Dr. James Netterville has for many years led a group of American otolaryngologists in conducting a surgical training camp in Malindi, Kenya. This spring, we are planning to spend one week in Malindi working with his longtime partners at Tawfiq Hospital. This trip aims to provide subspecialized care, which on this trip will include both head and neck surgery and otologic surgery, for a group of people who do not have easy access to this care in their community. Additionally, this trip provides a critical training opportunity for otolaryngologists and trainees to gain badly needed skills in these surgical subspecialties. University of Nairobi residents and local Kenyan otolaryngologists travel to the camp to assist with surgeries and learn from their American counterparts, with the goal that they will be able to take their knowledge into sustainable specialized patient care, eventually without our assistance. At the hospital, we will have access to three operating rooms for the course of the week and plan to have both head and neck surgeons and otologists performing surgeries throughout the course of the trip. My role on this team as a PGY-3 resident will be to coordinate patient care in the clinic setting, where we will evaluate patients for surgery and perform procedures under local anesthesia, and in the inpatient setting, where I will assist with floor management of our post-operative patients, ensuring a safe and easy recovery. I will additionally supervise the American medical students traveling with our group and participate in ongoing research projects requiring data collection and records updating from our team.
The primary population served during this trip will be patients in Malindi, Kenya, and the surrounding area. In Kenya, there is only one otolaryngologist per 454,546 people, meaning that access to otolaryngologic care is extremely limited. During our weeklong trip, our team will be performing badly-needed surgeries on a variety of pathologies, including head and neck cancer, thyroid and salivary gland neoplasms and chronic ear disease. We will be providing medical care for chronic, life-altering disease processes that require subspecialty care that is currently rarely available in the region. We will additionally be examining patients in clinic, performing surveillance exams, scheduling them for surgery, and performing clinic procedures. Our trip is well-established and a regular part of care in the community, meaning that we receive referrals from local providers for complex cases requiring our care and for rural patients who would otherwise go untreated.
This trip will also serve otolaryngologists, both attendings and trainees, at Tawfiq Hospital. The ultimate aim of these mission trips, in addition to providing patient care, is to provide the educational opportunities that will ultimately enable these surgeries to be performed without our presence. The surgeries performed during this week are valuable opportunities to provide surgical education on a variety of complex procedures that local providers may not have previously experienced. The hospital itself is equipped with resources typical for the region, and educational opportunities are designed throughout the trip to ensure that participants are receiving the training they need to move forward in providing this care independently. The long-term aim of these trips is to sufficiently prepare current otolaryngologists and trainees to perform these surgeries independently, enabling the people of the region to receive ongoing care from their own local providers.
This trip will have a long-term impact on the patients we serve, who will have significant improvements in quality of life with subspecialty management of their conditions. Local providers will additionally be better equipped to perform similar surgeries moving forward, helping patients in the region receive needed care long after our trip has concluded. This trip is one week continuing a long preexisting relationship between our group and the otolaryngologists at Tawfiq Hospital and the University of Nairobi, a critical partnership in improving otolaryngologic care throughout the country. Finally, the lessons that we receive working with this population will absolutely carry forward into our future work. I am excited to gain needed skills in the operating room, the clinic, and floor management, particularly in an environment very different than the one I work in here in the United States. This experience will provide a valuable opportunity to experience different practice patterns and to think critically about the ways in which I've come to practice at my home institution. I am excited to carry these lessons forward into my own patient care in the future, both at home in the United States and in other experiences abroad.
Patients came from as close as down the street and as far as countries away to receive subspecialist ENT care from Otologists and Head and Neck Cancer surgeons during our trip. Many were local, and many more traveled in anticipation of being seen by and receiving surgery from our team.
We were able to perform more than 60 surgeries, with many more people served by our awake procedures clinic and hundreds seen and evaluated in clinic.
We also were able to work closely with both residents from Nairobi and attending surgeons from across the country. These surgeries helped patients, but they also provided a critical opportunity for trainees and attending surgeons to gain new skills and refine advanced techniques so that they can better serve similar patients long term in their own communities.
This was part of a longitudinal mission in this community, with long term roots in Malindi and with plans for many future trips. We were able to begin identifying patients for surgery on a return trip this fall and are honored to have been part of the long legacy of this surgical training camp.
