The ultimate goal is to help mature the fledgling nuclear medicine department of Aga Khan University Hospital in Nairobi, Kenya. I have recently qualified for the Hyman-Ghesani Fellowship offered through the Society of Nuclear Medicine and Molecular Imaging and Rad-AID and am looking for some additional funding to help defray some of the costs of this project.
It will begin with providing AKUH with the Nuclear Medicine Intake Form that I helped create in conjunction with Rad-AID last year. This is an extensive worksheet that assesses current capabilities and limitations of the department, as well as their ultimate goals. Once completed, I can work with them prior to my visit to ensure that time onsite is maximally utilized. The next step is a two-week onsite visit to the hospital, where I will work alongside the nuclear medicine technologists, attending physicians, and training staff on clinical applications. I also want to ensure that the unique safety requirements for nuclear medicine storage and handling are in place. There will be additional opportunity to provide didactic lectures to the house staff, participate in multispecialty tumor boards, and interview patients. Finally, I intend to meet with the hospital administration to ensure they have a strong understanding of the departments potential and what it will take to achieve the goals from a staffing and infrastructure standpoint.
The Aga Khan University Hospital in Nairobi, established in 1958 is a 254-bed long-term care facility offering general medical services, specialist clinics and diagnostic services. The hospital receives referrals for specialized medical care and diagnostic services from various hospitals and clinics throughout West Africa. AKUH is a private, not-for-profit institution committed to making high caliber healthcare and medical education accessible to all Kenyans. The main hospital campus is located in the Parklands area of Nairobi. Their Patient Welfare Program also offers financial assistance to uninsured and low-income patients who would otherwise be unable to afford the medical care they require.
While I have done prior radiology field work in the Marshall Islands and Haiti, in each of those instances the lack of any significant reliable infrastructure limited my ability to truly make use of my subspecialty nuclear medicine background. I see this project as a unique opportunity to move beyond those prior limitations while still serving a needy population in a developing country, as the current department at AKUH is established and functional, but merely needs guidance to become a greater benefit to that population. As a teaching hospital, AKUH is committed to training the next generation of leading medical practitioners in East Africa. They offer the best in training for medical specialists, nurses and technicians in the region. Their participatory approach to learning also requires that all students spend a percentage of class time working in the local community. In this way, AKUH nurtures health care leaders with strong connections to their communities and nuanced understandings of local issues, and directly contributes to raising the standards of health care provision throughout the East African region.
Finally, I see this initial visit as an introduction to what I hope will transition to a sustained virtual relationship, supported further by regular future onsite attendance. With the right motivation, I can help them develop a program that can stand on its own as a shining example of what is possible for subspecialty care in Africa through safe application of diagnostic and theranostic isotopes.
My primary charge in visiting Aga Khan University Hospital in Nairobi this past January was to assess the status of their nuclear medicine department in regards to infrastructure, workflow, and growth opportunities. In addition to the generous funding from Doximity, the trip was additionally sponsored by a combined grant from Rad-Aid and the Society of Nuclear Medicine and Molecular Imaging. Having done some prior work in the developing world at sites where radiology infrastructure was remarkably limited, I was extremely impressed by what I found operationally at AKUH. They had a wide range of diagnostic capabilities, including cutting edge SPECT/CT and PET/CT scanners as well as an on-site cyclotron for PET radiopharmaceutical production. They also had a developing theranostic program with radioiodine treatment which was expanding into the high dose realm at the time of my visit. Using a Nuclear Medicine Readiness Assessment form we did identify some potential protocol changes to consider and highlighted the departmental strengths which include a very dedicated faculty and hospital administration. I also gave a series of didactic lectures to the radiology residents and nuclear medicine fellow currently in training, with these lectures streamed via Zoom to other teaching institutions in Nairobi. From a clinical standpoint, the most striking difference between their practice and my own related to the very late stage of diagnosis demonstrated for the wide variety of malignancies imaged via PET/CT there. As a referral hub for all of East Africa, this would speak to the need for regional development of more widespread screening studies to identify these cancers earlier in their course.
I look forward to further visits with this focus in mind, as well as the potential to use this highly functioning department as a standard for nuclear medicine departments elsewhere on the continent.
