Meet the most learned oncology pharmacist in sub-Saharan Africa.

Mr. Benjamin Mwesige is the head of pharmacy at Uganda Cancer Institute. Recently he finished his fellowship in clinical oncology making him the most qualified in his field in the whole of sub-Saharan Africa. Musinguzi John caught up with him to share his remarkable milestone.

I’m Benjamin Mwesige, an oncology pharmacist. I qualified as a pharmacist from Makerere University in 2007, worked in Mulago hospital until 2010 then came to cancer institute. But by that time I had enrolled for a masters in clinical pharmacy in Ireland in a university called University College Cork which I finished this year. Then I went on and had a fellowship in clinical oncology from Bristol Haematology and Oncology center in the UK that makes me an oncology pharmacist which I finished just last month. So now I’m by all means the most qualified oncology pharmacist I guess in the whole of sub-Saharan Africa.

It feels very good, it’s an accomplishment that makes me feel happy. But also most importantly I want to show cause for this. It may not be achievable overnight but with time I want to show the difference between having had myself trained in this area and see if I can put a difference. My real desire is to see more people going to train because it will directly impact into good quality service delivery in as far as pharmacy is concerned.

My experience has not been an easy one. For instance I funded my studies in clinical pharmacy from my own savings. That’s a lot of money that I’m not even sure I will ever recover but hopefully I will. It may not be that I will recover the money in terms of cash but I should see value for it. I should see why I spent that much in a foreign country to study. It should be translated into good outcomes. And I have started seeing them coming because in 2015-2016 I was awarded the best clinical pharmacist of the year by Pharmaceutical society of Uganda. To me that was a great achievement by just mere looking at the accolade I said okay this is it.

I want to really make a contribution out of it. A contribution that will impact change. It could begin with a small mentorship program among the pharmacists other colleagues of mine at work so that they see the value for not only sacrifice but also consistence. You know with pharmacy more especially oncological pharmacy you have to be very consistent in what you do, how you do it and who you do it with. That way you’ll be able to look back and appreciate.
There are many achievements I can talk about. Even where we are seated here (referring to the UCI Fred Hutch Cancer Center) I participated in the designing of this area as a pharmacy and this is one of its kind in the region. Whenever someone comes here and I show him around he goes saying wow this is better than Aga Khan or those in India. But this is something small. If we could have more of these units in the country then I would say it’s a dream achieved.

I think the future is bright and I look at it in this aspect, when we get the mandate that we deserve as UCI I feel that we are going to have good quality care because we are going to have the drugs available, given to patients at the right time, in the right quantities and condition. But also our perception towards cancer and cancer medicines is going to overwhelmingly change. With this I see the future of cancer care as being better, with achievable outcomes that are going to lead to patients living longer and happy because we shall be in charge of our own things. The struggles that patients go through today are the sacrifices for a better tomorrow. That’s how I can put it.

“There are many opportunities
out there but they are not as
good and satisfying as seeing
people happy back home.”

(Laughs) I would if I wanted to, I would have stayed away but I thought this is where I belong and this is home. Because where I was we were 17 of us and most us were foreigners and of course the payment is good there. Oncology pharmacists have a good life but you don’t appreciate that in that environment because you’ll be equivalent to them. When you go to an environment where they are not, you establish your own niche, you make things go the way you want to see them. Somebody can come 20years later and make a difference but you’ll have started that journey. So I thought I should come back at home and begin that journey. There are many opportunities out there but they are not as good and satisfying as seeing people happy back home. So to me that’s the reason I’m here and will stay for slightly longer.

I must admit that every day I get job alerts saying “This job matches with your qualifications” and in most cases I ask “What do you think matches my qualifications?” and they start enumerating things they think are within my qualifications. But for some reason I don’t go for those specifics because I think together as the UCI team we can make a difference and our voice can be heard all over if we are speaking the same language. So by and large I think I’m still here and I’m going to be here because this way I can make a difference.

A number of things but more importantly my director is a wonderful man. He’s like a father to me I talk to him about anything personal, academic, career you name it and such an environment makes you work more and better. But also his path of life is another motivating factor. I have seen him for many years at a distance and I have seen him for a number of years close. I have seen him struggle in life and I have also seen him as a very successful man. He is the kind of man you want to associate with not only because you want to be closer to him but also when you want to progress in your career. So that makes me feel like this is the best place to be.

Funding gaps, because in other countries oncology is fully funded by government but here in Uganda the funding gaps are sometimes very dreadful and make you feel like “Why can’t we do things differently!?”. If we can correct that then we are set to fly.

Ugandans should look at the causes for cancer, those which are preventable we should prevent them. On the side of the patients it would be important if patients can make a small financial contribution to their care. This would make us perform better because it would supplement on what government is putting in. But you know that has mixed signals with politics. Cost sharing was scrapped by the president during campaigns. Now that we rely only on government funding, if there is a deficit in government revenue collections, there are deficits in the money they give us and of course the deficits as well recur in what we can do with the money when it comes here.
A humble contribution of 10000/= to 20000/= from each patient can help us a lot in taking good care of them. Like now I don’t have disposable gloves but these cost as cheap as 12000 a box. If a patient can facilitate that then our work would be easier. Every day I feel very bad to tell the patient that I don’t have the drug they want. So to me I think that is the missing gap.

So the magic model in adult cancers is through prevention, vaccination and public health education. The core to reducing cancer among adults is not in the hospital but in the community.

The dynamic and vibrant team that is here. The Institution has over 80% of its staff that are young in their careers, open minded and very keen to embrace change and make progress. It’s really exciting to be part of the growing institution.

There are two things basically and one is Uganda Cancer Institute is grossly under-resourced. Talk of monetary budget, skilled personnel, technologies and facilities and that can be very frustrating. It is even more frustrating for a person like me who has worked in systems where things are accessible and they work. It is very saddening that many times your attempts miserably hit a brick wall.

That’s a very interesting question because Dr. Joyce who is the substantive head of the oncology section and Dr. Orem the director have talked about this and our mandate is clear. We want to be a world center of excellence in pediatric cancer care, especially serving the East African region and probably most of the Sub-Saharan Africa. Our goal has no ambiguity. It is curing children from cancer and that goal can be achieved within the coming 5 years. Thankfully we have the support of one of the centers that has done it before and that is Texas Children’s Cancer Center in the US. So it’s just a matter of time, resources and commitment and it will happen.

I think there’s a lot of hope in Uganda Cancer Institute because when you look at many countries in Sub-Saharan Africa, Uganda is unique because many countries do not even have a cancer institute or a clear strategy to control cancer. So Uganda Cancer Institute is in a good place because it has built partnerships with very strong institutions such as Fred Hutch Cancer center, Texas Children Hospital. So I think Uganda Cancer Institute is on the right path to becoming a leader in cancer care and treatment in the next 20 years. This does not happen all of a sudden. It depends on administrative structures as we all know it is what is killing medical institutions in our country.