Money, Money Everywhere . . .

We are in a remarkable new era of philanthropy, especially for the global health community. Unprecedented resources (think Bill Gates) are now combined with a more rigorous, businesslike methodology to giving. But could we actually have too much money going into Global Health? As one works in the HIV clinics in Uganda (average yearly income ~$300 per person) and have the resource-limitations omnipresent in clinical decision-making, the obvious answer is an emphatic, No. Money alone, of course, is only part of picture; the human resource shortage is real. Certain organizations (some previously noted on this blog) help fill this gap, and others exist such as GeekCorps.org and medically-oriented volunteer opportunities. Still, a more holistic, large-scale approach to paying for and promoting global health careers would be ideal.
Photo: A Ugandan HIV clinic on wheels that visits rural communities once every two weeks.

The Next (Same) President

The elections in Uganda are over. The current president, Yoweri Museveni, won again. Overall, most seem to be relieved, as it would have been absolute chaos if Museveni had not won. The main challenger is protesting the results though, and it remains to be seen how his future (and his sometimes rowdy supporters) will play out. I was actually in a remote game park during the elections and found out the results via, you guessed it, a Uganda SMS mobile phone text messaging service
Photo: Voting in Kalisizo on Election Day.

Election Eve

Well, things are heating up around here. The Ugandan elections are tomorrow and there has been some low level rioting in the capital. However, friends and family will be happy to know that I am in the semi-rural Rakai District currently, away from the capital and will be leaving tomorrow for a game park near the border of Rwanda. Our escape plan is to move into Rwanda if things go truly awry in Uganda (times have changed so quickly that Rwanda has become the escape route for potential political chaos in this part of Africa). Many ex-pats have acutally left already, hotels around the smaller city of Entebee, where the airport lies, are full, so that if there is an airlift people will be able to get to the airport quicker! I am at the Rakai Health Sciences Project (RHSP) now, in a very nice, new building (with wireless internet) and trying to get my project off the ground. Much more on RHSP to come.

Good Governance

Somewhat alarming were the recent deaths at an opposition gathering in Kampala. What does it mean to have good governance? The US government established some potential critieria for their Millenium Challenge Account, but it has subsequently been criticized for giving out very little money. And, some might argue American inconsistency with some of the principles we are espousing. While it may seem patent that good governments and economic development are directly related (Mugabe trashing Zimbabwe's economy is a good example), the reality is probably a bit murkier.

Finalemente...Uganda

And now...I'm in Uganda! London was a fun time. Cailin Henderson, another fellow UCSF resident and future rheumatology fellow, joined Jimee and I during my last weekend. We ended up one night at an Argentinian boat party into the wee hours (but that's another story). Now, I am in Kampala, the capital of Uganda. The big news around here are the upcoming elections which feature an incumbent president looking for his 3rd term (thanks to some constitutional changes allowing him to run again) and his main opponent who happens to be his former personal physician! I will end with a plug for Sona Aggarwal's Blog which chronicles her ongoing travels through South America.

Mobile Africa 2

Vodafone, a global telecom company which has been commended for its corporate responsiblity, has recently published a policy series paper entitiled Africa: the impact of mobile phones. This influential document makes a few key points including the positive influence of mobiles on development, social capital, and quality of life as well as the differing roles of mobile phones in developed vs. developing countries. My current project will look at how mobile phones may be used to improve the health of persons living with HIV/AIDS in rural Africa.

London and Tropical Medicine

I made it to London. I am staying with my wonderfully talented friend, Jimee Hwang, who is soon to add a DTM&H to her MD as she is taking the short course Diploma in Tropical Medicine & Hygiene at the London School of TM&H. It sounds like a great program, and the people I have met from it are an interesting, eclectic, well-travelled group from around the world. For many reasons, it is fascinating to hear non-Americans chat about global issues, with one reason being how it emphasizes how isolated America can seem (to both outsiders AND insiders).

Empathy, Medicine, and Coming Home

As some of you know, an unexpected medical event to one of my family members has been a recent and difficult ordeal. I don't particularly believe that bad things may happen for future good reasons that we cannot, in the emotional confusion of a crisis, see and understand until later, but it did make me think about how I see myself as a doctor...past, present, and future. It is almost trite to talk about the experience of doctor as patient, less so perhaps of doctor as family member of patient, and many good (and not so good) books and essays have been written on this topic. However, it does remind me of something I read a long time ago, Empathy and the Practice of Medicine : Beyond Pills and the Scalpel, and how challenging it is as a physician to constantly put yourself in the patient's situation, particularly if you have insufficient personal experiences to draw upon. Perhaps this is one of the better reasons to argue for admitting well-rounded applicants to medical school and supporting their "nonflatness"--They will have a potentially larger body of experience to draw upon to empathize with their patients which is, I think, the core of the humanity of this particular profession.