History of dermatology in Uganda

Until the “Skin Clinic” was established in Mbarara, there was no qualified treatment of skin diseases in Uganda, as in many African countries. In a health system that was not very efficient to begin with, the focus was on disciplines such as surgery, internal medicine, obstetrics and paediatrics. There were neither dermatologists in the country, where even today there are only 8 doctors per 100,000 inhabitants, nor any opportunity to learn this specialty. Yet skin diseases play an immense role in Uganda: most children suffer from fungal infections of the scalp, scabies is rampant in many villages, and bacterial skin infections, which can lead to severe complications if left untreated, are extremely common. With the onset of the AIDS epidemic, the number of chronic skin diseases (psoriasis and lichen planus, the most severe eczemas, infections and tumours of the skin) rose sharply; practically all AIDS patients suffer from severe skin manifestations in the course of their illness. In addition, there are the numerous skin reactions to medicines, caused by the uncontrolled use of antibiotics, for example, but also as a side effect of drugs against HIV infection, as well as tropical diseases of the skin.

In 1997 the Würzburg dermatologist Prof. Dr. med. Gerold Jäger, together with his wife Dr. med. Elisabeth Jäger, founded the Skin Clinic at the University of Mbarara and thereby laid the foundation for dermatological care in Uganda. Doctors who had completed their medical studies at the university could now undergo specialist training in dermatology. Prof. Jäger sent several of them to Germany for a time, where they were able to experience dermatology at German clinics. From 1997 to 2004 he and his wife were on site in Mbarara and continually expanded the Skin Clinic. Even after their return to Germany they continued to travel to their former place of work for many weeks every year and continued to accompany the project, increasingly supported by dermatologists from Germany, Switzerland and Australia, who also took part in training the aspiring Ugandan dermatologists. Further information is also available at the following link: http://www.fnweb.de/region/neckar-odenwald/buchen/dr-gerald-jager-kampft-fur-hautklinik-1.192879

For their commitment in Africa, Gerold and Elisabeth Jäger were awarded the Federal Cross of Merit of the Federal Republic of Germany in February 2014 http://www.fnweb.de/region/neckar-odenwald/buchen/hochste-ehren-fur-hochst-bescheidene-1.1404349

In 2010 the association “Skin Health for Africa”, based in Jena, was founded to carry on the life’s work of the Jäger couple. It was dissolved in 2019, and a Uganda working group was founded within the “International Society of Dermatology in the Tropics e.V.” to continue the support for dermatology in Uganda within the framework of this larger association.

Today the Skin Clinic in Mbarara is led by the Ugandan dermatologist Dr. Grace Mulyowa. Dr. Peter Mugisha, who died suddenly and tragically in September 2020 as a result of a COVID-19 infection, was in charge of training the resident physicians. They complete a three-year specialist training programme, and the Skin Clinic is enjoying growing popularity as a training centre throughout East Africa. Owing to the extremely precarious financial situation throughout the Ugandan health system, however, the Skin-Clinic remains urgently dependent on support. The university can hardly provide medical equipment, specialist literature and computer equipment, without which qualified training is not possible. Above all, however, the aspiring dermatologists need experienced teachers who pass on their knowledge and examine and treat patients together with them, in order to ensure high quality and international standards in training. At the association’s expense, some of the resident physicians are therefore sent for a few months to dermatology clinics in Germany or Australia to become acquainted with highly developed medicine and dermatology.