as fun times. I had never seen a cases of
gender based violence (GBV) before in Gulu and yet here, sadly this is too frequent
an occurrence. I got a woman who was beat to death by the husband because he was
drunk. He beat the woman and fractured all the arm bones (radius and ulna).
I have also had to cope with the poverty and problems with which so many of my
patients and their families go through. However, the graciousness with which they
tackle their difficulties and the happiness they find in the small things is very
humbling and wonderful to see.
My elective was an extremely enjoyable and educational experience. I feel that I have
learnt a lot about medicine, but also a lot about myself. I have experienced not only a
different health care system but also a different culture and way of life. I feel this has
broadened my horizons and made me more knowledgeable about the world.
As a doctor to be I will meet people from all over the World and my experiences on
my elective have met my appetite for this opportunity.
Tmk@gulu 2013
+256 776 505 193
Aciro sustained fracture injuries on
both arms when she was assaulted
by her husband (GBV) who was
drunk. We put her on POP since
she could not afford referral to a
nearby Orthopaedic centre because
of poverty.