The proposed global health trip is part of a long-standing annual surgical mission to Malindi, Kenya spearheaded by Dr. James Netterville and the Vanderbilt Department of Otolaryngology – Head and Neck Surgery. The aim of this outreach project is to provide care for otolaryngologic conditions and related suffering to underserved communities in Malindi. This will be accomplished through direct clinical care and education of local healthcare providers.
A carefully selected team of residents, fellows, surgeons, and anesthesiologists from Vanderbilt University, the Ohio State University, and Indiana University will work with local healthcare professionals and trainees to deliver clinical treatments and continuing medical education for the Malindi community and surrounding populations. My primary role would be to bring an expertise in pain management and interventional pain techniques, which would be a novel addition to prior mission trips.
My role will be to provide and educate on perioperative anesthetic care, as well as treatments for both acute and chronic pain conditions. As a current fellow in Interventional Pain Medicine, I will utilize the principles of adult learning that were integral to my learning. Furthermore, I will be engaging in the clinical care of patients in the pre-, intra-, and post-operative settings.
Respect for our common humanity and desire for self-sufficiency remain at the core of our mission throughout our endeavors. We hope to help the Malindi community create sustainable and self-propagating advancements in clinical care that outlast our time there by generations. Through conscientious patient care, local outreach, and invaluable clinical education, we aim to serve Kenya, her neighbors, and her continental diaspora.
The population we aim to serve on this global health mission includes both the patients of Malindi, Kenya as well as the local anesthesiologists, nurse anesthetists, and trainees. The decision to proceed with this location was a joint decision between Vanderbilt and local providers as Malindi has a need for otolaryngological care. Prior to the efforts in Malindi, our group has travelled to Kijabe, Kenya in a similar fashion. With the help of such trips, Kijabe now has a head and neck surgical oncology fellowship as well as established otolaryngology care that is led by local providers. We hope to replicate this success in Malindi, and our group has now been traveling here annually for over 7 years.
This year, I hope to add to the expertise of the head and neck surgeons by bringing my knowledge and experience in interventional pain techniques. I have a deep respect for the quality of life and symptomatic relief all humans deserve, regardless of socioeconomic status, and believe this is a fundamental human right. Specifically, there is a need for the delivery of and education regarding techniques for pain management in both the perioperative and chronic settings. The overall aim is to help establish a robust framework from which local otolaryngology surgeons may provide expert surgical care to their communities. Technical skills and clinical expertise in pain and symptom management techniques would be important elements of care that surgeons, anesthesiologists, and clinical anesthetists can employ.
Our primary goal is to provide advanced care of the highest standards to the patients of Malindi. We anticipate performing 60 or more major surgeries and an additional 100 or more minor operations/procedures, some of which will be aimed at treating painful conditions such as trigeminal neuralgia, migraines, brachial plexopathies, cervical radiculopathies, and spondylytic pain. Specifically, I hope to utilize perineural and intraarticular steroid injections, regional anesthetic blocks, and abalative techniques.
In addition to the delivery of such pain treatments, an equally important and concurrent goal is to educate local Kenyan health professionals for continued impact beyond our short time there. A key component this goal will be a formalized ultrasound curriculum for Kenyan surgeons and anesthesia providers. Ultrasound remains an invaluable and low-cost tool with not only substantial diagnostic potential, but also therapeutic value in the form of imaging guidance. Many of the interventional techniques we hope to bring to Malindi require imaging guidance, which can be accomplished with the use of ultrasound. Such a standardized curriculum would have enormous potential for continued propagation of clinical knowledge and therefore patient care. We have successfully applied for and acquired funding for 5 ultrasound machines to be used during our trip and subsequently be gifted to the community for ongoing use.
While the Malindi community remains at the heart of our mission, we participants will undoubtedly benefit greatly as well. This global health mission will provide valuable insights into how to provide sustainable care abroad and hopefully serve as a model for future ventures. By also emphasizing pain management, I believe we will not only expand our impact through a profound respect for our shared human condition, but also gain a deeper understanding of culturally informed patient care.
We had an incredible experience in providing surgical care and education for the Kenyan patients and providers, respectively. It was a truly humbling experience and I feel so grateful to have had the experience of learning from the gratitude and resilience of the Kenyan people. We were able to provide ENT surgical care for head & neck cancer patients. An incredible perioperative team came together to provide ablative and reconstructive surgeries via a surgical education camp for the Kenyan otolaryngolists / head & neck surgeons.
