ADUNU PROGRAM: Making A Life-Saving Discovery
*Names have been changed to ensure privacy
On the second day of the ADUNU Program rollout in a district in Northern Uganda, a remarkable story unfolded- one that would change a young boy’s life forever. The morning had begun with an echocardiography training didactic session for health workers, followed by a 30-minute break that allowed staff to attend to patients in the Outpatient Department. When the team reconvened, it was time for hands-on practice, an opportunity for the trainees to apply their new skills in heart ultrasound scanning.
Patients waiting for lab results were invited to participate in the supervised training activity by having their heart tested and imaged by one of the nearly trained providers. Many welcomed the offer with curiosity and enthusiasm. As they queued up, the facility in-charge, spotted a familiar face, Charles, a boy from a nearby village. Charles was known at the facility for his frequent visits due to a persistent cough, which was often treated as pneumonia. Wanting to prioritize Charles so he and his mother could head home, the in-charge invited them into one of the training rooms set up for scanning. Inside, under the guidance of ADUNU Program trainers Isaac Omara Otim and Jafesi Pulle, the in-charge received a quick refresher on the morning’s lessons on how to handle the ultrasound probe and image acquisition. As Charles lay quietly on the examination table, the gel was applied and the scan to get images of the heart began. Moments later, the in-charge remarked, "These heart valves look like they are hugging each other. They don’t want to let go." Curious and concerned, the trainers leaned in and were stunned. Charles had severe mitral stenosis, a dangerous form of rheumatic heart disease (RHD). His mitral valve leaflets were fused together, obstructing blood flow. This was the likely cause of his chronic cough, previously mistaken for recurrent pneumonia.
Left to right: Mr. Jafesi Pulle, Dr. Doreen Nakagaayi, Mr. Isaac Omara Otim before a training session.
The trainers explained the condition to the in-charge and Charles’ mother, emphasizing the urgency of specialized care. Charles was referred to the District General Hospital for a more detailed echocardiogram. Two days later, Charles and his mother made it to the District Hospital, where he was registered in the RHD clinic to receive more specialized care and close follow-up. During one of the program’s visits from Uganda Heart Institute experts, Dr. Doreen Nakagaayi, a program cardiologist, reviewed Charles and confirmed the need for surgery to repair his heart valves.
Charles has undergone successful open-heart surgery at the Uganda Heart Institute (Mulago). The operation, conducted by a team of Ugandan cardiac surgeons, was fully sponsored, offering Charles a fresh start. Today, Charles continues to attend school and receives the necessary support for his recovery.
Charles’ story illustrates the potential of echocardiography screening programs, such as those initiated by RRCU and the Uganda Ministry of Health under ADUNU, to identify disease and save lives. We are grateful to have been able to help intervene in the progression of RHD for Charles, giving him the opportunity to lead a healthier and fulfilling.