Cadavers scared the hell out of me

He had this uncle, a clinical officer, who was always treating the entire family before reporting to the hospital. That was how Dr Bernard Wambulwa, was inspired into medicine.

"My mother would not take us to the hospital when we got sick," says the infectious disease pharmacist.

"We would be taken to my uncle's home and he would treat us, either by prescribing drugs and would only refer us to the hospital if it was a serious matter. So I grew up in awe of him and wanted to be like him."

Dr Wambulwa, currently the County Pharmacist in Kakamega specialising on antimicrobial resistance, was often the best pupil in his class. And since he excelled in sciences, his cousins, some of whom were in medicine, kept urging him to follow suit.

This dream became a reality when he joined the University of Nairobi for his Bachelor's degree in Pharmacy in 2005. But too much class work in First Year made him almost begin doubting his choice.

"Life in the university was difficult; I started asking myself, did I really make the right decision? Everything was different from high school because the lecturers did not care whether you wrote the notes or not, whether you had understood or not and by the time we were done with class work, there would be assignments waiting. It was hectic," he recalls, laughing.

Then there was the time he was exposed to cadavers in human anatomy class which reaffirmed his decision to choose pharmacy. He could not wait to be done with anatomy classes in Second Year.

Dr Wambulwa proceeded for his internship at Machakos Level 5 Hospital, laboratory internship doing quality control at a pharmaceutical manufacturing firm at the Industrial Area in Nairobi before proceeding to work in Kakamega County as County Pharmacist.

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Machakos Level 5 Hospital. [Wilberforce Okwiri, Standard]

He had handled many patients suffering Sexually Transmitted Diseases (STIs) and HIV and that, coupled with the emergence of antimicrobial resistance, saw him developing an interest in infectious diseases.

And so it was that Dr Wambulwa joined the Institute of Tropical and Infectious Disease at the University of Nairobi for his Master's degree in 2015.

"There are few doctors specialising in infectious diseases; I chose this particular course because I had noted the gap and you can even tell they are few from the number of institutions offering such a course," he adds.

In addition to infectious disease, Dr Wambulwa has been the focal person in antimicrobial resistance in the Western region particularly in Kakamega where he has been working on two research projects on antimicrobial resistance surveillance and the rational use of antibiotics.

"Currently, we are recording antimicrobial resistance and if we don't use the antibiotics rationally, it means we may not have more drugs to use," he explains.

"That is why we have been creating awareness on antimicrobial resistance and ensure the health workers and the general public adhere to prevention and control of diseases through sanitation, by washing hands thoroughly, and for the medics to use equipment that protect them from acquiring and spreading pathogens with the resistant-genes," expounds the expert.

Antimicrobial resistance happens when pathogens like bacteria, fungi and viruses (with a special focus on bacteria), no longer respond to drugs that are being administered for treatment or prophylaxis; requiring that a medic gives a higher dose, multiple drugs or use second and third-line agents for the bacteria to respond, according to experts.

Antimicrobial resistance is a threat because such a patient will be managed by expensive drugs, or toxic drugs or drugs that will be used for a longer period and this may also translate to patients staying longer at the hospital.

The World Health Organisation (WHO) has five priority pathogens which have been ear-marked to be very dangerous: Staphylococcus Aureus, Pseudomonas Aeruginosa, Clostridioides Difficile, Clarithromycin-resistant Helicobacter Pylori and Carbapenem-resistant Acinetobacter Baumannii.

In his research, Dr Wambulwa has been getting samples from patients, grows the bacteria culture and subjects it to a number of drugs to see if it is resistant or not.

Dr Wambulwa Benard with a Cuban entomologist mapping mosquito breeding sites at Ahero rice farms. [File, Standard]

If resistant, the same is further sent to another lab in South Africa that conducts genomic sequencing to determine the particular gene causing the resistance.

"The main reason for all these is to establish the particular bacteria causing resistance to determine the right kind of treatment for the patient and also to make decisions on how to prevent further spread of the highly resistant pathogen," explains the researcher.

Dr Wambulwa is glad he's practicing what he studied in microbiology genetics and molecular biology.

He notes that drug resistant bacteria causes pneumonia, urinary tract infections, and blood stream infections, which may require patients to be admitted at the hospital.

Away from work, Dr Wambulwa loves spending time with his family; watching soccer, road trips across the country.

"I enjoy working and living here in the county because unlike the urban areas, the cost of living is not so high, although for those that want to get extra work as consultants, we do not have as many opportunities as those living in the urban cities," adds Dr Wambulwa.