Pandemic Loss: Pioneering Ugandan Neurosurgeon Was A 'Servant Of The People'

Uganda, a nation of 44 million, had only 13 fully-trained neurosurgeons in 2020. Now it has only 12. John Baptist Mukasa, age 54 and a pioneering neurosurgeon in his homeland, died of COVID-19 on June 29.

Mukasa is part of a still unfolding global tragedy: 4 million lives lost to COVID-19 as of July 8. Estimates by the Center for Systems Science and Engineering at Johns Hopkins University have now already surpassed 4.04 million deaths, a number that data trackers believe to be an underestimate.

Uganda, where Mukasa lived in Kampala with his wife and two sons, is currently in a second lockdown due to rising COVID-19 cases. It has over 87,000 cases with 2,129 deaths and counting.

The story of one COVID decedent is a reminder of the incalculable losses from the pandemic.

Interviewed by NPR, two of Mukasa's colleagues remember him as not only an esteemed surgeon but a man who loved his family, students, surgical colleagues and his patients, for whom he did brain and spine surgeries.

Neurosurgery in Uganda has a short history. In the 1960s, only one neurosurgeon practiced in the entire country, with two Russian neurosurgeons briefly arriving in the 1970s and helping in Uganda until the 1990s. In 2007, a cohort of four Ugandan neurosurgeons completed training in other countries and started working together at the Mulago National Referral Hospital. Mukasa was one of them, just returned from training in China and Russia, along with fellow neurosurgeon Joel Kiryabwire.

"It was a very big blow. He was a pillar," says Kiryabwire of his colleague and dear friend. "He was very keen on getting things right" for everyone he knew.

Kiryabwire recollects that Mukasa was once called into the hospital for a surgical emergency when the roads were filled with roadblocks and security officers. Someone had been in a terrible accident, incurring a brain injury that might require surgery. Mukasa was especially skilled in trauma neurosurgery, which necessitates quick action, like removing blood or part of the skull to relieve pressure from the brain. On this day, cars stuck in traffic stretched ahead of him. Knowing that his precious window of time to reach a dying patient was closing, Mukasa promptly turned his car into opposing traffic with indicator lights to drive to the hospital. When he finally reached the hospital, the traffic delay meant it was too late to save the patient. And Mukasa spent several hours in prison for his driving infraction, says Kiryabwire: "He would go to that extreme ... to [try to] save this gentleman's life at the expense of his own."

Given how few neurosurgeons there are in Uganda, Mukasa was, in many ways, the glue that bound them together, says his colleague. He was instrumental in creating a strong training program during the transitional period from the 1970s to 1990s when the Russian neurosurgeons left. Passionate about education, Mukasa had built and sustained the resident training program purely as a volunteer. He and his colleagues trained seven of the country's small group of neurosurgeons. The Mulago Hospital where he worked also hosts a neurosurgery training camp each year in collaboration with Duke and Stanford Universities.

The quintessential people's person, Mukasa served as "master of ceremonies" at camp's farewell parties, says Kiryabwire, leading everyone in a fun celebration of their work together.

Juliet Sekabunga Nalwanga, the first female neurosurgeon in Uganda, was an intern in 2008 when she first met her mentor. She had already been working in other hospital departments, but Mukasa instilled confidence in her from the beginning, encouraging her to consider neurosurgery. She went on to have pediatric training in the field. Ever the stalwart supporter of his surgical trainees, "Mr. Mukasa actually always introduced us as equally senior to our patients," says Nalwanga, who was amazed that the physician showed such respect for his mentees. "It was such an encouragement [that meant] 'I trust this person and know her judgment will be great.' "

Both Nalwanga and Kiryabwire spoke of Mukasa as akin to a bridge between people. He'd be the one to drive to different towns throughout the country to personally invite fellow surgeons to the neurosurgical association. And he was the rare senior surgeon taking his trainees out to dinner downtown after a busy day of operating and teaching.

"He was a big person," says Kiryabwire, referring to Mukasa's spirit and heart. "[We] are still in a state of shock."

His many friends and admirers — and patients as well — joined in the tributes online:

Copyright 2021 NPR. To see more, visit https://www.npr.org.