Tenwek Vitals
361-bed Christian Mission Hospital
Hospital staff: 800+
Inpatients/year: 15,000+
Outpatients/year: 220,000+
Surgeries/year: 6,000
Births/year: approx. 3,000
Hospital-wide HMIS and radiology PACS system
Full-time missionary staff includes physicians in:
General and Orthopedic Surgery
Family Practice
Internal Medicine
Neurosurgery
Pediatrics
Pediatric Surgery
OB/GYN
Ophthalmology
Gastroenterology
The Diagnostic Radiology Department plays a vital role in patient care. Over the last decade, the department has steadily grown and improved. The hospital’s first CT scanner was installed in 2011, ushering in a new era at Tenwek. The following year, a long-range radiology development plan (A.R.T. – Advancing Radiology at Tenwek) was launched to purchase new equipment and remodel the department.
Since 2012, over $500,000 has been raised to replace or upgrade Radiography, Ultrasound, and CT equipment – transforming the department.
A coalition of over 100 U.S. and Canadian radiologists also has developed to provide financial support and to staff the department through a combination of on-site and teleradiology services.
The Radiologist’s Role at Tenwek
Tenwek does not have a full-time radiologist on staff, which heightens the impact of on-site volunteer radiologists. Over the last eight years, nearly 40 different Christian radiologists have served on-site at Tenwek for periods of two to seven weeks. Volunteering to serve at Tenwek is a deeply gratifying and humbling experience. You have an opportunity to make a very tangible impact with your skills and knowledge – both in direct patient care and in teaching Kenyan medical staff.
The radiologist’s primary clinical responsibilities include daily reporting of CT scans as well as providing consultations for ultrasounds and plain radiographs. There are also opportunities to perform non-vascular interventional procedures if within the individual radiologist’s scope of practice and interests.
Educating Kenyan Christian medical professionals is an important goal at Tenwek, in which visiting radiologists participate. There are currently residency programs in General Surgery, Orthopedic Surgery and Family Practice, with plans to initiate an OB-GYN residency in the near future. Family Medicine residents from Tenwek and two other Kenyan mission hospitals perform their mandatory radiology elective at Tenwek. Under the guidance of one of our visiting radiologists, these residents learn the basic tenets of imaging during their three week rotation. Sixteen medical “interns” spend their first year of practice working/learning at Tenwek and visiting radiologists play a role in their training through consultations on imaging studies of their patients. Additionally, four Radiology Technologist students spend three to four months at Tenwek as a part of their “Clinical Attachment” each year.
Radiology Equipment
CT Scanner:
64 Channel Siemens Go Up CT – fully operational in January 2019 providing outstanding image quality.
A sample of images from the new CT and types of pathology seen at Tenwek can be seen here. (This teaching file was assembled by Dr. Michael Hartung at University of Wisconsin).
Ultrasound:
3 Sonosite Turbo’s including small parts and TV transducers (30-50 scans/day)
Plain Radiography:
- Two new Quantum radiography machines processed via CR (60 – 120 studies/day)
- Del Medical digital radiography machine at outpatient clinic
- 2 AMX portable radiography machines and 1 C-Arm for Surgery, OB/GYN
Converting our radiography processing from CR to Digital Radiography (DR) is one of the next objectives in improving patient care.
PACS
Imaging at Tenwek is entirely digital. Plain radiographs are acquired using a CR system, which together with CT scans and Ultrasounds are stored and viewed on a ClearCanvas PACS system. There is a dedicated radiologist workstation and office. CT reports are generated with voice-recognition software and entered into the hospital HMIS called “Kranium.” English is used throughout the hospital for all records and personal interactions. Approximately 20% of patients speak English.
Radiology Staff
There are approximately 12 Radiology Technologists, one receptionist and an assistant/janitorial staff member. There are dedicated techs in Ultrasound and CT. Providing encouragement and on-going education for the Radiology Techs, especially in Ultrasound and CT, are both fun and important aspects of serving on-site at Tenwek. The staff in radiology and throughout the hospital are welcoming, engaging and willing to help.
USA-Based Teleradiology
We encourage Radiologists to serve on-site at Tenwek because of the impact you can make with your presence and how you will be impacted by the experience of living and working among the Christian community there.
However, when there is no radiologist on site, “teams” of four to six radiologists based in the U.S. interpret the CT scans daily for a one-week time block. This is done through an image sharing company named Nucleus which donates their services to Tenwek. Scans are easily viewed in any major internet browser and a typed report sent back to Tenwek via the Nucleus software.
Stan Cheng is the teleradiology coordinator at Tenwek. He can be reached at: schengsd@gmail.com.
This Global Health Onboarding webpage features resources for onboarding radiologists for serving in low-middle income countries or resource-limited settings utilizing teleradiology platforms or on-site.