Endoscopy-Gastroenterology Program

Introduction & General Information

Aerial viewTenwek Hospital is a 300-bed Christian Mission Hospital located in the rural highlands of Kenya, 150 miles NW of Nairobi. It was founded by American nurses in the 1950s and its first physician, Dr. Ernest Steury, arrived in 1959. (The book, Miracle at Tenwek, tells his inspiring life story.)

Today, Tenwek serves 600,000 Kipsigis people in the region and receives referrals from throughout Kenya and surrounding East African countries.

 

Tenwek-Residents
Tenwek is a major training center with residencies for African physicians in Family Practice and General and Orthopedic surgery through the Pan-African Academy of Christian Surgeons (PAACS). About eighteen interns do their first year of training at Tenwek each year; approximately 22-25 residents serve at Tenwek in Surgery, Orthopedics, and Family Practice. There is a large Nursing School on campus as well as a Chaplaincy School. Tenwek has a large, active Community Health department impacting a wide geographic area and serving as a model program for developing countries.

 

History and Role of Gastroenterology at Tenwek

The current endoscopy/gastroenterology program at Tenwek was advanced by Dr. Steve Burgert who became a full-time medical missionary to Tenwek in 2009. Dr. Burgert has developed the endoscopy/gastroenterology curriculum, which is taught to medical and surgical Medical Officers in Tenwek’s training programs. He also has trained three endoscopists in two-year Endoscopy/Research Fellowships. His first endoscopy fellow, Dr. Michael Mwachiro, assumed the Tenwek Endoscopy Directorship in 2017. We are pleased that Dr. Mwachiro is the first Kenyan National to take on this important administrative and teaching role at Tenwek Hospital!
Pictured above, left to right: Drs. Burgert, Hallett, and Mwachiro. View a video here where they talk about Tenwek’s Endoscopy/Gastroenterology Department. 

Dr. Burgert recently has been promoted to Medical Superintendent at Tenwek Hospital.  Dr. Jeffrey Hallett is a passionate supporter of the endoscopy/gastroenterology program at Tenwek and currently serves as Friends of Tenwek Gastroenterology Champion.

Short-term medical missionary expatriates are always a welcome part of the development of the endoscopy program.  Currently, Dr. Mwachiro is receiving advanced training in ERCP techniques from Dr. Burgert and short-term visitors. The program continues to generate original research in the fields of epidemiology and oncology.

Daily Responsibilities of a Visiting Endoscopist


During a short-term medical mission to Tenwek Hospital, a gastroenterologist/endoscopist would be expected to report at 8 a.m., Monday through Friday, for participation in morning report and devotions. Attending level insights and teaching is always appreciated.

At 9 a.m., help is needed in the Endoscopy Theater. Monday through Friday, a queue of patients from a service population of over 600,000 reports to the Endoscopy Theater for outpatient consultation and endoscopy services.

 

There is a preponderance of squamous cell carcinoma of the esophagus and stenting extends life in these patients. It is not unusual to place 3-5 esophageal stents in a typical day. The Endoscopy staff is very experienced in esophageal stent placement and will assist a visiting endoscopist to learn the “Tenwek technique” for this procedure. ERCP skill and teaching is much appreciated and performing 1-2 ERCPs per week is not unusual when that service is available. However, it is not a requirement that short-term endoscopists perform ERCPs.


In addition to working the endoscopy queue, outpatient GI consultations are seen by endoscopy staff with input from the attending physician. Inpatient consultations are frequently needed and attending physician input is sought as appropriate. Translation services are always available and language barriers do not seem to pose a significant problem. Each person visiting endoscopy is offered prayer and a Bible in their language, as well as pastoral follow-up when appropriate.

 

Lunch typically is from 1-2 p.m., with the day usually concluding between 4 and 5 p.m. Short-term endoscopy missionaries usually stay at Tenwek 2-6 weeks with the average being 3-4 weeks. We are asked to participate in the internal medicine call schedule for one or two weeknights per week and one weekend per month. This consists of staffing hospital admissions presented by interns by phone, and being present for (but not necessarily performing) intubation procedures and resuscitations.

Department Equipment


Tenwek Endoscopy is well-equipped to serve its patient population with therapeutic upper endoscopy, PEG placement, colonoscopy and ERCP. Almost all of the procedures are currently performed with conscious sedation, and in the next year, additional endoscopes, monitors and gurneys are anticipated to arrive. This will allow Tenwek Endoscopy to consistently run two endoscopy rooms simultaneously when staffing permits.

 

 

Department Staff


Dedicated Nursing Officers and Endoscopy Technicians staff the Endoscopy Theater. They are well-versed in endoscopy care and fluent in English and the local languages. They are invested in the Christ-centered care of their patients. They know how to use a visitor’s knowledge and skills so efficiently,  that he or she will become a valued member of the team right away. Ancillary and research staffs also are part of the Endoscopy Theater team. Chaplain services are always nearby to help promote the life-changing gospel of Jesus to all.

 

Travel and Housing

Most physicians who serve at Tenwek do so under the auspices of World Medical Mission, a branch of Samaritan’s Purse (SP) It is a long journey to Kenya but once there, SP has staff who meet you at the airport and arrange a night at a guesthouse in Nairobi if necessary.

Tenwek Guesthouse
SP drivers will drive you four hours to Tenwek through the Rift Valley and center of Maasai land. There is a comfortable guesthouse on campus with private apartments. There is also a  common area with a cooking staff (or you can cook yourself). Tenwek is in a rural mountainous area surrounded by small farms and tea plantations. It is a family-friendly environment and a safe area. Elevation is 6,000 ft so although you are near the equator the climate is moderate and changes with the rhythm of “dry” and “rainy” seasons.

 

African Safari Opportunity

masai-mara

 

The world famous Maasai Mara game preserve is just two hours south of Tenwek. Many visitors work with the hospital staff to arrange a short visit to “The Mara.” Hospital volunteers receive significantly discounted rates for this once-in-a-lifetime experience. Learn more about the Fairmont Mara Safari Club in this video.

 

 

Where do I go from here?

If you are interested in serving at Tenwek or being part of our Endoscopy/Gastroenterology team, please contact Jeff Hallett, MD (jeffreyhallett@ymail.com/217-778-9061) or Dayna Wright who oversees volunteer physicians for Tenwek at World Medical Missions (dwright@samaritan.org /828-278-1168).

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