Giving hope: Improving medical standards
Be inspired by the Northern Irish man who founded a hospital in Uganda.
“Just because a country is third world, it doesn’t have to be third rate”, said Dr. Ian Clarke, founder of International Hospital Kampala (IHK), which rises tall above the Namuwongo district of Uganda’s capital. His words, rich with a Northern Irish accent, almost echo through the wards he founded back in 2004. Looking around, third rate is certainly not on offer here. The building’s architecture is deliberate, its surfaces clean; not words readily associated with medical practice in the country.
It was a distinct lack of services which drove Clarke to establish the hospital in the first instance. His aim was to raise the bar on medical practices across Uganda, causing a ripple effect in the quality of health services available and forge new intersections between public and private health provision.
Now, just a few years on, he has set up a private hospital and insurance company and with the profits and partnerships is able to use the resources to run a charity ward and outreach clinical services across the country. This is ripple effect: writ large.
But meeting Clarke it is initially hard to imagine that he has the energy within to drive such an immense project. His frame is lighter than slight; his look bordering on gaunt. Doubts though are jettisoned when we actually get into conversation. We had arranged to have lunch together and ordering a meal he is immediately insightful and remarkably quick. He orders so quickly in fact that the waitress hardly has time to call out the specials. And while his speed could be interpreted as abrupt, his undeniable charm and quick wit bring him back to courteous. One thing is very clear: he knows what he wants.
It is a sense of vision and clarity which has driven him away from his native Bangor into post-war Uganda, arriving first in 1988 with his wife, Robby, and three young children. Uganda at the time was still reeking with Idi Amin’s legacy, and things were bleak. “It was like nothing had happened since the war”, Clarke recalled, “there were still all the skulls and eerie silence, and I could see all this medical need”.
Responding to those needs, and putting his medical skills into practice, Clarke first set about establishing Kiwoko Hospital in the Luweero district of the country. His unorthodox methods at the time have already been recorded in Uganda’s national press: establishing the first clinic under a tree; transforming a local church vestry into an examination room and enlisting a lay preacher as a medical assistant. And, as a matter of course, Clarke himself would be out with hammer and nails building and constructing. “I’m from a farming background and I am used to doing things”, he explained, as if that was a legitimate reason, “I’m the sort of person who needs to see what I do”.
It was that same practical hand which geared him away from GP medicine in Northern Ireland in the first place. Having practiced medicine for a few years following graduation, he soon became restless. “Basically I was bored and wanted a challenge”, he recalls. Realising that he probably should have gone down the surgical route of medicine, Clarke instead decided to go into business, first with bookshops, then furniture shops. However, when an opportunity came up to visit Uganda, he seized it, packing up shop at home. A two week visit turned into two years, and two will soon be twenty. The challenge simply got bigger.
But the ride along the way has not been easy and a big buckle came when, just as Kiwoko Hospital was under steady heel, Clarke was diagnosed with cancer. Returning to Ireland for treatment, he saw the scans himself and knew the outlook was far from promising. “For a week I was totally sure that was the end of my life” he recounted, “so it was a very interesting week!” Emerging from an intense course of therapy, he arrived at the other end even more determined. “I felt had all this experience of working in a post-war situation, with the rural poor, with HIV/ Aids, and a near death experience myself. Why would I waste all that?”
And so Clarke returned to Uganda, setting up the International Medical Centre and later IHK. “I decided that my goal was to start a hospital in Kampala and to raise medical standards. This time, instead of targeting the rural poor, where we had been working, I would target the emerging middle income group and use the money that they pay to upgrade the services so that we could get a better level of service, and so effect the overall delivery of services”.
After lunch we returned to the hospital. It was an opportunity to see firsthand how some of those services were manifested, as Clarke took me on a quick spin of the wards. ‘Quick’ again being an appropriate choice of adjective - it was hard to keep up at times. As we twisted in and out of wards he greeted staff and patients with equal flurry, “Still riding that motorbike, Alan?”, “Where are you off to Irene?”, and as we passed the paediatric unit, calling out in an air of childlike glee, “Great news that those babies were well enough to be discharged”. Two premature babies had made it through healthy that morning, the empty incubators standing as emblems of success.
As we continued to the wards, I met one patient who was suffering from elephantiasis, complete with the tell-tale swelling of the lower limbs. The sight of his grossly enlarged leg is not one I wanted my camera to record, but the memory of it is a reminder of all that medical need which Clarke earlier spoke about. I must have concealed my faint-headedness well, for passing the main reception he took out an album of case studies, each double page devoted to before and after pictures of patients. Facial reconstructions, tumour removals, burn wounds, AIDS patients, more elephantiasis, more tumours. The young, the elderly, the middle class, the poor, the poorer. And while my stomach did Olympic-sized churns over the sight of the ‘before’ images, the stories from the ‘after’ were enough to fill me with optimism.
With no time to pause, the tour of IHK continued apace. Soon we are on the top floor where Clarke checked up on the construction progress in new university teaching rooms, part of the International Health Sciences University which IHK have just established. With a smell of wet paint lingering, I picked up a brochure for the new academic term; the list of courses on offer making for impressive reading especially knowing that the first intake of students was just a few weeks away.
Read Part two of this article.
With thanks to the Simon Cumbers Media Challenge Fund and Connect World for their generous support for this project.
Words and Images by Clare Mulvany
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