St. Joseph’s Healthcare reaches across borders

By  Sharon Boase, Catholic Register Special
  • February 25, 2007

HAMILTON, Ont. - It was after dark when the Canadian medical team pulled up outside the rural Ugandan clinic. Just outside of Kampala, St. Stevens was, as is often the case, shrouded in darkness due to a power outage. Inside, they found that many of the 20 patients were suffering the effects of malaria. A nurse was triaging a patient by the light of a kerosene lamp.

“We rounded a corner and saw a curtain drawn around a patient. It said ‘St. Joseph’s Hospital, Hamilton, Ontario’ on it,” said Brady Wood, manager of special projects for St. Joseph’s Healthcare. “Later, I found out that all the beds, some of the lab equipment, the furniture, basically the entire clinic, had been outfitted by donations from us.”

The “us” in this instance is St. Joseph’s Healthcare, a sprawling hospital in the heart of downtown Hamilton built in 1890 by the Sisters of St. Joseph to care for immigrants, orphans, the poor and the dispossessed. Today, the 600-bed, multi-site academic health sciences centre is part of one of Canada’s largest health care corporations.

Renowned for its work in respiratory health and specialized mental health services, St. Joe’s is also making a name for itself through its international aid program. Working in Uganda, Haiti, Jamaica and, until recently, Guatemala and Yemen, St. Joe’s health care workers are doing far more than supplying medicine, refurbished equipment and treating the needy — they’re working with resident health care workers to upgrade skills and collaborate on research.

“There are settings (in Ugandan hospitals) where there are patients on a mat on the floor,” notes Wood. “But not in that clinic that night. There, 20 beds from our system meant that someone had a comfortable rest despite being ill, and a curtain to shield them from some indignity while they’re being assessed for an illness. It’s not grandiose. It’s not a $20 million cheque but it’s a bed.”

During their two-week visit to hospitals and medical schools in Kampala and Mbarara in January, the eight-member team led in-service sessions for medical staff, visited St. Joe’s residents on training stints in Uganda, discussed the direction of collaborative research projects and laid the groundwork for biomedical engineer training, a program to teach Ugandans how to repair and maintain donated medical equipment.

“We don’t focus on disaster relief,” explains Brian Guest, CEO of St. Joseph’s Health System and co-ordinator of international activities. “We build capacity through education, equipment and supplies.”

Much like the Taoist proverb that teaching a man to fish enables him to feed himself all of his life, St. Joseph’s International Outreach Program is looking to empower health care workers in struggling nations. The program got its start in the 1960s following Vatican II when Pope Paul VI called the faithful to envision a global church. And it’s being done without a dime of public money. The program’s $150,000 annual budget comes entirely from the Sisters of St. Joseph of Hamilton and from individual donors.

“The vast majority of the resources for the program are human effort,” said Guest. “I think we’re up to 60 medical residents in the Hamilton system over the years in Uganda or Haiti and we’re pretty proud of that. And, I think, to a person, our participants would say they get more out of it than they put into it.”

The fact that St. Joe’s happens to run Canada’s largest capital purchasing operation goes a long way to making international work doable, said Sr. Anne Anderson, chair of St. Joseph’s Health System, to which the Hamilton hospital belongs. With volume comes savings — and the inside scoop on when equipment is to be replaced.

“The international program began with the realization that many of the things we were replacing had yet another life,” said Anderson. “And we certainly, as a country and as a province in particular, have a very fine health system. We have ways of helping places that are trying to develop and improve.”

Internist and hematologist Dr. Peter Kagoma co-ordinates St. Joe’s work in his native Uganda. While leading the latest trip, Kagoma and Wood laid the groundwork for bringing more Ugandan medical residents and fellows to Hamilton for training. They also took a look at obstetrics services in Uganda and the possibility of focusing St. Joe’s resources on ramping up those services, of sharing cutting edge practice with everyone from doctors to cleaners.

“In my mind, my effect has been multiplied thousands of times than if I had gone back to Uganda to practise as a single doctor,” said Kagoma, who is also an associate professor of medicine at McMaster University.

Although he trained abroad, Kagoma’s plan was to return to Uganda to practise medicine. But when he graduated in 1980, Uganda was in a state of bloody chaos. Idi Amin, the despotic, self-declared president for life, was overthrown in a military coup. That was followed by another military coup, then a five-year guerrilla war. Many of Kagoma’s classmates became casualties. Some were killed. Some went abroad. Others left medicine. And, like many of the young at that time, some were caught up in the HIV epidemic.

“There’s a very good likelihood that by now I’d be long dead,” said Kagoma.

The program operates with one inflexible rule, said Guest. “If we wouldn’t use it, we won’t send it. There’s a lot of stuff that gets donated that never ends up operational.”

Otherwise, their work abroad requires abundant flexibility and a willingness to adapt to the needs of Uganda’s political and health care systems.

“It’s very scary to developing countries to train their people and then risk having them leave,” Guest said. “It’s easier for us to go there and share our skills.”

Anderson hasn’t had the opportunity to visit Uganda to see the progress the Sisters can take pride in there. But she has visited projects in Jamaica and Haiti.

“I came away from my visits, to Haiti in particular, very solid in the knowledge that what we are doing is good and is right and just for a nation that is so impoverished.”

(Boase is a freelance writer in Hamilton.)

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