About UNC Project-Uganda

In 2004, a group of UNC physicians established the Amal Murarka International Pediatric Health Foundation in memory of their colleague, Dr. Amal Murarka, who died unexpectedly in 2003. The foundation sent a medical team to Kampala to establish the country's first pediatric intensive care unit at Mulago Hospital, Makerere University, where Dr. Murarka had previously conducted research. Subsequent work in 2007 and 2008 focused on pediatric cardiac surgery. The foundation not only built a cardiac ICU, but also performed a total of 21 life-saving pediatric cardiac surgeries.

In 2008 the foundation partnered with the Institute for Global Health and Infectious Diseases to establish UNC Project-Uganda.


The UNC Project-Uganda was established to support sustainable delivery of compassionate and competent health care to infants, children, and adolescents in Uganda; to improve the medical knowledge of the Ugandan health care workforce through in-country training and a physician exchange program; and to provide advanced medical equipment, medications, and services necessary for the delivery of compassionate and competent pediatric care in Uganda.

Tuesday, October 30, 2007

Ahsante Sana

Its been 48 hours since landing in RDU from Africa, but the experiences are as vivid as ever. One thing is for sure: this trip exceeded my expectations in every way! From the moment we walked into the Mulago Hospital intensive care unit until we departed the beautiful city of Nairobi, we were surrounded by colorful, friendly people. Each one of them touched us in different ways but all were eager to make us feel welcomed as honored guests in their countries. The dignity and warmth of the African people were an inspiration to all of us.

To all of them, I say "Ahsante sana" for all you gave us and we learned from you.

This medical mission was made possible through the generosity of many and I'd like to thank the following sponsors of our UNC Team:

The Family of Dr. Amal Murarka
UNC Hospitals
Health Volunteers Overseas
Samaritan's Purse
GE Healthcare

We are very grateful for their support and commitment to our mission. We literally could not have been successful without their help all along the way--both before, during and after the trip. They were our partners as well as our supporters.

Finally, on behalf of the entire UNC Medical Team, I'd like to thank Dr. Keith Kocis for his enormous leadership, encouragement and unfailing good humor throughout the trip. To say that we were met with many challenges is an understatement; but Dr. Kocis always kept the faith and inspired us to solve the problems. He led by example, staying up later and sacrificing his own comforts for the sake of the children and our team. It was a privilege to work with him. Thank you, Dr. K, for being there for all of us!

Afrique, natumaini tutaonana tena--

Helen Snow

The Ugandan children, on their way home

Monday, October 29, 2007

Our safe arrival home

We left Kampala and began our journey home traveling through Nairobi, Kenya. Helen Snow and Debbie Sams spent three days at UNC's Carolina for Kibera Program, an amazing experience (see Helen's Blog below). We traveled from there to Amsterdam through Detroit and finally home to RDU. We were all exhausted but glad to be home once again reunited with our families and our children. I thank my two children, Kyra and Connor for letting me leave them for two weeks to travel far away across an ocean and several continents to help other children with greater needs and far fewer opportunities. At ages 9 and (almost) 8, I am pleasantly surprised that they understand....Of course, I rewarded them with artifacts from Africa and they were thrilled.

Overall, we had 3 people with brief GI illnesses (fever, chills and sweats) and one lost bag on the return home. We hope it will be found. We will continue to take our Malarone to prevent malaria, since we did get bitten a bit in Kampala. We have had so many conversations on the return trip and even today at work at what an amazing experience this has been for us all. We worked so hard, for many months planning this trip, but no planning could account for all that we had to face and overcome. We all adapted quickly and gracefully to make this medical mission a success.

I am so proud and honored to have lead the UNC team over the past 2 weeks. This was an amazing group of people who came together and gave so much of their time, expertise, but most importantly, their hearts, for the success of this mission...I remind myself that this is not a characteristic of a few individuals, but of our wonderful institution. Core values of all we work with who have been encouraging us and following our mission through the blog. Unfortunately, so many individuals had volunteered and yet we could not take them all with us on this mission.

These are values we live with each day in caring for the children of North Carolina. I am so happy to be home again in Chapel Hill.

The updated PICU (est. 2005)

We were saddened by the fact that the PICU that we established two years ago in Amal's name, could not be used for this trip due to it's remote location from the main hospital and operating theatre. We did find time to up the hill to visit our dear friends, Matron Jollie and Dr. Justus,
Since we left, Great Ormond Street Children's Hospital in the UK donated several PICU beds. Two ECG machines were there and two non invasive ventilation (BiPaP) machines were available. Unfortunately, they were not trained on its use.

Matron Jollie's son painted the entire PICU with wonderful murals, it really cheered up the place. All of the equipment we previously brought was functional and in use. We were happy to resupply the unit to some degree. They have managed 67 kids there, but expanded use is limited due to staffing (both nursing and physician). We will not forget our dear friends or our work in the PICU on future trips.

Farewell reception: the American translation

The farewell reception

WOW, what an amazing evening at the Serena Hotel. We all got dressed up (Katherine wearing her Makerere University scarf) and went to the lavish downtown Kampala Hotel. There we met probably 100 individuals including the Ugandan team (all the RNs, perfusionists, physicians, administrators, etc) along with representatives from the Ministry of Health (and probably others).

We were treated to a FABULOUS African Dance troupe. They dressed, danced, and sang a whole series of native African pieces. We all joined in and added a little American "translation" to the dancing. Rain came and we ran inside to the more formal introductions and speeches. We had our group picture taken and then retired home (a little late in the evening). What a fun and exciting conclusion to our trip!

UNC's last operative day

Today was the last day of patient care for the UNC team. Dr. Dabal and Dr. Tom operated on a child with an atrial septal defect. They remained focused even though the Hospital, OR, and Cardiac ICU were spinning with the arrival and tour of President Museveni. The child did well and was extubated within several hours of arriving in the CICU. The DC Children's Team will continue care until they depart home on Friday. The Ugandan surgeons will operate on the 10th child tomorrow (Wednesday), a child with a PDA (non bypass case). Dr Dabal finished his case, said goodbye to all, and dashed off to the airport for his return trip home....The UNC team will pack and say good bye to everyone tomorrow.....We were just made aware of a good bye reception for the team tonight from the Ugandan team......How generous and kind...

Wednesday, October 24, 2007

Carolina for Kibera

October 23, 2007

Today we were met by Salim Mohamed, Executive Director of Carolina for Kibera and taken to the CFK Office in the Kibera slum on the outskirts of the centre city of Nairobi. The CFK Office is painted a cheerful Carolina blue and a guard is posted at the gate into the office area. But everyone we met was warm and welcoming. We met the CFK program directors and then set off with Salim and Hillary Omala, the Director of the Tabitha Health Clinics.

As Salim and Hillary led us through the narrow passages of clay, we ducked under many metal roofs which overhung the paths. Homes constructed from clay and straw lined the path and we were told that these fragile structures had to be rebuilt after any hard rain.

The first stop was the new Tabitha Clinic which is under construction in the heart of Kibera and where the two clinics will be consolidated once it is completed in early 2008. The foundation is complete and the framing should start soon. We've posted some photos of the construction. Many workers were carrying bags of cement or wheelbarrows full of gravel through the labyrinth of passageways--not an easy access.

Then it was on to visit the first Tabitha Clinic which was founded by the late Tabitha Atieno Festo, a widowed registered nurse from Kibera, with the $26 initial investment made by Rye Barcott from CFK. We met each of the medical team--Mark, Lucy, Julia, Angela and James-- who were busy debriefing about the 120 patients they had seen the previous day. We also met Fred (one of two pharmacists) who presides over the pharmacy.

Next it was off to the Tabitha 2 Clinic which is newer and located across the railroad tracks in the upper area of Kibera. The two clinics are very active and accessible but need more resources. When they are consolidated into the new clinic building, there will still be alot of new equipment needed to meet the communities' needs. It is our hope that we at UNC can help CFK find sources for contributed equipment.

Next we met with Caroline Sakwa, CFK Deputy Director, who directs the Binti Pamoja Center for young women. She describes it as a "safe place" program that seeks to empower and teach self-development skills to the women who have so little opportunity in the slum. Through training and education on subjects such as reproductive health, literacy, HIV, teen pregnancy and sexual abuse, the program trains a cadre of 80 young women in the various villages of Kibera about ways to protect themselves and insure their future. The program employs mentoring, photography, and drama as tools to deal with some tough subjects. Caroline said that UNC could help her program by providing mentoring program prototypes for her to use as models. We will ask the UNC Women's Center to set up regular contact with Caroline and act as a resource for her program.

Next we spent time with Cantar Abdul Hussen who directs the Soccer Program that now comprises 210 teams from all of the 12 villages. This was the first program undertaken by CFK and it has grown to over 4,000 participants. Besides the games and tournaments, the teams participate in community awareness events such as "Kicking AIDS Out" and the Clean-up Days organized in each village in Kibera. Cantar hopes that the program teaches the discipline and focus that each participant will need to lead a successful life. Among the needs of this flagship CFK program are: scholarships to reward winning teams; uniforms, socks & shoes; balls & equipment. In addition, Cantar says that UNC could provide "visiting coaches" from our own teams to mentor and inspire the players, especially the women's teams.

Medina Abakar, directs the Trash is Cash program and is a specialist in waste management. She leads 6 groups of 180 people (90% males) who work in waste management and recycling in all the Kibera villages. This is a sustainable enterprise to put people to work and meet a huge community need. Medina's motto is "Waste isn't Waste until its Wasted." The business has grown so big and fast that hauling off the collected trash has become the challenge. She hopes that they will be able to have a lorry or truck provided in the near future, and eventually be able to employ residents of Kibera in a community waste/recycling processing facility.

Directing the HIV-AIDS Prevention Program for CFK is Mary Waithera who grew up in Kibera (as did Medina). Mary works hard to do community education forums and get info into the homes about ways to prevent HIV infection. Like several of the directors, Mary is a "hometown girl" who is effective because she works with her friends and neighbors who trust her.

What struck us as we met with each of these CFK leaders was how dedicated, strategic, and caring each of them are in pursuit of their program goals. They each spoke with one voice and a strong unity of purpose. They were all careful to build a solid, sustainable plan for their respective program objectives, always being mindful that the communities of Kibera are the primary stakeholders.

The CFK organization is a model for many NGO's hoping to have sustained impact. We were touched by their commitment and humbled by their ability to leverage so much action with so few resources. We hope that everyone will investigate further how they can help these inspiring young adults achieve what few others have done.


Helen Snow and Deborah Sams

Tuesday, October 23, 2007

Ugandan President Museveni visits the Pediatric Cardiac Program

We were all suprised to have His Excellence Museveni come and spend about an hour visiting our successful program at Mulago Hospital. He arrived with the Minister of Health and a larger entourage and went to the board room for a meeting with senior leadership at the Hospital, Medical School, Board of the Uganda Heart Institute, and the US Medical Team (Lead by Dr Craig Sable, with Dr Stephanie Lacey and myself reprenting each of the 3 institutions). But the most prominent individuals were Edward, our first bypass patient (S/P ASD), and his grandmother who cares for him. Edward was sporting his UNC tee shirt under his dress outfit and the President had a chance to see his sternal scar and the UNC shirt (see pictures below). The President went to the pediatric cardiac ICU and meet all of the US and Ugandan Nurses, RT's, and staff. He then went to "theatre" (OR) to see the last surgery (number 9) in progress. He then left the Hospital.

The night owls: nursing collaboration at its BEST!

All of the nurses have been sharing the overnight (12 hr) shifts. This morning I wanted to share a pictures of the UNC, DC Children's, and Ugandan Nurses working side by side in caring for the fresh post op patients.

Sunday, October 21, 2007

Durham children learning about Uganda

NOTE: I received this letter on Friday from Esther Hahm....7th Grade Humanities Teacher (Duke School For Children) and with her permission I am sharing this with the group.
We are SO HAPPY that school children from North Carolina are intrigued and following our mission. We will create a presentation for these children when we return....
Dear Dr. Kocis,

Hello! I hope this message finds you well and in good spirits. I recently read an article in the UNC-CH Tar Heel Daily about your medical group's trip to Uganda. Your work inspired and intriguied me, and I was wondering, if there is any way, if a member of your group could share what you all did in Uganda with my students here at the Duke School for Children.

Our seventh graders are currently studying a unit on Africa, and one class is devoted to studying contemporary health issues that affect specific tribal groups in Sub-Saharan Africa. Right now they are reading articles and analyzing data, but I can sense that they are finding it difficult to grasp how people are affected day-to-day and to realize that people are suffering right now.

Ideally, a presentation at our school would reach the most number of our students, but if your group is already planning to present in a venue that is appropriate for our students to attend, we would love to encourage our students to be there. In any case, thank you for leading us to become a more compassionate and global-thinking community.

Esther Hahm
Seventh Grade Humanities Teacher
Duke School for Children
3716 Old Erwin Road
Durham, NC 27705

New pictures posted

Sorry for the delay in uploading pictures to the blogs the team has been writing the last few days....Please, if you have read the blog, go back and see some new pictures.

And on the seventh day...

Last night the UNC medical team was able to get coverage in the ICU, and gather altogether for dinner for the first time since we arrived. It was a beautiful, starlit evening and we dined alfresco at the Emin Pasha Hotel. Though everyone was tired, spirits were high and we all toasted Pablo Durana, our team photographer, who was leaving today (Sunday)to go back to the States briefly before returning to Benin to finish his assignment with the Discovery Channel. Pablo has been a beloved part of our team as well as with the patients, their families and everyone at the Mulago Hospital. Stay tuned for the film...

It was great to celebrate together the achievements of 1 week and hard to believe that our trip would be wrapping up in the days ahead.

But what better way to end this incredible week than to attend church with Pastor Appollo of the Walls of Salvation Church in the outskirts of Kampala. The Pastor had been in touch with Dr. Kocis for over a year and arranged to meet us to take us to his church by van this morning. The roads--mainly clay--were muddy with many deep potholes and puddles from the storm last night. The fumes from the exhaust of thousands of cars and scooters in a "jam" were overwhelming. Thankfully, we finally reached the destination and were led into the service which was already vigorously underway.

The Sunday service lasts from 10am-1pm with revolving preachers and singing groups.
It reminded me of an evangelical tent revival except it was held in much humbler environs. As honored guests, we sat at "the front" behind the preacher with all eyes on us through the whole service. One little 3-yr old girl wandered over and just sat down beside me and took my hand. We felt the warmth and welcome of the entire congregation of approximately 45 colorfully-dressed men, women and children.

The music was performed by various performing groups of children or young adults accompanied by an electric organ complete with sound effects. In fact everytime that the preacher shouted "halleluia!" the whole congregation said "amen" and clapped with the electronic "tinny" applause machine. After two other preachers completed their orations, Preacher Appollo welcomed us and then asked Dr. Kocis to speak to the congregation. Keith was eloquent and sent a heartfelt message to them about our hope to help them with their new church faciities.

Of course, this was met with much applause from both the parishioners as well as the applause machine! Then Appollo asked me to speak and I found myself speaking with tears in my eyes as I gazed at this roomful of people with such expectant looks of hope on their faces that our visit might somehow make their dreams for their new church come true.It was humbling and touching as each person pressed to shake our hand as we left I was so glad that we had made the trip to this cheerful church where you felt religion more deeply than in the grandest cathedral. Somehow Dr. Kocis and I hope to help this church after we return home,and so far when we have put it out there, dear friends, family, and colleagues have responded.

Tomorrow, Debbie and I leave Kampala for Nairobi, Kenya, but the memories of this place are imprinted on our minds and hearts.

Helen Snow