361-bed Christian Mission Hospital
Hospital staff: 800+
Births/year: approx. 3,000
Hospital-wide HMIS and radiology PACS system
Full-time missionary staff includes physicians in:
General and Orthopedic Surgery
The current endoscopy/gastroenterology program at Tenwek was advanced by Dr. Steve Burgert who became a full-time medical missionary to Tenwek in 2009. Steve retired in 2022. Endoscopists are trained in two-year Endoscopy/Research Fellowships. Dr. Michael Mwachiro, assumed the Tenwek Endoscopy Directorship in 2017. He is the first Kenyan National to take on this important administrative and teaching role at Tenwek Hospital.
Dr. Jeffrey Hallett, a passionate supporter of the endoscopy/gastroenterology program at Tenwek, 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 short-term visitors. EUS is coming soon. The program continues to generate original research in the fields of epidemiology and oncology.
In this video, Dr. Hallett and two colleagues talk about their March 2021 visit to Tenwek.
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).
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.
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.