Oral & MaxilloFacial Surgery

Introduction & General Information

Aerial viewTenwek Hospital is a 300-bed Christian Mission Hospital located in a rural, mountainous area 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 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.

 

The Oral and MaxilloFacial Surgeon’s Role at Tenwek

There is not a full-time oral and maxillofacial surgeon (OMFS) serving Tenwek. The general surgeons are able to provide some treatments of head and neck disorders, but are unable to keep up with the demand or tackle the more challenging cases.  The general dentist performs some of the needed dental alveolar surgery and trauma here, but not the more “complicated” cases.

pic-4-cleft-lip-surgery-for-webThe types of disorders the visiting OMFS may see include dental alveolar (removal of teeth, biopsies, pathology, and infections), cleft lips/palates, acute trauma and traumatic deformities, developmental disorders, and various types of infections and pathology. Ameloblastomas, ossifying fibromas, and large dentigerous cysts seem to be three of the more common ‘benign’ lesions of the jaws we see at Tenwek.

 

pic-5-ameloblastoma-for-web

 

Malignant lesions of the mouth and head/neck are also frequently seen. Currently, an OMFS may be at Tenwek for only a couple of weeks each year and many patients in need of this type of care must go a year or more without treatment. Those fortunate enough to have the means, must travel to Nairobi for their care. As a result, patients often present with a more advanced stage and size of lesions than they would in the United States.

 

 

Anesthesia and Surgery Staff    

pic-6-tenwek-surgery-staff-300-webAnesthesia is provided by a dedicated and well-experienced staff of Kenyan anesthetists. These practitioners are extremely well-versed in long and complex surgical cases. Visiting anesthesiologists may also provide anesthesia when serving  at Tenwek. If and when indicated, the general surgeons will assist and/or work with the OMFS. The surgeons at Tenwek practice a much broader range of surgical care than those in the U.S., due to the need and their experience on the mission field. It can be advantageous to serve as a team of OMFS’s, OMFS/ENT, OMFS/Plastics, etc.  The different backgrounds, as well as experience and training, often are complementary towards patients’ care.  

Daily Schedule and Teaching Opportunities

The “typical” workday begins with morning rounds followed by conference/lecture/devotions – depending on the day. Surgeries begin at about 8:00 a.m. The visiting specialists are given preference in surgical scheduling while there for short periods of time. Consultations may be needed between surgeries or at the end of the day. Clinic patients are seen about two days per week. Although the OMFS is on-call at night, it is quite unusual to be called in. The surgical residents treat most emergencies and will involve the OMFS or consult with them the following day as appropriate.

pic-7-omfs-staff-and-resident-300-web

 

One of the most gratifying aspects of serving at Tenwek is the opportunity to interact with and teach the general surgery residents in the PAACS program. A surgery resident is usually assigned to the oral surgeon so that he/she can be involved with and begin to appreciate the complexity of OMFS cases. Tenwek also has 16-18 first year interns in training each year whom the OMFS might interact with on rounds or morning report.

 

Other Important Information

The hospital has “gone digital” with an electronic HMIS for medical records as well as PACS for radiographs and CTs. Internet access is easily obtained and aids in communicating with “home” and there is a facile system to send CTs for review by your colleagues in the U.S.

 

East Africa’s largest eye/dental building has been under construction at Tenwek for three years and is scheduled to open in the Summer of 2017. This incredible new facility will provide clinic space, surgical suites and in-patient beds for dental, eye and oral surgery/ENT patients.

 

 

Our Future Goal

 

Our goal is to provide more continuous and predictable oral and maxillofacial surgical care at Tenwek with an oral and maxillofacial surgeon or a team rotating at least quarterly.  We would also like to develop a team of oral surgeons willing to be available for consultation digitally to provide expertise and advice for the general surgeons at Tenwek.

 

 

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 GuesthouseSP 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

pic-8-masai-mara-lions-300-web

 

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 have any questions or are interested in serving at Tenwek or being part of our consultation team, contact Russell Williams at Rwilliams@saoms.com or (217)-546-8100, or Dana Wright, who oversees volunteer physicians for Tenwek at World Medical Missions at Dwright@samaritan.org or (828)-278-1168.

Print Friendly