Falling in love with providing cancer care in Uganda: One oncologist’s story

Dr. Fred Okuku
"As a young man, when I came [to the Uganda Cancer Institute], I didn't have an idea I would stay," said oncologist Dr. Fred Okuku. "Then I began to fall in love with the whole place." Photo by Robert Hood / Fred Hutch News Service

Dr. Fred Okuku is an oncologist at the Uganda Cancer Institute, or UCI, and a research investigator with the UCI/Hutchinson Center Cancer Alliance. On May 21, the alliance, a 10-year-old partnership between the UCI and Fred Hutch’s Global Oncology Program, opened a 25,000-square-foot research, training and outpatient care facility in Kampala.

I don’t have a family history of cancer. As a young man, when I came [to the UCI], I didn’t have an idea I would stay. The buildings lacked paint. The place looked like it had no future. I thought I’d get quick clinical skills. That was all I thought at the time.

Dr. Edward Mbidde was here. He was the only medical oncologist in the country, and the [UCI] director. He didn’t have doctors, so to help out, he got two third-year medical students [from Makerere University medical school]. I was one.

It was a good opportunity to learn. It was hands-on. It also came with accommodation nearer the college, so that was convenient. I did transfusions. I took care of patients at night. I did all the procedures – lumbar punctures, biopsies. I learned a lot of things – skills that other medical students lacked.

Then I began to fall in love with the whole place.

Dr. Mbidde was very tough, but a good teacher. I loved the way he examined patients. His rounds started at 7 a.m. and ended at 5 p.m. Single-handedly, he had such a hard job. I really commend him. We saw a lot of children die. Every patient, children especially, that we lost caused us lots of emotions.

We had a few successes when a patient had family in the United Kingdom and they could buy and send drugs. But we saw a lot of people, mostly children, from poor families just dying. [After] the transition from Dr. Mbidde to Dr. [Jackson] Orem [in 2004], Dr. Orem didn’t have money to pay staff.

He said, “Look here, Fred, I know we’re not paying you, but there are many opportunities for you to learn. There will be a future. Research may start. If you stay on, I believe we will have done something for our country." The [Ugandan] government paid for my medical school. I was thinking it’s my payback time.

I saw Dr. Orem as a man who really needed my help, and so after my internship, I stayed on as a volunteer to help him out. My wife said, “Are you really going to work for nothing?” I told her, “At least I’m satisfied that I’m helping.”

The next year, [Dr.]Corey [Casper] and his group started a small study. In 2006, I did my residency. In 2008, I got an appointment as a medical officer and was transferred to the UCI. A couple more studies were started by Corey and his team. I’ve seen myself being transformed. These training opportunities we’ve had have transformed me into a good doctor. I learned how to talk to a patient and family. In Washington [at Fred Hutch], you spend an hour, you give them time.

It was mind-boggling in Chicago when I was there for ASCO [the American Society of Clinical Oncology conference in 2007]. I started to learn that research moves the world.

I was feeling bad that no work was being presented from Africa. Now a little research is coming out of Africa. It’s improving. I’ve seen it change from almost nothing. It’s been a long, long journey here – all the suffering we went through, all the death we saw. We still see people dying, but at least we have medicine to give them.

All those things we talked about in those days and thought would never come to pass – now here we are. I feel proud. We had a chat, my wife and I, and reflected on those early days. She said, “It was God who kept you there.”

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