Denis Olweny Otika

UGANDAN SEEKING FUNDING FOR MEDICAL DEGREE

• The prospect of attending Medical School seemed so distant in the wildest of my dreams. As a young boy growing up in Gulu District, Northern Uganda I could only relish the prospect of attaining a medical career with great joy when I engaged my father during evening chats at the traditional fireplace in our compound. He would assure me with that trademark confidence any loving Dad would normally show to his son, “you know, son, you will only make it if you work hard and focus on your goals,’’ he would exclaim. It all seemed a fore gone conclusion albeit for the upheaval that engulfed my traditional homeland. The war in northern Uganda has brought about suffering of unimaginable proportions among the Acholi people, and only time will underpin any meaningful improvements in the welfare of the people, we may be long gone before total normalcy is achieved.

• I have had to grapple with the challenge of setting a role model for my other four siblings as well supporting my parents in providing for their basic human needs. They are virtual peasants now and since the fighting in Northern Uganda has ebbed, we are considering relocating from the East of the Country. My ancestral home was one of the worst hit; we can only be wary of unexploded bombshells lurking in the bushes. This is a major fear factor for the indigenous people, the Luo-speaking Acholi tribe, who are traditionally good farmers.

• I struggled through school not because I had a low IQ, but majorly due to the fact that most of the time I would be out of school as a result of fees dues. I remember with a sense of pride, some of my exploits at acquiring funds to pay up for my fees. I hawked bread in a suburb of Kampala, the capital city and also had a stint at a shoe- sole making factory. I recognized that diligence and patience paid off after all. I eventually made it to a National College on a Government sponsorship and attained a National Diploma in clinical Tropical Medicine and Public Health.

• I would like to present this request for funding of my Undergraduate Degree in Medicine at Moi University, Kenya to anybody willing to see me achieve the career I have gracefully longed for with professionalism, hard work and dedication. Upon completion of my studies, I will return to serve in the health sector in my Country.

• My Admission Letter, References, Fees structure and Living expenses plus financing for books and other educational materials are available at your request.

Please feel free to contact me at the following address:

• OLWENY DENIS OTIKA – NGORA FREDA CARR HOSPITAL. P.O.BOX 5, NGORA, KUMI, UGANDA, EAST AFRICA.
• EMAIL: denisotika@yahoo.co.uk
• Cell: +256772191365

PROFESSIONAL CAREER GOALS

Non-communicable diseases such as diabetes, hypertension and other endocrine diseases are increasingly gaining significance as major causes of morbidity and mortality in Uganda. My country still lacks a clear policy framework and guidelines for prevention and control of such diseases according to the ministry of health due to lack of information on their prevalence and magnitude. An estimated 500,000- 1million Ugandans suffer silently with diabetes yet they are still undiagnosed (local news daily, the monitor, Friday 21^st march 2008).

Diabetes has become one of the fastest growing epidemics in Uganda. Country wide there are over 12.000 registered diabetes patients, a sharp increase from 400 in 1980. Mulago national referral hospital alone handles 300 patients weekly according to a report by Professor Marcel Otim, Uganda’s senior Endocrinologist.

As the developing world urbanizes and becomes more affluent, so the incidence of type 2 diabetes rises. This classification comprises 80 percent of the total population with the disease and the result is increased pressure on health care providers ill-equipped to cope with the problem, particularly at the primary care level. The level of care such patients receive is a far cry from universally agreed standards as a result of inadequate skilled human resource and the limitations from the very costly medicines and facilities needed to effectively care for these patients.

In 1998, the WHO reported that between 1995 and 2025, the numbers of adults affected by diabetes in developing countries is projected to grow by 170 percent from 84 to 228 million. The prediction for the developed world over the same period is an increase of 41 percent from 51 to 72 million. Globally, a 120 percent increase is projected from 135 to 300 million due mostly to population ageing and growth, lifestyle issues associated with industrialization and rural to urban migration.

Table 1: Number of Adults with Diabetes in 1995 and projected increase by 2025(WHO)

Adult population with Diabetes	In 1995	By 2025	Projected growth
Developing world	84 million	228 million	170 %
Developed world	51 million	72 million	41%
Total Global	135 million	300 million	122%

It is against this background that I would like to incline a greater part of my upcoming medical career to joining the efforts geared towards enhancing health service delivery to patients with endocrine problems including diabetes. It is important to appreciate the fact that the HIV/Aids pandemic has stolen the limelight in as far as health issues are concerned in this twenty-first century, virtually every health budget has to be cognizant of this new trend. One could as well say that HIV and Aids have tipped the scales in the dynamics of medicine in this era. Major pitfalls occur in the effective control of other diseases and conditions, because their budgets have to be downsized to pave way for a greater financing of an HIV/Aids program budget. The result is increasing morbidity and mortality across the health spectrum, which is far from our noble mission of preserving life and ameliorating suffering. The division of neglected tropical diseases is drumming up concert across the globe towards a rethink of the way budget financing and public health issues are handled today. This is just one of the many voices advocating for a more objective approach towards dealing with the numerous public health challenges facing our globe in this era. There are categories of diseases that if disregarded by way of more research budget allocation could spark of epidemics in their own right with global consequences, so we should comprehensively look at every possible avenue to objectively and collectively deal with all diseases across the public health spectrum notwithstanding issues related to race, creed or borders. It is worthwhile noting that African governments including Uganda pay little attention towards funding research initiatives and yet this is one major aspect that forms a platform for development across a wide spectrum.

Out here in a rural hospital in eastern Uganda, faced with limited resources and inadequate facilities, what seems to sustain the seemingly fractured health system is the motivation of the skeleton staff to be in it all, to help these poor people. For example in this health facility of which I am supervisor, the burden of attending to over two hundred deliveries a month is no mean fete with just five midwives. Our sundries and medicines barely last a fortnight when they are brought because of the huge patient attendance. Apparently there is a building meant to serve the purpose of a theatre, and yet with no operation table and all the necessary apparatus let alone the skilled manpower. All the operations are conducted close by at a fee of about 30USD; this  sometimes serves as a deterrent for mothers to seek or rather attend obstetrical care early, thus leaving them with no option but to try the traditional birth attendants with grave consequences most of the time.

Upon completion of my medical degree, I will undertake a period of service in primary health care in northern or eastern Uganda for a period of at least three years before enrolling for a masters program in internal medicine. Given the opportunity and with the availability of resources, I hope to enroll for a fellowship in endocrine medicine at an established centre of excellence in any region of the world.

It is my hope that with this level of expertise attained, I will be in a position to inform and influence on pertinent health matters regarding but not limited to endocrine medicine in Uganda and beyond. I will also render better services to my community at a higher level given the level of expertise I will attain upon completion of my studies, this has been my passionate goal which I  gracefully  seek.

BY: MR OLWENY DENIS OTIKA

APPLICANT