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Originally published December 16, 2012 at 6:00 PM | Page modified December 16, 2012 at 7:22 PM

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Ugandan doctor helping reshape cancer care there

Jackson Orem gave up the potential for a lucrative practice in the U.S. in order to return home to Uganda, where as the country's only cancer doctor he saw 10,000 patients a year. Now he's at the forefront of improving and expanding cancer care there.

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When Jackson Orem was 8 years old, the young Ugandan went with his mother to visit a relative in the hospital. It took a long time for a doctor to show up.

That's when Orem decided there weren't enough doctors in his country, and that he would be one when he grew up.

Meanwhile he worked beside his mother in the fields, and his father worked as a driver and salesman to pay for his son's secondary schooling. University education was free so long as he passed the exams.

Orem's parents insisted he stay in school during the fighting and murders that came with the brutal reign of dictator Idi Amin. Orem graduated from medical school and trained under a legendary, demanding mentor. In 2002, he traveled from Uganda to Ohio to study oncology at Case Western Reserve University.

Many foreign doctors who train in the U.S. remain. They have access to the sort of sophisticated medical equipment and pharmaceuticals that they trained on, and they can draw a far higher salary than back home.

Orem went back to Uganda.

"I would have made a lot of money," he says. "But when you come from a background like mine, you look at things differently. There was need for my expertise back here in Uganda."

When he returned in 2004, he learned just what he was getting into — a solo stint as the only cancer doctor in a country of 26 million people.

The two other oncologists had retired or moved on.

Orem is a quiet, unassuming man, but he admits "it was really very, very demanding." From 2004 to 2008, he saw up to 10,000 cancer patients a year — most of whom didn't come in until they were in the final stages. Much of what he did was palliative care.

What kept him going?

"I'm a very optimistic person," he says. "I tend to see possibilities in areas people may neglect. That's how my life is structured."

In 2004, he began working with Dr. Corey Casper and others from the Fred Hutchinson Cancer Research Center.

Orem, says Casper, is "quiet, erudite, pious, and exceptionally committed."

Orem started with a bunch of dilapidated structures and a few trained staff. Now two new buildings are going up, a pharmacy is coming in, and there's a strategic plan for the future. That's "nothing short of awesome," Casper says.

In the last few years, things have gotten a little easier for Orem. He's got five young doctors trained by "The Hutch" who are caring for patients and doing research projects.

Orem has time now for other things — he's working on getting a doctoral degree in cancer care, developing ideas for a national cancer-control program, lobbying the Ministry of Health, and raising funds for the Uganda Cancer Institute.

And when he has time, he still does what he most enjoys — he sees patients.

— Joanne Silberner

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