I plan to go with my attending Dr. Andrew Kesselman from Stanford Interventional Radiology (IR) to University of Nairobi in Nairobi, Kenya, to assist with training IR fellows and technologists at the University Hospital there so that they in turn can provide more effective service to their communities. I am obtaining my Registered Physician in Vascular Interpretation (RPVI) certification this month which gives me added proficiency in vascular ultrasound, and ultrasound will be a key teaching modality during the trip. University of Nairobi does have angiographic equipment and we will be training and performing basic and complex interventional procedures.
The interventional radiology fellows will benefit from the additional training and partnership with Stanford Health Care. The hope is to establish an encrypted Whatsapp group between the Fellows from University of Nairobi IR and the fellows at Stanford IR so that we can share interesting anonymized cases and also share teaching pearls even after the service trip has ended.
We also hope the radiologic technologists and sonographers will benefit from us sharing best practices from Stanford.
The patients we are able to serve during the trip will also directly benefit from the project as well.
This population stands to benefit from minimally non-surgical procedures that can sometimes be performed with equipment as simple as an ultrasound, needle, and syringe. We hope to also solicit industry support prior to the trip, especially hand-held ultrasound companies who may be able to donate refurbished hand-held ultrasounds that can be used by the fellows and sonographers after the service trip has ended.
The impact expected is primarily teaching and dissemination of best interventional radiology practices to all staff, including the fellows. The secondary impact is the patient impact from procedures performed. Learnings will carry forward through the Global IR fellows Whatsapp group that we aim to start during the service trip, with the plan to add the University of Nairobi IR fellows to the Stanford Angio Club where we monthly discuss interesting cases and morbidity/mortality (after initial rapport has been established through the Whatsapp group).
Rad-AID IR has a longitudinal relationship with University of Nairobi and my attending Dr. Kesselman is Assistant Director of the national Rad-AID IR initiative, and has been making annual trips as part of RAD-AID.
I had the privilege of working alongside the interventional radiology fellows from the University of Nairobi at Kenyatta Hospital, which is the public hospital for Nairobi that accepts public insurance. There were 2 senior IR fellows, and 2 junior IR fellows, and several diagnostic radiology residents that I interacted with in addition to the KNH attendings. I watched procedures, performed some procedures, and also occasionally asked questions or offered insights based on what I had experienced thus far in my training. I will never forget a 34 year old female I saw in clinic with one of the IR fellows who had suspected metastatic cholangiocarcinoma and based on getting a history from her husband that she had started having fevers the same morning, I told the fellow that I suspected cholangitis and maybe she could benefit from antibiotics, which we sent her home with. I gave a talk on middle meningeal artery embolization for chronic subdural hemorrhage, and learned that several years prior an internal maxillary artery embolization had been performed and was complicated by blindness so a middle meningeal artery embolization had never been performed since. After my presentation, I was invited to give the same talk at a hospital conference in Nairobi in June 2023. I would say that I gained several new colleagues, and hopefully shared some knowledge along the way. The person who was most impact by the trip-was probably me. I hope to return next year for even great usefulness to hospitals like Kenyatta hospital in Nairobi.
