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Nursing in Uganda: view from the frontline

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In June 2007, Senior Staff Nurse Duncan Smith swapped the Coronary Care Unit at Guy’s & St. Thomas’ in London for the International Hospital in Kampala, Uganda. For the next two years, Duncan will be sharing his skills as a VSO volunteer, training the next generation of Ugandan nurses, improving the standards of nursing care and the number of students entering the profession. Here he describes the experiences of his first few months

What inspired you to volunteer with VSO?

As a student nurse I spent time working in a rural clinic in Swaziland, Southern Africa. I was privileged to work with a team of highly skilled and dedicated nurses. I was inspired by the way in which they maintained such a high standard of care and by their unlimited compassion. In fact, I often felt humbled by the size of the task they faced. On the one hand they were coping with the enormity of an HIV & AIDS epidemic, but on the other, doing it with very limited resources.

Since qualifying I have been determined to return to Africa and make my contribution, however small. I am eager to share some of the benefits of the UK system, both in terms of clinical and academic experience, with student nurses in Uganda.

How are you settling in?

Things are going well here and my first impressions of Uganda are great! Everyone is extremely friendly and Uganda is a beautiful, green and fertile country.In central Uganda, English is widely spoken however the predominant tribal language is Luganda which I have been trying to learn. Fortunately for me I have been assured I should only need to learn the simple greetings to be courteous, as most people will speak English. The other volunteers are great. We have bonded really well and have become a bit of a ‘lifeline’ for one another sharing skills and experiences to help our transition during the first week.My new home is best described as very basic by British standards but in Africa is undoubtedly luxurious.

Tell us about the hospital you are working in

The hospital has an outpatients department which incorporates Accident & Emergency and an Intensive Care Unit (ICU). There are two inpatient areas, one for all medical and /or surgical inpatients (busy, busy ward) the other for obstetric cases.

Inpatients here have conditions that could not be easily treated at public hospitals, for example severe complications associated with AIDS, some cancers, more obscure tropical diseases and even some cardiac problems.

The ward has a paediatric bay and I am sad to say these were the sickest patients on the ward. I spent the day observing the nurses to see how they practised and what their skills and knowledge base was like. The nurses carry out many tasks that would be an extended role in the UK (e.g. administering chemotherapy on the ward with no additional training) – but lack the underpinning knowledge to rationalise their actions, through no fault of their own I hasten to add!

Tell us about your teaching work

Currently we have 15 first year students and 10 second year students. There are no lesson plans or any type of presentation materials for the nursing course at all. In some ways it is a great opportunity to be able to shape the course and ensure the students receive a good level of information to support their practice. On the other hand it is really hard work; writing a lesson plan and presentation for a couple of sessions a week is one thing, but writing 20 hours worth of teaching whilst also delivering it and carrying out clinical instruction on the wards I think will be a challenge.

This week I taught cardio-pulmonary resuscitation (CPR) to a group of new nurses. The resuscitation situation in the hospital is quite unfortunate. In many larger hospitals in Africa resuscitation is never attempted because there is no equipment and no facilities for post resuscitation care. However, where I am they have some resus facilities so the director of nursing and the clinical director are trying to improve resuscitation services. I have been recruited to help with this.

How does it feel to be at the start of two years working in Uganda?

I guess I have reached the stage where it has become apparent this is not just a holiday or a short elective placement like I have carried out in Africa before. Uganda is now my home and that transition hit me a little last week. I feel much more settled this week and quite accepting of the fact that this, for the time being, is where I am meant to be.

If you’re interested in following in Duncan’s footsteps, find out more about our current volunteering opportunities for nurses at

Would you like to support VSO’s work from the UK? Want to find out more about how Duncan gets on?Join VSO’s Volunteer Linking scheme and you'll be able to follow Duncan's progress through his regular reports, updates and photos, as well as have the chance to meet him when he returns to the UK. It's a great opportunity to hear directly from Duncan and see the positive impact he is making in Uganda.

If you want keep up with Duncan’s work, you can read more about the Volunteer Linking Scheme here

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