Projects:

Georgetown Teaching Hospital and University Medical School, Georgetown, Guyana.
Lacor Hospital, Gulu, Northern Uganda

Georgetown Teaching Hospital and University Medical School, Georgetown, Guyana.

Guyana has a population of ~700,000 of whom ~250,000 live in greater Georgetown. Tens of thousands of other Guyanese are also found throughout the world, having been compelled to leave Guyana over the past 30 years for economic reasons and lack of opportunity to develop.	(Please click on the picture to view full size image)
With a physician to population ratio of 1 to 5,500 Guyana has the second lowest in the region, second only to Haiti. Within the country there are 116 health posts, 112 health centers and 39 hospitals. One is a referral (teaching) hospital, 6 are private hospitals, and do some tertiary work (all are in Georgetown), 4 are regional hospitals and 28 are district hospitals. The few specialists are all in Georgetown and most work at both the private and public hospitals. The country has an inpatient bed ratio of 1 to 323 population (>3 beds per thousand).	(Please click on the picture to view full size image)
This project originated by Dr. Bob Taylor has CIDA funding to help establish a two year Postgraduate Training Program in Surgery for Guyana. It will involve sending 4 Canadian Surgeons per year over a three-year period to provide clinical and didactic instruction to a group of surgical trainees in Guyana. Each mission is expected to last 2 - 3 weeks and participants will be expected to teach several modules of the Royal College of Surgeons (England) STEP course as well as participating in clinical care, teaching in the ORs and wards and some outreach work. This will be appropriate for experienced surgeons interested in teaching. Travel and accommodation are covered by the grant.	(Please click on the picture to view full size image)

Contact Person: Dr. Brian Cameron

Lacor Hospital, Gulu, Northern Uganda.

(Please click on the picture to view full size image)	Uganda has a population of 22 million. There are fewer than 1000 doctors in the country, giving a doctor to population ratio of 1 to 25 000. There are about 70 specialists in Uganda and most of these are located in the two major urban centers, Kampala and Mbarara. Because of the inadequate resources and infrastructure, many specialists have left Uganda. There are two medical schools (Kampala & Mbarara) that graduate a combined total of 120 doctors per year. Life expectancy at birth is 40 years; under-5 mortality is 140 per 1000; maternal mortality is 1200 per 100,000 live births. About 60 hospitals of various capabilities exist throughout the country of which some 15 are designated "regional" where some basic surgery can be done. A major portion of Uganda's population is simply without access to surgical care, and it will be years before this changes. The community of Lacor is located just outside the city of Gulu in northern Uganda. Gulu is about 300 km north of the capital, Kampala, and these cities are connected by a paved road.
(Please click on the picture to view full size image)	In 1959 a small medical dispensary was begun in Lacor as an outgrowth of a nearby Italian mission of the Verona Fathers. In 1961 Dr. Piero Corti (Italian pediatrician) and Dr. Lucille Teesdale (Canadian surgeon) joined the staff and the dispensary developed progressively into a hospital and has continued to grow in response to the enormous need of the area. By 1970 it was already recognized as a teaching/training institution and by 1980 young Ugandan doctors were beginning to join the staff. The surgical department continued to develop under this Canadian Surgeon.
(Please click on the picture to view full size image)	During the past 30 years Uganda has seen much social upheaval and civil war with consequent strain on its medical services. Despite that, the hospital at Lacor has maintained a significant presence and has received national recognition. A recent external review commissioned by the Ugandan Ministry of Health of all service/teaching hospital facilities of the country reported that St. Mary's Hospital had the most stable and functioning infrastructure to be found.

The hospital has over 500 beds and runs a 130% occupancy. It serves a population of one-and-a-half million and is the regional referral hospital for the northern districts. The buildings are of cement, brick and plaster and are in good repair. The hospital has its own water supply and it is reliable. It can also use the town's water supply if ever necessary. The electricity, 220 volts, is quite regular, although needs updating. It also has its own back-up generator.

There are separate buildings, connected by walkways for surgery, medicine, gynecology, pediatrics and maternity. Separate wards also exist for infected cases, both surgical and medical and for child welfare - which is a special nutrition center. The wards are somewhat crowded, with the high occupancy, although there is still room to get around, and they are quite tidy. As anywhere, there is a nursing shortage, although their numbers are helped by the presence of student nurses.

Lacor Hospital in Gulu, northern Uganda was the hospital built-up by Canadian surgeon Lucille Teasdale who died there in 1996 after serving for 35 years. Lacor hospital is a 500-bed general hospital treating over 150 000 patients annually. Since her death, CAGS has sent four.

Canadian surgeons (Bill Fitzgerald, Brian Ostrow, Barbara y and Eric Webber) on 2 - 3 month missions to provide clinical expertise and teaching support. Current priorities include urology, intensive care and burns. There is a heavy ongoing burden of trauma there, much of it related to the ongoing civil unrest in Northern Uganda. No funding is available through CAGS for missions here, but accommodation is provided by the hospital. It is hoped that we can send four surgeons per year to Lacor. See Dr. Fitzgerald's excellent piece in the summer 2003 CAGS Newsletter.

Contact Person: Dr. Brian Ostrow

More background documentation.