Clarissa (Foran) Johnston, MD
Clarissa (Foran) Johnston, MD
Internal Medicine · Austin, TX

Improving Access to Palliative Care In Kenya

March 23rd
Eldoret, Kenya

Project Description

As a way of introduction, I am a clinician educator with over 20 years of clinical and medical education experience in internal medicine and palliative care. I will travel to Eldoret, Kenya to work with AMPATH Kenya in March-April 2023. AMPATH Kenya is a partnership between Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya and a consortium of North American medical schools that started over 30 year ago. The mission of the partnership is to build sustainable, holistic health care in western Kenya and around the world. (
I travelled to Eldoret, Kenya with AMPATH last year and worked with the MTRH Palliative Care Team to develop curriculum for their palliative care team. MTRH has a novel 14 month training program for clinical officers (our closest equivalent in the United States would be physicians assistants) to become palliative care specialists. One accomplishment was doing the first palliative care consults in the MTRH intensive care unit; the prior model limited palliative care consults to cancer patients. I would like to continue with palliative care curriculum development on my next trip, focusing on improving communication skills and pain management skills with learners.
The second goal of my project is to work with the Internal Medicine residency at MTRH with our three internal medicine residents from Dell Medical School who will be doing a global health elective. I will spend time rotating with the residents on the internal medicine teams. I will have a POCUS handheld device and will do teaching sessions on POCUS for the Kenyan medical students and residents both as we round and in dedicated afternoon teaching sessions. If the teaching sessions are successful we hope to fund raise to purchase several POCUS devices for the Internal Medicine department in Eldoret.

Population Served

AMPATH Kenya has provided services to over 8,000,000 people and trained 2,600 health professionals and community healthcare workers. Three communities impacted by AMPATH Kenya can potentially benefit from my project:
• Kenyan Clinical Officers: the second cohort of clinical officers will start their specialized palliative care training this winter and I will do Vital Talk serious illness communication trainings with them, along with pain management didactics and mentoring and supervising individual palliative care consults.
• Kenyan Medical Students and Residents: I will rotate with the internal medicine ward teams at least 3 mornings a week and will contribute palliative care and POCUS teaching during morning rounds and during afternoon teaching sessions.
• Kenyan Patients: I will interact with individual Kenyan patients and their families during internal medicine and palliative care interactions.

Expected Impact

Our project will have a direct impact on Kenyan learners and patients, in palliative care and internal medicine, with the patients I consult on and with the learners I supervise and teach. There will be a broader impact on accessibility to palliative care in the Eldoret region in Kenya as I continue the strong work done by others establishing a palliative care program at MTRH. I hope to contribute to the growing body of work in global health and palliative care developing better models of accessible, culturally appropriate care. Finally, on a personal level, this project will allow me to learn from my Kenyan colleagues about innovation and transformation of healthcare in a low resource setting. I currently am leading a project entitled “Improving Access to Culturally Appropriate Palliative Care in Austin, Texas and Puebla, Mexico” with AMPATH Puebla. I hope my learnings from a more mature palliative care program in Kenya will help with palliative care program development in Austin, Texas and Puebla, Mexico. Because I am at a new medical school, we do not have well developed lines of funding for global health. I anticipate paying for my own airfare and lodging while in Kenya and would love assistance.

Trip Photos & Recap

We were able to spend a lot of time teaching at Moi Teaching and Referral Hospital in Eldoret Kenya. We worked with the Internal Medicine teams in the hospital with their residents (medical officers) and medical students and pharmacy students. We also worked with the Palliative Care team and helped teach the innovative clinical officer training program in palliative care.