Training program, year
Anesthesia, Brigham and Women’s Hospital
CA-3
Destination
The anesthesia department at Kijabe Hospital, Kijabe, Kenya (60km west of Nairobi)
Sponsor and funding
Funding was provided by a sponsorship from the Benjamin H. Josephson Fund (bhjfund.org) and Samaritan’s Purse, which is a non-profit that organizes logistics for visiting physicians to the hospital.
Team
This site regularly hosts anesthesia residents from Vanderbilt and UNC Chapel Hill for month-long international electives throughout the year. In addition, trainees from other specialties including general surgery, pediatrics, and internal medicine commonly rotate here. The director of the anesthesia department is Mark Newton, MD who is a faculty member at Vanderbilt Children’s Hospital and the primary contact for the rotation.
Nature of work
I was at the site for a month-long rotation and did a combination of teaching and clinical care. My teaching was in the operating rooms and classrooms for students in the nurse anesthetist training program. My clinical care included supervising nurse anesthetist for cases and procedures, doing more complicated OR cases under the supervision of Dr. Newton, and working for several days in the ICU. I took care of a range of patients from neonates to geriatric patients undergoing a variety of operations with orthopedic repairs, Cesarean section, and pediatric VP shunt cases being the most common. The hospital is a large referral center and handled more complex neurosurgical and pediatric surgery cases, as well.
Take aways
I was very impressed with the focus on education and training a core mission of the hospital. For a privately-funded mission hospital the number of trainees in surgical and medical specialties and subspecialties was remarkable and included orthopedic surgery, general surgery, pediatric surgery, pediatric neurosurgery, anesthesia, pediatrics, medicine, and emergency medicine. In anesthesia, this took the form of a nurse anesthetist training program that seeks to place graduates in areas of Kenya and surrounding countries with limited anesthesia providers. The quality of education and available resources was beyond what I had expected to find.
One of the other primary goals of the hospital was to provide access to quality healthcare for patients regardless of their level of income. This was accomplished by a tiered fee structure and a heavy reliance on private donations. In Kenya, there is a basic health insurance system which also provided coverage for many patients. It was interesting to see this model in action, and it appears to be a viable and sustainable model in this setting.
Finally, this area of the Rift Valley in Kenya is beautiful. It is at a high altitude and the weather is cool in the evenings with gorgeous views of the surrounding area.
Future plans
I hope to continue contact with this hospital as I continued into my fellowship and beyond. I may return during my pediatric anesthesia fellowship at Vanderbilt Children’s Hospital
