MUST MIT SANA Global Health Informatics

‘Trend as a trade’ a phenomenon in global partnership for development

 

Generally it is a moment of ecstasy having reached the graduation day for often school is an arena for struggle in my home area since many students do not come from well off families. You start many at the beginning but graduate a few at the end. This is a clear sign that perhaps, a few individuals get the chance to attain formal education. 

‘Over three billion people live on less than $2.50 a day, 22,000 children die each day due to poverty and they die quietly in some of the poorest villages on earth. About 72 million children of primary school age in the developing world were not in school in 2005 and 57% of them were girls. Some 1.1 billion people in developing countries have inadequate access to water and 2.6 billion lack basic sanitation and millions of women spending several hours a day collecting water. For the 1.9 billion children from the developing world, there are: 640 million without adequate shelter and 270 million with no access to health services. Worldwide, 2.2 million children die each year because they are not immunized and 15 million children orphaned due to HIV/AIDS. The GDP (Gross Domestic Product) of the 41 Heavily Indebted Poor Countries (567 million people) is less than the wealth of the world’s 7 richest people combined.’  Anup Shah.

For the past two years, I lived by a phenomenon of ‘reverse engineering’ which involves employment of retrospective approaches in work, actions and thoughts, but also emulation of ways and conducts for people, companies and organizations one would like to be and build, hence making one a clone. ‘We ought to be the change we seek’ was the song for each day that passed by. 

Education is an expensive entity, if you can get it for free, then count yourself among the luckiest people on planet earth. It is a fundamental tool in neutralizing global challenges, but the type, style, learner and its access plays a big influence in the context. The ongoing campaign of Mass Open Online Courses ‘MOOC’ is one of the best strategic initiative to rectifying global challenges. It ensures that those who cannot afford education, at least can access free knowledge. This shows diversification and a new education pattern hence ‘trend as a trade’. 

It’s paramount for one to have a trend to trade in as a means to investment or livelihood. Trading is not necessarily having money as a means for transaction but rather a trend of patterns to break through. Intangibles such as good reputation, honesty, passion, insightfulness, verbal intelligence, critical, logical and creative thinking make a trend. ‘Our mission is to give a world class education to everyone, everywhere, regardless of gender, income or social status’ edx .This implies trend as a pattern and a trade to achieve the millennium development goals. 

The whole is greater than the sum of its parts. The worldly challenges shall best be solved through global partnership for development. This move is highly evidenced with the following organizations and initiatives: Young African Leaders Initiative Network by the US government, Consortium of Universities for Global health in Boston, free e-learning by Food and Agriculture organization and Youthful Cities in Canada.

Strategy needs a great deal of time and an efficient multidisciplinary team approach. Tactically, learners should be highly taught to use one discipline to solve challenges in another. This should mark the modern day education foundation.  Further, feasible, efficient and a tested innovative strategy should come before any intentional or purposeful trend. The variability in tackling similar problems shows a trade in a trend. This is so due to patterns.

You can’t solve a problem you are not aware of. Institutions mainly in developing countries should aggressively embrace and focus on research as a pillar to reaching means of resolving both local and global challenges. A big applaud goes to the United Nations Institute for Training and Research (UNITAR) for its campaign on research. The different exposure among countries should be taken advantage of as measure to coming up with creative means for solving global challenges.  

Reverse engineering should be the order for day in developing countries. It has an entity of emulation which is highly fueled by motivation for emotions are energies in motion. This implies that organizations and governments should focus on the youth empowerment for development as a strategy for the day to day and future investment. 

More than 50% of women are in the middle management level. How best should women be transcended to higher executive levels?  Perhaps having more of them in those positions would escalate easier achievement of millennium development goals. This could be so, for there would be an increment in numbers of personnel focusing on and tackling similar challenges hence a synergistic approach and trend. 

There are lots of talents that go unnoticed and unutilized in developing countries. Mobilizing and transforming them into purposeful and solution oriented entities would perhaps contribute to an escalated global partnership for development. The question is, how best can we locate and transform those talents in the communities?  

Think like an economist, reason like a philosopher but act like a medic. Any type of decision is an investment. Bad ones make bad or poor investments. Giving financial aid to developing countries may not profoundly aid in efficient rectification of global challenges. Teaching people how to solve challenges is sustainable and a better option for skills can be transferable from one generation to another hence a platform for future development and self-sustainability. You are barely interdependent unless you get independent.  It’s therefore imperative for nations to embrace and initiate integrated agendas which emphasize or highly prioritize research, creativity and equitable access to resources as a trend of neutralizing global challenges.

Combating the Dynamic Service Industry

Gone are the days when the world profoundly focused on products during the industrial revolution.  It is a different case with the current 21^st century that is highly service and information oriented through information communication technology (ICT). 

The ‘optical lens’ through which we view the universe is ultimately influenced by the upgraded information technology. He/ she who shall not embrace technology shall artificially be selected against in the service industry.  

Complexity is not difficulty, but rather a route to simplicity. Professions and industries shall best be transcended through global, national or local partnership for development.  They should further welcome and conform to the changing trends in approach of issues rather than sticking to old dogmas. 

Project innovation through design thinking should be a norm for every profession and industry. It entails reframing experiences of processes, services and products to bring about better desired outcomes. Skills, unlike talents, are easy to identify. Sometimes we don’t need skills but rather the appropriate talents to play change agents of fields. This is not rocket science! You can be qualified but not talented to be a change agent. 

It’s so absurd for many graduates are qualified and unable to interpret information for personal and professional development. My dear ones, it’s not about who finishes worst or best, but rather he who conforms appropriately to the dynamic demands of the world. He who best interprets information rises on top of that field, and is a potential change agent, for we are in an information era. This simply implies survival of the fittest. School doesn’t provide it all. It’s your personal initiative to go an extra mile to learn how to interpret information to survive. 

A great deal of energy and focus should be directed towards industrial and professional capacity building rather than capacity development. This is pretty much an appropriate sustainable approach to development in the 21^st century. 

Uganda is on the verge of population explosion. Seventy-eight percent of its population is comprised of youth. This implies that more than ¾ of professions or industries are either run, or are soon to be run by youth. Are we prepared for the change? Have we prepared the youth to interpret information and not deviate from the set professional or organizational missions to undesirable ones?

I am not optimistic and neither pessimistic but rather empirical. Having the ability to read patterns is a key to predicting the probable future. Sticking to old dogmas is living in a ‘P.O. Box era’. It is not about who starts or finishes first, but rather who accomplishes the set goals and objectives in the set timeline. 

Any profession or industry that does not respond to the changing world demands, is equivalent to a dog barking at the moon. Talents will take you to places, but it’s the characters that shall keep you there.   

Where is the future of Uganda?

Uganda is located in East Africa astride the equator. It is bordered by the Sudan in the North, Kenya in the East, Tanzania and Rwanda in the South and Democratic Republic of Congo in the West. It shares Lake Victoria with Tanzania and Kenya. Uganda is landlocked and lies in the equatorial belt with temperatures between 20 to 30 degrees Celsius.

The Uganda Bureau of Statistics has indicated that worldwide, Uganda is the leading country with the youngest population of 78% below the age of 30 years. Currently 21.3% Ugandans are in the age group of 18-30. Of the students who graduated in 2011, only 33% were able to find employment in the formal sector. This is partly explained by the small private sector and the failure to match the skills needed in the economy. Thus it is a key challenge affecting tertiary and university education in Uganda.

The UN put Africa as the continent with the youngest population in the world due to the fact that over 200 million people in Africa are aged between 15 and 24 years.  The Africa Union Commission agrees with this fact by stating that 65% of the total population in Africa are aged below 35 years and 35% are between 15 and 35 years. These statistics could be indicators of a ticking time bomb or an opportunity for the continent to rise higher (John Wesonga,) 

A report launched by State Investment Minister Gabriel Ajedra alongside the World Population Report in 2014 showed that the national population of Uganda stood at 34.9 million, and was predominantly youthful about (75 percent). The Minister noted that the situation would place the nation in peril in the near future. 

The rampant duplication of courses especially by illegitimate and illegal institutions has contributed to rise of unemployment of youths in the market. (Sarah Bunoti, 2001). Graduates from institutions of higher learning in Uganda experience both a high rate of unemployment and underemployment due to programs and courses that are not relevant to the job market.

With Uganda's unemployment rate at near 83 percent, the government is being challenged by a group of former students who have formed the National Association of the Unemployed.  Uganda has one of the highest rates of unemployment on the African continent. The group is asking the government for widespread reforms to ease unemployment burdens.

Uganda is ranked 122nd (out of 144) in the World Economic Forum’s Global Competiveness Index and 150th in the World Bank’s ‘Ease of Doing Business’ Index.

All in all, where is the future of Uganda?

BSN Student Nurses Playing a Role in Eradication of Hepatitis B in Uganda

Worldwide 2 billion people are exposed to hepatitis B infection, 350 million have chronic infection, with 65 million infected in sub-Saharan Africa. Uganda is highly endemic with 10% national prevalence of the infection, rates vary across the country from 4% in the southwest to 25% in the Northeast (Ocama ponsiano, 2013). 60.1% of health workers by 2006 had the chronic infection. Needle stick injuries were identified by 77% of health workers as the source of exposure. (Makumbi Issa et al. 2006).

Being part of the executive committee as a president of Mbarara University Nursing Students’ Association (MUNSA), we executed a project whose purpose was to provide protection against Hepatitis B to student health professionals, the staff at Mbarara University of Science and Technology and Mbarara regional referral hospital (MRRH) in 2014.

As a cabinet, we initiated a hepatitis B vaccination campaign through MUNSA in western Uganda. This campaign was executed as a response to an accidental splash of blood on five students during a clinical rotation at MRRH in February 2014. Heather Wappot and I later wrote and attained a hepatitis B grant through the Peace Corps for a one time immunization campaign for majorly Nursing, Medical, and Medical lab students. This was a blanket immunization program offered to all the health students. No prior immunization or exposure information was obtained before administering the vaccine.

The series was offered as follows: dose 1 March 2014, dose 2 April 2014, and the third dose September 2014. Participants: 101 medical students received three doses and 12 two doses of vaccine. 49 Nursing students received three doses and 15 two dosages of vaccine. 56 medical lab students received three doses and 5 two doses of the vaccine.

The results demonstrate the high student interest in protection against hepatitis B infection. There is a need to establish a baseline prior exposure and prior immunization of entering students to target the most vulnerable populations with future vaccination campaigns. This calls for universities and the ministry of health to generate policies to initiate and sustain programs that vaccinate students in health professions against hepatitis B. This initiative would curb the disease at the primary level.

I presented my research abstract entitled ‘The need of student protection against Hepatitis B’ during the 10^th Annual Research Dissemination Conference organized by faculty of Science, Mbarara University of Science and Technology at Lake View Resort Hotel in 2014.

Samson Wakibi my Vice President also carried out a research initiative which involved assessing the ‘Level of Hepatitis B Virus Protection of First Year Medicine and Nursing Students at Mbarara University’. It included an exploratory study, a Setting of Mbarara University of Science and Technology, a convenience sample of first year medical and nursing students and an instrument of a questionnaire.

Results included the following; 73 students completed the questionnaires, 29 females, 44 males, average age 23.2 years, 49 first year medicine and 24 first year nursing students. 78.1% had never been vaccinated (n=57), 2.7% had received one dose (n=2), 6.8% had received two doses (n=5), and 12.3% were fully immunized with three doses (n=9). Reasons for not receiving vaccine included:  lack of information (n=20), lack of access (n=29), lack of money (n=4) and indifference (n=2).

Only students who have a prior diploma in medicine or nursing had received some HBV Vaccine.  The data indicates that the entering medical and nursing students have no prior HBV protection. 

Generally there is shortage of HBV vaccination facilities and hence immediate interventions are needed.

This cordially calls for a response from the university boards and the ministry of health to initiate sustainable programs to immunize all first year students. This will be beneficial if it runs for at least eight years as the children who first benefited from the routine vaccination (in 2002) initiated by government shall be expected to be first year university students in 2022.

Samson Wakibi also presented his research abstract entitled ‘Level of Hepatitis B Virus Protection of First Year Medicine and Nursing Students at Mbarara University’ during the 10th Annual Research Dissemination Conference organized by faculty of Science, Mbarara University of Science and Technology at Lake View Resort Hotel in 2014.

The whole process of vaccination was undertaken by MUNSA in partnership with MRRH, the faculty of medicine and also the nursing department Mbarara University of Science and Technology.

MUNSA mobilized the student nurses who offered labor, MRRH stored the vaccines, provided the nurses to supervise the students and the university played a part in supporting the students to execute the campaign.

The university contributed funds to MUNSA which were added to the association’s savings and a 100 seater tent was bought by the student nurses to run a hepatitis B and other health campaigns in western Uganda.

Samson Wakibi and I continued to take a lead role to fight against hepatitis B whereby we wrote letters attached with our research abstracts to the hospital director of MRRH and the dean of students faculty of medicine Mbarara University requesting for a 10 year sustainability project of hepatitis B vaccination amongst health workers and students from universities like Bishop Stuart University in western Uganda.

Our wish was granted and the project was initiated. The project is being undertaken through Mbarara University Nursing Students’ Association which accesses the vaccines from MRRH, it then uses them for vaccination.

A national nursing students’ body named ‘Nursing Students’ Association consortium Uganda’ (NSAC-UG) was formed to play a part with other stakeholders to rectify health problems like Hepatitis B infections. It comprises of an executive board of students from 6 universities who include;

NAME	POST	UNIVERSITY
Mr. Mulungu Kenneth	President	Mbarara University of Science and Technology
Mr. Emenyu Michael Richard	Speaker	International Health Sciences University
Ms. Namuganza Stella	General Secretary	Makerere University
Mr. Muteebwa Laban	Finance Minister	Bishop Stuart University
Ms. Asio Alice	Vice President	International Health Sciences University
Ms. Itait martha Irene	Deputy Speaker	Mbarara University of Science and Technology
Mr. Muhwezi Talbert	Deputy General Secretary	Bishop Stuart University
Mr. Lukyamuzi Ronald	Public Relations Officer	Victoria University
Mr. Nazif Adam	Publicity secretary	Mountain of the Moon University
Ms. Amanya Sharon	Justice and constitutional affairs	Makerere University
Ms. Batte Winfred Cecilia	Gender and women affairs	Victoria University
Mr. Rwabambari Robert	Research coordinator	International Health Sciences University
Mr. Tumwesigyire Jonan	Overseer	Bishop Stuart University
Mr. Muhindo Kitima	Ambassador Central region	International Health Sciences University
Mr. Matovu Gideon	Ambassador Western region	Mbarara University of Science and Technology
Mr. Kabiru Yusuf	Ambassador Southern region	Mountain of the Moon University

NSAC-UG plans to play a role in expanding the hepatitis B campaign to central region by working hand in hand with different stake holders like ministry of health and Mulago national referral hospital.  

It further looks forward to promoting research in Uganda whereby a research hub (Website) shall need to be established to disseminate research data by both university students and health practitioners. This will promote evidence based practice among different health professionals.

More than 70% of the Ugandan population is composed of youths. NSAC-UG looks forward in mobilizing the youths undertaking health sciences to play a role in rectifying health challenges like hepatitis B in rural areas of Uganda. The project proposals are being designed and shall be forwarded to various international organizations and the ministry of health through the deputy registrar of the Uganda Nurses and Midwives Council.

All in all, we humbly request the government, international organizations and other local stakeholders to support developmental initiatives by youths since they make the greatest composition in the Ugandan population.

A healthy population boosts up the economy. 

Kenneth Mulungu

President, Nursing Students’ Association Consortium Uganda (NSAC-UG)

Guild Council Representative BSN Program, Mbarara University of Science and Technology.

2013/14 President, Mbarara University Nursing Students’ Association. (MUNSA)

Mulkent90@gmail.com