This is a surgical hospital and the new operating room wing (theatre) is testimony to its importance. It is very well supplied. There is also an emphasis on surgical teaching at all levels. What is most amazing is the presence of surgical subspecialties.
There is another reality and that are the expectations and variety of patients treated. Today, we treated a Somali woman that required a good deal of cross-cultural translation. Before the surgery the Christian surgeons prayed for this Muslin woman! There are many Western surgeons that are here as mentors/teachers for the surgical residents and interns.
Like my previous experiences, I have seen what is unusual....abdominal pregnancy and intusseption after a cesarean section for severe pre-eclampsia and a growth restricted fetus. What is also challenging is deciding when not to operate! Would you recommend a “fertility operation” in a woman with secondary infertility that is HIV positive? A prior child died at 2 years of age of pneumonia about 8 years ago. Her HIV disease is relatively well controlled on medications for the last 3 years. The American College of Obstetrics and Gynecology has recommendations but do these apply here in Kenya?
One last observation...The WHO Safe Surgery program posters adorn the walls of each of the operating rooms. It is my understanding that they have been up on the walls for the last five months. I have made it one of my missions to implement these in the surgeries that I attend. It is a good teaching tool.
Marv
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