Kenya

Moi Teaching & Referral Hospital
Embu Provincial General Hospital
AIC Kijabe Hospital
Coast Provincial General Hospital
Nakuru Provincial General Hospital, Rift Valley
Nyanza Provincial General Hospital
Nyeri Provincial General Hospital
Kenyatta National Hospital
Visitor Information

Languages:  English (official), Swahili (national), over 40 other languages from the Bantu, Nilotic, and Cushitic linguistic groups

Population:  36.9 million

Kenya is home to diverse people groups and environments. Mountains, coral reefs and wildlife parks can all be found in this country. Although many people live in rural farming areas, some also live in Kenya's metropolitan areas. Farming and tourism are important parts of the economy. Until recently, it has been noted as one of the more stable and free countries in its region.

Despite these many great qualities, many other issues face this country. Drought plagues this country. UNICEF says that a half million are in great need of water. Many children are malnourished and urgently need food and immunizations. Healthcare issues cover a broad spectrum. In 2006, there were less than 30 orthopedic surgeons to treat the entire population of Kenya and there was no certified orthopedic training program within the country. A great need for orthopedic trauma care exists for Kenyans because there are so few physicians within the country trained to meet the orthopaedic needs of their trauma patients.

Moi Teaching & Referral Hospital

Moi University was established in 1894 in the city of Eldoret in western Kenya. The medical school was established in 1989. It trains graduates in medicine, nursing and environmental health and has post-graduate training in internal medicine, pediatrics and family medicine.

	Dr. Lectary Lelei

It was not until 2006, under the leadership of Dr. L. K. Lelei that Moi University established an orthopedic residency program. He realized that fewer than 30 orthopaedic surgeons served the entire population of Kenya, and most of them were located in Nairobi. Because there was little opportunity for orthopaedic training in Kenya, most surgeons went overseas to learn, and many of them did not return. Dr. Lelei was determined to provide a way for Kenyan doctors to learn orthopedics so they could remain in Kenya where they were needed. 

Indiana University and Moi University have been in partnership since 1989. IU helped to pioneer a program to combat AIDS and treat those infected with HIV. This program, known as the Academic Model for the Prevention and Treatment of HIV/AIDS, or AMPATH, cares for about 60,000 HIV- infected patients. This program serves Kenyans in a variety of ways, such as: providing HIV/AIDS education, fighting hunger through food security programs to serve malnourished patients, building self-sufficiency through income security programs by giving loans and skills training, and providing for Kenyan children orphaned by AIDS. Only recently is the program becoming more active in the surgical disciplines, including orthopaedics. IU hopes to develop a more formal relationship involving exchanges of faculty and trainees between both schools. SIGN surgeons, Drs. Jeff Anglen and Mike Coscia, are a part of this partnership and have visited Eldoret. Also, SIGN program manager and senior orthopaedic consultant, Dr. Lelei, has been to Indianapolis University numerous times. The Indiana Orthopaedic Society has set aside funds to support resident travel to Kenya to participate in teaching and learning.  

Embu Provincial General Hospital

Embu Provincial Hospital is located in the city of Embu in central Kenya. This hospital has partnered with SIGN since 2005 and the program is managed by Dr. Soren Otieno.

Embu Provincial Hospital serves the people northeast of Nairobi. It sees a large number of patients on a daily basis. Although Embu District Hospital is a referral hospital with busy inpatient wards, the facility’s resources are scarce. There is only one theater and another room for emergency c-sections and overflow. These rooms are also shared by all the surgical services, including general surgery, neurosurgery, gynecology/obstetrics, and orthopaedic surgery. Orthopaedic surgery is allocated one day each week to do all urgent and elective cases. Despite improvements in the availability of basic materials, implants for orthopedic cases are not available through the hospital, but must be provided either by the surgeon or in most cases by the patient. Even if the patient’s family is able to obtain what is needed, access to the operating room often delays the case for weeks. These delays lead to hospital wards full of patients waiting to have traumatic injuries appropriately fixed.

Dr. Soren Otieno completed his orthopaedic training in Uganda and was assigned to Embu District Hospital when he returned to Kenya. The principal surgeon at Embu, Dr. Otieno also travels to examine and treat patients. Dr. Otieno and other trauma surgeons at Embu now have implants available to provide free of charge to their patients, this allows access to the operating room in a more timely manner. Patients who would have been bedridden for months in traction are now walking with the aid of crutches in less than 48 hours and discharged from the hospital in less than a week. Participating in something so dramatically positive has been motivating to the staff at Embu. This permeates through the hospital and improves efficiency. 

Dr. Otieno continues to provide the best care possible to his patients at Embu. Through his efforts to train other surgeons, he is also having an impact on the entire country and continent. Dr. Otieno has trained doctors at Nakuru Provincial General Hospital, Nyeri Provincial General Hospital, and most recently at Kenyatta National Hospital.

After visiting Embu Provincial Hospital in January of 2008, Dr. Ralston of Wisconsin said this about Dr. Otieno:
“He is a very competent and motivated surgeon. Arriving in Embu equipped with enthusiasm, skill, and donated SIGN instruments and implants, Dr. Otieno started to see a change in the delivery of orthopaedic care. While the facilities are the same and the availability of something as basic and necessary as anesthesia is still wanting, having the SIGN instruments and implants has made a difference.”

There is no residency program at this hospital, however, interns spend one year in rotation at Embu. Along with orthopedic surgeons, medical students and nurses are welcome to this hospital and can rotate in surgery and orthopaedics.

Dr. Soren Otieno

AIC Kijabe Hospital

AIC Kijabe Hospital is located in the town of Kijabe outside of Nairobi. This 212-bed hospital started its partnership with SIGN in 2005. The SIGN program manager is Dr. Joseph Theuri Macharia.

Six orthopedic surgeons and two residents do SIGN nailing in the Orthopedics department of AIC Kijabe Hospital. This hospital is part of the COSECSA (College of Surgeons of Eastern, Central and Southern Africa) residency program, with five residents enrolled. It is working on a partnership with Moi University for a Master of Medicine Program in Orthopaedics.

AIC Kijabe Hospital welcomes short-term volunteers staying less than one month. This hospital is interested in developing a strong arthroscopy and arthroplasty service for hips, knees and shoulders. Dr. Theuri has an added interest in spinal surgery. Interested volunteer skilled in any of the before mentioned surgeries are encouraged to share their skill and knowledge in these areas.

The hospital provides housing at a fee. This housing is usually in short supply and must be booked in advance. Visitors generally make their own meals, however, meals can be made at the request of visitors. There is also a motel on-site which has limited rooms.   

Coast Provincial General Hospital

Coast Province General Hospital is located in the city of Mombasa in southeastern Kenya, on the coast of the Indian Ocean. It is a 700 bed hospital and 70 beds belong to the orthopaedic department. There are three SIGN trauma surgeons in the department and there is no C-arm available to these surgeons. This hospital has partnered with SIGN since 2007 and the program is managed by Dr. Khaemba.

The trauma surgeons at Coast Provincial are interested in learning arthroscopy and arthroplasty for SIGN volunteers who are skilled in this area of surgery. Along with orthopaedic surgeons, medical students and nurses are welcome to volunteer here but must get clearance from the Director of Medical Services at Ministry of Health Headquarters.

Volunteers can go to the following site http://www.medicalboard.co.ke/ to view the requirements that must be met prior to serving at Coast Provincial General Hospital.

Nakuru Provincial General Hospital, Rift Valley

Nakuru Provincial General Hospital is located in the city of Nakuru in western Kenya. This is a 550 bed hospital and 75 of the beds belong to the orthopedic department. In 2006, Dr. Lelei of Moi Teaching & Referral Hospital trained surgeons, such as Dr. Mark Lumbasi Lutomia and Dr. Amin Sakr, in the SIGN technique. Currently, there are two orthopaedic surgeons on-staff who have mastered the SIGN technique and one more is in training. There are four operating rooms available to these surgeons who are able to perform SIGN surgery without C-arm magnification. The SIGN program is under the leadership of Dr. Amin Sakr.

This hospital has a two-year residency program with approximately 18 residents, three of them serving in general and orthopaedic surgery. Along with trauma surgeons, the hospital welcomes medical students and  nurses from overseas. Dr. Amin Sakr is interested in arthroscopy and spinal surgery. Interested volunteers with  expertise in this area are encouraged to share their knowledge and skill.

Nyanza Provincial General Hospital

Nyanza Provincial General Hospital is located in the city of Kisumu in western Kenya. It has partnered with SIGN since 2006.

Dr. Stephen Tower noted upon his first visit to Nyanza that, although it is a referral hospital for millions of Kenyans, there was no orthopedic surgeon on staff. The general surgical staff was in charge of fracture care management but lacked the appropriate implants. There were many patients with severe fractures crowding the beds. Now that trauma surgeons have access to the SIGN system, they are able to provide these patients with appropriate implants and reduce the number of patients in the trauma ward. Dr. Dan Raburu, who has great skill in fracture surgery, is the senior general surgical consultant at Nyanza as well as the SIGN program manager. Dr. Gordon Calleb, who was involved with SIGN at Coast Provincial General Hospital, is involved with the SIGN program at Nyanza.

Dr. Raburu	Dr. Gordon Calleb

Dr. Raburu recently wrote to SIGN about the after effects of the disturbances in Kenya in December of 2007:

“I am sorry that it is been difficult to communicate back to you in the last two or so months. This has been as a result of unrest and violence which has been in the country following a disputed presidential election. This has been putting so much pressure on me administratively. But further, following these skirmishes, I had my surgery burnt down with all the equipments and documents.
 
It is very unfortunate and saddening that since I used to work on documents regarding SIGN nail program in this my office I had the Laptop and Camera so often kept in there. This was also for the reason that I don’t have any other personal office in the hospital for safe keeping of my items. Therefore as a result of this fire the laptop, camera and documents were involved along with the last supply of nails and screws which had been delivered in November 2007. Otherwise it is my humble request that you continue to support us as sincerely this was not in any way out of carelessness. I have valued sign nailing and been happy doing the procedures.
 
For the time being we hope to continue with the program running. Thank you for your continued support."   

Nyeri Provincial General Hospital

Nyeri Provincial General Hospital is in the city of Nyeri, located north of Nairobi. Dr. Victor Muyembe is the hospital superintendent as well as the SIGN program manager.

Dr. Muyembe recently wrote to SIGN:

“I am glad to inform you that at long last we received the SIGN equipment, nails and screws this morning. There is a lot of excitement in the hospital and we look forward to carrying out at least two cases tomorrow. We needed something to lift up our spirits given the gloomy atmosphere in our country and this set has done just that. Once again, our deep appreciation goes to SIGN, Joseph and Amy Cass.”  

Kenyatta National Hospital

Kenyatta National Hospital is located in Nairobi, the capital city of Kenya. Founded in 1901, it is the oldest hospital in the country. It is an 1800-bed hospital with 12 orthopedic surgeons on staff. This hospital has partnered with SIGN since 2008 and the program is managed by Dr. Cyrus Kiarie Kinyanjui.  

His application to SIGN revealed that nearly 400 patients a year would best be treated by SIGN surgery. Trained by Dr. Macord in Uganda in 2007, Dr. Kinyanjui  is confident that treating these patients with SIGN surgery will improve life for everyone that goes through his ward.

“Thanks a lot. We really appreciate all you are doing for us. We will discuss the logistics with the theatre nurses and the surgeons. I am sure we will find a way round any obstacles. I will update you as we use it. The other equipment arrived. The hospital was very grateful and they will fax their gratitude letter. I will encourage all the surgeons to use the nail so that we can decongest our wards and treat our patients faster than we are doing currently. Thanks a lot once again.” –Dr. Kinyanjui 

Volunteers can go to the following site http://www.medicalboard.co.ke/ to view the requirements that must be met prior to serving at Kenyatta National Hospital.

Visitor Information

Nairobi

Photo: L.N. Batides

Visitors to Nairobi arrive at the Jomo Kenyatta National Airport via one of dozens of international airlines. Nairobi is known as the safari capital of the world, and Nairobi National Park, home to lions, giraffes, and other exotic wildlife, is minutes away from the city. As the capital of Kenya, Nairobi is home to the National Museum of Kenya, Kenya National Theatre, and the Kenya National Archives.

Eldoret

Visitors to Eldoret fly in to Jomo Kenyatta International Airport in Nairobi, then either fly to Eldoret from Nairobi's Wilson Airport or take advantage of the reliable bus service to Eldoret. The city is surrounded by picturesque farmland and forests. Kakamega Forest, to the southwest, is a tourist destination with a variety of wildlife, including over 400 species of birds. Kijabe is surrounded by impressive scenery including lakes, plains, forests, extinct volcanoes. There are several wildlife preserves northwest of Kijabe by Lake Naivasha.

Nakuru

Photo: Paul Mannix

Nakuru is a local center of agriculture, industry, education, and tourism. The greatest attraction in Nakuru is Lake Nakuru National Park, which is famous for the huge number of flamingos who feed there - as many as two million at a time. Some other unusual attractions include Menengai Crater, a nearby dormant volcano; Hyrax Hill, an archaeological site; and the Rift Valley Sports Club, which hosts cricket matches and an annual rugby tournament. Volunteers can find reasonable hotels, near the hospital and with a fair rate of $300-400 for one week full-board. Volunteers can also rent houses near the hospital for $200-300 for one month.

Nyeri

Nyeri is located between two beautiful national parks. To the west is the Aberdares National Park, with miles of forests and rivers and Kenyan wildlife, such as lions, leopards, rhinos, and baboon. Fishing, camping, and bird-watching are popular tourist activities. To the east is Mount Kenya National Park which features Kenya's highest peak.

Kisumu

Photo: David Wilmot

Visitors to Kisumu fly to Nairobi's Jomo Kenyatta National Airport and take a short flight from Nairobi's Wilson Airport to Kisumu Airport. Kisumu has museums, wildlife preserves, and scenic vistas, but the biggest attraction there is Lake Victoria, the world's second-largest freshwater lake.

Mombasa

In Mombasa, volunteers can stay at nearby hotels or the YWCA hostel.