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2/5/16 - "Adherence to International Pediatric Pain Protocols: Focus on Uganda" by Matthew Quillen

Adherence to International Pediatric Pain Protocols: Focus on Uganda

by Dr. Caprice Knapp, Professor Julia Downing, and Matthew Quillen

Matthew Quillen received an ARC research grant in Fall 2014 for his project entitled "Adherence to International Pediatric Pain Protocols:  Focus on Uganda".

Preparation

Boarding the airplane to Entebbe, Uganda, was unlike anything else I had ever done. When I say that-it truly was something I had never done. Never had I traveled outside of the United States. In telling people that, I initially received rather negative responses along the lines of “Your first trip is that far? Do you think you can handle it?”

I have Dr. Caprice Knapp (my research adviser and principal investigator on this project) to thank for suppressing my nerves and helping me address those skeptical critics. Never did Dr. Knapp make me feel as though I could not handle a research experience 20+ hours away from home. In fact, her confidence in me at times proved surprising.

Nevertheless, under the guidance of Dr. Knapp, I first involved myself in learning more about pediatric palliative care (PPC) during my sophomore year. PPC was a specialty I previously knew nothing about. For those presently in the same boat, pediatric palliative care, as defined by the World Health Organization (WHO), is the active total care of the child’s body, mind and spirit, and also involves giving support to the family. Essentially, it was our research team’s project goal to assess PPC in Uganda. Although Uganda is a developing country, rather extensive pediatric palliative care systems exists within certain regions.

Research Experiences

While in Uganda, Dr. Knapp, Dr. Julia Downing, and I visited three different clinical sites-Mildmay Uganda, Mulago Hospital, and Hospice Uganda-all offering different methods of care provision. (An interesting side note I learned while on site- the Queen of England once visited Mildmay Uganda, something Ugandans were very proud to discuss).

Queen of England at Mildmay Uganda

Queen of England at Mildmay Uganda. Photograph taken from http://www.mildmay.org/wp-content/uploads/2013/07/queen-resized.jpg

On site, the three of us completed two major aspects of our research project. First, our team collected anywhere from 25-50 pediatric patient medical records for data extraction purposes. Demographic data including sex, age and tribe was collected, as well as any pain assessment, prescription information, or doctor’s handwritten notes.

The second aspect of our project was to conduct care provider interviews with members of the staff at each of the three sites. Dr. Knapp and I were able to meet with three care providers at each site (for a total of nine provider prospectives) to discuss how pediatric care providers were taking care of their pain-ridden patients. Most specifically reviewed within the interviews were the providers’ comments and opinions on how they are abiding by World Health Organization (WHO) palliative care guidelines. Both provider adherence to, and shortcomings of, the guidelines were discussed between our team and site providers. It is our goal to better understand where sites succeed and fail in following international guidelines, in hopes of increasing palliative care programs adherence WHO goals.

The City of Kampala, Uganda.

The City of Kampala, Uganda. Personal Photograph, Matthew Quillen (2015).

Ugandan Culture

Outside of our normal field work, Dr. Knapp and I immersed ourselves in Ugandan culture. Most memorable was our trip through the heart of Kampala (the biggest city in Uganda) lead by our trusty driver Patrick pictured below.

Personal Photograph, Matthew Quillen

Personal Photograph, Matthew Quillen (2015).

To my surprise, the Acacia Mall in Kampala was very similar to the malls you see here in the states. Burger King and Apple were amongst the recognizable companies hosting stores in the mall. Conversely, noticeable differences were present as one might imagine. Most notable was the amount of street sellers posted on both sides of major roads. The streets themselves were chaotic, with drivers uninterested in following any sort of guided lane. On top of that, these street sellers had no regard for their own safety. Putting themselves inches within harm’s way to sell one more newspaper, one more CD, etc., was fascinating. In my opinion, this really spoke to the Ugandans work ethic and the culture as a whole.

Acknowledgements

The time and effort put into my research trip abroad would not have been possible without the assistance of the Africana Research Center. I can not thank the Center, specifically Mrs. Dawn Lavera, enough for their continued support throughout this process. I would also like to thank Dr. Caprice Knapp and Professor Julia Downing for their support, as everything I learned ultimately stemmed from their expertise. I look forward to completing my analysis of our collected data so that Dr. Knapp and I may present our findings, helping to improve international pediatric health outcomes.