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 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.
“In these videos, Diane and Andrea teach Mission Hospitals about scope care and maintenance.
Thankful for 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.
Equipment Donation Wish List
Wish List for endoscopy 2024
(par 200) Polypectomy snares – Standard 10-30 mm
(par 400) Disposable GI cleaning brushes
CRE Dilation balloons: pyloric or esophageal – Sizes 6-15 mm – smaller sizes needed
(par 50) Roth Nets
(par 100) Plastic Biliary stents 7 & 10 french – 5cm-12 cm (and delivery systems, short wire preferred)
Metal Biliary stents
(par 50) Wire guided ERCP cytology brushes (Short wire preferred)
ERCP wires -.025 and .035 straight tip (shortwire and longwire)
ERCP Extraction balloons- multi size
ERCP Dilation Balloons
(par 20) ERCP Wire holder for shortwire system
ERCP Baskets
(par 150) ERCP Sphinctertomes – .025 and .035 (short wire 035 preferred)
ERCP Disposable distal tips for Olympus 170 TJF (same as TJF 190)
(par 100) Injection needles
(par 50) Replacement G tubes
(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)
(2) Savary Dilating set
(par 10) Savary Dilator wires
Metal Esophageal Stents
(par 50) EUS Needles New item needed
(par 10) EUS Balloons
(par 50) EUS Cleaning Brushes
Endoscopes – EGD-(including pediatric)/Colon/ERCP we will consider matching Olympus on trade-ins
ERBE Cautery unit
CO2 Insuflation device
Light bulbs for 180 Olympus Light Source
Research from Tenwek
Establishment of an endoscopic retrograde cholangiopancreatography (ERCP) program in rural Kenya: a review of patient and trainee outcomes
Background: Endoscopic retrograde cholangiopancreatography (ERCP) is a leading modality for treatment of biliary and pancreatic disease but is not widely available in sub-Saharan Africa. We aimed to assess the development and outcomes of an ERCP service in southwestern Kenya, including case volumes, success rates, infrastructure, and training.