Suubi Trust

From New Vision

The people of Kiwoko were really concerned. They had been promised a muzungu (white) doctor. But it looked like they had instead been sent a carpenter.

At least that is the impression they had got, after several days of observing Dr. Ian Clarke at work.

Since his arrival, the Irish doctor had been busy with hammer and saw, converting packing boxes and other wooden odds and ends into furniture for his new home.

What the local people could not understand was why a whole doctor had to take on the mundane task of making his furniture, when he could just have called in a carpenter. Later, when he put on an apron to wash dishes, the locals decided they had had enough.

A local elder took the doctor aside and suggested that for the sake of cultural decency, he should do the dish washing behind drawn curtains.

That was 1988.

Eighteen years later, very little has changed in Dr. Clarke’s modus operandi.

The Chief Executive Officer (CEO) of International Hospital Kampala (IHK), which won last year’s Uganda Investment Authority (UIA) investor of the year silver award, can sometimes be found nimbly climbing the scaffolds of the hospital building, part of which is still under construction, to assess the quality of workmanship.

Although the sign in the parking slot reserved for him at the hospital reads CEO, his employees refer to him as omusawo muganda (traditional healer) behind his back of course. Like a typical traditional healer, Dr. Clarke tends to be a jack-of-all-trades, who often has to use unorthodox methods to get things moving. And yes, he has a lot to move.

When he is not doing the ward rounds or sorting out administrative issues with his top managers, he is up on the scaffolds giving builders tips on how to economise on materials without compromising the quality of work.

He then heads for the workshops behind the hospital building where most of the construction material used on the building is made. It is also here that the furniture and most of the equipment used in the hospital is fabricated. He needs to know how the various artisans are fairing.

Come to think of it, Dr. Clarke’s office seat must be the most underutilised piece of furniture in the hospital. The doctor is a man who thinks on his feet; he is permanently on the move. “I have a low boredom threshold. I cannot keep on one thing for too long,” he admits.

Part of the interview with the Sunday Vision has to be conducted up on the scaffolds of the new hospital wing, still under construction. The reporter must see the ongoing work, not just be told about it.

Once up on the scaffolds however, the interview becomes one sided. The doctor turns around and makes a quick diagnosis; the reporter suffers from height phobia. The tour has to be cut short.

If you work at IHK, you don’t need to go to the gym. The running around you do is enough to keep you fit. Everyone looks busy, especially the medical staff. With a boss like Dr. Clarke, there is simply no room for foot dragging.

To keep up with his pace, the staff often have to trot between workstations. In a society where professionals proudly declare their ignorance about anything outside their field of specialisation,

Clarke sometimes comes across as a meddling busy body who someone should do a favour by dropping a concrete block on his foot, to slow him a bit.

But then, it is highly unlikely that Clarke would have started Kiwoko Hospital in Luweero and later International Hospital Kampala; two of the best hospitals in the country, if he had stuck to the traditional belief that the doctor’s place is strictly in the operating theatre.

To start off Kiwoko Hospital and to keep it going, the doctor had to do a few unorthodox things that they didn’t teach him while he was in medical school.

Like converting a church vestry into an examination room; enlisting the local lay preacher as medical assistant, equipping a laboratory with Blue Band containers, demolishing abandoned homes for building material, ferrying timber on his head, mining sand from a swamp and passing bricks at the construction site.

Improvising is something Clarke has been doing since the age of nine, when he became head of his family, after his father passed away.

As the eldest boy, Clarke had to look after his mother and three siblings, run the family poultry farm and at the same time continue with his studies.

“For 16 years I had to look after the farm; feeding the chicken, driving the tractor and keeping records. It taught me to be practical, to think on my feet. I am quick at making decisions and taking action,” the doctor recalls his childhood, which shaped him into the practical adult he is today.

Like many other decisions he has made, the decision to exchange a successful medical career and a middle class lifestyle in Ireland for a precarious career as a mission doctor among peasants who were still struggling to recover from a five-year civil war was made on a spur of a moment.

On learning about the appalling health situation in post-war Uganda, through his local church, he decided to join a group of church members who were visiting the country to assess the situation.

A flight later, as he stood on the roof of a concrete shell of a looted house, surveying the devastation around him, Clarke decided there and then, to do something about the suffering the people of Luweero were going through.

Not even the social and financial implications of removing his family from their comfortable home in Ireland, to the Spartan conditions in Luweero would deter him from what he believed to be his true calling.

Accompanied by his wife Roberta (Robby) and three pre-teenage children Sean, Michela and Lauren, Dr. Ian Clarke headed for Luweero, to embark on what initially looked like a “lunatic express” project.

“The need here is appalling. Everywhere you turn there is squalor, poverty, dirt and disease,” Clarke made a quick assessment of the situation soon after setting up the first tree shade “clinic” in Luweero.

Then it rained, and the tree shade clinic had to be relocated to the Church, where the vestry was used as the examination room.

Over a period of five years, operating on a shoestring budget that often reminded him of the biblical widow’s oil jar that had just enough for the next meal, in his case provided by friends and wellwishers, Clarke struggled to turn the tree shade clinic into a fully-fledged hospital, with several wards, a modern laboratory, operating theatres and a training school for nurses.

However, just when things were beginning to look up, disaster struck, Clarke was diagnosed with what was suspected to be cancer and had to immediately fly back to Ireland for further investigations and treatment.

“Kiwoko had been my life, I loved the people and it was my home. It had grown up from nothing to a fully equipped hospital,” confesses the doctor in his book, The man with the key is gone.

Clarke recalls the feelings he had, as he waited for the final diagnosis. “I felt as if I had been driving down the avenue of life, turned the corner and suddenly found that the avenue, which I had expected to be on for many years still, had become a dead end.”

The final diagnosis contained both good and bad news. “The bad news was that Clarke had testicular cancer, which had spread to the lungs. The good news was that it was treatable.”

The treatment was harsh; the then 40-year-old doctor emerged out of it looking like a cross between an Aids and a famine victim.

But looks didn’t matter. What did was the fact that he had been given a new lease of life, and since he had no idea how long it would last, Clarke intended to make the most of it. That might partially explain why he does everything on the trot. Back in Uganda in 1996, Clarke set up the International Medical Centre (IMC) on KPC building, and followed up three years later with International Hospital Kampala (IHK) initially based at Old Kampala, before moving to the present site in Namuwongo.

Today he employs 400 people at the hospital and the satellite clinics, plus another 100 who are involved in construction work at the hospital.

One thing you will immediately notice when you go to IHK is that most of the staff are young people, probably working at their first job after school and most of them are ladies. Clarke strongly believes in hiring young people straight out of school. “They are still willing to learn and chances of molding them into what you want are higher,” he explains.

That is one of the reasons he started a nursing school in Kiwoko and more recently another in Old Kampala, and is planning to set up a medical school attached to the hospital.

As far as Clarke is concerned, the problem with the education system in Uganda is that it encourages cramming, instead of training people to be problem solvers. “Professionals in Uganda are very poor at improvising and are not very good problem solvers,” he says.

He wants to change that situation, at least in the medical field. “We employ young nurses straight out of school, teach them procedure and then give them targets to meet,” he says.

But most important, he wants to instil in them the work ethic that seems to be in short supply in Uganda. “The work ethic never evolved. Some people just exist to talk. They think talking is as good as doing. That is why they love gossip,” he adds.

But on the other hand, Clarke believes that when handled properly and when the conditions are right Ugandans can actually do some serious work.

“There are many good artisans, their only problem is finishing and being precise in their work,” he says, referring to the local artisans who make the beds and other equipment in the hospital’s metal and carpentry workshops.

He also gives the example of those Ugandans who go abroad for kyeyo after failing at home, and in the end make it big.

As the CEO, Clarke believes his role is to make conditions conducive for his employees, not to just sit back and play big boss.

“My role is to facilitate and motivate them. I need to make sure that they have the right equipment and a conducive working environment. I am here to serve them, not them to serve me,” he outlines what he believes to be his obligations to his employees, vowing not to fall victim to the “I have arrived” disease which afflicts most Ugandan top managers.

Although he drives a “powerful car”, lives in an exclusive neighbourhood and enjoys a busy social life, Clarke still misses Kiwoko where he had to gallop around the village paths in a Suzuki Samurai, and where social life revolved around attending church and funerals.

“The stresses I have to go through here are far worse than what I used to go through in Kiwoko,” he says.

There are more patients to see, but that is not the worst bit. As the CEO, he has to deal with issues like taxes, sabotage and back stabbing by business rivals and getting sued by patients, something that would never happen in Kiwoko.

“You need a thick skin to survive. You come with good intentions, then you are misunderstood,” he laments.

Of course there has been a lot of speculation about the source of funding for IHK, which seems to have sprouted overnight, with allegations that Clarke is just a front for the first family.

“People forget I have been in Uganda for almost 20 years. During all that time I have been working hard and saving. Of course I have also taken bank loans, which have to be paid back,” he says.

Currently he is wooing the corporate world to help fund Hope Ward, a new ward where patients from disadvantaged backgrounds, especially in the war torn north, are treated free of charge.

As far as Clarke is concerned, the health sector in Uganda has tremendous potential. “It is possible to start from a tree shade clinic and end up with a hospital like IHK,” he says, referring to his experience and adds that it all takes discipline and focus.

What frustrates him is the negative attitude towards his efforts to make a difference in the health sector. “You come with good intentions to offer a service, but people think you are out to make money. What they don’t realise is that the money is actually being re-invested to improve the services. I could be taking that money away,” he says.

In spite of the frustrations and the stress, Clarke feels he is in the right profession.

“I always wanted to get involved in a profession that affects people. I get a lot of pleasure from watching people develop and patients recover. It balances the stress,” he concludes.