A Survey of the prevalence of refractive errors among children in lower primary schools in Kampala district

Refractive errors are a known cause of visual impairment and may cause blindness worldwide. In children; refractive errors may prevent those afflicted from progressing with their studies. In Uganda; like in many developing countries; there is no established vision-screening programme for children on commencement of school; such that those with early onset of such errors will have many years of poor vision. Over all; there is limited information on refractive errors among children in Africa. Objective: To determine the prevalence of refractive errors among school children attending lower primary in Kampala district; the frequency ofthe various types of refractive errors; and their relationship to sexuality and ethnicity. Design: A cross-sectional descriptive study. Setting: Kampala District; Uganda. Patients: A total of 623 children aged between 6 and 9 years had a visual acuity testing done at school using the same protocol; of these 301 (48.3) were boys and 322 (51.7) girls. Results: Seventy-three children had a significant refractive error of +-0.50 or worse in one or both eyes; giving a prevalence of 11.6and the commonest single refractive error was astigmatism which accounted for 52of all errors. This was followed by hypermetropia; and myopia was the least common. Conclusion: Significant refractive errors occur among primary school children aged 6 to 9 years at a prevalence of approaximately 12. Therefore; there is need to have regular and simple vision testing in primary school children at least at the commencement of school so as to defect those who may suffer from these disabilities

Sexual Misconduct in the Practice of Medicine

There is a long-standing consensus within the medical profession that sexual contact or sexual relations between doctors and patients are unethical. Current ethical thought uniformly condemns sexual relations between patients and doctors. The ban on doctor-patient sexual contact is based on the recognition that such contact jeopardises patients' medical care. A number of studies in the Western World have tried to establish the incidence of doctor-patient sexual contact. Much of the research done on the prevalence of doctor-patient sexual contact is based on studies that survey doctors about their own behaviour. The general stigma attached to sexual contact with patients and the professional repercurssions that many researchers to beleive that the occurrence of patient-doctor sexual contact is under-reported. One the local scene no study has ever been conducted on the subject; however; an ecdotal tales reveal that the problem exists. Available studies from eleswhere show that between 5and 10of doctors engage in sexual contact with patients

Partnership Replaces Paternalism in Medical Practice

"The belief and practice that doctors know best what is good and suited for their patients is deeply rooted among practicing doctors in Uganda. It is benign; and may be well intentioned; but it has had the effect of creating and maintaining an unhealthy dependency which is now out of step with currents elsewhere or even with out currents in Uganda. Assumptions that doctor; nurse or midwife knows best; making all decisions on behalf of patients without involving them; and feeling threatened or offended when patients ask questions or make suggestions - these signs of patermilism should have no place in modern health care. In this article I consider the scope for creating meaningful partnership between doctors and patients. ""Paternalism"" has no further part to play in health care delivery now; and most countries have embraced or are embracing ""partnership""; which is known to greatly increase patients satisfaction and compliance; and also increases the rate of recovery from their illnesses."