Endoscopy-Gastroenterology
Medical Specialties
The current endoscopy 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. Micheal Mwachiro assumed the Tenwek Endoscopy Directorship from 2017-2022. He was the first Kenyan National to take on this important administrative and teaching role at Tenwek Hospital.
Dr. Jeffrey Hallett and Ronda Flesch, RN, passionate supporters of the endoscopy program at Tenwek, currently serve as Friends of Tenwek Gastroenterology Co- Champions.
Short-term medical missionary expatriates are always a welcome part of the development of the endoscopy program. Currently, surgical residents are receiving training in ERCP and EUS techniques from short-term visitors when schedules permit.
In this video, Dr. Hallett and Ronda Flesch,
RN talk about their February 2023 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 and EUS 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 ERCP and EUS.
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.
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.
Wish List for endoscopy 2025
- (par 200) Polypectomy snares – Standard 10-27 mm- Do not need specialty snares
- (par 100) Polyp traps
- (par 150) Biopsy forceps 2.8 mm
- (par 50) Biopsy forceps 2.0 mm
- (par 400) Disposable GI cleaning brushes
- (par 100) CRE Dilation balloons: pyloric or esophageal – Sizes 6-15 mm – smaller sizes needed most
- (par 50) Roth Nets
- (par 100) Plastic Biliary stents 7 & 10 french – 5cm-12 cm (and delivery systems, short wire preferred)
- (par 20) Metal Biliary stents
- (par 50) Wire guided ERCP cytology brushes (Short wire preferred)
- (par 50) ERCP wires -.025 and .035 straight tip (shortwire and longwire)
- (par 50) ERCP Extraction balloons- multi size
- (par 50) ERCP Dilation Balloons
- (par 20) ERCP Wire holder for shortwire system
- (par 20) ERCP Baskets
- (par 150) ERCP Sphinctertomes – .025 and .035 (short wire 035 preferred)
- (par 100) ERCP Disposable distal tips for Olympus 170 TJF (same as TJF 190)
- (par 100) Injection needles
- (par 50) APC Probes
- (par 50) Replacement G tubes size 20/24, need to use blunt tip syringe or have adaptors
- (par 20) Peg trays – 20-24 french
- (par 50) Pediatric polypectomy snare – 2.0 working channel
- (par 100) Pediatric biopsy forceps – 2.0 working channel
- (par 5) Achalasia balloons
- (par 150) Speedbanding kits (Cook preferred)
- (par 2) Savary Dilating set
- (par 10) Savary Dilator wires (referring to .035-.038 guidewires)
- (par 50) Metal Esophageal Stents- 18-20 mm -various lengths Greatly needed
- (par 50) EUS Needles New item needed
- (par 10) EUS Balloons – radial and linear
- (par 50) EUS Cleaning Brushes
- (par 20) Oximeter probes (prefer small portable ones)
- (par 10) Hemorrhoid bands
- Olympus scopes, 140-190 series – we will consider matching Olympus on trade-ins
- ERBE Cautery unit
- CO2 Insuflation device
- Blue procedure gowns, medline blockade extra large, ceil blue
- Light bulbs for 180 Olympus Light Source
- 1 oz hand sanitizer bottles
- Plastic kidney dishes
- Dilator cleaning brushes
- Lead gowns
- Flexible Savory Dilators
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