Each year, the Vanderbilt Otolaryngology Department coordinates a 2-week trip to Malindi, Kenya to provide surgical education to local surgeons and deliver surgical care to local patients alongside our Kenyan colleagues. We will work in tandem with local ENT surgeons and their surgical trainees (residents and fellows) to provide excellent surgical care to patients in their community who require surgical treatment of an otolaryngologic condition, most commonly cancer of the head and neck. Unlike many surgical mission trips in which the visiting surgeons conduct the operations themselves, the primary goal of this trip has always been surgical education for local ENT surgeons, thereby providing more sustainable and meaningful surgical care to the Malindi community in the long-term. As a resident on this trip, my role will be primarily supportive -- I will provide pre- and post-operative care for patients as well as logistic coordination to facilitate timely care for all patients who have been listed for surgery.
Our two key stakeholders in the project are: the members of the Malindi community with surgical ENT disease and the existing ENT surgeons in the Malindi hospital. Members of the Malindi community in need of specialized surgery will receive excellent surgical care close to home. ENT surgeons currently serving the Malindi community will receive highly specialized surgical training, which will enable them to continue providing excellent surgical care to their community. The Vanderbilt Otolaryngology department has a longstanding relationship with the hospital in Malindi, and we return yearly to continue working alongside local surgeons and learning from one another while we provide necessary care for local patients. This longitudinal relationship has fostered trust and an open exchange of ideas/techniques between our teams, and we have grown to care for one another's communities as our own.
The most readily measurable metric of our trip will be delivery of excellent surgical care for patients in Malindi in need of specialty ENT surgery. Over the two-week trip, local patients will undergo surgery and receive post-operative care from a combined team of surgeons from the US and Kenya, comprised of staff surgeons and trainees from both countries. By prioritizing education of Kenyan surgical residents throughout this trip, our hope is that all ENT surgical needs of the local community can be met with or without presence of surgeons from the US in the future. From our perspective as visitors, we will return to the US with a new understanding of how a different medical system approaches surgical care with fewer material/technologic resources.
Our team of U.S. and Kenyan ENTs performed approximately 60 surgeries during 10 operative days in Malindi, as well as approximately 20 procedures under local anesthesia. Our entire multidisciplinary cohort included surgeons at various levels of training, anesthesia providers, a pathologist, peri-operative nurses, speech language pathologists, and medical students. We worked closely alongside Kenyan surgeons, nurses, and OR staff, learning from one another with the ultimate goal of providing outstanding surgical care to patients. Surgical residents and fellows practicing in Kenya traveled to Malindi to receive instruction and hands-on experience from expert head and neck surgeons.
Members of the Malindi community in need of head and neck surgery received high level surgical and post-operative care. Common procedures included thyroidectomy, parotidectomy, resection of sinonasal masses, and excision of lymphovascular malformations. Additionally, patients from surrounding areas in need of advanced head and neck surgery were able to travel to Malindi to undergo complex resection with microvascular reconstruction. During this trip, we performed two total laryngectomies as well as six mandibular resections followed by microvascular fibula free flap reconstructions.
