The Mulago Hospital Gastro-Enterology Unit is acknowledged as one of the premier units for clinical care and research in Uganda and has attracted clinical and research fellows from all over the world. The Unit has a particular reputation for the clinical care of colitis and Crohns disease, including trials of novel therapy and research into the causes of inflammatory bowel disease, as well as in the management of coeliac disease, irritable bowel syndrome, nutritional support and intestinal failure, cancer, autoimmune liver disease and viral hepatitis.

Great emphasis is placed on multidisciplinary care, with close cooperation between medical gastroenterology, the colorectal and upper gastrointestinal surgeons, gastrointestinal pathology and radiology. Joint clinics and joint meetings are held weekly to facilitate patient care and patients often have joint management between surgical and medical teams. There are specialist nurses, two Gastroenterology Dietitians and a Gastroenterology Pharmacist attached to the team.There is close liaison with paediatric Gastroenterology, especially for adolescent inflammatory bowel disease. Interaction with general practitioners in primary care is given a high priority, through joint educational meetings (Gastroenterology Forum), management meetings, shared-care guidelines, research and publications.

SERVICES OFFERED AT THE UNIT

The Unit cares for a wide range of patients with gastrointestinal or liver disease and nurses can consolidate their general experience and develop specialist gastroenterology nursing skills. These include caring for patients with acute GI bleed or acute flares of inflammatory bowel disease and the opportunity to assist with out of hours endoscopy. The units' nurses also care for day patients undergoing paracentesis or specialist infusions such as Infliximab or intravenous iron.

The Unit provides secondary care for the country (21 million- population) and tertiary care for inflammatory bowel disease, nutrition, intestinal failure, hepatobiliary disease and other complex gastrointestinal disorders. Each year there are around 1500 inpatients, 2500 new patient gastroenterology referrals, 10500 follow-up appointments and 10000 endoscopic procedures/year performed at Mulago. The Endoscopy Unit has three procedure rooms, separate facilities for biliary imaging in radiology, endoscopic ultrasound and all interventional procedures, as well as an endoscopy simulator for training.

Patients in the Unit are often facing life-changing illness or experiencing repeated visits to hospital over a period of months. Nursing here means treating patients as people providing psychological and social support as well as caring for them in their illness. Informality is a characteristic of a ward where staff get to know the patients very well, which demands a strong interest in people and an ability to build relationships.

The Unit's management is keen for staff to continue their education and staff are encouraged to attend a variety of courses and learning opportunities. The Units Practice Development Nurse works closely with staff to develop their skills and knowledge and advance evidence based clinical practice.