By Dr. Muniini K. Mulera

 Dr. David Sengendo Sennoga, a Ugandan-born paediatrician, died in Durban, South Africa, last week. His life was claimed by an acute illness that he had valiantly fought for several weeks under the care of professional colleagues who continue to risk their lives to help fellow humans in this terrible global crisis. 

Dr. Sennoga was my classmate at Makerere Medical School. Together with many members of the Class of 1977 who continue to serve humanity in Uganda, Kenya, Tanzania, Botswana, South Africa, Nigeria, Australia, USA and Canada, we forged a siblings’ bond that endures. 

A group of us who are in almost daily communication via our class WhatsApp forum, were kept informed of our classmate’s struggle. However, news of his death hit us as though we were unprepared for it. Death is always shocking. 

My colleagues who have shared their reaction to Dr. Sennoga’s premature death - Dr.  Christina Mugwanya Kadama and Dr. Jane Nannono Kavuma-Kayonga in Kampala; Dr. Apollo Ikbo in Tororo; Dr. Crispus Tegu in Mbale; Professor Valentino Lema in Nairobi; Professor Thabiso Lebona in Pretoria; Dr. Dunstan Kibuuka Lumu in Johannesburg; Dr. Geoffrey Mukasa Mukwaya in Philadelphia; and Dr. Sam Mwesezi Kigongo in New York City - are deeply saddened. 

We have lost a brother, one whose distinguished career, achievements and well-earned accolades reflected the excellence of the men and women who gave us an outstanding education at Makerere.  

Dr. Sennoga had dedicated his post-specialization years to teaching paediatrics to younger colleagues and to caring for children and their families. He helped establish and led the paediatrics service at Netcare Kingsway Hospital in Durban, South Africa for many years. He was a very highly respected and loved paediatrician.  

Very many parents whose children benefitted from his professional excellence and obuntu (humaneness) have shared their thoughts and memories in written tributes.  Reading through nearly 1,000 messages on a Facebook Page dedicated to Dr. Sennoga, which was started on January 14 when the community learnt that he was critically ill, had me in tears and joy. My classmate fulfilled the constant exhortation of Professor Latimer K. Musoke: “it is about the child, remember?” 

The frequent words used to describe Dr. Sennoga in the Facebook posts include hero, legend, humble, awesome, gentleman, jovial, amazing, brilliant, treasure, hard-working, dedicated, kindest, listener, empathetic and selfless. 

Numerous parents wrote about his diagnostic excellence, his willingness to meet them at the hospital emergency room deep in the night, and his calm reassurance to incredulous parents that all would be well. Many called him the best doctor, and some judged him to be the best paediatrician in South Africa. 

The testimonials of the parents and some of his former patients showed that Dr. Sennoga tirelessly strove to achieve the ultimate goal of becoming “the complete paediatrician.”  This is a station that one does not reach simply because one has passed difficult specialist examinations and attained fancy titles after one’s name. The label consultant or professor does not a complete paediatrician make. 

There are certain attributes that form the foundation of excellent provision of health care to children. First, the paediatrician must put the child and their family at the centre of his practice. It must never be about the doctor’s interests but those of the child and the family.

Second, the paediatrician must look beyond the obvious. She does not see a child as “a case” or a set of interesting symptoms and signs that flag the presence of a disease. The child is a wholesome human being, not a diseased organ. 

To that end, the complete paediatrician combines traditional diagnostic tools such as thorough history-taking, physical examination, judicious tests through the laboratory and other modern technological tools, with an awareness and thorough understanding of the whole child. A child’s life is shaped and impacted by physical, mental, spiritual, social, economic, family, community, cultural and political factors.

Third, the paediatrician must be a good teacher, with skills for effective communication and listening to patients, families and colleagues. As always, a good teacher is an enthusiastic learner from patients, families, students and colleagues from all disciplines. 

Fourth, the complete paediatrician strives to maintain the high standards of the profession, consistent with the practical resources and other realities of the society in which she is serving. This includes a realistic appraisal of what can be safely and effectively done in one’s centre. The  non-negotiable principle of primum non nocere (above all do no harm) must apply at all times.

One of the essential strategies for maintaining high standards is constant reading of the latest evidence-based literature, participating in formal continuing medical education programs and, where possible, collaborating in clinical research and visiting other centres to see the world beyond one’s professional comfort zone. 

Fifth, the complete paediatrician engages in constant evaluation of self, of his practice, of the program and health care system in which he works. Yesterday’s successes and glowing testimonials by one’s patients, students and colleagues must not lull one into a state of overconfidence. 

Finally, the complete paediatrician must remain firmly rooted in his family, enjoying them and setting aside time to engage in self-care and restoration.  Pursuits of pleasurable hobbies and restorative time off work is an essential part of healthy living – even for the most hardworking doctor. 

The testimonials of parents, patients and his colleagues suggest that Dr. Sennoga actively lived towards these goals. Space does not allow us to quote the beautiful messages that were written before and after his death. Two encapsulate his legacy.

Taryn Lisa Andrew wrote: “Dr Sennoga changed my life. After 18 months of other doctors looking at me like I was a crazy person (sometimes even telling me so), I had given up on finding a paediatrician for my baby. I think fate intervened and led me to Dr Sennoga.  He was the only person that saw me, listened, understood and helped me.  I don't know where my family would be today if our paths had not crossed. My heart is truly broken.” 

Hlengiwe Hlabisa wrote: “My daughter is determined to be a doctor because of Dr. Sennoga. He was such a good doctor.”

To his wife Christine and their children,  heartfelt condolences from his medical school classmates. May the Lord’s presence among you help you to navigate through the deep pain of loss. May the good memories of David and the esteem in which he was held by those whom he served and lived with shine a bright light in the present darkness. 

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