Intended for healthcare professionals


Wasting time with people

BMJ 2004; 328 doi: (Published 24 June 2004) Cite this as: BMJ 2004;328:1573
  1. Simon Challand, medical adviser (
  1. Kasese, Uganda

    “Waste time with people,” advised the African bishop with a smile. “You Europeans are always concerned about projects and budgets. The African does not worry about them—just waste time with people.” He gave me this advice in 1996 shortly before I came out to work in Uganda. Since then his words have kept coming back to me, and I reflect on their truth and wisdom and how difficult it has been for me, as someone with European values and attitudes, to apply them.

    I supervise eight rural health centres in the west of Uganda, scattered among the foothills of the Rwenzori mountains. I love driving out on winding dirt tracks, past steep fields planted with cassava and coffee, and dodging the ubiquitous goats, to an isolated health centre run by two or three nurses and community health workers, a centre with few drugs but many patients. The dedication and perseverance of the staff are a real inspiration to me.

    Health centres in Uganda, even those built and …

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