Adam Watson

My elective was to Mulago National Referral Hospital in Kampala, Uganda between April and June 2022. Kampala is an extremely busy and hot city only 70km from the equator, with hundreds of thousands of boba-boda motorcycle taxis on the streets.

I opted to work in the under-staffed and under-resourced Casualty Unit, which saw all surgical admissions. The department consisted of a resuscitation area with 8 beds plus a larger open room with another 50 or so beds. We received about 20 major trauma patients per day, mostly from boba-boda accidents, and these patients often stayed with us for up to 72 hours.

The system of care in Mulago was quite different to what I had previously experienced. There was very little triage and many staff believed patients should be seen in order of arrival, irrespective of clinical condition. It was also obvious that staff had different and sometimes contradictory views towards patient safety and risk.

My elective greatly developed my confidence managing emergencies such as major trauma, and I feel like my leadership, communication and teamwork skills have improved substantially. It would be extremely difficult to get this exposure here as we are lucky to live in a relatively safe country.

At the weekend, I was able to visit the source of the River Nile in Jinja and enjoyed rafting on the rapids there. Towards the end of my trip, I also managed to visit Bwindi Impenetrable Forest to see one of the two remaining populations of mountain gorillas in the world. Although the experience was exhausting, I hope to work overseas again for a period after my Foundation training and am very grateful to the Vaughan Williams Medical Fund for supporting my trip.