Richard Feinmann on volunteering after retirement

Richard Feinmann What to do when you are a sexagenarian physician who has retired from hospital practice with 40 years in the NHS under your belt and golf/Sudoku not really appealing? Well, my health visitor wife and I applied to Voluntary Service Overseas (VSO) and I am writing this from a hospital in Kampala, Uganda, where I have been working for five months.

VSO did seem to want us and so long as your health is good, age is not a bar; the average age of volunteers is climbing all the time. So, off to Uganda and although it was hard adjusting to a huge change of lifestyle and temperature I recommend it. It’s great to be blissfully unaware of crashing stock markets and to be in a continent where everyone thinks Obama is their president too.

I really believe VSO and Africa do need doctors of my age. 30+ years of general and chest medicine gives experience which is so useful to hospitals in Uganda who aspire to provide quality care. I can treat and manage TB which is useful and I am fast becoming expert in HIV, but Uganda needs experienced generalists. Senior doctors who can make decisions (usually right ones), can’t operate but know when you need a surgeon, can reasonably confidently manage sick kids, teach and mentor and bring management skills both clinical and general, are certainly needed.

My ward is a charity ward in a private hospital, so I’m lucky to have good facilities, good nurses and doctors and a clean hospital. The patients are destitute and come from all over Uganda and they are very sick. I don’t think we’ve had a CD4 count over 10, and the TB presentations are extraordinary, not to mention extra pulmonary. This is a country where 58% of the population of 30 million is under 18, yet abortions are illegal, where the government hospitals are understaffed and oversubscribed. Even in government hospitals health care is not free. Life expectancy is under 50 and HIV may affect 10% of the population with half having TB. Uganda is a member of “the bottom billion club” and the sad stories of patients selling their HIV drugs to buy food are all too true.

Many of my patients are babies or young people. It’s very different to the average age of a UK medical ward. They mostly have HIV with complications, but they are remarkably resilient. Rehydrate, feed them with naso gastric porridge (works wonders), restart their TB and HIV treatment and they seem to get better even though they look at deaths door on admission. Initially as an adult physician I was scared stiff of managing the babies and although many still cry when I pick them up (I’m told it’s my white skin!), we seem to manage.

I’m really busy, and my range is from pneumocystis pneumonia (PCP) in a 9 month old to myasthenia gravis in an 82 year old…both survived!! Of course there are lots of lows, and you have to keep reminding yourself you can’t cure all of Africa. I get really tired because it’s hot and humid with unfriendly mosquitoes, but I think I’m making a difference. A year might be enough but we’d do it again.

It’s good to go with your wife and support each other through the ups and downs. She’s working with the National Community of Women Living with AIDS (NACWOLA), an organisation staffed by dedicated women many with HIV and giving help to women and children with the disease. Her role is to develop child protection policies and a youth strategy.

HIV has wiped out many parents and it’s elderly grandmas who often bring up the children. We are socially very busy both with locals and other volunteers. We have just been to our third wedding out here!

Winston Churchill called Uganda the ”Pearl of Africa” and it is a beautiful country with lovely friendly people. Its only blemish is appalling roads and heavy smelly traffic in Kampala.

So, that’s it, I am a physician, paediatrician, house surgeon, TB and HIV specialist and a fundraiser. I teach, do appraisals and appointments, go to hospital meetings and have good friendly colleagues. Patients are universally grateful, even when I get it wrong, and I’m not being complained about or sued.

Come on you bulge-baby doctors…Africa needs you.

Richard Feinmann is a 62 year old general and chest physician who retired a bit early after a serious health scare. He felt he had more to give and jumped at the chance to work with his health visitor wife in Uganda.

  • Congrats Richard. Why not keep in touch. I’m not far away from where you are. (64). How ’bout short stays to help out? My wife and i adopted a 4 yr old from China so time becomes the issue. Congrats again. tom

  • Gert van den Berg

    Dear colleague,

    I was glad to read your letter about working in Uganda as a doctor with a lot of experience in the UK.
    Glad, as you write you like the change and your wife seems to like it as well. Glad, as the work in a hospital ward in Uganda seems worth while. Glad, that I’m not the only one considering such a change of work.
    I am a general practitioner in Holland; I decided some time ago I would leave the Netherlands when I am 59 (in 2012) and go back to Africa, where I worked before for eight years. I will spend my next years partly in the ER, the OT and the Maternity. In the Netherlands one can do a training in surgery, obstetrics and tropical medicine before going to Africa, while progress is measured by a committee; Following the scheme will result in a cetificate.
    I agree we may do very useful work in Africa, for our patients there, and moreover something very interesting and enjoyable for ourselves.
    I hope more colleagues will follow your example.
    I wish you many more good years in Africa.

    with kind greetings,

    Gert van den Berg

  • Rupert Gude

    Hi Richard,
    I too am a 62 year old retread who is working with VSO not too far distant.
    I moved on from General Practice aged 60 and am now near Bukoba, north Tanzania working mainly in HIV opd and my wife is working here too.
    I cannot add anything to your excellent blog. It certainly opens ones eyes to a differet way of looking at the world.
    If you want to come down here for a break please contact via
    Rupert and Annie Gude

  • Rupert Gude

    to BMJ blogs

    oops wrong email address on previous one

  • pat naidoo

    congrats Richard. good on you and what a fantastic effort.
    almost 60 myself and doing some work in east timor. the smile on the faces of those u treat make up for the many lows. keep safe and good luck. pat naidoo

  • Rupert Gude

    Hi Richard,
    Sun has obviously gone to my head.
    Email in response was correct, not the one to bmj editors!!
    Keep up the good work and I do encourage those who want to meet a challenge to give it a go.
    best wishes

  • eman

    hi sir,
    an energetic challenge man of sixty like you make the spirit of sixty asthe thirty i am really happy to know a man giver like you go on and continue
    eman immunologist quality improvement fever hospital egypt

  • steve leveson

    Hi Dick
    How are you, am organising a reunion for next yr hope you can make it. Am in Rwanda/Uganda for 2weeks early Dec. Prehaps we can meet up.

  • Hilary Thornton nee Thompson

    It looks to me as if you are the Richard Feinmann who lived in Osborne Ave and went to RGS. i was very interested to come across your account of your recent work! While I know quite a lot from that would be good to hear from you.