Death and dying are never easy to deal with as a physician. However, that process is different in Africa. Morbidity and mortality are more commonplace and seem to be accepted. Religion is pervasive in all aspects of healthcare: the Wednesday morning chapel service, the preoperative prayers, and the prayers after meetings.
I was taking care of a very sick patient that was not expected to do well. Previous deaths in the ICU were simply accompanied by filling out the Kenyan Death Certificate and the family finding out the news when they arrived in the morning. However, this patient’s family drove about two hours from Nairobi to discuss the hospital course and prognosis. All six of them spoke perfect English and were aware of lab values and surgical findings. They were more informed than typical American families I have had discussions with. Despite the expected grief and frustration, they were grateful for the dedication of the hospital and physicians. We prayed together at the end of the meeting. The patient died later the next day.
Despite several deaths in the ICU during the previous week, the evaluations of the anesthesia students were completed. The improvement was remarkable. They were pushed harder than they have been pushed before, and they rose to the challenge. This was evident in the final didactic portion on our final clinical day where we asked the students to present a given topic to their classmates. Not only did they exceed our expectations, they started quizzing their fellow classmates. The lecture was completed by presenting us with high quality coffee table photography books of the Mara. The students signed the inside cover, we took group photos, and we were asked why we can’t stay longer and when we will return.
As we took care of final business with the hospital such as paying for our lodging and Kenyan medical license, the operating room manager asked to meet with us because she wanted feedback on how we can improve things. Kijabe is a place that can follow through on initiatives for change. The cohesive atmosphere is amazing and will provide the impetus for being one of the leaders in Africa for healthcare and mission work. It has been a sincere pleasure to be part of the global health initiative here, and for me, it won’t end here.