hospital, and as it happened, the hospital van was due to pick up supplies from Kampala, so they had offered to take them to Mulago on the same trip. Everything happened so fast. Kweete had no opportunity to tell her friends that she was going to Kampala. They would be so envious! Only Kwesi was there to wish he was going.
The Medical Outpatient Clinics at Mulago were located on the 4th floor of the hospital’s front wing. There was a pharmacy at the entrance, and there were labs on site to do most of the basic tests needed by the doctors. Patients who did not need imaging could come in for care and leave without needing to get farther into the hospital. All the consultation rooms were designed with wide glass windows overlooking the car park, and the sun and fresh air made this a pleasant place to work, even considering that it was a hospital. Sr. Imelda Atim kept a very orderly clinic. Dr. Kibukamusoke liked to know as soon as he came in how many patients were booked, and if they had the latest lab results on file. He usually saw the new patients first, especially if they were referrals from upcountry. The child from Kabale was the first in line.
Eight o’clock came and went, as did 9 o’clock. This was unusual for Dr. Kibukamusoke to not be at the clinic on time, and more unusual still that he had not communicated about his absence. On the few occasions when he was unable to run the clinic, he let the staff know who would see his patients. At 9.30 am Atim called the doctor’s office, and the telephone went unanswered. Atim walked to the Department of Medicine on the same floor and asked the Department secretary if she had seen Dr. Kibukamusoke. “No. I have not seen him this morning. You may want to check with Dr. D’Arbela in case he is teaching somewhere.”
“He would have let us know. And I noticed his car is not at its usual spot. It seems like he has not come to the hospital at all. Could you please check if someone else has been assigned to see the patients? We have a full clinic.”
It had been only three months since Kibukamusoke took over the headship of the department from Dr. Bill Parson who left in December 1972. By the following day, rumour had it that Dr. Kibukamusoke had left the country. Within a few weeks he was replaced by Dr. Paul D’Arbela, a physician with specialization in diseases of the heart, and one that had made major contributions to the training of specialist doctors at Makerere.
Kibukamusoke’s departure was by no means unique. Some doctors walked off ward rounds to go to the bathroom, and did not return for decades, if ever. The less lucky were picked up by the State Research Bureau agents, never to be seen again. Dr. D’Arbela’s succeeding Kibukamusoke as department head was the easy part. The more difficult assignment proved to be that of personal physician to the Head of State, Field Marshal Idi Amin Dada. Very early on in that role, D’Arbela found out that his predecessor’s woes had stemmed from his attempt to monitor and treat the President’s gout problems. The repeated requests for urine samples worried Amin. He feared that he was being poisoned through the urine. Too paranoid to place his health in the hands of one doctor, Amin had secured the services of an Egyptian doctor on the side. With this knowledge, D’Arbela played it very safe. He made all his prescriptions sound like mere suggestions, knowing that Amin would discuss them with the Egyptian physician, who would very likely issue the same instructions D’Arbela would have given. With this delicate triangular relationship between suspicious patient, cautious doctor, and trusted expatriate back-up, D’Arbela was able to survive Amin’s presidency. His unceremonious exit would come later through a different avenue. For the moment, his biggest preoccupation, and that of his senior colleagues, was how to maintain and even expand the teaching and medical services despite the continuing exodus of highly trained staff.
“Kibukamusoke had taken over as acting Department Head from Bill Parson who left in the first wave of departures after Amin expelled the Asians,” D’Arbela recalled. “When Kibukamusoke left, I was asked to head the department. The Master of Medicine program had been started in 1968 under Parson, and we had to sustain it. Olweny and Kiire were among the first batch from that program. I quickly assigned the promising young doctors to various specialties – Otim to endocrinology, Batambuze to cardiology, there was Mugerwa, Kiwanuka … We ensured that there was succession and continuity of the programs. It was the Masters of Medicine programs that saved the medical school from collapse.”
Drs. Krishna Somers and Paul D’Arbela conducted most of the original research on endomyocardial fibrosis, a disease of obscure cause, which leads to heart failure in the extreme. When the New Mulago opened in 1962, the medical school received a £10,000 grant (equivalent to £160,000 [UGX881 million] in September 2019) from the National and Grindlays Bank in Kampala. With this, they bought equipment for the heart laboratory.9
***
If the hospital suffered a shortage of doctors, the Medical School was probably even more acutely affected. The biomedical sciences of anatomy, physiology and biochemistry were practically depleted of senior staff. Lab technicians were in some instances taking on the roles of the teaching staff. Anthony Gakwaya, an undergraduate in the early seventies, recalled that the class spent almost a year in the biochemistry class discussing the DNA structure which had been discovered by James Watson and Francis Crick some twenty years earlier. Gene sequencing was still very topical, and Frederick Sanger and others were still racing to see who would be the first to discover a method of rapidly ordering – sequencing – the building blocks of proteins. Ugandan medical students were facing an uncertain future with few teachers and hardly any lab reagents, but they were doing what they could to stay in the mainstream of knowledge. The Albert Cook Library that had enjoyed great prestige, and that had subscriptions to a wide variety of scientific journals, could no longer keep up. First there was a slowing down, then the deliveries stopped altogether.
In a span of a few years, student life at Makerere changed from one of relative luxury to one of great hardship. Where the halls of residence had been the envy of even the working class around Kampala, now they were often plunged in darkness from frequent power outages, and water was erratic. Food quality suffered, and was the cause of a few strikes in the early Amin years, before it became evident that the problems facing the nation were far graver than poorly cooked meals. Military presence on Makerere campus became commonplace, and the insecurity that had engulfed the rest of the city now extended to the hill that prided itself in being the seat of independent thinking and academia. The stage was set for a violent confrontation.
President Idi Amin Dada visits Mulago Hospital at its
10th Anniversary, 16 October 1972. DS Archives
***
On the night of 27 June 1976, Dr. Adam Kimala, Provincial Medical Officer for North Buganda Province, was driving from Mityana to Lugazi when he ran into a big military convoy at Kibuye. He gave the convoy a wide berth and continued his journey undisturbed. The following day he learnt that an Air France plane had been hijacked and landed at Entebbe, and he thought that might explain the military presence on Entebbe road. As the situation evolved, most of the hostages were released, except for some 106 passengers who were either Israelis, or non-Israeli Jews. The hijackers were trading their lives for the release of terrorists held in prisons mostly in Israel, but also in some European countries. All this remained remote to Kimala, whose responsibilities as both the provincial head of the medical services and the Medical Superintendent of Kawolo Hospital kept him busy enough. But fate was about to hand Kimala a strange assignment.
As he recounted, “One morning that week, a Police detective from Lugazi called me to say that they had found a dead body, and I was required to go and do a postmortem. The body was in a sugar plantation in Namawojjolo along Jinja Road. When we got to the body, I examined it, and noted that it was burnt. There was a burn in some sort of straight line from the head to the legs, a pattern unlikely in a live person who would be struggling, suggesting that the burn was inflicted after death. I could see that it was a
