With 80 pounds of microscope equipment packed in their bags, second-year University of Vermont College of Medicine students Karl Kristiansen and Taylor Goller left the United States June 26 bound for the Uganda Cancer Institute (UCI) in Kampala, Uganda. The duo’s month-long visit includes studying, conducting research, and laying the groundwork for a partnership that may allow future UVM medical students to study at UCI as part of an expanding global health education program.
Majid Sadigh, M.D., an infectious disease specialist at UVM clinical affiliate Danbury Hospital/Western Connecticut Health Network, has been working to connect UVM medical students with opportunities to study abroad, and spearheads the program that has allowed the pair to study in the East African country.
As part of their trip, Goller and Kristiansen have also been working with The Microscope Exchange, a project created by fourth-year medical students Adam Ackerman and Peter Cooch. Their mission is to match donated microscopes with locations where they are needed. At UCI, Goller and Kristiansen transported and helped to set up a bench microscope and a five-headed teaching microscope equipped with a digital camera. This equipment will hopefully serve as the foundation for a new independent pathology lab staffed by the several lab techs who already work at UCI, and a pathologist who has recently been hired. Goller has been posting updates to The Microscope Exchange blog. He wrote on July 2:
“It’s exciting to imagine a time in the very near future when the laboratory at UCI is able view a biopsy from a cancer patient in Kampala, make a diagnosis through a collaboration of the local team, then ask for a second opinion from a supporting pathologist at a hospital in the United States!”
Goller and Kristiansen have already witnessed first-hand the challenges of medical care in a resource-scarce setting. UCI, which is affiliated with Makerere University and Mulago Hospital, is the sole referral center for a country of 34 million people. UCI registered 2,800 new cancer cases in just one year, with 31,000 patient follow-ups. Patients who fill the 24-bed Solid Tumor Clinic present with cancers that have progressed “well beyond anything you would typically see in the United States.”
“After being here a week, I have begun to appreciate the strength of the patients to be able to bear their diseases, especially in such a resource-limited setting, and the strength of the doctors and nurses who deal with the tough realities of disease and treatment every day,” Goller writes for The Microscope Exchange blog. “This is my first experience on the wards as a medical student and it really feels like I have jumped into the deep end.”
David Chia, M.D., M.Sc., a faculty member at Yale School of Medicine, and Fred Okuku, M.B.Ch.B., M.M.E.D., an oncologist at UCI, are mentors to Kristiansen and Goller during their time in Uganda. Sadigh has also been in close contact with the students and plans to be at UCI for the final week of their stay. Kristiansen notes that Chia “has already been a great resource with his medical knowledge at UCI...He has many great project ideas which will allow Taylor and I to make a difference at the UCI and have a long lasting, positive impact on patient care.”
Says Goller: “Dr. Okuku has been an unbelievably patient educator and an enthusiastic guide to UCI and to Kampala in general. It's obvious he is very invested in the partnership and will ensure many future positive experiences by visiting UVMers.”
Goller and Kristiansen are also working on two research projects. They have started to examine data regarding utilization of care and course of treatment at the Solid Tumor Clinic, with an eye on identifying which treatments provide the best outcomes for different cancer types.
Their second research goal is to create a standard protocol for commonly seen cancers. Kristiansen writes: “The idea is to make a reference sheet that will be used by future UVM students as well as Ugandan physicians, nurses, and staff at the UCI. Both Taylor and I are very excited to be able to deliver something that will improve patient care for years to come.”
Read Taylor Goller’s posts on The Microscope Exchange blog.