This semester, Yale physicians, residents and medical students are celebrating 10 years of collaboration with Uganda’s Makerere University College of Health Sciences and its teaching hospital, the Mulago National Referral Hospital. In September, internal medicine faculty at Yale celebrated the 10 year partnership at grand rounds — routine medical events at which an expert presents a lecture concerning a clinical issue to doctors, residents and medical students.
The Makerere University-Yale University collaboration began when Asghar Rastegar, director of the Yale Office of Global Health, and Majid Sadigh, director of the Global Health Program at the University of Vermont, travelled to Kampala, Uganda in 2005 to meet with the leadership of MCHS and Mulago Hospital. Rastegar said that Sadigh, who at the time was the associate director of the Yale Office of Global Health, had been visiting Uganda for the past two years to train health care workers in HIV prevention and treatment. Rastegar said that upon visiting he was struck by the fact that despite the “phenomenally bright students and faculty” and advanced research programs at MCHS, patient care at the hospital was faltering.
“At that time, around 60 percent of the patients admitted to the hospital would die within six months,” Rastegar said.
While in Uganda, Sadigh and Rastegar met with Harriet Mayanja-Kizza and Nelson Sewankambo, the chair of medicine and dean of the MCHS medical school, respectively. The purpose of these meetings was to establish the terms of the partnership, according to Rastegar.
Rastegar said that the parties decided on a “bilateral capacity building” agreement under which Yale residents and faculty would travel to Uganda for clinical rotations and Ugandan physicians and students would train at Yale.
“The aim [is] to have global health experiences for students and residents of Makerere University and Yale University,” Mayanja-Kizza said. “At Makerere, a number of our junior faculty have had beneficial rotations in relevant disciplines at Yale, improving their knowledge and application of clinical skills in these selected disciplines.”
Tracy Rabin, a professor of medicine at Yale and the co-director of the MUYU collaboration, said that for the participants at Yale “gaining perspective” is the most important benefit of the program.
According to Rastegar, since the beginning of the program, 18 junior faculty from Uganda have come to Yale for between six- and 12-month periods of subspecialty training and 79 Yale faculty members have spent time at Mulago Hospital in Kampala. Additionally, more than 150 Yale residents have spent six-week rotations in Kampala, while 119 medical students have completed clinical clerkships there.
Rastegar said that the greatest area of need for Ugandan faculty was training in how to treat non-communicable diseases, such as diabetes and kidney disease, adding that this came as a surprise to him.
“Uganda, like many countries in lower-resource settings, has really struggled over time with the staggering weight of infectious disease,” Rabin said. “However, the entire world is seeing this epidemiological shift where it’s becoming clear that non-communicable diseases, such as hypertension, diabetes, stroke and chronic respiratory disease, are becoming much more prevalent.”
Rabin added that while collaborative efforts have thus far has been based on enhancing clinical capacity, the parties involved are shifting their focus towards developing research projects that focus on applied medicine.
Robert Alpern, dean of the Yale School of Medicine, expressed his enthusiasm for the collaboration, describing it as a “win-win” for the institutions and individuals involved. He added that in the past, medical students who wanted to travel to countries in Africa would carry out rotations independent of faculty involvement, but that when the MUYU collaboration began, it was one of a group of programs in which a faculty collaboration was developed alongside a student rotation.
“When the students visited [Uganda] they frequently had faculty there with them,” Alpern said. “If the faculty weren’t there, they still had enough of a presence during the year that they helped to make sure it was a good experience for the students.”
He added that now almost every Yale student rotation program is accompanied by a faculty collaboration.
Makerere University, founded in 1922, is the largest institution of higher education in Uganda.