Jan 22 2012
Vanderbilt International Anesthesia
We arrived safely in Nairobi and stayed at the Mennonite Guest House. The next morning we ate breakfast with missionaries from all over the world in different stages of their calling around Africa. Kijabe’s reputation is well known and they wished as well as we were picked up and driven to Kijabe via a road that had terrible slums juxtaposed with sweeping views of the Rift Valley.
We toured the hospital and got settled in our lodging for the month and got sign-out from the ICU as one of us was on-call the first night. It took adjusting to drugs and equipment that were foreign to us. All of the patients did well overnight leading into our first day in the operating rooms, or “theatres,” as they are called.
The staff comprises one MD anesthesiologist and in our case, two anesthesia residents, missionary and local surgeons, surgery residents, KRNA (the Kenyan version of a CRNA), and anesthesia students. Patients present with late-stage disease, terrible trauma, and for obstetric emergencies without previous prenatal care. One could take care of a neonate with a tracheoesophageal fistula followed by a patient after a road traffic accident followed by a C-section. The steep learning curve of anesthesia is addressed with intense didactics combined with a sick and varied patient population. The KRNAs and students do a great job. However, there is not insignificant morbidity.
I had the pleasure to oversee a few operating rooms, help the KRNAs and students perfect there neuraxial anesthesia techniques, discuss pharmacology and physiology, and teach them approaches to regional anesthesia that they have not seen before. The way they gather around and pay attention exhibiting their willingness to learn is refreshing.
After the first day, we brought two heavy suitcases of medical supplies to the anesthesia workroom as most of the equipment is donated. It caused me to step back and realize the amount of equipment we use in America and how we take many things for granted at our institution.
Everyone at Kijabe has been extremely welcoming and the missionary spirit of providing excellent medical care in the midst of educating the local medical staff is encouraging for the future. All of this paired with the beautiful land, delicious food and chai, and local wildlife seen on our weekend hikes prepare us for a busy week next week in the operating theatre.