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
Can I really use my neurosurgical skills in rural Kenya? Yes! There is a great need for neurosurgeons in Kenya, with only 1 provider for every 2 million people, compared to 1 for every 60,000 in the US. This need is particularly seen in rural settings, as less than half the population has access to a neurosurgeon within two hours of their home. Tenwek has been offering full-time neurosurgical services since September 2016 and has developed the infrastructure necessary to make good use of your skills.
The Role of the Neurosurgeon at Tenwek
The neurosurgery service is anchored by Dr. Will Copeland who came to Tenwek with his family as a full-time missionary in 2016 after completing his neurosurgery residency at the Mayo Clinic in Rochester, Minnesota. There is also a full-time neurosurgical clinical officer (equivalent to a physician assistant), and a monthly rotating resident from the general surgery residency program. There is occasionally an interested medical student or medical officer intern who requests to rotate as well.
The inpatient census is usually between 10 and 15 patients. Formal teaching rounds are held Monday, Wednesday, and Friday at 0700. Monday is the main clinic day where 30 – 40 patients are typically seen, though nearly every day there are additional consults from clinic, casualty (the ER), or other hospital services.
There is a smaller scheduled clinic day on Thursdays. Our clinical officer and rotating resident assist in seeing all clinic patients and consults. Operations are scheduled for Tuesday, Wednesday, and Friday, as well as many Thursdays. Neurosurgery has a dedicated room and there are two full-time nurses that assist with all cases.
The average weekly volume is between 6 and 8 scheduled cases, though there are always some urgent/emergent ones to be added. Cases encompass both adults and pediatrics. Approximately one-half of the operative volume is the result of trauma, hydrocephalus, or spina bifida, and the remaining half related to a variety of pathologies such as benign intracranial tumors, degenerative and infectious spine disorders, and aneurysms.
Technically the neurosurgical consultant is always on-call, though typically emergent cases overnight will be handled by the surgical residents and reviewed with the consultant the following morning.
Equipment
There is a variety of modern equipment including a Stryker electric drill, Zeiss NC4 microscope, Storz flexible endoscope, a multitude of spinal implants, aneurysm clips, and more. An electronic medical record and PACS imaging system facilitate patient encounters. On-site imaging includes X-ray, ultrasound, fluoroscopy, and CT, though MRI is also easily obtainable in the region.
A Rewarding Experience
Serving at Tenwek Hospital is an incredibly rewarding and enlightening experience. Most visiting neurosurgeons prefer to stay at least two weeks, but any length of visit is welcome. Perhaps most meaningful is the chance to teach the residents, all while encouraging them in their desire to provide Christ-like care to their patients. On graduating they take the neurosurgical skills they’ve learned to other parts of the country, thereby multiplying your efforts at Tenwek.
