"AMR killed my father. There's no question about that."

November 2024: Antimicrobial resistance (AMR) could cause 10 million deaths annually, with over 90% of these expected to occur in Africa and Asia.

Stephen Aupal, a microbiologist at Lira Regional Referral Hospital in Uganda and a Fleming Fund Fellow at the University, understands this devastating reality.

The loss of his father earlier this year to a resistant infection fueled his passion to combat AMR, inspiring him to become a fellow. Here he shares the deeply personal story that sparked his journey.

A devoted dad

My father served as a soldier for 15 years before retiring and becoming a farmer in our local village. About ten years ago, he contracted HIV and started treatment immediately.

He was incredibly disciplined about taking his medication and became what they called an "expert client"—someone who not only took care of themselves but encouraged others in denial to start treatment too.

He didn’t stop there. He helped people in our community who couldn’t travel to get their HIV medication, making sure they got what they needed. He was dedicated to helping others.

Stephen Aupal's father Akol Robert Ali, during his time as a soldier.

Called back to duty

In 2022, the Ugandan army called him back for refresher training, asking retirees to serve in Somalia. I was really worried. I told him, "You’re getting older, and you're not in the best health. Please don’t go." But he felt it was his duty as a soldier.

After three months, I got a call that he wasn’t well. He was admitted to the hospital for three days, discharged and I continued caring for him. Despite this, he returned to his soldier training.

He came back home in December 2023 for Christmas and I could see he had deteriorated. He told me the conditions were bad—poor food, no water. It was taking a toll on his health.

I asked him to stay home and continue farming but he wouldn’t. He felt he had a mission to complete, to go to Somalia.

The shocking diagnosis

By January this year, his health got even worse. He called me from camp and told me things were bad.

He was in so much pain, especially on the right side near his liver, that he couldn’t move. I took him to the hospital where I work for further tests—an ultrasound, blood work and liver function tests.

The results were devastating. They found a tumour on his liver and diagnosed him with hepatitis C, the most aggressive type. As a medical professional myself, I knew how serious this was. It hit me—I couldn’t focus at work and everything felt like it was falling apart.

In February 2024, the doctors confirmed it was stage one cancer. I struggled with whether to tell him. He had so many plans for the next five years and I knew this news would obliterate him.

I couldn’t bring myself to tell him right away but eventually we had to face it together. Even with the stage one diagnosis, we thought we had more time.

But his condition worsened. His temperature was so high that he couldn’t sleep and the pain was unbearable—he was given morphine. A blood transfusion followed, but that didn’t help. Then, he caught an infection in the hospital and things spiralled.

"I wanted to save him"

The doctors ran more tests and found he had an antibiotic-resistant (AMR) infection. Nothing seemed to work. Watching him on oxygen, being fed through a tube, was awful. It made me realise we were fighting AMR head-on.

I wanted to save him. So much so I bought a drug that cost 2 million Ugandan shillings (about £422). But he had a bad reaction and we had to stop using it. I didn’t give up though. I drove 250 kilometres, searching for platelet-rich blood that could help him. I thought this might be his last chance.

But before I could return from my trip, before I could say goodbye, he passed away. It was 8 pm on 11 March 2024. My mum broke the news to me. She told me they appreciated all the efforts I made to try and save him but he had taken his last breath.

I broke down. I was so close to him and I didn’t get to say goodbye. AMR robbed me of that. It’s hard to accept. With stage one cancer, we thought we had years left, but AMR sped everything up. It weakened him until there was nothing more we could do.

Now, I’ve stepped into his role, looking after all of his eleven children. The youngest is only six years old, and they were incredibly close. It’s been a heavy burden, but I’m doing my best to honour him and keep the family going.

"AMR killed my father. There’s no question about that."

On the day we buried him, I received an email about the Fleming Fund Fellowship for AMR.

I didn’t even wait to see my father being lowered into the ground—I knew this was something I was meant to pursue. So, I stepped aside and made a call immediately, asking how I could apply to become a fellow.

In our culture, when you bury a family member, you stay with your loved ones. You don’t leave. But this opportunity was too important. I told my mum, “We’ve buried dad, he’s at peace, and I have a mission to fulfil. If I don’t act now, I’ll lose the chance.”

"The fellowship has renewed my energy"

When I went for the fellowship interview, I spoke from the heart, my dad on my mind the whole time.

Finding out I had been selected gave me a sense of peace, even as I grieved. The fellowship has renewed my energy and given me a clear purpose. It’s an opportunity to fight against AMR, both globally and nationally, all in memory of my father.

When he passed away, I vowed to do whatever it takes to face drug resistance head-on. And now, that’s exactly what I intend to do.