Health
From Working as a Houseboy to Being the Best in School: Ssembuusi’s Story of Overcoming Hardships & Achieving Success
Against all odds, Allan Ssembuusi-Mayengo rose from a house boy to a First-Class student. In this episode of Makerere University’s week-long 73rd graduation ceremony slated to run from February 13-17, 2023 we present to you a story of a determined young man who never let his circumstances define him, and how he achieved the impossible through hard work, perseverance and the power of prayer. He will graduating as a second best in his class at Makerere School of Public Health (MakSPH) with a Cumulative Grade Point Average (CGPA) of 4.42.
With determination and a willingness to take on any job that came his way, Ssembuusi struggled through financial hardship to make a better life for himself. From selling water at the new taxi park to working as a phone repairman and even starting a mobile manicure and pedicure business, he used his entrepreneurial spirit to support himself through University, despite the challenges he faced he carved out a path to success, proving that with grit and perseverance, anything is possible.
Born on 15th February 1996 in Kyabiiri, Kibinge Subcounty, Bukomansimbi District in Greater Masaka to Wilson Mayengo and the late Sarah Nantongo, Ssembuusi is the 4th born in his family.
School life
For the better part of his childhood, Ssembuusi stayed with his step-mother Ms. Margret Namuddu in Kawanda, Wakiso District after a separation between his mother and father. His mother later passed away while he was in Senior four (S.4). With obstacles in his path he hopped from school to school sometimes to dodge school financial requirements.
As early as 2004, he had started school at Bituntu Church of Uganda Primary School in Masaka. He only completed his Primary One class before he was transferred back to Nalujja primary school in Kawempe in Kampala, where he had a short stint of two academic terms.
In 2005, his family shifted to Kawanda, a small town located north-west of Kampala, the Uganda’s capital town. While here, he completed his Primary Two (P.2) at Little Angels Primary School, a private school. The comfort was short lived as he would later relocate to Nakyessanja Church of Uganda Primary School from P.3 until he sat his Primary Leaving Examination -PLE in 2010.
“This was so hard for me, we didn’t even have lunch at school. In the morning, our step-mom would prepare for us tea with acoil bun (Mwana akaaba) bread of Shs. 100, and this would take us all day until our next meal in the evening. My stepmom always had dinner ready whenever we returned from school. It was hard being at school, seeing your colleagues going to the canteen to buy eats during break and lunch time when you are in class “eating shadows” but still I managed to perform well. I started being in the first position in class in P.3 up to when I finished P.7. All these challenges gave me determination and courage to work hard so that I get a better future,” recollects Ssembuusi.
While in P.3, Ssembuusi was top of his class in promotional examinations but he could not access his report card because his parents had failed to pay UShs 2,000 (approximately $0.54).
“While appearing at end of term School assembly, I was announced as being in the first position—the School administration used to announce the 1st, 2nd and 3rd place holders. We didn’t have that money at home so I didn’t pick my report. With this in mind however, I just reported to P.4 at the start of the next year. The headmaster however, came reading out names of those who didn’t pick their reports, and we were all taken back to P.3,” he says.
He recalls crying endlessly by this act but would only console himself knowing the situation back at home and that his father genuinely did not have the money; “We used to eat cassava flour with avocado. We had an Avocado tree at home and we would temporarily forget hunger in seasons the tree would, bear fruits. We would pick avocado and mash it as the sauce.”
As luck would have it, Ms. Grace Nakidde, his teacher provided him the required Ushs.2,000 that granted him access to his report, and then became officially promoted to the next class in 2006.
Ssembuusi, was frequently engaged in various household tasks, which caught the attention of a neighbor. At the age of 12, while in Primary Five, he went to work for this neighbor as a houseboy to earn money for school fees.
“At the time, we were paying around Ushs 10,000 (approximately $2.72), for remedial classes and Ushs 5,000 for lunch. I used to work day and night, but I stayed focused because I wanted to study. I would go to School barefooted. At P.7, I got 9 aggregates and this was the only first grade at my school.”
Ssembuusi’s excellent performance earned him a bursary to attend Central College Kawempe, a school owned by a relative of his employer. Despite this financial aid, he still had to pay for some school materials, which prompted him to continue working at home. “I would wash cars for our neighbor every day to buy books, but I still excelled and was the best in all three terms of S.1,” he said. However, due to the mistreatment he experienced as a houseboy, Ssembuusi confided in his parents, who then spoke to his employer. Unfortunately, this led to the loss of his bursary.
“Since my parents were unable to pay for my education at Central College Kawempe, they transferred me to Luteete Senior Secondary School in Luweero. I am grateful to Mrs. Kiwanuka who, through our shared faith at Elim Pentecostal church in Kawanda, connected me to Luteete where I was able to obtain a half bursary. This required me to raise Ushs 150,000 (approximately $40.82) on my own. Despite this, things were still difficult for me, as I often only had Ushs 20,000 (approximately $5.44) to last me through the entire term.”
Ssembuusi states that the school’s provision of lunch and supper helped him stay focused. He adds, “Sometimes I sold my lunch to afford necessities like books and pens, but I still excelled and remained the best throughout my stay, up to S.4. I scored 13 out of 8 aggregates, the best performance in the school’s 60-year history. I achieved it through hard work and prayer, even fasting dry for 3 days.”
After getting his Uganda Certificate of Education (UCE) results, Ssembusi moved to Wampeewo Ntakke Senior Secondary School along Gayaza Road with the help of his former head teacher Mr. Mike Ssekaggo. He says, “I scored 12 points in BCM/ICT and I remember getting a D1 in Biology Paper 3. I was also the founder and pioneer of the school’s Science Club.” After finishing S.6, he found a job as a porter at a construction site near his school. He adds, “Although students saw me working there, I was determined to survive. Later, my former head teacher helped me get a job as a canteen attendant at his school, where I stayed for 1 and a half years.”
Failing to join University and Resorting to Barber and Taxi Tout
Ssembuusi had always dreamed of going to university, but his journey was not an easy one., Despite sitting for his Uganda Advanced Certificate of Education (UACE) in 2016 with hope to join a university in 2017, he was not admitted to any of the institutions he applied to on his application forms. He lost that year of 2017 and decided to try again in 2018. “I had understood my points, and weights better and thought by trying on a Diploma, I would get admission. I applied for a diploma in Education at National Teachers College NTC Kaliro, but was not admitted once again”
Feeling defeated, Ssembuusi left his job as a canteen attendant and returned home, but struggled to find any opportunities. However, things still weren’t working out and he found himself living with his uncle who was a barber and taught him the trade. He also started working as a conductor on a taxi route from Jinja road-Kawanda-Matugga, where he used to meet his old teachers and colleagues. He felt like a failure, but still held on to hope for better opportunities.
“We used to ply the Jinja road route. I grew up on this route and so I had mastered it. While in this trade, I would meet my teachers, my former colleagues, the students I used to discuss for. For once, I felt like I was a total failure,” says Ssembuusi.
One day while operating as a taxi tout in Wandegeya, he bumped into an old friend, Jackline Nankya, who in 2020 graduated from MakSPH. They had studied together at Wampeewo Ntakke Senior Secondary School. Concerned about him she asked for his contact to check on him. Ssembuusi explained his situation and Jackline told him about the Government Loan Scheme program, a fund that awards study loans to Ugandan students seeking to pursue Higher Education but are financially constrained. She helped him apply for a course in Environmental Health Science, which he made his first choice, and also helped him apply for the Government Loan Scheme.
Ssembuusi was in a dilemma, he had even prepared to go to the United Arab Emirates to do “Kyeeyo” (cheap employment for immigrants to the developed world) with some sisters that were already there. His parents were excited about the prospect of him making money. “I didn’t tell them [parents] when I applied. I told them when I was admitted. I was in a dilemma and in fear of how my parents would react to me leaving an opportunity to work and provide for them.”
He sought advice from a few people, including his boss in the taxi business, before ultimately telling his parents. To his surprise, they were overjoyed when he finally shared his plans with them. They had the assumption that Makerere University was the only university in Uganda.
Life at MakSPH
Determined to succeed, Ssembuusi used all the money he made working in the taxi to buy the requirements needed for his first year. He was so passionate about his studies that he even joined a week before his colleagues and was voted unopposed as class representative. “This is where my journey to perform well started,” he says.
Adding that; “After our first lecture with Ms. Ruth Mubeezi, I felt deeply inspired. I approached her after class and shared my struggles with her. Her words of encouragement and assurance that I would be able to manage school, gave me the courage and determination to push forward. And that’s how I embarked on my journey towards achieving a first-class degree, starting off with a strong 4.6 GPA in my first semester.”
He commuted to school in his first semester, but during a brief holiday before the second semester, he decided to stop commuting and go back to his taxi business in the Old Taxi Park to earn money for accommodation. He was able to get some money and temporarily moved into Nkrumah Hall, one of the halls of residence for male students admitted to Makerere University, named after the great pan Africanist Nkwame Nkrumah of Ghana with a friend Kelvin Langat.
“I wanted to go back to work as a conductor to earn money for accommodation but it was the festive season so things didn’t work out. I decide to sell sugarcanes in Old Taxi Park because most people there, knew me. I used to contribute something and stay with him on the same bed before COVID came in and we had to leave campus,” a teary Ssembuusi recalls.
COVID-19 and Ssembuusi’s campus nail business
As the COVID-19 pandemic swept the world, it brought with it a host of challenges for students like Ssembuusi. With lockdowns in place and classes conducted online, Ssembuusi was forced to find ways to make ends meet. Like many students, Ssembuusi found himself struggling to afford the costs of accommodation, and everyday living expenses.
“I went to New Taxi Park (the old one was closed for renovation at this time) and sold water there. It was a tough moment, because I found so many classmates there boarding taxis to go about their business. I wanted to quit, but I also still wanted to survive,” he says.
The Student Loan Scheme is a cost sharing initiative. The Loan strictly covers the academic component, i.e., Tuition fees, Functional fees, Research fees, Aids and Appliances for Persons with Disabilities (PWDs). For Ssembusi’s case, the loan covered Ushs1.8m fees inclusive of functional fees and he is indebted to the loan scheme; “I am thankful for the Student Loan Scheme for enabling me to continue my education, however, they have not yet paid for my last three semesters, preventing me from accessing my transcript until the debt is fully cleared. Despite the delay in payments, they would still allow us to sit for exams with the assurance that they would pay later.”
It was during this time that Ssembuusi stumbled upon an unexpected opportunity. At a friend’s home, he discovered a salon offering manicures and pedicures. Intrigued, he asked the owner to teach him the trade, and soon found himself learning the skills needed to set up his own mobile manicure and pedicure business.
With the support of his classmates, Ssembuusi’s business quickly took off. Working on almost all of his female classmates, Ssembuusi found himself juggling the demands of her coursework and his business. But he was committed to making it work, and with the help of a loan from a friend, he was able to purchase the equipment he needed to keep his business running.
“I have been doing pedicure and manicure, and all my clients have been my colleagues. I was charging 10,000 to 30,000 Ushs for gel nails. People perceive it as a “low-key job”, and I am sure it’s hard for most campusers to do this kind of work especially on their classmates. I know some people come from advantaged families, but for those of us who have been disadvantaged, please don’t look down on any opportunities or jobs that will help you raise some money to sustain you,” he says.
“I think I have worked on almost all my female classmates. The business boomed, I started getting recommendations but it was a challenge on my side to attend lectures and also attend to clients. My course is a full day course, and being a course representative, I had to be around. I managed to schedule my clients in the evenings and over the weekends when I worked all day.
Ssembuusi has throughout his school life struggled with self-doubt and imposter syndrome, but along the way found ways to overcome it through self-improvement and taking advantage of opportunities. He was active in the school community, serving as a class representative and holding leadership positions in Makerere University Environmental Health Students Association (MUEHSA).
He found success in extracurricular activities, such as participating in medical camps and running events. After finishing his course, Ssembuusi sought guidance from his mentors and ultimately landed a volunteer position under the mentorship of Dr. David Musoke, a Senior Lecturer in the Department of Disease Control and Environmental Health at Makerere University School of Public Health (MakSPH). His future goal is to pursue a Masters and eventually a PHD in academia and research. He encourages others to take advantage of opportunities in order to be successful.
To achieve a first class, one must put in hard work and strive to do their best. “I didn’t set out to achieve a first class, but I now understand its value. A lecturer once told us, ‘Don’t listen to those who say a first class isn’t worth it – if you can earn one, go for it.’ That’s my advice to my peers – aim for the best and don’t be discouraged. I didn’t actively pursue a first class, but my efforts paid off in the form of this distinction,” says Ssembuusi.
He adds; “Mr. Frederick Oporia, who taught me inspection, court etiquettes, and environmental health legislation, is my standout lecturer and role model. Currently the Head of Trauma, Injury, & Disability (TRIAD) unit, he continues to inspire me. Additionally, Dr. David Musoke, who is my mentor, is someone I look up to and strive to emulate in my work.”
Four Makerere University School of Public Health (MakSPH) faculty have been inducted for the 2024 Uganda National Academy of Sciences (UNAS) fellowship, a preeminent nation’s most respected scientific bodies. This is the first time MakSPH is scooping a large number of faculty fellows, which was the highest for a single institution. This prestigious honor was awarded on Friday, November 1, 2024, at Four Points by Sheraton Kampala, Uganda.
The recipients are;
⦿ Professor David Guwatudde, a Professor of Epidemiology and Biostatistics at the MakSPH where he has been teaching for over 32 years. In the last decade, Dr. Guwatudde’s research interest has been on characterising the epidemiology, evaluattion and effectiveness of appropriate interventions for prevention and control of selected non-communicable diseases (NCD) especially diabetes and hypertension.
⦿ Dr. Fredrick Edward Makumbi, an Associate Professor of Biostatistics at MakSPH in the Department of Epidemiology and Biostatistics. A seasoned public health professional in Uganda, he is also a Gates Fellow. Through his expertise in population health and the evaluation of public health interventions, Dr. Makumbi has generated significant evidence that impacts the field. He has published over 300 journal articles and leads the PMA project, which focuses on evaluating schistosomiasis and family planning initiatives in Uganda.
⦿ Dr. David Musoke, a Senior Lecturer in the Department of Disease Control and Environmental Health at MakSPH. He serves as the Chair of the Grants and Research Capacity Building Committee at MakSPH and is the President Elect of the International Federation of Environmental Health (IFEH). A graduate of Makerere University, his research interests include environmental health, malaria prevention and community health. He organized the first International Community Health Workers symposium which was held in Uganda, and is an academic editor and reviewer for several journals.
⦿ Dr. Victoria Nankabirwa, an experienced clinical researcher and Lecturer in the Department of Epidemiology and Biostatistics at MakSPH. She holds a PhD from the University of Bergen and is also a member of the WHO Immunization and Vaccine-related Implementation Research (IVIR) Advisory Committee. Her key interests include mother and child outcomes, particularly survival and the impact of immunization.
UNAS is an independent, non-profit, and non-political organization, established and founded in October 2000 to provide Uganda with credible, balanced, and evidence-driven guidance on matters of science and development. Membership is drawn from distinguished scientists and scholars who have made significant, lifelong contributions across diverse fields, including natural and social sciences, arts, and humanities.
The UNAS Fellowship remains one of the nation’s most respected scientific bodies, with over 200 members working collaboratively in interdisciplinary and transdisciplinary fields to address Uganda’s challenges through science and innovation.
Every year, Fellows of the Uganda National Academy of Sciences (FUNAS) have an opportunity to nominate potential fellows into the academy based on their merit, impact and contribution of the world of Science. A nomination stands substantive once it is seconded by another FUNAS, after which the nominees go through a rigorous selection process by a highly competent committee of scholars in the academy.
Once selected and inducted, fellows in the academy devote their time on honorific activities and service provision through arbitrating on contentious national debates such as whether to provide free social services to refugees and whether to use DDT to control Malaria. Since inception on October 20, 2000, the UNAS has distinguished itself as a premier honorific society for eminent scientists in Uganda. It leverages on the expertise and stature of its members to provide pro bono evidence-informed advice to government and Ugandans on science, technology, innovation and sustainable development.
Dr. David Serwadda, an Exemplar Scholar of Makerere University who this year received the prestigious Professor Emeritus title presented the new fellows to the UNAS convention. He described Dr. Nankabirwa as a prolific researcher, with over 80 publications in peer-reviewed journals and an impressive funding portfolio that includes a number of highly competitive research grants.
On her part, Dr. Victoria Nankabirwa said she was grateful for the recognition and pledged to uphold UNAS values.
“I am very thankful for this recognition, and as I reflect on the journey that has brought me to this point, I am reminded that this is not the result of solitary work but of shared aspirations, collaborations, and partnerships. As such, I am very thankful to my nominators and seconders, Prof. David Serwadda and Prof. Rhoda Wanyenze, as well as to my colleagues, my students, and my family, represented by my mum. To these people and to you, I extend my deepest gratitude. I pledge to uphold the academy’s values, advocate for science-driven policies, and mentor future generations. I will work as hard as I can within this FUNAS,” said Dr. Nankabirwa.
Dr. Fredrick Edward Makumbi expressed his gratitude and commitment during his recent induction as a fellow of the Uganda National Academy of Sciences (FUNAS). “I am delighted to have been nominated and accepted as a FUNAS. I am truly appreciative and acknowledge the support of all those who have helped me, from my family to my teachers and colleagues—many of whom are here today. They have supported me and brought me to this great podium. I pledge to continue working, supporting, and promoting the health and well-being of the people of Uganda and beyond through science, as well as mentoring others to ensure a sustainable generation that can uphold the health and well-being of Uganda and beyond. I am glad to be here, and thank you very much,” Dr. Makumbi stated.
Dr. David Musoke is a promising researcher and Senior Lecturer in the Department of Disease Control and Environmental Health at Makerere University’s School of Public Health. He serves as the Chair of the Grants and Research Capacity Building Committee and is the President Elect of the International Federation of Environmental Health (IFEH).
“I am really delighted and humbled to be joining this elite class of academics and scholars as a fellow of UNAS. It is an honor to join many of my mentors from over the years, including my very own father, who is also a fellow of UNAS and is here today, Prof. Miph Musoke. I wish to thank my family—my parents, wife, and children—for all their support, as well as the research teams we have worked with,” said Dr. David Musoke.
Adding that; “I also extend my gratitude to my mentors from the university, Professor David Serwadda and Professor Rhoda Wanyenze, for nominating me, along with all the others who have contributed throughout this journey, including funders, collaborators, the community, and everyone else we work with. I look forward to serving in this capacity and upholding the goals and aims of UNAS, especially in the field of Environmental Health and Community Health.”
Professor Guwatudde, a lead investigator in two national surveys assessing non-communicable disease (NCD) risk factors in his country—first in 2014 and again in 2023—expressed his commitment to tackling NCDs as he was recognized by the Uganda National Academy of Sciences (UNAS).
“I would like to thank the UNAS council, the secretariat, and all members for accepting me as a member,” Prof. Guwatudde said.
“I pledge to contribute in the area of non-communicable diseases. We have conducted extensive research in this country, giving us a clear picture of the NCD burden, a reality that affects us all. I would be glad to share this insight with fellow members,” added Guwatudde.
National academies worldwide provide neutral platforms for experts across disciplines to tackle societal challenges and clarify emerging issues in science, technology, and policy. These institutions play a crucial role in preparing for and responding to global threats such as pandemics. Since its inception, the Uganda National Academy of Sciences (UNAS) has been led by four presidents: Prof. Paul Mugambi (2000-2014), Prof. Nelson Sewankambo (2014-2019), Prof. Peter Mugyenyi (2019-2022), and, since October 2022, Prof. Grace Bantebya-Kyomuhendo, a Professor of Women and Gender Studies at Makerere University—the first female head of the academy.
Prof. Bantebya extended her congratulations to the newly inducted fellows. She emphasized the responsibilities UNAS fellows carry, including upholding the academy’s constitution and contributing to its vision, mission, and objectives. “Our fellows play a critical role in advancing the academy’s goals, and their dedication is vital to our impact on science and policy,” Prof. Bantebya stated.
“Remain academically active. Please listen to that. In meaningful pursuit of academic excellence in your respective areas of expertise. Do not say that now that you have become a fellow, you will stop being academically active. We expect you to continue,” she emphasised.
She also called on the fellows to actively participate in the academy’s conventions, consensus-building efforts, and other activities. Prof. Bantebya emphasized the importance of consensus studies to the academy’s mission, urging fellows to make themselves available when called upon.
“Ensure high standards of conduct based on national and international best practices. We expect you to maintain and ensure high standards yourselves and foster good relations among members as well as with the academy, the general science community, and the public. You also need to meet all the obligations as a fellow of UNAS, whether financial or otherwise, as stipulated,” the Academy President said
A fellow may lose their membership in the academy if they act against the UNAS constitution or bring disrepute to its goals, name, or vision. Membership can also be terminated if a member is convicted by a competent court or authority of a felony or serious crime, or if they are declared bankrupt or of unsound mind.
UNAS’s mission is to foster the welfare and prosperity of the Ugandan people by generating, sharing, and utilizing robust knowledge and insights to deliver independent, merit-based scientific counsel to government and society. As part of the global scientific community, UNAS maintains strong ties with the Network of African Science Academies (NASAC), Network of Science Academies in Islamic Countries (NASIC), the U.S. National Academies, IAP, and TWAS.
Article courtesy Fogarty International Center
September/October 2024 | Volume 23 Number 5
Until recently in Uganda, most children with sickle cell disease (SCD) never celebrated their fifth birthday—only 30% lived past this milestone. This low survival rate was mainly due to inadequate health care interventions for these children, plus lack of widespread newborn screening, explains Dr. Sarah Kiguli , a professor at Makerere University College of Health Sciences. Things are different today. Over the past decade, the East African nation has instituted a policy of screening newborns while strengthening strategies to manage their health. This means more children with SCD are growing into adolescence and adulthood.
Challenges still exist, says Kiguli. For example, the community and district facilities where many Ugandan children are born cannot provide comprehensive services, including newborn screening. Another issue: the risk of SCD complications related to kidneys, lungs, heart—almost all organs—grows higher as patients grow older, yet scientific research in Uganda hasn’t caught up with the reality of these longer lives. As a result, teens and adults with SCD don’t get “the care they deserve,” says Kiguli.
“It’s very painful for us pediatricians to see our patients encounter challenges and problems when they transition to adult care.”
Renewed research focus
Despite years devoted to children’s health, Kiguli believes it’s time to prioritize studies exploring appropriate SCD management in teens and adults. “We need solutions that address all the patients’ needs, including reproductive health, as they transition out of childhood.” She’s spearheaded a multidisciplinary research training program for researchers focused on the needs of people with SCD at all ages: Enhancing Research capacity for Sickle Cell Disease and related NCDs across the Lifespan in Uganda (ENRICH).
“Among our PhDs, we don’t have anyone from pediatrics—and that’s fine,” says Kiguli. Importantly, the researchers are trained as a group to amplify the benefits of multidisciplinary collaboration. “We’ve been working in silos—pediatricians alone, physicians alone, social scientists alone—that won’t help us address the comprehensive needs of these patients.”
Methodology has also been given sufficient consideration. “We provide both individual and team mentorship from the beginning,” said Kiguli. Monthly meetings help trainees develop personal development goals and career path plans in the hope they will continue in the field. The program also provides research training to health professionals, such as medical doctors, laboratory personnel, and nurses, who are not necessarily doing degree programs, “so those who manage patients routinely might also benefit,” said Kiguli.
South-to-South unity
For the project, Makerere University has partnered with Busitema University, located in eastern Uganda, where “prevalence of the sickle cell trait is as high as 20%,” says Kiguli. (Sickle cell trait refers to when a person has inherited one mutated allele of the sickle cell gene, not two.) This local prevalence contrasts with about 13% prevalence elsewhere in the country. Studying the disease in a high burden locale is highly relevant, because results may influence policy and treatment guidelines.
Kiguli has other reasons for collaborating with Busitema University, which is less than 15 years old. “We want to build capacity at this young institution since our colleagues there have less chance of doing research than we at Makerere do.” Working and supervising trainees together will give Busitema’s faculty much-needed experience, while providing opportunities for faculty at both universities to learn from each other. Kiguli also hopes the new collaboration will advance progress made as result of the universities’ past partnerships. “Capacity must be built in a sustainable way,” says Kiguli.
“It’s important to work collaboratively and not competitively—this is just as important for Makerere University as it is for Busitema University.”
ENRICH trainees talk about their projects
Dr. Jackline Akello
Dr. Jackline Akello, PhD candidate
Dr. Jackline Akello, PhD candidate
My project is “Sickle cell disease in pregnancy: Experiences in provision and access to care and adverse pregnancy outcomes at Mbale and Kawempe Referral Hospitals.” As an obstetrician and gynecologist, I work as a lecturer at Makerere University and provide clinical care at the two national referral hospitals. I have encountered significant challenges in managing pregnant women with sickle cell disease (SCD) due to a number of healthcare navigation challenges. Additionally, the diverse cultural beliefs associated with SCD in Uganda affect access to care and ultimately outcome and quality of life for the patient.
By October, I will have started the enrolment of 161 pregnant women with confirmed SCD for my project. These participants will be followed throughout their pregnancies to track maternal and fetal complications, including stillbirths and low birth weight. Their experiences with the healthcare system will also be explored. As a Safe Motherhood champion, I have been focusing on hypertensive disorders in pregnancy, including pre-eclampsia, but this October at the Safe Motherhood Conference I will discuss the effects of SCD during pregnancy with the Ministry of Health. One of the endpoints of my study is to improve care for pregnant women who have SCD to enhance their pregnancy experience and outcomes.
Dr. George Paasi
Dr. George Paasi, PhD candidate
Dr. George Paasi, PhD candidate
My project is “The Clinical Epidemiology, Spatiotemporal Patterns and Disease Modifiers of Severe Malaria among Children with Sickle Cell Disease in Eastern Uganda.” Uganda ranks fourth among countries with high burden of SCD and is in the top 10 with respect to malaria burden. Eastern Uganda has the highest burden of both diseases. My project addresses this dual burden of SCD and malaria in eastern Uganda—I want to decipher the SCD-malaria syndemic in this region.
I’m a medical doctor, I have a master’s in public health, and I just finished a fellowship in infectious disease, epidemiology, and biostatistics. I’ve worked at Mbale Clinical Research Institute for the last 10 years. Previously, I worked on an NIH-funded trial in Africa called Realizing Effectiveness Across Continents with Hydroxyurea (REACH) as a medical officer, and now I’m embarking on this PhD training. My hope is that the findings from my study will improve the identification of patients with SCD at risk of adverse outcomes when they get malaria. I also want to identify, through spatial temporal analysis, hotspot locations that require priority interventions. I also want to gain skills as an independent researcher in SCD and make a meaningful contribution to this field.
Dr. Anita Arinda
Dr. Anita Arinda, PhD candidate
My project is “Prevalence, associated factors, course and impact of major depressive disorder in adolescents with SCD in Mulago National Referral Hospital.” We have limited data on mental health of adolescents with SCD, so that’s why my project mainly looks at depression in adolescents (ages 10 to 17).
In our setting, we are fortunate that children with SCD live past their fifth birthday thanks to improved health care, but this presents new challenges. During adolescence, patients enter a crucial stage where they’re trying to develop their identity, yet they’re also beginning to understand the implications of their condition—that having this serious health condition cuts their life short. I want to understand their experiences. How does depression in adolescents with SCD differ from depression in adolescents without SCD? We know that sickle cell disease causes inflammation, so does that contribute to their depression? How does depression affect clinical outcomes, if at all?
If we can understand the underlying mechanisms of depression in teens with SCD, then we might find new ways to manage their care (as opposed to conventional treatment with antidepressants). I’ll do my research at Mulago National Referral Hospital, which has a clinic dedicated to children and teens with sickle cell disease. The clinic provides many services, but unfortunately no specialized mental health services. One day I hope that changes, so that children with SCD and depression can get help early.
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