two student midwives. Shortly after birth the baby started turning blue, a sign that he was not getting enough oxygen into his blood. The nurses took the baby to the nursery where newborn babies received more intensive care. A few hours later the tragic news came – despite the doctors’ best efforts, the baby had died. The doctors said there were serious defects in his heart and major blood vessels which were incompatible with life. Kweete was plunged into the depths of grief. She declined to have a post mortem done, and chose to bury her baby ‘without him being turned into a specimen’. As the country started to cautiously celebrate the victory of the NRA and the end of the bush war, Kweete mourned the death of the baby that had barely lived.
***
Professor Francis Omaswa was coming back to Mulago after a hiatus of more than 10 years. For three years, he had headed the Cardiothoracic Department at Kenyatta Hospital in Nairobi. He had just spent five years at Ngora Hospital in eastern Uganda, and he could hardly wait to get back into heart surgery at a big hospital. But Mulago had scars and wounds from years of abuse and neglect, and he was about to find out the hard way that fixing a hospital could be harder than fixing hearts. It felt great walking along familiar corridors, running specialist clinics, and deciding what patients to schedule for surgery. His first heart operation was a straight forward one, the surgery went well, and the patient was taken to the Intensive Care Unit on 3D as planned. At the end of the day, Omaswa went by to see how he was doing, and was pleased to find him stable. The hospital was quickly emptying out, and the evening shift was giving way to the night staff. The big hospital routines were all very familiar.
The following morning Omaswa went to the ICU to check on the patient before heading to the ward for a teaching round. An unpleasant surprise awaited him. His stable patient of the previous evening had passed away in the night. The night team was gone, and there were scanty notes to explain how a patient that had done well at table and for the following several hours suddenly made a turn for the worst. That was not a good start, but Omaswa was not so easily discouraged. A week later he had another patient scheduled, and it was another fairly routine heart procedure. This time he gave more elaborate instructions, and went over them with the nurses in ICU to be sure that nothing would be missed. Before he left the hospital in the evening he want by the ICU, and was happy with the patient’s condition. He lived just above Galloway House within Mulago, and he told the nurses to call him if there were any serious concerns. Decades later, Omaswa still recalled how things evolved.
“I was relieved that there were no calls in the night, as that meant that the patient had had a comfortable night. In the morning, I walked to 3D ICU to see the patient. As soon as I walked into the ward, I sensed that there was a problem. The procedure room was open and I could see there was a body behind a screen. As I turned to head towards the room where I had left the patient, the matron came out of the office. She did not waste any time. ‘Professor, I am sorry but your patient died.’ I stood still and felt a tightening in my chest. ‘How? When?’ I asked the questions, but somehow did not hear the answers. I knew it had to be the nursing care. There was nothing worrisome or highly complex about the procedures, I had done these same operations countless times before, and never had deaths. I turned and walked out of ICU without looking at the file. I walked down to the second floor, out into the parking, and I got into the car. A plan was quickly forming in my head, and the painful lumps in my chest and throat were not shifting. I knew I had to find a solution. A short while later I drove out of Mulago and headed straight to Nsambya Hospital. I walked into Dr. Duggan’s office and told her secretary that I had to talk to her, and that it was urgent. I got straight to the point. ‘I am looking for a hospital where to do heart surgery. I would do a weekly list.’ She must have heard the pain in my voice. Or maybe there were tears in my eyes. She was quiet for a while, then she simply said yes. I thanked her, and said I would be back to work out the details.
From Nsambya I drove to Nakasero, to Dr. Ruhakana Rugunda’s office. He was Minister of Health at the time. I still had the sense of urgency, and I told him I needed premises for a unit where we could treat patients with heart problems. I had walked around Mulago looking for space before, but that day I had an urgency like fire under my feet. I had to find a way to treat patients safely. That second death had rattled me pretty badly. I was angry and depressed all at once. Rugunda listened to me, and asked if I had suggestions. ‘Yes. There are some old buildings in Old Mulago that accommodated internally displaced people from Luwero during the war. I think those people have left.’ He said we could have the buildings. I walked out of there elated. In one morning I had a theatre in Nsambya where I could start work right away, and a couple of houses where I could set up a heart unit as a more permanent solution. The question was now how to find the money to get the unit together.”
Rotarian Robert Ssebunya had been in exile in Nairobi, and he had seen the work of the Kenya Heart Foundation. On returning home after the 1986 change in government, he set about creating the Uganda Heart Foundation fashioned after the Kenyan one. Omaswa had been a natural ally, and the two had had several meetings with a few other people to give direction to the Foundation. It was to this group that Omaswa now turned to find the resources to give life to his dream. Some wealthy Asian patients made contributions, but the grant that really set them firmly on their way was US$350,000 from Rotary International. They renovated the dilapidated buildings and turned them into wards, built and equipped the operating theatre, bought a top-of-the-range Echocardiogram, and recruited staff. The Uganda Heart Institute was born. The rest was paperwork.10
Prof. Paul D’Arbela, first Ugandan cardiologist.
Monitor Publications Limited.
Prof. Josephine Namboze (first Ugandan female medical graduate
1959). Makerere University School of Public Health 2019.
Dr. Rosemary Bagenda (second Ugandan female
medical graduate 1965) DS Archives
Prof. Charles Olweny, first Ugandan Head of
Uganda Cancer Institute. Prof. Olweny
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Prof. Richard Bwogi Kanyerezi. Monitor Publications Limited.
Prof. Sebastian Kyalwazi, first Ugandan surgeon.
Prof. Ian McAdam. Albert Cook Library, College
of Health Sciences, Makerere University
On 20 December 1988, President Museveni visited Mulago Hospital. The staff of the hospital gathered in Davies Lecture Theatre to listen to him. The President was dapper in a stylish suit and tie and, if a little cocky in his speech, had an infectious optimism about him. This was the boardroom president; the bush guerrilla
