ACCESS: The Nakaseke Oasis

Two years have passed since I went to ACCESS (African Community Center for Social Sustainability) but the ramifications of that experience foretold who I am today. The University of Vermont and Western Connecticut Global Health Scholarship that afforded me the opportunity to go to Uganda between my first and second year of medical school has had far reaching implications for who I am as a person and the type of doctor I wish to become. I have immense admiration for the staff at ACCESS as their dedication and service to their community is unwavering. The physical beauty of Nakaseke and the grounds of ACCESS are striking. However the history of Nakaseke, in the Luwero district of Uganda, is contrary to the peaceful oasis-like feeling of ACCESS. For decades, war and disease destroyed the lives of villagers in Nakaseke. In town, an abandoned partially demolished building is a daily reminder of the past. Generations of young adults were killed by either the war or AIDS which left vulnerable children and elders desolate with uncertain futures. Living day to day in a place where life is fragile and uncertain makes investing in the future seemingly frivolous.

Investing in a child’s education is a luxury that most cannot afford and certainly do not prioritize. Living in poverty excludes a person from being able participate in government and advocating for themselves. It is for these reasons that ACCESS is vital to this community – expanding the educational and health opportunities for community members and helping to break the cycle of poverty. Poverty is complex that requires multifaceted solutions. For example, one woman who I will never forget, was nursing her fifth child. The woman’s husband had left her promptly after infecting her with HIV. The infant had tested HIV negative but now risked becoming infected through breastmilk. The woman had no money for formula as she was trying desperately to send her eldest child to school. She knew of the risks and was faced with an impossible choice. She was 24 years old and I wonder if she is still alive. She and many others is why I am choosing to continue to work for impoverished communities and I continue to draw inspiration daily from the patients and staff I met at ACCESS. I am grateful for the partnership and commitment the University of Vermont has to global health and the opportunities we have as students. One person in particular at UVM was instrumental in helping the Ugandan doctor who initiated ACCESS and in turn set me on my trajectory.

Now it is my turn to help the next generation as a future emergency room doctor. My experience in Uganda solidified my desire to want to work in an all-inclusive environment where no one is denied healthcare regardless of social, demographic or economic status. Emergency medicine is fulfilling for me in the regard and the wide scope of practice will enable me to see patients in various settings, improve pre-hospital health care and to appropriately use diagnostic tests for triage that will improve patient outcomes and healthcare expenses.

Alexander K Miller MD
University of Vermont