I have come to Kijabe, Kenya with the help of the Hope Through Healing Hands with the goal of training local providers in the OR and ICU. My first days in Kenya have been uplifting. The people here are kind, thoughtful, and show great appreciation for any expertise we have been able to provide them with in the operating rooms – or “operating theatres,” as is the common vernacular here. I have been surprised at the case volume, severity, and complexity of the system here at AIC Kijabe Hospital. Its patients are mostly Kenyans from the countryside who have no other options for care – indeed some patients are brought from other ‘hospitals’ that have withheld necessary care for an inability of the patients’ families to pay up front. I will always remember caring for an elderly gentleman who had severe esophageal bleeding, brought in from an outside site for upper GI endoscopy. I was first presented with concerns from a student nurse anesthetist who saw something concerning on the ECG monitor (they are largely untrained on this at this point). Indeed, there were clearly signs of heart ischemia. I inquired more about the patient’s clinical history, and learned that he was severely anemic – to a point we don’t often see in the U.S. We chose to go on with the procedure with some light sedation to identify and stop any further bleeding. We got him through his procedure safely, were able to get him a blood transfusion, and really did a good job in caring for him. This scenario was just something you don’t see to this degree in the U.S. and was an incredible learning experience for me, even as I used the skills learned in residency to help train the providers here to the best of my ability.
Interacting with the Kenyan nurse anesthetist students here has been very rewarding. They are capable, inquisitive, and very hard working people. After having a formal didactic teaching session on diabetes and its anesthetic care concerns, the ability of these students to assimilate the information presented and to end with challenging, relevant questions to the practice they have seen in training was impressive. They are well studied with the limited resources they have, perhaps most apparent when I instruct them on conducting peripheral nerve blocks. They are familiar with the textbook descriptions of these procedures and nerves involved in particular blocks, even though many of them have never even seen one of these blocks performed. It is clear that they have a strong desire to learn medicine to properly care for patients.
My first week here has been incredible. I will be taking my first ICU call this weekend and look forward to the challenge as well as the teaching of Kenyan medical residents. I have no doubt we are making a real impact on both providers and patients.