I will spend one month, 10/25 - 11/20, serving at a missions hospital in Tenwek, Kenya. I will be the primary physician in the "Casualty" area or ER, as well as rounding and taking call in the ICU. In addition to serving the local patient population, I will be teaching a Critical Care conference for Kenyan clinical officers and residents.
Tenwek Hospital was established in 1937 and is currently a 300-bed missions hospital that serves as the primary referral site for southwest Kenya. The hospital serves to train medical students, nurses, laboratory assistants, and multiple other medical specialties. The mission of the hospital is to not only serve the local population but to empower Kenyan medical professionals and enable their training. Thus, my participating in teaching Critical Care medicine will have a lasting impact through educating Kenyan medical professionals who will continue serving their community.
1. Providing help to the hospital in staffing their ER and ICU
2. Providing education in Critical Care Medicine to Kenyan residents, medical students, and midlevel practitioners
For me, I am considering long-term service overseas. I will be bringing my entire family on the trip for the month (wife, 4 year old son, 2 year old daughter, 10 month old son) and this will be an opportunity for us to experience overseas service as a family and see if this would be a long-term fit for us.
Additionally, it will provide me with valuable training in seeing tropical diseases not often encountered in America while learning to practice medicine in a different healthcare system with fewer resources.
We served in southwest Kenya at a hospital with an 800,000 person catchment area. The main cultural group were the Kipsigis people, a group of caring, colorful, and joyful men and women. In the morning, we would watch the sun rise over thousands of square tea fields and women would walk through these fields with their children and a basket, collectively pulling the top leaves from each tea plant. The streets were lined with booths offering fresh avocado, mango, and myriad other fruits and vegetables.
The axiom is true that one always gains more than they are able to contribute on a short-term mission trip. While in Kenya, we served in "Casualty", the hospital's equivalent of an Emergency Department, as well as on the floors and Intensive Care Units. My role was to oversee care, provide stabilization for critically ill patients, and, primarily to encourage and teach the Kenyan Clinical Officers and Interns.
The Kenyan medical staff was competent, intelligent, caring, and hard working. It was a joy to interact with them and to offer any help we could in their clinical practice. In the mornings, I taught a series of sessions on BLS, ACLS, and ATLS. In the evenings, I taught multiple sessions on ECG interpretation, as well as other pertinent Emergency Department topics such as the treatment of various electrolyte abnormalities and the recognition and treatment of sepsis.
While in Kenya, I was overwhelmed by the gravity of illness. On the medical wards and ICU's most patients had HIV or TB. Scores of children were admitted for meningitis secondary to bacteria, TB, or cryptococcus. I treated wound botulism, ecclamptic seizures, rheumatic heart disease, and numerous traumatic injuries from motorbike accidents.
One medical encounter had particular impact on me. On the medical ward there was a 35-year-old man with AIDS who was dying from overwhelming sepsis. Despite all the care we provided he was worsening. I won't forget telling his young wife that he was dying. Their ten-year-old son sat by his father's side and looked down at him as if he wanted to scream, "Wake up, Dad!" The wife had a distant look in her eyes, and I imagined she was thinking, "How will I raise four children without him?" That night when I tucked my children into bed I was overwhelmed with gratitude for life and health. What an honor to be able to serve in another country and seek to bring life and health to others, all the while being filled with gratitude for my own.