The father of Neurosurgery in East and Central Africa

He might be gone, but his legacy lives on. Add the name Jovan Kiryabwire to a statement and it will have an enhanced meaning, especially to that man or woman who has walked through the neurosurgical ward in Mulago Hospital.In the past, neurosurgical issues were handled abroad. People who afford to go abroad had to suffer from unresolved neurosurgical issues. But today, because of the efforts of role models like Kiryabwire, that is no longer the case.

“The number of people going out of the country for neurosurgery has reduced. The system is developed in such a way that we do not chase people away because we have a unit that handles the issues,” says Joel Kiryabwire, a neurosurgeon at Mulago, who followed in his father’s footsteps.

Jovan Kiryabwire was the first neurosurgeon in east and Central Africa. He took active part in the setting up of the neurosurgical unit at Mulago Hospital and defied all odds that it was impossible to practise neurosurgery in Uganda.“He is the father of neuro surgery,” Dr. Margaret Mungherera, the president of Uganda Medical Association says. Neurosurgery is a specialised field that treats diseases of the brain and the spine.

In the past, the neurosurgery unit faced many challenges, among which was a threat of closure. Kiryabwire became a full-time staff at Mulago Hospital and is credited with having elevated the neurosurgery department into a respected unit.

“The ward was clean, his staff were kind and polite, his team respected one another and we were a shining example to Mulago hospital,” wrote Dr. James Tibenderana, in a memoir dedicated to Kiryabwire. Staffing in the department was a challenge. Kiryabwire managed by attracting doctors from other fields. He attracted the late Dr. Kahaawa from obstetrics and gynaecology and recommended some doctors to go and train abroad, but because of the economic turmoil, they would not return.

Those who were left had to work harder and stick together to keep the ward running. “He had principles that are rare to come by these days. Keeping up with him was a nightmare at times, but usually it was worth it. Once a person got into his routine, it was impossible to do otherwise. Patients benefited from this enormously,” Dr. Tibenderana said. “If he had decided to work abroad, we would probably not have neurosurgery in Uganda, he left a legacy” Joel Kiryabwire says.

Contributions
Part of his legacy is The JMK Foundation, a charity nonprofit company set up by his children. Its activities so far have been in the areas of highlighting the importance of developing local capacity in Uganda in the super specialisation of neurosurgery. “The unit has started a programme that will be producing two neurosurgeons each year to increase the number,” Joel remarks. Kiryabwire’s desire to see more and more students join neurosurgery lives on.

According to Dr. Mungherera, the number of accident victims with head injuries has increased and so has the number of patients in the unit. “The ward admits, on average, six people every day.

People no longer have to suffer long term consequences arising from unsolved neurosurgical issues because of the work of role models like Kiryabwire.” As standards of healthcare weakened in public health facilities, Kiryabwire appreciated private healthcare providers as the future of healthcare in Uganda.

As a result, he and other doctors, who worked in Mulago, started Kampala Hospital in Kololo determined to create a model for private healthcare. Kampala hospital became the first medical facility in Uganda to provide MRI (magnetic resonance imaging) facilities.

Sacrifice
His schedule kept him away from home for many hours yet he kept a keen interest in his children’s education, “When we completed school, he would mentor us to become exemplary professionals at our places of work and taught us to give back to our country,” says Geoffrey, his son. He adds that his father never gave up on his belief that Uganda would one day get better if everybody played their rightful role.

At 76 years, he succumbed to cancer on January 19, 2004, but the banner still flies high through his children, he lives on and will always be remembered as East and Central Africa’s forebearer by the 23 neurosurgeons recorded in the world directory of neurosurgeons in 2005.

Background
Kiryabwire began his formal education at the age of 10 at Butebo Primary school. His quick progress was noted by his teachers who recommended he joins a better school. He was moved to Kolonyi Boarding School before joining Kamuge then called a sub-grade primary school. He passed his primary exams and won a district bursary to study at Nabumali High School, which was the best in Mbale at the time.

Shortly after joining Nabumali, Kiraybwire’s father, Yafesi Mabudo died. His mother Eserezi Namuzungu, a traditional birth attendant and an agriculturalist had to fend for the family.

She managed to keep all the children in school. This, however, weighed heavily on Kiryabwire since he often went to school late after the term had begun. Despite all the trials, he emerged the best student at the Cambridge examinations and joined Makerere University in 1952, for a degree in medicine and surgery. His mother’s occupation as a birth attendant inspired him to study medicine.

For Kiryabwire, joining Makerere was more than a chance to further his education. He saw it as an opportunity to be groomed well enough to change his family and the nation. “He was a nationalist who believed in his country,” stated Prof. George Kirya, in a tribute to Kilyabwire, a year after his death.

In 1957, they were only eight students from all over East Africa; he excelled yet again and was retained as an assistant lecturer. Five years later, he undertook a postgraduate course at the Royal College of Surgeons in Ireland and later Edinburg.

Kiryabwire made an enormous impact on his professors that saw the General Medicine Council offer him a licence to practise medicine in the UK. Kiryabwire did not yield, his desire to make a difference in his nation was not quenched. “All attempts by other countries to hire his services were turned down,” says Geoffery Kiryabwire. He was appointed senior consultant and head of the neurosurgery department, a position he held until 1998 before becoming a member of the Health Service Commission.

By DOREEN MURUNGI: The New Vision Newspaper
21-April-2012