During residency I traveled to the AIC Kijabe hospital in Kenya where I spent four weeks engaging in exchange of knowledge and experiences in anesthesia. The hospital has had a robust history of training nurse anesthetists and now are training anesthesiology residents to meet the anesthetic needs of Kenya and surrounding countries. My roles were to deliver education intraoperatively on anesthetic considerations pertinent to the surgical case, during in-classroom dedicated lectures, and through simulation. In addition, I assisted ultrasound-guided peripheral nerve blocks and urgent/emergent perioperative scenarios. The number of cases involving sick pediatric patients performed there was higher than expected and reaffirmed my pursuit of subspeciality training in pediatric anesthesiology.
I plan to return to AIC Kijabe hospital in January 2024 with a stronger foundation of pediatric anesthesiology after five months of fellowship training to better serve in the roles of educator and clinical instructor. Specific areas of focus leveraging subspecialty training in pediatric anesthesiology include creating safe anesthetic plans for pediatric patients with complex pathology, teaching ultrasound-guided vascular access and nerve blocks/catheters for perioperative pain control in pediatric patients, and advanced airway planning and management in pediatric patients with difficult airways.
The immediate benefit will be the population of adult and pediatric patients undergoing perioperative care in Kijabe which was estimated to be around 10,000 surgeries per year back in 2015. This number will have surely grown since then. Surgical services at Kijabe hospital include general surgery, pediatric surgery, pediatric
neurosurgery, ENT surgery, obstetrics and gynecology, and plastic surgery, all of which require highly skilled personnel to deliver safe anesthesia care. The patients' conditions are often complicated by delay of care in part from long distance traveled and trial of local healers before turning to westernized medicine.
The primary goal of this trip will be capacity building and educating the next generation of East African anesthetists and anesthesiologists who will help to meet the increasing demand for safe surgical, obstetric and anesthesia services in East Africa. The goal will be to educate on how to better take care of surgical patients with updated training in regional, pediatric, and general anesthesia. A long term goal is for the nurse anesthetists and physician anesthesiologists trained in Kijabe to emigrate to other regions of Kenya or East Africa and take their expertise to help provide safe anesthesia care to other populations outside of Kijabe and .
Patients of AIC Kijabe come from a large area. They are usually less likely to seek medical attention from Western doctors unless other methods have failed and often need to travel long distances.
Nurse anesthetist students come from all over Kenya some sponsored by their home hospital/region to learn how to provide safe anesthesia.
Anesthesiology residents have completed medical school and an intern year before being selected for this program which trains them to be independent consultants. They come from not just Kenya but also surrounding countries. Some will be the first anesthesiologist in their country after completing training.