After the events reported in last week’s The SteffeScope, I traveled to Maua Methodist hospital in central Kenya. We traveled north around Mt. Kenya six hours to get there. Later in the week, I would go south around Mt. Kenya to return to the Kijabe Hospital via Chogoria. Neither time would the clouds permit me a glimpse of the snow-covered top. Maua Hospital founded in 1928 by Methodist missionaries and like all such hospitals has largely lost its formal mission agency support. There remains only a single British missionary family practitioner in her 60s who was away on business for the hospital, so I didn’t get to meet her (Claire Smithson). I traveled there with Dr. Jon Fielder, the CEO of the African Mission Healthcare Foundation, who is presently trying to build the hospital back up. I knew Jon from their support of PAACS and a previous visit to him in Lilongwe, Malawi. He is doing a fantastic job supporting lots of projects in many smaller mission hospitals across eastern Africa.
Tony Mwenyemali, who is graduating from Mbingo Baptist Hospital in Cameroon this year after five years of financial support from the AMHC for his training, is going to be the surgeon there soon. There is a superannuated Kenyan general surgeon there who will retire in a year. I came to see the hospital and to see whether it would be a site for future surgical rotations and placement of other surgeons. I hoped to influence the thinking of the administration and bias them a bit toward the need for two or three surgeons there in the future. Three of our present trainees have done rotations there in the past.
The biggest need in almost every hospital I have ever visited in Africa is not more medical practitioners – as much as they are needed. The greatest need is competent administrative and financial decision making. That is the problem at Maua as well – they are just squeaking by. There is hope that a North American physician and administrator will come in the next few months – he is experienced in Africa and has turned around some other places.
The hospital has some potential surgically and I hope with the new surgeon, things will turn around a bit. The chief medical officer, surgeon and matron (head nurse) as well as Dr. Fielder listened intently to some thoughts I had on various topics and I hope that some changes will be made to improve the hospital a bit.
Next, we drove two and a half hours to Chogoria. Founded about the same time as the Maua Hospital but by Scottish Presbyterians, this 350 bed hospital has none of the original missionaries left. Last October, a family practitioner under the World Gospel Mission (same as Tenwek) by the name of Jim Ritchey moved there with plans to begin family practice training. He is retired from the Navy and has become a great friend and mentor of our recent PAACS graduate from Tenwek, Dr. Elijah Mwaura.
Elijah is already making a great impact on the hospital. There was another Kenya surgeon there who worked with Elijah a short while, but then he took annual leave and then took permanent leave. I was told it was because Elijah had outshone him. Don’t know if that is true.
Elijah is the only surgeon and I was there to again see about surgical rotations from Tenwek and Kijabe and to see about how best to recruit a PAACS graduate to join him. There is a Kenyan surgeon in training who is to come in October. He managed to cram four years of training into seven so I am a little concerned about his abilities but it will certainly help Elijah if he stays and is a safe and competent surgeon.
I had left some refurbished instruments in Maua for Dr. Mwenyemali’s use and I was able to give a complete tray to Elijah. He was very thrilled with them. However, he continues to need some specific things that are pricy – a SIGN nail set (to fix broken extremities), a self-retaining retractor set and a powered dermatome and mesher (for skin-grafts). It would probably take $20,000 or more to get all four items. As I think about it, they are probably needed at almost all of the sites where our graduates go.
While I was there with him, an auto accident victim came in with a torn intestine and a torn blood supply to the intestine (2 places) and it was a pleasure to watch him competently save this man from a death of hemorrhage and infection. It was a good affirmation of the role of PAACS and its graduates.
Next, I came back to Kijabe – another 4.5 hour drive. This was made a little more exciting by the cars racing by us to get miraa (khat) to the market. Meru is the center of the miraa-growing region bringing it some financial wealth but also a wealth of mental illness and violence as the people there sample what they chew. It is a leaf valued among the Somalis and some other east African peoples for its stimulant properties. The delivery drivers get a bonus to get the stuff to market early and despite over 160 speed bumps, they drive fast and recklessly to Nairobi each day.
It was always good to return to Kijabe. In the past few days, I have met with every one of the residents and faculty members, observed in the OR, participated in scheduled conferences and gave mock orals to the residents slotted to sit the exams for the MCS and FCS exams coming up. I was able to talk to them more intelligently about their options for placement in mission hospitals in Kenya (and elsewhere throughout the PAACS system). The new BethanyKids pediatric wing is nearly finished and will be opened when enough nurses are obtained (as early as October but probably later). I met the new ENT surgeon, David Nolen, who trained at Duke University and who is out with his new bride under the Post-Residency Program of World Medical Mission. Rich Davis, Jack Barasa and I had some good discussions and made some decisions about the approach to some troublesome issues.
This morning, Rich Davis came with me to Nairobi and we inspected the Dimesse House of Spirituality in Karen (suburb of Nairobi) as a possible site for our basic science conferences and also toured the Mater Hospital. The Mater Hospital is a Catholic private hospital in Nairobi that wants to start a COSECSA program and they desire a close relationship with the PAACS-COSECSA training program at Kijabe. There are some immediate concerns that arise but perhaps some rotations (with appropriate reassurances about the codes of conduct) might be possible and valuable to us and them.
Prayers and Praise:
- Please pray for safety and wisdom as I finish my trip in Ethiopia. There are some new issues that are arising there and Andrew Chew and I will need wisdom in approaching them.
- Pray for wisdom as we consider how best to interact with Mater Hospital
- Pray for Elijah as he carries on alone at Chogoria and for Tony as he makes the transition to Maua.
Onward to Ethiopia,