A Yale-Erlangen Cooperation in Uganda

Visiting Partner: Christian Knipfer
Home Institution: FAU
Host Institution: Yale/ Makerere University, Uganda
Rotation and Time: Visiting Student 2015 (not financed through TRENAL)

Details of visit: Four FAU medical students have been accepted to the YALE global health program at Makerere University, Kampala, Uganda. While not a program directly sponsored through TRENAL, the FAU students successfully applied to the YALE Global Health Program. Christian is one of them.


“My name is Christian Knipfer, I am currently in my last year of medical school (6th year). I was luckily the first German medical student who could participate in this established rotational program. First of all I want to say thank you, to all the people at Yale and Makerere University and the University of Erlangen that helped me in the process as well as on site in Mulago. I had a wonderful time with wonderful people around me.

The Visit at the Makerere University gave me a lasting impression on many things. If I could summon what I learned of the experiences and the time in Uganda in one word it would certainly be: Awareness. Awareness concerning Africa, concerning the people that live here, the struggles they have in their daily live and of course the many structural problems that the residents face each day at Mulago. It did, however, not only make me aware in terms of Uganda solely. It reached far beyond that. During my time in Mulago there was the first immigration crisis in Germany in a long time. Here are some facts on what is going on in Germany at the moment: The number of immigrants, applying for asylum in the European Union, reached a total of 213 200 in the second quarter of 2015. This number equals an additional 85% compared to the second quarter of 2014. One third of these first time applicants, i.e. 38%, were registered in Germany ,which yet has the highest number of pending applications in the EU. According to that, the European Council on Refugees and Exiles reported a sharp increase of 57.9 per cent in asylum seekers in Germany in its recent asylum information database (AIDA) country report in 2014 compared to the number of applicants in 2013.

I started to think a lot about all the people trying to come to Germany and saw the connection between my time in Uganda and the people that come to us as refugees. I guess that is what is meant when people defined the term “Global Health”. As Health is a big part in the context of why people flee their countries, one would suggest that in Germany we are able to actually care for these persons in an adequate manner. I was wrong. A recent report by Medecins du Monde brings attention to the fact that various governmental and financial issues hamper access to basic healthcare for the undocumented immigrant population as well as asylum seekers in Europe. Consequently, about 25 per cent of this population group – considered as particularly vulnerable – does not have sufficient health coverage including primary care or chronic disease management programs when they come to Europe. That are figures not worthy of the European Union and not worthy of Germany. I think this is what Mulago actually can teach us medical students from abroad. To be aware of health problems outside the box of the German Health system. To learn to address cultural differences and to understand the global burden of disease. Africa is not that far away form Germany like many people in Germany would believe. This, I think should be also a big aim to teach in medical schools. Because they should provide support for humans, not only on a regional level but on a global level. Mulago teached me, what it meant to work in a hospital so short of resources that it was almost unbearable at the beginning. It also taught me to make the best out of each situation, because I think the people that work there are constantly trying to get the best out of it, even if they do not have a blood pressure cuff, an oxymeter and really basic things that you actually need to work efficiently. I do not know what the mortality rate in this hospital is, but based on what I saw I think it is about 30%. People get here in very bad conditions and sometimes the only thing that you can do is to watch them suffer, even if in Germany you could help them in some way or the other. It is hard to see and to withstand.

I am used to that feeling that every patient which gets to the hospital in Germany, the best thing possible is done for him and that was good for my consciousness and did let me sleep at night. Even if the people eventually died, you still have the felling that there would have been no other method or treatment to help them. It is quite different here. I mean, if you just look at Uganda the people here do their best and do not have sufficient resources to help them, so there is actually no one to blame. The disparity between Germany and Uganda was really big. As we have also been in touristy areas in Murchinson Falls and Lake Mburu which are by the way wonderful, I can see that also tourists can not really grasp how different Uganda is compared to their home country. The program helped me a lot to see the shortfalls and problems in Uganda Healthcare System. But it also showed me, that you can be happy with much less than in Germany. The people were so welcoming and the country is frutile and full of vegetation. This is another thing that struck me. Uganda is actually a really rich country when regarding water resources, the possibility to farm, to grow cattle, regarding the tourist hotspots and the beautiful scencery. I certainly believe, someday it will change for the better and the people in Uganda can profit from the richness of their country. I will come by and check on them ;)”