"Ghanaian" performs Uganda's first open-heart surgery

IT sounded like a cowboy story. Open-heart surgery in Uganda! When Dr. Clement Akomea Agyin, a consultant cardiac surgeon, presented his credentials to the management of International Hospital Kampala, (IHK) two years ago, they were doubted.

He later led the team that recently carried out the first open-heart surgery in Uganda’s medical history.

The Briton of Ghanaian origin had gone to meet the IHK proprietor and CEO, Dr. Ian Clarke, over the possibility of carrying out open-heart surgeries in Uganda.

Finding it hard to believe his story, Clarke referred Agyin to Dr. Moses Galukande, the director of medical services, education, and research at the hospital and also a surgeon.

Galukande recalls that Clarke later rang him asking whether Agyin was not giving them a “cowboy story”.

What they didn’t know was that the soft-spoken man was actually a highly qualified heart surgeon with a well-paying job at St. Anthony’s Hospital in London, and a career spanning over a decade, during which he had opened 2,080 hearts.

It was his sentimental attachment to Uganda — his wife Joy Akissa is from eastern Uganda — that kept Agyin looking for a way to save the thousands of desperate Ugandans, condemned to death because they can’t raise the millions required to pay for such a delicate surgical operation. He recalls his first encounter with the IHK proprietor:

“When I first met Dr. Clarke, he was skeptical; he thought open-heart surgery in Uganda was impossible. But when I later discussed the matter with Dr. Galukande, who later became team leader of the open-heart surgery project, we decided to give it a try.”

However, there was a big technical problem. IHK lacked a heart-lung bypass machine; a very crucial gadget, which works as an artificial heart during the operation.

Determined to get the project going, the big-hearted surgeon donated a heart-lung machine, which he had bought from St. Anthony’s Hospital and even footed the bills of delivering it to Uganda. He also made arrangements with a British perfusionist, John Francis Nelson, to fly in to operate the machine.

With the main problem out of the way, Agyin and the management of IHK worked with renewed resolve. There was a whole list of equipment to be procured, in addition to training the local team which was going to handle the complex operation.

With Agyin’s help, the hospital was able to buy monitoring, anaesthetic, theatre, intensive care and laboratory equipment, which could not be obtained locally. A team of theatre nurses was sent to Mulago to gain some experience in cardiac surgery.

With Galukande as its leader, the team worked tirelessly for 11 months, doing their homework, perfecting their act, preparing to make medical history. Indeed on April 13 and 15, 2007, the 14 experts made news when they successfully carried out the first open-heart operation in Uganda’s medical history by repairing an atrial septal defect (ASD), commonly known as a hole in the heart.

“This is a very big achievement for my wife and me. It is the fulfillment of a lifetime dream to come back to our roots and help fellow Africans,” reveals Agyin, who was impressed by the local medical team.

“The local medical team I worked with was very enthusiastic and co-operative. We are happy we have been able to pool our resources with IHK and we shall continue with in-house training of staff as we prepare to handle more complicated heart surgeries in the future,” he said.

Agyin credits the project’s success to his wife Joy, with whom he has three children. The eldest, Victoria, 17, is a student at Katikamu SDA. She is followed by twins, Carol and Crispina, 12. Both attend Kabojja Junior School in Kololo. Joy and Agyin met in 1989 in London, where she had gone to do a diploma in ophthalmic nursing after training and working at Mulago between 1979 and 1985.

How did the two meet? They coyly glance at each other before bursting into loud laughter.

Agyin rhetorically repeats the question: “How did we meet?” before answering: “Oh in a cafeteria at the London Hospital.” Agyin was pursuing a postgraduate degree at Guy’s Hospital in London after his first degree in Ghana. The two shared a passion for the medical field. In 1992 Agyin became a Fellow of the Royal College of Surgeons. Joy later pursued a BSc in healthcare. She is currently employed by the Primary-care Trust in Southwark in Britain.

For seven years, the couple has been trying to introduce open-heart surgery in Uganda with little success. In 2000 Agyin presented his credentials to Prof. Francis Omaswa, then director of health services in the health ministry, who promised to get back to him. Seven years later, he is yet to do so. Next, the couple met Gen. Elly Tumwine in London in 2003. The general too never responded.

In May 2005, Joy took Agyin to the then Mulago Hospital director Dr. Lawrence Kaggwa, who was so busy, he offered only three minutes to discuss the issue.

“When I went in, he realised I was talking sense, so he referred me to the Mulago cardiac department. The sorry state in which the department was appalled me. Looking after heart patients, without nurses to attend to them for long periods of time and without the necessary equipment, can only give them a few more years before they die,” Agyin says.

Agyin, who had all along dreamt of working at Mulago Referral Hospital, now switched his attention to private hospitals like the Paragon at Bugolobi. They were ready to take him on, but had not started on the surgery project.

It was at this point that the couple thought of setting up their own a hospital. They even bought land; three acres near the Anglican Martyrs’ Shrine at Namugongo at $25,000 (about sh425m). But the project hit a snag over land wrangles with a neighbour; a lady politician. However, they did not give up on their dream of carrying out heart surgery in Uganda.

Besides fulfilling the couple’s life dream, the two maiden open-heart surgeries have given Mark Atwine, 13, and David Kalenjera, 14, a new lease on life. It has also been a great achievement for IHK staff, additional practical work for the indigenous cardiac surgeons and a great hope to the over 5,000 Ugandans on the waiting list with heart defects.