Joseph Blackman Reflection – Building EKG Capacity for Emergent Conditions in Rural Uganda

Joseph Blackman is a College of Medicine student at MUSC. He was awarded a Center for Global Health Student & Trainee Travel Grant in early 2023 to pursue a project with OneWorld Health in Masindi, Uganda. View more photos of Joseph's time in Uganda in this Flickr photo gallery.

I had the privilege of traveling to Masindi, a town in western Uganda, from March 11 to April 9, 2023. Now about a month out, I feel like I have processed the trip a bit more than when I first returned. This trip was a time of development and discovery, both academically and personally. I want to start by discussing the academic growth, which had many facets.

First of all, I was able to assist with an ongoing project based in MUSC, headed by Kathryn Koval, M.D., in the Emergency Department, which centers around the recent use of electrocardiograms (ECG) in Masindi. During my time at Masindi-Kitara Hospital, I was able to do a Continuing Medical Education lecture for the entire hospital staff, focusing specifically on when to perform an ECG. There are plans for a future lecture(s) centered around actually interpreting and using ECG in treatment, but we were essentially starting at the ground floor. I was also able to assist with the administration of a few ECGs, helping me further understand where we are having issues in the process of implementation.

In addition to my personal project, I was able to get firsthand clinical experience in a low-resource area. Not only was this my first clinical exposure in Africa, it was my first true clinical exposure period, as a rising third-year student who has only done preclinical curriculum. This included rounding each morning in this hospital as well as assisting with minor procedures as the need arose. Additionally, we had a week of community outreach where we went to a new town each day to put on a semi-mobile clinic. Here, I was assigned to the role of provider, and after the first day was asked to start seeing patients on my own due to incredibly high volumes. I was definitely pushed out of my comfort zone, but it was an amazing learning experience. Whenever I needed help, I was able to lean heavily on other Ugandan medical staff, so I was never expected to have all of the answers or be a full doctor. However, I was still given much more independence than nearly any other preclinical medical student, and I believe that this will serve me very well going into my clinical rotations. Mentally, it was also just another reminder that you have to trust yourself and your training, because at some point you’re going to have to develop the confidence to treat people on your own. While I wasn’t completely alone in this instance, it was very reassuring to see myself rise to the challenge.

As mentioned, the clinical and academic challenges were only part of the significance of this trip. So much of this was also about discovering what is most important to me and figuring out how this plays a role in my career. For a few years now, I’ve been fairly confident that I want to work international medicine into my career. I wasn’t always sure what that would look like, and originally I thought I wanted to do long-term trips instead of working in the United States. This trip was helpful in both reassuring and reshaping these plans.

After traveling and working in Uganda, I am more sure than ever that I want trips like these to be a part of my entire career. While I know there is still so much need even in my neighborhood, I feel a calling to do medical work in low- or middle-income countries, and this is something I can’t ignore.

That said, I also see the value of having a “home base” in the United States, and I could see myself doing similar trips to this one each year while still practicing in my home country. Part of these realizations came just from being in a different place, and part of it came from conversations with others, such as those with Dr. Koval, which have been instrumental for me and my career aspirations. Talking to someone who has very similar motivations and has achieved so many of these goals is inspiring, so having her in Uganda for the last two weeks was a complete blessing.

Overall, this trip has shaped my future in multiple ways. I’m sure that I still have some processing to do, but this is a small look into my trip to Masindi.