Spotlight Interview with Dr. Godfrey Zari Rukundo  

“Many Ugandans have never seen a psychiatrist with their own eyes. Many couldn’t even recognize the word ‘psychiatrist’ by name.” – Dr. Rukundo

Location: Mbarara, Uganda

Bio: Dr. Godfrey Zari Rukundo is a Child and Adolescent Psychiatrist, Senior Lecturer, and Head of the Department of Psychiatry at Mbarara University of Science and Technology (MUST) in Uganda. He has been a member of the faculty at MUST since 2001. His research focuses on depression, suicide, child and adolescent mental health, and mental disorders secondary to general medical conditions. He has successfully supervised several research projects of doctoral, master’s, and undergraduate students at MUST and other institutions. Dr. Rukundo is a clinician with over 20 years of experience in different settings.

What does your day-to-day usually look like?

My day is usually quite complicated. I have to do so many things because of the understaffing we have in the department. I usually start my day at 6am and I first take the children to school. Around 7:30am I start my work. Sometimes I start with teaching or lecturing. On clinic days I will see my outpatient clinic patients. On some days I’ll attend administrative meetings. I usually don’t have enough time in the day to complete all the tasks I am required to do because the demands are many. I am able to work on my research in the evenings whether that is grant writing, research design, reading students’ proposals, research management or other research administrative items. I love being a psychiatrist and conducting research in this field. It aligns perfectly with the characteristics of my personality. This field is a challenge that I enjoy. My investigations are very intellectually stimulating, and I learn something new every day.

How did you begin your career in global mental health?

I knew I wanted to become a health worker during my second year of high school because I saw that I could help people with what they need the most – good health. At the time, I didn’t know what kind of doctor I wanted to become, but I just knew I needed to help people. In the fourth year of my medical training, I came across a patient having a mental breakdown. He was so distressed and had been through so much loss. We were able to treat him and after a few weeks he came back for a checkup. I couldn’t even recognize him when he walked in; He was wearing a proper suit and hat with a huge smile on his face. When I asked for his name he responded, “You know me! You treated me two weeks ago. Look at me now! Look at how I’ve improved.” I couldn’t believe he was the same man who had a breakdown only two weeks ago. It was amazing to see that our assistance helped him have a better quality of life. I realized this is where I am needed. During my intern year, I chose a position in psychiatry because I was able to treat patients who were neglected and felt hopeless. Later on, I decided it was important to support others who were training to go into psychiatry. That’s when I thought of teaching and training. I ended up writing a curriculum for the residency program. I have also wanted to work with children because they are innocent, and they mostly tell the truth. I have since been able to fulfill my dream now working in child and adolescent psychiatry.

Were there any obstacles you faced in medical training?

When I decided to pursue psychiatry, I went to my advisor who was an internist, and he was really against the idea. It was discouraging to hear him say that he didn’t think it was the right path for me. The field of mental health has so much stigma surrounding it. It really isn’t understood even amongst some of my colleagues in other fields. I think that’s what makes it even harder to enter the field since it is already judged from society. It is also a very underfunded field; funding is something you’ll always have to argue for. Lastly, it is extremely hard to properly diagnose patients with mental illnesses because it’s truly based upon history taking; you cannot simply use machines like CTs, MRIs, or EEGs to diagnose. It is on the doctor’s ability to read the patient well.

Although I faced many obstacles, the positives of being a psychiatrist will always outweigh the obstacles to get there. Every day I see people being restored. I see my patients being able to live productive, fulfilling lives, staying in work, keeping their marriages together. It is a beautifully rewarding field.

Can you describe the status of mental health in Uganda?

The field of mental health is just getting to be known. After the resistance in northern Uganda and now the pandemic, more people are experiencing for themselves and understanding why mental health is important. People don’t necessarily worry about the symptoms of a mental illness, but more so fear the stigma they will face from having a mental illness. Back when I first entered the field of psychiatry, we only had eight psychiatrists for the entire country. Today, we have 54 psychiatrists for a population of over 45 million people. However, most psychiatrists remain in the capital city and many rural towns don’t have any services for mental health. Many Ugandans have never seen a psychiatrist with their own eyes. Many cannot even recognize the word ‘psychiatrist’ by name. There are three psychiatrists in Mbarara employed by the University, even though the hospital serves about three million people. Many people with mental illness will go to church to pray for healing or look for traditional healers. Less than 1% of the government’s budget is allocated to mental health whether that be to services or research.

What do you hope to accomplish with your research this year?

I hope to reduce the stigma surround mental illness in Uganda and also increase mental health awareness. By doing more research, I hope we can convince the government to invest more resources and support in psychiatry. We want our people to have better access to mental health services. Currently, I am investigating suicide criminalization in Uganda. We want to decriminalize suicide because currently if an individual has thoughts of suicide they could be arrested. It is unjustified and that’s why we need to do something about it. We need to train other professionals and work with stakeholders to make this an issue that is talked about. If we are all addressing the same issue, then maybe we will be unavoidable. We want to create a platform for suicide decriminalization to change policy and practices. We are currently on the right track and are building up our reputation as researchers working on an important cause.

Any advice to youth who are interested in pursuing a career in this field? 

Firstly, it depends on where they are trained. If they are based in a low- or middle-income country (LMIC) and seeking a career in clinical psychiatry, I urge them to seek the non-financial benefits of helping. At the end of the day, the field of health is a profession of helping. I encourage them to work with others and build a reliable team. This work cannot be done alone. Stay committed to your foundations. Stay focused and bring energy to what you’re working on. Move steadily and work together.

Closing Thoughts

We are looking forward to future partnerships. We would love to work with a T32 Global Fellow. I met Dr. David Henderson and Dr. Gregory Fricchione around 2005 and have since had a wonderful partnership and commitment to supporting each other. I hope to continue building relationships and working together on important research.

 By Joanne Won, April 2022