Obstetrics and Gynecology (OBGYN)
Medical Specialties
The Department of Obstetrics and Gynecology (OBGYN) is an active service at Tenwek Hospital. OBGYN physicians primarily serve high-risk obstetrics patients and other complicated OBGYN medical and surgical conditions.
The Maternity Unit, which includes a NICU/ newborn nursery, is the largest single department in the hospital. The 67-bed maternity ward is often fully occupied.
The Unit is very busy with low-risk mothers arriving for delivery who have had prenatal care at the Tenwek maternity clinics as well as women without prenatal care. Women in labor are managed by Kenyan nurse-midwives, with doctors providing constant support if complications arise. In recent years, 22-25% of over 3,000 annual deliveries were done by cesarean section.
Some common OB/GYN conditions treated at Tenwek include: intrauterine fetal demise, miscarriages, severe pre-eclampsia, advanced cervical cancers in 20-40-year-olds, illegal abortion complications, severe anemias, massive fibroids and ovarian tumors – with many of these conditions compounded by multiple co-morbidities.
Daily Responsibilities of a Visiting Obstetrician
There are two operating “theaters” in the maternity unit. When on call, the visiting physician will perform or supervise cesarean sections or gyn surgeries. There is a maternal-child health clinic where prenatal care is provided Monday through Friday generally cared for by MCH nurses and clinical officers. High Risk Obstetric Clinic is conducted on Mondays and Thursdays.
The Obstetric service includes many high-risk antepartum patients with the diagnosis of chronic hypertension, preeclampsia, preterm labor, preterm premature rupture of the membranes, rheumatic heart disease, previous pregnancy losses, and diabetes, as well as frequent patients with severe HELLP syndrome, many complicated by IUGR. HIV affects about 5% of the patients.
The Gynecologic service also is busy. Gyn clinic is held on Wednesdays and Fridays. Elective Gyn surgical cases are done Tuesdays and Thursdays. Surgery for fibroids (hysterectomy and myomectomy) are the most common Gyn elective cases. Nonelective cases include pelvic masses, ectopics, D&Cs for hemorrhage and complicated pelvic abscesses. Advanced gynecologic cancers are frequently encountered, particularly cervical, uterine and ovarian.
The unique challenges of providing care in a resource-poor country makes treatment more challenging. Tenwek is one of the few hospitals in Kenya that provides electronic fetal monitoring. This is a tertiary center by Kenyan standards, with a CT scanner and NICU with ventilator capability. However, nothing is easy or straightforward. You have to be flexible, innovative, and creative.
The maternity unit, Maternal Health Clinic (MCH) and the radiology department have ultrasound machines, including a vaginal probe transducers. Ultrasound expertise is needed to teach the Ob/Gyn residents, Medical Interns and Medical Students as well as provide Ob and Gyn ultrasound diagnostic evaluations on a daily basis.
Department Staff
The Ob Gyn Department is not only providing compassionate healthcare but is providing training for service including ObGyn Residents, Surgical Residents, and Family Medicine Residents. Medical Interns and Medical Students also are being trained for thorough understanding of women’s healthcare in all aspects of medical practice.
Department Staff include:
- ObGyn “Consultants” (Specialists)
- Obestetric/Gynecologic Residents
- Medical Officer (generalist doctor) working exclusively on our service
- 2 Clinical Officers (physician assistant level practitioners)
- Medical Interns (Usually around 4-6 at a time, on the service for 3 months),they do most of the “clerking” of the patients and do the primary orders and H&Ps.
- Medical Students (variable), Clinical Officer Students on Mondays and Tuesdays
In addition, most of the year, a first or second year surgical resident is rotating on the service. Family Practice residents also come in three-month rotations.
This is the only training they will receive in women’s health so they need intense and comprehensive training during their clinical rotation. Visiting OB/Gyns will work with long term staff and will be involved in many aspects of care and teaching of our students, interns and residents. These young staff are so enthusiastic and eager to learn; this is one of the most rewarding parts of service at Tenwek.
Daily morning rounds are done on all the patients, along with prayer with each.
How You Can Give
Our current needs are to support Tenwek Hospital through assistance with needy patient funds and support some critical staffing needs of the ObGyn department.
PRAY
- Pray for the health and safety of the mothers and babies who are treated at Tenwek.
- Pray for physical and spiritual strength for the OB/GYN department’s missionary and Kenyan staff.
- Pray that Tenwek can continue to recruit qualified, mission-minded African physicians for the OB/GYN residency program.
GIVE
- Provide lifesaving medical equipment and supplies for OB/GYN services.
- Support an African OB/GYN resident with a gift that provides housing, a small stipend, certification testing, insurance, and educational materials.
- Use this online form to make a gift.
SERVE
- Serve at Tenwek through a short-term medical mission trip and share your expertise with the next generation of African physicians.
Visit Tenwek Hospital
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