The Patient. Olive Kobusingye

so kept his head low for a couple of days, bought a ticket, and left the country without ceremony. His first stop was London where he was no stranger, having trained at Hammersmith Hospital. He would later move to Saudi Arabia and make that his home for the next several years. Back home the exodus of health workers continued, each with their own unique story. It would be several years before he returned.

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      Dr. Bwogi Kanyerezi was head of the Department of Medicine when Dr. Obache, one of his colleagues, came to see him with a worrying story. Obache said he had been told by a close relative that some soldiers were planning to harm him. The relative was married to someone who worked as a secretary at the Army headquarters, and she had overheard some conversations. He had laughed it off the first time he heard about the threat, but the night before he had come home to find a strange car parked close to his gate. In the morning, he had noticed the same car at the end of the street as he drove out, and it had followed him to the hospital entrance. Although the car had civilian number plates he thought he saw some people in military uniform in his rear view mirror.

      “Obache, if you feel threatened, get out. Do not wait. We can give you a leave of absence until things get better,” Kanyerezi urged.

      The following day Obache returned with an update. “I have been offered military protection. I now have a tent full of soldiers in my compound. They are going to protect me.”

      “You trust these people?” Kanyerezi was incredulous. “What are you doing here? How can you trust soldiers to protect you? You are not a soldier. Obache, just get away.”

      “I think I am now okay. I have been assured that I will be safe.” Obache looked more relaxed than the day before, and the two doctors parted and went about their day’s business.

      Three days later Obache was killed in his house in Kololo. The soldiers that were supposed to ensure his personal safety were nowhere in sight when the killers came. From what his colleagues and relatives could piece together, Obache was considered a traitor by his Langi kinsmen. He had stayed in the country and thrived during Amin’s time when all the Langi, particularly the elite, were being hunted down. His wife had worked as a secretary to the Minister of Finance under Amin.

      Kanyerezi’s turn to flee came through bizarre circumstances only a few weeks later. The end of term exams in the Department of Medicine had concluded without incident. Results were displayed in the usual manner, and the students who had not passed were required to repeat the rotation. Four months later, someone reported that the Department of Medicine had “failed UPC students.” There was no way the lecturers could have arranged this even if they had wanted to, because they did not know which students had what political leanings. The accusation was initially dismissed, but an insider revived it and escalated it directly to Vice President Paulo Muwanga.

      “Who is this Kanyerezi, to think he can just fail UPC students? We shall teach him a lesson,” Muwanga said. One of the people present when Muwanga was told about the UPC students’ examination results sought to alert Kanyerezi that he was now a marked man. The information eventually got to him the following day. He did not need much persuasion, remembering the fate of his colleague Obache. He drove home, prepared his family as best he could for such an abrupt departure, and around 7pm he drove out of his gate despite the nighttime curfew that was in effect. Because he did not have a better plan yet, he drove from his home in Rubaga to neighboring Lungujja and the whole family spent the night with friends. “A couple of hours after we left the house, a military truck full of soldiers drove up to the gate. Finding that there was nobody at home, they shot several rounds of ammunition in the air and left.”

      Over the next three weeks, Kanyerezi either lay low or moved with great stealth. A friend took him to see a sympathetic Member of Parliament who was also a Major in the army, to find out just how grave the situation was. Major Angwa offered to get him military protection. “No thank you! I will take my chances without their help.” He reached out to the university Vice Chancellor, Prof. Asavia Wandira, explained his predicament, and let him know that the department was going to need a new head. He moved the family to a different location every few days to avoid being tracked down by the security agents. Through a network of friends, he secured help with escape plans. In the end, he left the country in a UNICEF vehicle that was destined for Kenya to pick up supplies. His wife followed soon after in the same manner.

      Dr. Charles Olweny was already heading the Uganda Cancer Institute, now he took over as Head of Department of Medicine as well. Four and a half decades later, Olweny could still vividly remember how he became head of the Cancer Institute.

      “In 1972 I was at the National Cancer Institute in the USA doing a Fellowship in Oncology. Six months to the end of the Fellowship a message came from Uganda. ‘You should return to Uganda immediately. If you delay your return there will be nothing to return to.’ Back home, Amin had expelled Asians, and many other expatriates had started to leave. All eight expatriate staff at the Uganda Cancer Institute were leaving. I wound up my stay prematurely and headed home. On arrival I reported to Kibukamusoke, who was Head of Medicine. He told me to go and talk to Prof. Kyalwazi. Kyalwazi was in Surgery, but had closer dealings with the Cancer Institute because of his research in liver cancer and Kaposi sarcoma. I went to see Kyalwazi, and told him that I could not head the Cancer Institute. ‘The Institute has just lost all its senior staff. I don’t think I can manage,’ I told him. Kyalwazi held my hand. ‘Son,’ he said, ‘you can do it. I will support you.’ Two expatriate colleagues were waiting to hand over the Institute. As soon as I showed up they effected the hand-over, wished me well, and left. To his word, every Wednesday without fail, Kyalwazi came to the Institute to do rounds with me, and to help me think through any issues I needed help with.”

      Olweny lasted much longer than his predecessors in Medicine, but by 1983 when he left under the guise of a sabbatical, he was living like a fugitive, often having to spend nights in different locations to avoid ‘disappearing’ under the cover of darkness. These men were among the forerunners of the generation of Ugandan doctors that would go ahead to have illustrious medical careers while scattered in the diaspora. Despite the great odds, the Cancer Institute gave the world the first evidence that lymphomas (cancers of the lymphatic system) in all ages could be treated successfully with chemotherapy. Amidst scarcity, Olweny pioneered the concept of an essential drugs list, which concept was adopted by the World Health Organisation for use globally.

      ***

      David Kisumba was the first Ugandan professor of orthopedics, attaining this status at a relatively young age. The reason few people know of him is that he died a truly untimely and premature death in a road traffic crash in Kololo, then a posh quiet neighborhood north of Kampala central business district. Nevertheless, he left an impression on his young nephew Mutyaba, who determined that he would be an orthopedic surgeon as well. The aspiration would have died the death of many such youthful dreams had his ambition not met with providence in the names of Professor Rodney Belcher, an American Navy flight surgeon who fell in love with Uganda. Belcher was no stranger to East Africa. He had started in Dar es Salaam as professor of surgery in the 1970s. In 1983, he came to Makerere as a Fulbright lecturer, but the country was in the throes of a full scale civil war, and he was forced to relocate to Nairobi. He was so committed to working in Uganda though, that as soon as the war ended in 1986 he started planning his return. Return he did, to a badly run down Mulago Hospital, where there were no orthopedic services to speak about, and where all surgical services were a major struggle.

      Belcher realized that the care of the diseases of the bones and joints was always going to lag behind unless a department was created, where specialists could be trained. He was going to begin from the ground up. Mutyaba, who already had his general surgical training under his belt, was his first student. They needed a ward, an operating room, consulting rooms, classrooms … they needed a lot of infrastructure that did not exist in post-war Mulago in 1988. What did exist though, that came to their aid, was a dilapidated bungalow in Old Mulago that housed patients with disabilities, mainly from polio. Having identified the house as a potential base, Belcher had to find the money. For this he turned to his old friends from his Airforce days. One of them was now a Senator, and Belcher thought he might find a way to get his dream department funded. He went back home, asked around, and then decided that Mutyaba would