Providers With Purpose: Emmanual Bua, MD
Q&A with Emmanual Bua, a surgeon working in Uganda and 2021–2023 HEAL Fellow
Emmanual Bua is a 2021–2023 HEAL Fellow from Lira, a district in northern Uganda. After his medical training in surgery, he moved 3 hours south, to Mbale, Uganda where he is currently a registrar in surgery at Mbale Regional Referral Hospital.
Mbale Regional is a major teaching hospital at Busemita University, and is a recent and valued addition to HEAL’s international partners sites. HEAL partner sites are hospitals and community programs that prioritize delivering holistic and equity based health programs to the most marginalized across 9 countries.
In July of 2021, Emmanual will begin a 2-year journey as a HEAL Global Health Fellow. Learn more about the HEAL Fellowship and the incredible 21 health care professions in the 2021–2023 HEAL Initiative Cohort. Be sure to follow “Voices on the Frontline” on Medium for more stories from our community.
You have been a surgeon for nearly a decade, what initially inspired you to pursue a career in medicine?
To start with, I was inspired. My mother is a nurse and midwife. She is one of the people who inspired me first to join the medical profession. Even though I didn’t know where I would end up, I knew I would become a doctor one day.
So, I began that journey. I worked very closely with her. I was amazed by how she helped very poor people, sick people, and even when they had little resources, she was able to help the sick. I remained inspired and chose to pursue the medical discipline.
How has your perspective on providing care for your patients changed over time?
“When I began my journey into surgery, I was so excited. I thought that everything had to end in the operating room. Every patient that I encountered, I had to operate. But as I speak now, over the years, things have begun to change.“
I am getting to be what they call a mid-career surgeon, and recently, I got to a point where I began to question everything I was doing, whether it was making sense, whether it was helping people or not. So, I slowed down and began to reflect seriously about this whole thing called healthcare.
One of the things that came up was that healthcare is not just about treating the sick. It has a lot to do with visiting the community and really getting to understand the determinants of disease processes. In a way, I got interested in public health and health equity because it gave me the opportunity to begin to ask myself questions like: what, when, and why is it that people from a particular region are facing these specific health challenges.
One of the things that stands out of all these things that push me is the idea that you can never change things alone. We are like the components of a chain. Every component is important, but on its own, it cannot make a big difference. I think I need to offer myself as a part of the chain, and if someone else can come and train with me and we pass that knowledge to the next person, then collectively we can work together to address such improvements.
“The bottom line is: treating and making a difference in healthcare does not only end in hospitals.”
It has a lot to do with finding out what causes disease and suffering, and it also has a lot to do with working together with people, especially those who think like you, to ensure that you join forces. Everyone brings a little of what they can, and when you put everything together we can address healthcare needs.
What is unique about your work in Mbale, Uganda and what have you learned from serving the community there?
I’m very interested in pediatric surgery. It’s not given that much priority here in Uganda. Where I am from, our children die and no one seems to care. Children are born with abnormalities and the world is not remarkably interested in that.
I remember early on in my career, I encountered a mother who had spent three days on her way to reach the hospital. She came with a child whose intestines were outside of the body. They were born with a condition called Gastroschisis, where part of the anterior abdominal wall is lacking.
The baby died on arrival. Everyone blamed her for taking too long, as if it was her fault.
She sat me down and said, “Look, if you could listen to me, I’ll tell you what happened.” She shared that when this child was born, her husband left her.
In Africa, many men will not tolerate children born with abnormalities. She was alone, poor, hungry and living very far from the hospital. It was the rainy season and the roads could not be traveled. She had to go through Kenya, over three days with her sick child to reach our facility.
“I realize that many of these challenges such as access to healthcare, gender violence, poverty and hunger, have to do with larger systemic problems. I began to get interested in teasing out what exactly causes all these things that we see, and it led me to understand the relationships between healthcare and the socio-economic status of people.”
I’ve learned that healthcare workers alone cannot solve these problems because they are structural in nature. To address the real root of the issues, you have to bring everybody in every sector on board. This emphasizes the need for collaborations, partnerships and organizing together to seek solutions, collectively.
What drew you to join the HEAL Fellowship at this stage in your professional journey?
I have spent a lot of my time in hospitals. Sometimes, I ask myself what is beyond these hospital walls that I cannot see?
That is precisely why I’m so interested in working in the community. I want to know what factors are contributing to different communities’ challenges and how they learn to thrive in the face of those challenges.
When I found HEAL, I realized it was a collection of people with different backgrounds, educational experiences and specialties, all working together towards one goal.
I am quite optimistic that this fellowship will change the rest of my life forever. I will look at things different from how I’ve learned to look at them. HEAL is this unique opportunity to meet the people who can influence my life and maybe I can also influence theirs, and the lives of other people in my community and beyond.
Follow our Medium Publication “Voices From the Frontline” to hear more from our community of over 180 Global Health fellows and alumni and their work in promoting health equity in resource denied communities across the world.
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