Bridging the Gap: Infection Prevention in Uganda

From a young age, Ronald was set on pursuing a career in health care: “it was my passion to be a healthcare worker, in order to achieve it I had to work hard”. The loss of family and friends to HIV/AIDS fuelled Ronald’s passion to work in healthcare, at a time when awareness of drugs and treatment guidelines was sparse. His first job was with an HIV/AIDS management and treatment organisation, NGO Mildmay International, after which Ronald went on to pursue a career in Pharmacy – a growing profession in Uganda.

“Due to the lack of pharmacists in the country, the population suffers with drug related complications and minimal technical assistance. Therefore, I decided to join the pharmacy profession in order to bridge that gap.”

Through the Commonwealth Partnerships for Antimicrobial Stewardship Scheme, the Kampala-Cambridge Infection Prevention Control and Antimicrobial Stewardship partnership was established in early 2019. Building on obstetric and maternal health links with Kawempe National Referral Hospital, Makerere University and Mulago Specialised Women and Neonatal Hospital, this partnership focusses on reducing healthcare associated infections on the obstetric and neonatal wards. Ronald has become a key stakeholder in the partnership.

“The Hospital Director, together with Dr. Musa Sekikubo, Consultant Obstetrician and Uganda clinical lead, briefed me about the partnership and some of the key objectives it intends to achieve. I knew we needed to change practices in the hospital and was keen to get involved.”

Every partnership is unique and organic. Whilst there are practices and guidelines that should be adhered to, such as the Principles of Partnership, partnerships are a journey and over time relationships strengthen and bonds form.

“Honestly, I didn’t know what to do at first, but Dr Sekikubo was very helpful in so many ways. Above all he gave me a good reception and was very honest.”

Since joining the partnership, Ronald has enjoyed significant personal and professional development. Sharing knowledge is the bedrock of Health Partnerships, and Ronald has charted improvements in his interpersonal and technical skill base thanks to knowledge exchange. He has gone on to train numerous Pharmacy Interns, teaching them how to produce alcohol gel, rational dispensing, and supply chain management.

“It has allowed me to interact with colleagues from Cambridge in areas of antimicrobial stewardship and infection prevention control. In doing so, I have gained a lot of technical support from them. Furthermore, we borrowed some of the ideas and applied them to our department, for example each pharmacist is assigned or specializes in a role, leading to improved departmental efficiency.”

When reflecting on the impact of the partnership within the hospital, Ronald noted that he had seen tremendous change:

“The partnership sponsored the establishment of an alcohol hand rub production room, the procurement of a water distiller, alcohol meter, and many other types of equipment. This has helped us to produce our own alcohol gel for hospital use. This has reduced costs, time and improved access, and as a result we have registered lower cases of sepsis.”

Ronald has championed the on-site development of alcohol gel. The gel dispensers are refilled daily and line critical areas of the hospital from the entrance gate, to clinical wards, through to the administration block located out back. With the arrival of COVID-19, he highlighted the timely introduction of the now readily available gel:

“It has been a blessing for our staff, patients and care takers, who are making use of them especially during this critical time of COVID -19”.

Over the past 15 months, the partnership has been a hive of activity. Looking to the future, Ronald is excited by the prospect of continued partnership development and opportunities for collaborative research between Kampala and Cambridge. Whilst the arrival of COVID-19 has placed some activity on hold, the partnership continues to thrive as partners meet on Zoom to share experiences and expertise relating to pandemic management.

Amid an all-encompassing global crisis, Health Partnerships maintain an openhearted culture of sharing and bidirectional learning. Ronald concludes:

 “Above all, we have enjoyed the cordial relationship we have with partners and are overjoyed by their heart of giving at all times. Even in the most difficult times, for example during COVID-19 when every country is taking care of its own people and their problems are at home, partners are still giving a helping hand to Ugandans. For this we are very grateful”.