Duke Raleigh Hospital

By Michael M. Haglund, M.D., Ph.D

Dr. Muhumuza and Dr. Haglund in new Neurosurgical Theater (a.k.a. Operating Room)

Medical missions have been part of my practice for 18 years. I’d been to Ecuador many times and felt called to that part of the world. But when a Ugandan pastor visited my church in 2006, he told me I’d be going to his country. “With all due respect,” I told him. “I’m already doing missionary work in Ecuador.” He was undeterred.

He knew more than I did.

January marked my 13th trip to Mulago Hospital in Uganda – a country I now feel part of. Our team of 22 medical professionals from Duke reviewed 75 patients and operated on 27. I was there for a week, and one of our surgical residents, Amitoz Manhas, stayed for three more weeks to continue our work.

New operating room in Uganda

This visit was especially meaningful because the new operating room we donated – the hospital’s sixth – was inaugurated. The 1,500-bed hospital is 10 times bigger than Duke Raleigh, yet we have 15 state-of-the-art ORs compared to their five.

Not only that, their neurosurgery OR shared space with a cardiac and trauma OR. Patients who needed brain surgery would check into the hospital and wait – and hope – for months for an operation as trauma patients were treated ahead of them. The head trauma cases – and there are many in a country where people ride motorcycles without helmets – take precedence.

Each time I go to Uganda, a crew of 22 to 55 medical professionals joins me. Over the last six years, we’ve delivered more than 42 tons of new and used medical equipment, valued at $6.25 million, as part of the Duke Global Health Plus program we started in 2007. The program makes great use of our old equipment. What seems dated to us is positively revolutionary for the people in Uganda.

Before we got involved, their equipment was the kind medical staff used in the U.S. in the 1930s. They were still using hand drills to get into the skull and gauze to stop bleeding in the brain. They still used ether as an anesthetic! Now, their equipment is the equivalent of what leading U.S. hospitals were using in the early 2000s.

It’s not that the Ugandan neurosurgeons didn’t have modern skills. These doctors were trained in Germany, Australia and other first-world centers. But then they went back to Uganda and had to make do with what was there. They are the real heroes.

We’ve performed more than 175 neurosurgical procedures since we’ve been going to Uganda. And our delivery of technology and training has more than doubled the surgical capacity at Mulago Hospital. Seven years ago, the five operating rooms at Mulago treated 1,200 cases a year. Since we’ve been working with them, they can now perform more than 2,400 surgical procedures a year.

We don’t just pop in, drop off equipment and come back home. We teach doctors and staff how to safely use and properly maintain the equipment we’re giving them.

And, it’s an effort supported by everyone at Duke Raleigh, including Duke Raleigh’s President Rick Gannotta and Dr. Victor Dzau, president and CEO of the Duke University Medical Center. I couldn’t do it without the support of the entire team. It’s more than my mission. Helping bring our medical expertise to a part of the world that desperately needs it is a central part of the Duke Univeristy Health System, the Duke Global Health Institute, and more specifically Duke Raleigh’s mission.

Dr. Haglund is a distinguished professor of Neurosurgery, Neurobiology and Global Health. He is also the Training Director at the Duke Neurosurgery Training Program, and Surgical Director at Duke Epilepsy Center.