Kids in the Kibaale District of Uganda

“We might lose this one,” said Patti Poole, a UC Davis Health specialty pharmacist, sitting under a tree that offered essential relief from the brutal equatorial sun. “This girl is bad; she’s super dehydrated, and she’s totally non-responsive.”

The little nine-year-old was so weak from typhoid that her father had to half-lift, half-drag her to the makeshift pharmacy, set up in a village within the Kibaale District, one of the most remote and impoverished areas of Uganda.

The girl immediately threw up the Tylenol. She rejected the water.

UC Davis Health Nurse Manager Stacy Hevener sees a patient.

Poole and her small team dug into their rudimentary inventory of drugs and gave the girl an antiemetic to counter the nausea. She swallowed it dry.

The girl lay down and her family put a blanket over her head. It was about 100 degrees Fahrenheit, Poole guessed. The covering looked like a burial shroud, she thought.

After 20 minutes, Poole found a shrink-wrapped corn muffin saved from the overseas flight, and the girl managed a couple of tiny bites.

After that stayed down, Poole tried an oral rehydration solution, which the girl sipped from a bottle cap.

Poole mixed some Tylenol and sugar in four drops of water to make a sweet slurry. The girl took that and kept it down for another 20 minutes. And finally Poole was able to administer the first dose of Bactrim, the typhoid antibiotic.

Three hours passed, with the pharmacy station shifting several times to chase the slinking shade beneath the tree, until finally the little girl was strong enough to leave, successfully pulled from the brink.

“There’s always one to five really impactful patients who literally could have died if you weren’t there that day,” said Poole, who has been traveling to the village of Buseesa and surrounding communities every year since 2013.

In January, the young girl with typhoid was able to be treated because Poole, UC Davis Health nurse manager Stacy Hevener and three UC Davis pharmacy residents were part of this year’s 12-person medical mission from the Sacramento area to the Kibaale District.

Their work, the medical outreach component of efforts led by the nonprofit Buseesa Community Development Centre (BCDC), took place over five days across the region. The team saw more than 1,300 patients during that period, providing a range of services from acute care to family planning to the provision of eyeglasses and toothbrushes.

Residents wait to receive care.

In a place where even a pair of reading glasses can be “life-changing,” Poole and Hevener have seen marked improvements in the health and well-being of residents, with the BCDC offering microloans and spearheading infrastructure improvements like a school and mill.

“There’s a village that has erupted as a result of the school and clinic there,” said Hevener, who has been visiting Uganda since 2015.

The UC Davis Health providers said this year they observed fewer HIV diagnoses, fewer chiggers and fewer wounds. At the same time, they continued to stress the educational aspect – clearing up misconceptions people have about illnesses, explaining to patients what has been written in their individual paper medical records, and emphasizing the importance of hygiene.

“As a nurse, I’ve seen the evolution of people’s knowledge of self-care, but there’s still a huge gap of basic hand hygiene, body hygiene, dental hygiene,” Hevener said.

As patients moved among the different stations – registration, nursing triage, provider consultation and lab/pharmacy – they heard (via interpreters) consistent messaging about hygienic and preventative health practices.

Front row: Noelle Nelson, Patti Poole, Kathy Ton and Daniel Nguyen; behind them, Brian Poole, Army Corps of Engineers volunteer for mobile clinic logistics.

While the Ugandans learn a lot from the medical outreach each year, the UC Davis pharmacy residents on the trip are also getting a multi-faceted education, Poole said. In addition to the “therapeutic interchange” in a cross-cultural context, they are involved with planning and inventory, formulary development and administrative aspects of the pharmacy work. As part of their preparation, the residents develop nursing field care educational modules so the nurses on the trip can earn CE credits.

This year’s pharmacy crew of resident trainees – Daniel Nguyen, PGY2 pharmacy resident in Medication Safety & Policy; Noelle Nelson, PGY1 pharmacy resident in HIV ambulatory care; and Kathy Ton, PGY1 pharmacy resident in HIV ambulatory care – were a vital part of the team.

“They are the hardest working group, because of their energy,” Hevener said. “They’re go-getters and they care a lot – they want to make sure patients are getting good care.”

Like the rest of the team, the residents pay their own way – airfare, transportation and ground fees.

“It’s a significant financial sacrifice, but I’ve never taken someone who didn’t say, ‘I totally want to go again,’” Poole said.

Getting to know the “generous and gracious” care providers on the trip is always a highlight, Poole said, as well as building relationships with the Ugandans – patients, staff and interpreters – year after year.

And giving back in an impactful way and renewing one’s sense of gratitude “fills your soul cup,” in Hevener’s words. It’s why volunteering is a passion for many health care professionals across UC Davis Health, including those who participate in Project Medishare (which works in Haiti), Operation Smile (which heals children’s cleft lips/cleft palates worldwide) and other international programs.

“UC Davis fosters that kind of an environment,” Poole said.