Uganda experience - a thankyou from Andrea...

September 20^th, 2011

Dear Dr. Macnab,

I am writing to say thank you for the trip with Brighter Smiles Africa I was selected for through the UBC Global Health Initiative.  I am so grateful to have had the experience I did.  

I immigrated to Canada in 2006 and one of the biggest reasons I turned to medicine as a career was I wanted to be able to work internationally.   I have always dreamed of going to Africa, and I have a particular interest in international medical aid work.   I was inspired to apply for Brighter Smiles Africa after hearing what a great training opportunity it was, and I am so happy to report that it was completely aligned with my goals and more than met all my expectations both personally and professionally. 

As a student in the Northern Medical program we have an unprecedented chance to experience rural medicine both in Prince George and the outlying communities.  It was so nice to see how well the Brighter Smiles program complimented what I had been taught, but it was also great to find how much it added, both on the team’s visit to Hartley Bay, and during project delivery in Uganda.  (I was also very happy to have the Hartley Bay experience for my DPAS project on Aboriginal health).  I was fascinated to see how the work we did in Ugandan rural communities like Kalisizo was a natural extension of what we did in Hartley Bay.  So many of the health concerns and challenges the BC and Ugandan communities face proved similar, and I particularly like the way you have connected the children in the BC and Ugandan schools through your program.

Medicine is truly an international endeavor and I was very pleased to learn so much from the many health professionals you were able to connect us with in Uganda.  Also the variety of the medical experience we were able to gain in the different communities we visited (Urban Kampala, Kampala slums, family practice with Dr. Emma, community clinics and hospitals, and outreach), and the inter professional time spent with the Makerere students and professors. I even had the chance to watch a variety of specialists in Kampala; and being called out with you at night to see a child with hydrocephalus was something I will never forget. 

However, I really think that most of the experiences I had would have been wasted on me without the effort you put into teaching and guiding us.   I am so grateful that I had someone like you to learn from; and it really helped to have you as a guide when I felt overwhelmed.   What you taught me about pediatrics and international medicine was invaluable, as was the real world experience you gave us of medical ethics in a developing country.  Because of the connections and history that Brighter Smiles Africa already had in Kampala and Kalisizo I was able to step into a fully functioning long-term alliance.   Time is so limited for medical students and I think that Brighter Smiles Africa neatly blends the energy of a first-timer to Africa into an established collaboration with a history, local reputation, and track record of sustainability and returning volunteers.

As you know, I am going in to third year now.  At the end of second year, I was starting to feel like I would never survive medicine.  Being a member of Brighter Smiles gave me a new and much-needed perspective on the role of a doctor in society.  I particularly enjoyed what I learned from you about kind, empathic, and integrated patient care.  I am doing my full-time rural rotation now in McBride BC and I feel so much better about seeing patients in the clinic than I did prior to the Brighter Smiles Africa trip.  The hands-on practical medicine that I learned in Uganda, from you and our Ugandan colleagues has guided and informed my clinical reasoning in McBride.  I feel much more comfortable with what I am looking for in a clinical assessment after the opportunity to see so many patients in Africa.

I can't help but thank you as well for the opportunity to realistically assess my future goals in international medicine.   Having such a broad and well integrated program really allowed me to see many aspects of global health delivery and western funding at work.  I have an understanding now of how western aid is used, and what is effective and efficient and what isn't.  It was so neat to see how your link with African Hearts helps them to integrate their service work in the community and support the vulnerable children in their care in culturally appropriate ways.  I also enjoyed our chances to collaborate with western aid workers like the Peace Core and Rotary on the trip.  Being able to participate in fund-raising for Brighter Smiles Africa in Canada before we went, and then to see the funds at work in Uganda was also a great experience, and I think I will be much more effective as a fund-raiser, and as a donor because of that balanced view.

Of course I must mention the fantastic opportunity we had to experience so many aspects of Ugandan life and culture.  I really felt lucky to associate with people from so many different walks of life; from the street kids in the slum to medical students and doctors, rural community members and urban politicians, women and men, children and teens, westernized and traditional.   The cultural experience was invaluable, the ideas shared amazing, and I am so grateful for everything I learned. 

Some of the medical experience I garnered in Uganda I would never have been able to see in Canada, especially so much exposure to tropical medicine and third world medical concerns.  We receive excellent lectures at UBC, and I felt I had the factual knowledge needed about many of the conditions I saw.  But I was immensely grateful to have you there to add the clinical perspective to the theory, and underline the social relevance of illness, as we saw malaria, HIV, malnutrition, untreated congestive heart failure and so many other conditions in person.

I must also thank you for all the time, help, and encouragement you gave me over my research project.  I had never considered doing research before I signed up with Brighter Smiles.  Now I have written a research proposal, written an ethics proposal, applied for funding, conducted clinical research on the ground as part of a team, and am in the process of submitting results!  I can't thank you enough for taking the time to teach me about clinical research, the research process, and how to interpret data.    For the first time EVER I can see research as an integral part of my future career as a doctor, I never thought I had the skills to do research before this experience. 

I think a great strength of Brighter Smiles Africa is that while you engage us full-time, 24/7, the program is flexible and your leadership lenient.  Thank you for giving me so much leeway to become involved with social issues that I encountered that particularly interested me.  I really felt like I had the best of both worlds in so many senses; full time support and direction, but the invitation to be open, creative, independently explore. Obvious highlights of the program are having so much patient contact with your guidance, seeing real global health issues first hand, participating in a truly international partnership, being constantly reminded of issues of social conscience and debating ethical conduct, and experiencing both the challenges and practical solutions of aid programs in the context of balancing Ugandan and Western culture and values.   

 I guess we all look for "synergy" when we work together, but as a member of Brighter Smiles and the African Hearts collaboration I really felt like I was part of something bigger, both in my personal growth and in our changing world. 

Thank you.

Third Year Medical Student

Northern Medical Program (Southern Medical Program)