The Observer (Kampala)

13 January 2013

Uganda: New Hope for Brain Patients At Mulago

Lukeman Lwegaba has lived with a brain tumour all his life.

Sitting on his mother's laps, the seven - year - old is literary clinging to her for support. His parents were stunned when at one year and seven months, Lwegaba's head started swelling. By the age of two years, he was already convulsing about eight times a day.

"We even tried taking him to school but his convulsions were too many to maintain him in school," Sarah Ssegwanyi, his mother, said.

The condition also affected his development, making it difficult for him to crawl, while his speech and interaction with other children was limited. Lwegaba's slow development and constant convulsing prompted his mother to relinquish her shopkeeper job in order to attend to her son. It was during this time that she noticed her son's persistent head swelling and his indifference to child play. Worried that her son might die, she sought medical help from Mulago hospital in 2007.

It was here that she discovered that Lwegaba had a brain tumour. As if that was not bad enough, the doctors added that this tumour could not be removed, as it was located in a sensitive part of the brain which conveys blood from the brain to the heart.

"Instead, the surgeons inserted a tube to drain excess liquid from his brain," Ssegwanyi says.

Since the discovery, Lwegaba survives on regular draining of fluids and other medications, provided every three weeks. This medication costs Lwegaba's mother Shs 50,000 every session, and he will have this treatment for the rest of his life. With this, Dr John Baptist Mukasa, Lwegaba's neurosurgeon at Mulago hospital, describes him as a miracle child because ordinarily, children with this condition do not survive beyond the age of two years.

However, Mukasa adds that while Lwegaba is lucky to be alive, there is now an opportunity to help other less fortunate children, following a recent upgrade of the Mulago hospital theatre responsible for such cases.

Help on the way

Recently, the hospital received specialist equipment worth $200,000 (about Shs 530m) from Prof Michael Haglund from Duke University in the USA. Some of the donated equipment include: modern neuro-microscopes, sophisticated electrical drills, operating lights, anaesthetic machines and an operating table. After commissioning the new theatre, Dr Mukasa acknowledged that the new efforts would be life- changing.

"Originally, we were operating three to five people a week but with the revamped theatre, we shall be able to operate three people daily," Dr Mukasa said.

Since the commissioning, 16 people have undergone surgery in the upgraded facility. One of them, Luke Engor, said he will forever be grateful for the new services. The 36-year-old father of two underwent an operation on January 7 and is due to leave Mulago.

"On September 6, I had an episode of fits and collapsed in the night after suffering from a splitting headache for two weeks," he recalls. "My headaches have ceased and I am now ready to leave."

Because of numerous patients on the waiting list, Engor, who was first put on the waiting list on September 20, had to wait for three months to be operated on. In the meantime, he survived on tablets, which have cost him Shs 3m since September.

Dr Haglund

The America - based professor of neuro-surgery first came to Uganda in 2001 and was saddened that the department lacked basic equipment, yet there was a huge patient load.

"The equipment I found is what one would find in an American hospital in the 1960s; so, I made a decision to raise money and boost the department," he said.

Mulago's neuro-surgery department is the only referral in the country and receives 20 cases of trauma, skull fractures, ruptured brain vessels and congenital abnormalities like excess liquid in the brain, every week. Although Mulago offers the operations free of charge, Dr Mukasa says they cost between $15,000 and $50,000 (about Shs 39m to Shs 132m) in private hospitals.

The department is still struggling to attract neuro-surgeons, with only four on staff currently. These are also the only neuro-surgeons in the country.

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