By F. Bruce Cohen
Chief Financial Officer, United Therapies
Co-Founder, Knock Foundation, Inc.
(Previous post: Development in Kenya: Hope Muddled with Heartbreak)
What most impressed me and, I think, the doctors is that although NPGH lacks even basic medical equipment and supplies (NPGH did not have a cystoscope (a basic piece found in any U.S. hospital or surgery center) and they specifically asked us to bring our own scrubs and surgical gloves), the Kenyan doctors, nurses and staff are no less committed to providing quality healthcare services than their American counterparts albeit with significantly more limited resources.
Indeed, the most significant obstacle to this seems to be the lack of basic medical equipment or outdated medical equipment (during one operation, the doctors used a circa 1950s Soviet piece of equipment used to electronically cauterize a bleeding wound) and, perhaps, more specialized training (most of the surgeons were general surgeons without specialized training).
For example, in the U.S. benign prostatic hyperplasia (enlarged prostate) is usually treated with a TURP (an instrument is inserted up the urethra to remove the section of the prostate that is blocking urine flow), which is much less invasive then open surgery. Because of the lack of such equipment at NPGH, almost all such procedures are done as open surgical procedures that naturally have a much greater morbidity.
In some respects, it could be argued that the Kenyan doctors are every bit as skilled as their counterparts because the circumstances under which they operate call for much greater improvisation and technical skill because they cannot rely on technology to the extent their American counterparts can.
On our last day, I met with NPGH’s administrator, who expressed her great satisfaction with the doctors, their work ethic and professionalism and most importantly, how they conducted themselves and interacted with the staff which she said showed great respect for and humility towards their Kenyan counterparts. This contrasted markedly, she said, with a group of doctors that arrived the previous day and were demanding, condescending and so taxed NPGH limited personnel and equipment-related resources as to be not as helpful (or welcome) as one might otherwise expect.
There is little doubt that we acquitted ourselves well.
The trip was a great success and we have begun planning a return engagement, perhaps April 2012. We now have a much better idea as to what equipment and supplies we can bring which will, we hope, leave a lasting mark on the services NPGH will be able to provide.
Moreover, when the trip was to be two weeks, we had hoped to provide some educational training courses for the general surgeons and, perhaps, those surgical residents that might be interested in a urology specialty. This, we believe, would be the most significant thing that we can provide (in addition to equipment), as this person could pick up where the visiting doctors left off and then, rather than have visiting doctors clear a backlog of patients (which is essentially what we did), NPGH will be able to provide these services long after our departure.
[...] My Reactions to our Development Work in Kenya [...]