Kolabo-McMUST Partnership Uganda Trip 2023

PURPOSE OF PARTNERSHIP

For over 10 years, McMaster University in Hamilton, Canada has been partnering with the Mbarara University of Sciences and Technology (MUST) in Mbarara, Uganda to provide resources and psychiatric residency training under the leadership of Dr. Godfrey Rukundo and Dr. Sheila Harms. As a result, McMaster University psychiatrists and residents have travelled to Uganda on many occasions to assist with consultation and learning opportunities alongside their local counterparts.

In the fall of 2022, members of the Kolabo team met with Dr. Harms to discuss the possibility of a joint partnership. As many reading this are aware, Kolabo is the partnership between the University of Calgary and the Catholic University of Health and Allied Sciences (CUHAS) in Mwanza, Tanzania. Kolabo has been transitioning from a focus on undergraduate medical education to starting a psychiatric residency program at CUHAS in the near future. As a result, the Kolabo teams felt there was a lot to be learned from the successes of McMUST over the past decade.

Trip planning began in June 2023 and over several months a team and joint mission were planned with individuals from four universities coming together to learn as one and work towards the common goal of building capacity for psychiatry and mental health care in East Africa. McMaster University members Dr. Sheila Harms and Dr. Angela Li (PGY3) met with University of Calgary members Dr. Megan Howlett, Dr. Elisabeth Merner (PGY5), and Dr. Deborah Adesegun (PGY3) to travel to Uganda this September. The Kolabo team was also able to sponsor the arrival of Dr. Matiko Mwita and Dr. Gemma Simbae from CUHAS. The Calgary and CUHAS teams hope to build a similar collaboration and psychiatry residency program in Mwanza, hopefully to begin in October 2024.

DAY 1

The first day at Mbarara University of Sciences and Technology (MUST) brought all of the teams from four universities together to meet one another. The morning began strong with Monday morning inpatient major ward rounds. These rounds cover the presentation and management of patients living with major mental illnesses, including Bipolar Disorder, Schizophrenia, HIV induced psychotic illnesses, and other neurological conditions, such as Epilepsy. Consultation occurred between residents and staff psychiatrists with perspectives from the various cultural and scientific knowledge bases.

After these rounds, members of each of our four teams were able to get to know one another better and discuss their common reasons for wanting to pursue a career in psychiatry, which often included caring for those impacted by stigma.

Dr. Muwanguzi Moses, Dr. Matiko Mwita, Dr. Mukiibi Nicholas, Dr. Kugonza Tonny, Julian Kembabazi, Dr. Elisabeth Merner, Dr. Gemma Simbae, Dr. Shabani Moshi, Dr. Namwase Joyce, Dr. Deborah Adesegun, Dr. Megan Howlett, Dr. Angela Li, and Dr. Angella Nanziri (left to right, back then front)

Discussion around alcohol use and its relevance to psychiatry.

Day 2

In the morning, residents from Canada and the psychiatrists from Tanzania were able to form groups with the Ugandan resident physicians and see patients from either the inpatient unit who required further assessment or in the outpatient clinic setting. Team members collaborated on history taking, diagnostic formulations, and management plans.

In the afternoon, Dr. Kugonza Tonny and Dr. Namwase Joyce gave a presentation discussing Alcohol Use Disorders which was followed by an explorative group discussion around alcohol use in both the East African and Canadian cultural contexts, its medical and psychiatric sequelae and how to help those suffering from addiction to alcohol.

Dr. Deborah Adesegun and Dr. Elisabeth Merner lead a lecture on Cannabis Use Disorders.

Day 3

The morning began with a teaching session by Dr. Sheila Harms for the residents about Speech & Language Disorders. Uganda has 30-40 speech and language pathologists reportedly to serve an approximate 1.5 million children with speech and language disorders which have a functional impact on both the individual and their family. The team members were able to discuss this resource shortage in all of our clinical settings, as well as how to recognize such disorders, and what the general psychiatrist can try to do to help.

The team then worked together until the afternoon in a child and adolescent mental health outpatient clinic. Following this, there was an afternoon teaching session which was led by Drs. Elisabeth Merner and Deborah Adesegun on Marijuana Use Disorders.

Dr. Harms leading a discussion on speech and language disorders.

Dr. Kugonza Tonny and Dr. Namwase Joyce— third year residents of the MUST psychiatry program.