James’s life will never be the same again. At least not as rough as he has had it these past few years. He didn’t seem to be able to wipe the wide smile off his glad face as he spoke to theDoctor of his treatment story. For 3 years, he had been helpless, unable to even raise a toe. His ego had been stripped off and his life ruined by a spinal disease whose name he couldn’t even pronounce. He tells of his struggle back to health amidst tears, and what pains him the most is that his local doctors in Kisumu knew his diagnosis and the required treatment but none of them had the skills of performing a spinal surgery. He had to be referred to Eldoret.

There was nothing wrong with that, all he had to do was present himself to the hospital with a referral latter. But for James, it wasn’t such a simple fairy tale: at MTRH, he wasn’t going to be admitted and operated on immediately as he had hoped. There was a list, a long list and he had to wait. His surgery was not to be, until in at least 6 months. Raising money for the MRIs alone and the transport from his rural home had cost him more than half of his meager resources.

A poor man, who had depended on small scale subsistence farming and fishing to feed and raise his family was now becoming even poorer and less productive. He now needed a wheelchair, lest he develops bed sores, he needed dippers, and someone to change them and turn him in bed: it was devastating. A man, barely 50 with a relatively young family brought to his knees, not because he had a very strange illness, but because our country lacked enough specialization in neurosurgery.

He felt cheated; because to him and to most patients, a doctor was just a doctor and they should be able to fix anything. “I kept asking myself how someone whose legs were totally broken in an accident was able to be fixed right here in Kisumu, but mine which appeared very simple, I was not hurt anywhere, I had to go to Eldoret, “he explains.

By the time his six-month appointment came, he was broke. Too broke to afford transport money all the way to Eldoret, let alone the theater fee and labs he had been told to pay on admission. Insurance! the least said about it, the better. He missed his surgery.

He had to wait another 5 months. And as if he hadn’t had enough, after 5 months of saving and going hungry and begging from relatives and friends, he had the money, but there was a countywide doctors strike. “I prayed everyday of those 100 days that I wake up to the news that the strike was over, that doctors had returned to work, because then I had hope of walking again. But it never happened.”

For the second time, he missed his surgery. He gave up.

Intraop, Dr. Raore and Nurse Sharmaine morrison: operating on James

“I had decided that I would not waste my last days fighting what God had planned. I was even contemplating suicide because I was just a burden to my family. But then I heard about the neurosurgery camp on radio. I got my hopes back. I came to the clinic, they assessed me afresh, they took my spinal images again, for free, I was booked for surgery and operated on by Dr. Raore at JOOTRH. The fact that I now know I will be able to walk on my own in a few weeks is a miracle. I really thank the American doctors for doing this for me.”

This is only one of the over fifty neurosurgery cases operated on in a span of 3 months in Kisumu at JOOTRH. Two camps have been held so far, the first in May and the most recent, one in which James got a chance was in September. Who is doing the surgeries? You ask!

A group of diaspora Kenyan neurosurgeons have come together in what they are calling the Kisumu Neuroscience Initiative. Neurosurgery is arguably the most complicated of medical specialties. It is probably the hardest to train  and it takes the longest as an Mmed specialty. In fact, in our setup, specializing in neurosurgery usually passes around as a joke and a near impossible. Probably it’s because while in school we don’t get to see so many of them or we are just lazy and don’t want to spend all that time in school. But there is a light at the end of the tunnel.

Dr, Bethwel Raore and his team posing for a photo at the JOOTRH theatre

During the Cuban doctor takeover in June, Kisumu received one Spanish speaking neurosurgeon. He is present daily but its just not enough.

The Kisumu Neuroscience Initiative seeks to breech this gap. It aims to make Kisumu the countries heart of neurosurgery. The current plan involves 4 American based and one Germany based neurosurgeon with Mr. Oluoch Olunya as the Kenyan based patron neurosurgeon. Each of the five surgeons are scheduled to camp at JOOTRH for 2 weeks together with their teams. Dr. Victor Awuor came in May and performed 23 surgeries, Dr. Bethwel Raore came in September. Dr. Timothy Ogutu is scheduled to come in January and Dr Calvin Omondi is scheduled to come in March 2019. Kisumu based resident and attending general surgeons led by Dr. Odira are in charge of clinic review of the patients and obtaining the required imaging and tests.

Once the neurosurgeons jet in, the procedures start. Two of the operating rooms in JOOTRH theatre are set aside for the neurosurgery. Equipped with modern equipment and a working air conditioner, they provide close to the ideal theatre environment. The American team comes with most of equipment, including sterile surgical gowns, drapes and surgical gloves. “Most of this equipment is donated by hospitals and manufacturing companies,” explained Dr. Raore, the attending Neurosurgeon during the September camp, “we have to reach out to them and ask for assistance.” “Most of the equipment we are going to leave here but some of the surgical tools we have to account for, so we’ll take them back.” Added Lila, one of Dr. Raore’s Nursing team.

The September team, led by Dr. Raore are from Atlanta, Georgia working at the Gwinnett Medical Center. Where most of the donated equipment were from. They managed to conduct a total of 33 neuro surgeries within the two weeks of the camp. The team works tirelessly from morning to evening conducting an average of 3-4 surgeries a day. “exhausting, but worth it.” says Dr. Raore.

Dr. Odira during a surgery

“We really thank Nurse Susan,” said John, another team member ICU nurse, “she has been a very major part of the team, actually, she is the team. She organizes everything for us, from the minute we land in Nairobi to the time we leave, Susan is in Charge.” “The hotel, the medical licenses, everything,” added Dr. Raore.

What is even more interesting is the fact that all the team members cater for their every moment of being in Kenya serving our people, from transport to accommodation to meals. Such sacrifice is unmatched.  In the future, the initiative plans to have a neurosurgeon coming over to Kisumu every single month. And just like Dr. Raore each one comes with their team.

According to Dr. Raore, they started out as Kenyan born doctors willing to give back to the community that raised them but they plan to bring on board even more surgeons so they can establish a permanent presence.

 Dr David Oluoch Olunya (Kenyan Patron)
Mr. Oluoch Olunya the team leader and Kenyan patron

Mr. Oluoch Olunya, the Kenyan patron and leader of the entire program speaks extremely passionately about the initiative. The Nairobi based accomplished Neurosurgeon makes monthly visits to Kisumu for follow-up and consult for past and future cases and also conducts neurosurgery in the private hospitals in Kisumu. Being from the western Kenya region, just like the American surgeons, Mr. Oluoch Olunya dreams of a self-sustaining neuroscience practice in the region. He hopes, with the help of other diaspora doctors, to be able to partner with local medical training institutions (Maseno an Uzima) alongside the regions renown neurologist, Prof. Jowi, to start serious training in neurosurgery and neuroscience.

In fact, it is already happening. Medical students and residents from both COSECSA and Maseno learnt a great deal. Anesthetists and student nurses are also getting the chance to observe and perform procedures that would otherwise have been theoretical. The likes of Dr. Odira have also had a chance to find their new passion.

Dr. Victor Owuor Teaching residents and students at JOOTRH during the May camp

According to Dr. Raore and his team, one of the biggest challenges they have faced is that of having to pay for customs duty for the supplies they are bringing for philanthropy  in Kenya. They hope to find a way to work with the county national governments to assist in getting supplies that will help the initiative succeed.

The team, however, showed a lot of concern on the general state of the hospital especially the wards according to one of the nurses it is not ideal for the recovery of neurosurgery patients and she hopes the hospital would improve. The administration have committed to making necessary changes which include: according to the Hospital CEO, Dr. Okoth, creating a purely neurosurgery ward.

theDoctor sincerely thanks the American Neurosurgeons and their teams for showing great compassion and being more than willing to give back to the society from which they came. We wish them the best and hope that the Kisumu residence and the medical family can benefit to the fullest from this great initiative.

by Nyadimu Festo

Nyadimu Festo MD

Medical Doctor. MBChB with IT (Maseno university). Passionate about medicine, writing and leadership. Voice of the Kenyan doctor.

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