Joining together to treat patients a half a world away

Doctors in Uganda and Seattle meet virtually to do rounds, discuss patient care
New sign
Workers finish the sign for the UCI — Fred Hutch Cancer Centre, which opens next week in Kampala, Uganda. Photo by Robert Hood / Fred Hutch News Service

KAMPALA, UGANDA — As he does every second Thursday of the month, oncologist Dr. Fred Okuku dialed into WebEx to host an online video discussion between researchers gathered around him in Kampala, Uganda, and  Seattle physician-scientists half a world and 10 time zones away. As if this international collaboration were not remarkable enough, he did so from a spacious room in a new research, training and outpatient facility that is the fruit of a decade-long alliance between the Uganda Cancer Institute and Fred Hutchinson Cancer Research Center.

“We are in the brand new building, and it’s really nice,” Okuku told his colleagues on the phone in Seattle.

The new building will officially open a week from today. As the Uganda doctors, nurses, pharmacists, lab techs and students met for the first time in their new training room, workers were busy riveting the letters “UCI - Fred Hutch Cancer Centre” to the building’s exterior, installing locks on doors and hanging paintings by local artists on the walls of patient waiting rooms.

Michel Alexandre
Michel Alexandre Photo by Robert Hood / Fred Hutch

“To have grown up in the U.S. and to see this in Africa — that’s a first for me,” said Michel Alexandre, a lab consultant who was born in Haiti and grew up in Boston and was hired by the alliance to prepare the center’s four laboratories.

The monthly presentations and discussions of medical cases is a standard practice for research hospitals. What’s unusual is the international nature of the meeting, held at 7 a.m. in Seattle and 5 p.m. in Kampala to accommodate the differing time zones.

Thursday’s case was a 65-year-old Ugandan woman with glioblastoma, a type of brain cancer that has a dismal prognosis no matter where it is diagnosed.

Participants on both sides learn from the presentations, in part because cancers in Uganda can take very different forms. Figuring out why is the kind of question that can lead researchers to a better understanding of how cancer works — and what can treat or cure it.

One of the mysteries discussed Thursday by Dr. Marc Chamberlain, a professor of neurology and neurological surgery at the University of Washington, was why glioblastoma is relatively rare in Uganda, which has high rates of other cancers, especially those that are associated with infections.

“For reasons we don’t understand, people of color get brain cancers far less than Caucasians,” said Chamberlain, who is also an affiliate clinical researcher at Fred Hutch.

Virtual rounds
Once a month, physicians in Uganda and Seattle meet by video conferencing to discuss specific patients and how best to treat them. Photo by Robert Hood / Fred Hutch News Service

The monthly clinical care discussions — recent topics have included lung, breast and cervical cancers as well as palliative care — draw up to 40 Ugandans regularly, a crowd that was a challenge to accommodate in the old facility, a jumble of nearly 50-year-old buildings crammed with both in- and out-patient beds.

“We were always fighting for space,” said Dr. Warren Phipps, a Kampala-based Fred Hutch researcher who serves as medical director of the UCI-Hutchinson Center Cancer Alliance.

The new state-of-the-art center will for the first time bring all of the alliance’s work under one roof, accommodating 20,000 outpatient visits a year as well as housing laboratories and ample space for meetings and conferences. It is the first comprehensive cancer center jointly built by U.S. and African cancer institutions in sub-Saharan Africa.

Training is an integral part of the alliance’s mission, especially in a country which, less than a dozen years ago, had just one oncologist for a country of more than 30 million people. As Dr. Corey Casper, director of Global Oncology at Fred Hutch, puts it, building infrastructure in Uganda and other low-income countries means more than constructing new buildings. It means training the people who will work in them.

“We’ve trained more than a dozen oncologists,” Casper said. “We’ve trained over 300 health care workers and researchers in cancer.”

Robert Hood is a staff photographer and multimedia editor at Fred Hutchinson Cancer Research Center. A longtime photojournalist, he's also worked at NBC News digital and Reach him at

Mary Engel is a former staff writer at Fred Hutchinson Cancer Center. Previously, she covered medicine and health policy for the Los Angeles Times, where she was part of a team that won a Pulitzer Prize for Public Service. She was also a fellow at the Knight Science Journalism Program at MIT. Follow her on Twitter @Engel140.

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