Photo by Dean Forbes
Forced to decide between two dreams, Amos Mwaka choose to become Dr. Mwaka, not Father Mwaka. His decision cost Uganda a priest, but has gained the East African nation of more than 30 million people, its third oncologist.
In August, Mwaka completed a yearlong oncology fellowship at the Hutchinson Center. He joins Dr. Victoria Walusansa as the second graduate of the program, which is part of the Uganda Program on Cancer and Infectious Diseases (UPCID). The UPCID is a formal collaboration between the Hutchinson Center and the Uganda Cancer Institute.
The plan is to train five more Ugandan doctors during the next five years. “In the six months I’ve been here, I already feel a great change in terms of my knowledge and skills and my focus as far as research is concerned,” said Mwaka, halfway through his fellowship.
Working under Dr. Corey Casper, an investigator with the Center’s Vaccine and Infectious Disease Institute, Mwaka divided his days between the classroom and the clinic. He studied epidemiology and biostatistics at the University of Washington and saw patients at the UW Medical Center, Harborview Medical Center, Virginia Mason Medical Center, Seattle Children’s Hospital and the Seattle Cancer Care Alliance—a rigor for which he came well prepared.
Accidental escape to Sudan
As a boy, Mwaka spent half a year living as a refugee in Sudan with an older brother. Mwaka was 12 and his brother 16 when they fled Uganda with their father’s uncle— a prominent politician—after a power struggle during the mid-1980s led to violence in the countryside.
Their escape was actually a mistake. The uncle had stopped at Mwaka’s home with his family to obtain food from Mwaka’s father to take on the journey to Sudan. Mwaka and his brother assumed their family also was fleeing and hopped in one of three trucks. Not until they reached Sudan did they realize the rest of their family was not in any one of the vehicles.
Mwaka, his brother and the others took refuge in a Catholic mission called Palutaka in southern Sudan. The brothers worked in the fields planting and weeding cassava root. “We typically ate only one meal a day in the evening, so we preferred weeding instead of planting a new garden because the cassava provided lunch without cost to us,” Mwaka said.
They used their meager wages to purchase sugar cane and sell it in a refugee camp—an endeavor that required them to walk five miles across a swamp after spending eight hours in the fields. When they finally returned “home” at 7:30 p.m., they gave all the money they made to the wife of their father’s uncle with whom they were staying.
Mwaka’s stay in Sudan was short-lived as Ugandan refugees eventually faced even greater violence in Sudan. Six months after arriving in Sudan, Mwaka and his brother joined others from the family of their father’s uncle in a reverse exodus. “In Uganda, it was the frying pan, but in Sudan, it was real fire,” Mwaka said.
While brief, Mwaka’s experience as a refugee left a lasting mark. “Those very hard six months taught me a degree of independence and autonomy in myself early,” Mwaka said. “I learned how to focus and do A, B and C to get where I want to go.”
After finishing high school, Mwaka planned to study theology and medicine at the same time, but couldn’t get a good way to combine the two. Family history—one brother is a lab tech and another is a physician’s assistant—tipped the scale in favor of medicine.
Tragedy also played a role. A third brother died after being beaten by street thugs— a death that might have been avoided with a proper diagnosis of his injuries. “We did not discover until post mortem that he had bled in his brain,” Mwaka said. “I felt there was a gap in medical care and that I could contribute to filling that gap.”
Mwaka was completing his master of medicine in internal medicine and caring for patients at Mulago National and Makerere University teaching hospital as a general internist when Dr. Jackson Orem, the Uganda Cancer Institute’s director, suggested he pursue an oncology fellowship at the Hutchinson Center.
Back in Uganda to improve cancer care
Now Mwaka hopes to start a program to train rural doctors to better diagnose cancer, and do so early enough. “We many times see patients at the cancer institute too late and when we can do so little to help them,” Mwaka said.
A training program also will help improve follow-up care. “If every general practitioner has a handful of knowledge, not every patient would have to travel to the cancer institute,” Mwaka said. “It’s a dream that will not be easy to achieve because it will take a number of resources, but we should be able to start in a small way and grow.”
“For a long time, cancer was more or less a neglected field in Uganda,” Mwaka said. “Much needs to be done so that the patients get good care.”