OB/GYN

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 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 sixteen 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.

 

Obstetrics and Gynecology Department

The Department of Obstetrics and Gynecology (OBGYN) is a growing service at Tenwek Hospital. OBGYN physicians primarily serve high-risk obstetrics patients and other complicated OBGYN medical and surgical conditions. Since Dr. Joy Draper joined as a full time physician and became the department director, many changes and improvements in care have occurred. Dr. Cheryl Cowles, another experienced full time American OB/Gyn also has joined Dr. Draper. Both of them are amazing and inspirational physicians to work with.

OBGYN has the feel of a busy public hospital. The busiest part of the service is obstetrics. The Maternity Unit, which includes a NICU/ newborn nursery, is the largest single department in the hospital. Moms and babies make up approximately 100 beds. The Unit is very busy with low risk mothers arriving for delivery who have had prenatal care at the Tenwek maternity clinics and also women without prenatal care. There were 3,679 admissions to the unit, with 2,496 deliveries in 2015 (SVD-1834, C/S-662), with an increased number of both in subsequent years. Women in labor are managed by Kenyan nurse-midwives, with doctors providing constant support if complications arise.

The Ob/Gyn Physician’s Role at Tenwek

There is an OB theatre in Maternity and available OR space in the Main Theatre. When on call, the visiting physician will perform this surgery. There is a maternal-child health clinic where prenatal care is provided Monday through Friday. Complicated pregnancies are referred to the obstetrics team while normal pregnancies are generally cared for by MCH nurses and clinical officers. The Tenwek OB service provides care for many complicated patients.

The Maternity service includes many high-risk antepartum patients with the diagnosis of chronic hypertension, preeclampsia, preterm labor, preterm premature rupture of the membranes, and diabetes, as well as frequent patients with severe HELLP syndrome. Also, IUGR is common as is malaria, typhoid, HIV and postpartum cardiomyopathy.

The Gynecologic service also is busy. Gyn clinic is held on Wednesdays, and elective Gyn surgical cases are done in the Main Theatre Tuesdays and Thursdays. Surgery for fibroids (hysterectomy and myomectomy) are the most common Gyn elective case.

Equipment

The unique challenges of providing care in a resource-poor country makes treatment much more difficult. This is a tertiary center by Kenyan standards, with a CT scanner and NICU with ventilator capability. However, nothing is easy or straightforward. You have to be flexible, innovative and creative.

In June 2017, three new fetal monitors were delivered by Dr. Phil Greig, FOT’s Champion for OB/GYN, who plans to add three more in the future. While the maternity unit and the radiology department have ultrasound machines, a vaginal probe and other ultrasound supplies are needed. Ultrasound expertise is needed to teach the ultrasound techs and provide OB and Gyn ultrasound evaluation on a daily basis. Many ultrasounds are needed daily to meet the clinical diagnostic needs of both the Obstetrics and Gynecology service.

Ob/Gyn Staff

Both medical officers and Interns rotate through the Ob/Gyn service. This is the only training they will receive in women’s health so they need intense and comprehensive training during their three-month rotation. Visiting OB/Gyns will work with long term staff, and will be involved in many aspects of care and teaching of our students, interns and residents. These young staff are so enthusiastic and eager to learn; this is one of the most rewarding parts of service at Tenwek. Daily morning rounds are done on all the patients, along with prayer with each.

 

 
Very exciting news is that we are currently in the process of applying to have our own Ob/Gyn Residency.  We would like to have an international OB/Gyn faculty who can provide teaching at Tenwek for a minimum of two weeks per year and possible telemedicine consultation.  In this way we would be able to teach a comprehensive obstetric curriculum. We invite you to come and experience the adventure of practicing and teaching all aspects of Obstetrics and Gynecology in Africa. You will be changed forever.

 

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 and 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 is a 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 Ob/Gyn team, please contact Dr. Phil Greig (philgreigmd@aol.com/Cell-864-616-6243) or Dayna Wright who oversees volunteer physicians for Tenwek at World Medical Missions (dwright@samaritan.org /828-278-1168).

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