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The future of cardiothoracic surgery in Eldoret and international justice

April 7, 2011

Part of the Cardiac Crew

It certainly is unclear what the future of cardiac surgery will be at Eldoret. I think it will go forward. At what speed remains unknown. The surgeons here already perform select thoracic surgeries and will be performing heart surgery for patients with mitral stenosis from rheumatic heart disease. The mitral valve sits in the left ventricle. These patients can be extremely symptomatic (short of breath, faint etc) and would benefit from dilation of their small mitral valve. I just spoke with the Duke cardiologist here at MTRH. He apparently has a long list of patients ready for the procedure and has brought the Tubb’s dilator back for Otsyula to use. In addition, the cardiac cath lab is realistically scheduled to be online in the next 2 or 2 1/2 years. Certainly, the closed heart program will take off with the cath lab and the Tubb’s dilator.

Open heart surgery would require a heart-lung machine which is not here yet. The open heart team has trained for 15 months over the past five or so years. In the picture to the left, you see Charles (cardiac anesthesiologist), Rose (cardiac perfusionist) and Zipporah (cardiac scrub tech). They are extremely dedicated people who have been waiting years for an open heart unit. After discussion with some of the key Kenyan players, this unit would most likely require a dedicated separate cardiac ICU, dedicated nurses (which is not the norm, usually the nurses rotate), and the procurement of a lot of infrastructure (heart-lung machine, more vents, more monitors, stable supply of drugs/OR materials etc).

This task of opening an open-heart unit might seem daunting if not for the fact, that progress is continually made at MTRH. For instance, the hospital OR started with one room that served as an ICU and minor procedure room. Now there are eight ORs. In addition, IU has built a mother-baby hospital for the neonates. Toby Tanser is also raising funds for a brand new pediatric hospital on the the hospital grounds. The ground breaking ceremony is to begin in two weeks or so. Here’s a blurb about him from a Facebook page.

“It all started back in , when Tanser was one of those elite-runner mazungos training in Kenya. He had arrived in country with the sole purpose of training with the world’s best. He got off the plane with bags filled with his training shoes. Deeply affected by the poverty he saw during his stay, he left with nothing, deciding to give everything away — even the shoes on his feet. After that memorable trip, Tanser founded Shoe 4 Africa, a charity that gives donated running shoes to impoverished Kenyans.

Fifteen years later, Shoe 4 Africa has grown by leaps and bounds. The charity still takes used shoes, but also accepts monetary donations. With the money, Shoe 4 Africa sponsors races for HIV/AIDS awareness and has recently broken ground for a new school.Tanser isn’t resting on his laurels, however. Shoe 4 Africa’s latest project is enormous: building the largest children’s hospital in the entire continent of Africa — a $15 million project in Eldoret.”

Now this hospital project has been in the works for several years and $1 million has been raised, so I anticipate it will be a while before it’s finished. I find the information on the Tanser website interesting especially the proposed design of the hospital seen below. I’m not sure how this hospital will fit in the existing space if you recall the photo of MTRH that I posted. We’ll have to see what happens.

The future children's hospital

The website also states: “After 15-years of experience in Kenya, this is the first water-tight project I have found. It is almost too simple to be true, and all the medical experts I have spoken too, whether they be American or Kenyan, who have delved through the plans, the studies, and the proposal, agree that this is a solid and very doable, and will be a hugely effective, project. It is going to happen, and thousands upon hundreds of thousand of lives will be bettered because of it. People talk about sustainability, but all the ‘white elephant ghost projects you see are the ones that the Western Investors did not believe and invest in the local work power. The MOI Referral has been through the fights for Independence, changing Governments, wars, and more, and continues to run in an impressive fashion for the last 90-years. It is a center of excellence for the region and well known in the Western medical world. Please help the children of Kenya get their own public hospital in this amazing set up; a place where the Kids are the priority. We have a fantastic team of Doctors, builders, Ministers, & members of parliment, to make this dream a reality.” Toby Tanser, Founder/CEO.

Certainly, Toby has garnered some publicity for MTRH. He interviewed with CNN’s Sanjay Gupta last month. I don’t know if the IU staff would appreciate this following line from the print interview about the 2008 post-election violence.

“I was there when Kenya erupted with tribal violence, 18 miles up the road from a church that was burned with around 50 women and children locked inside. I saw all the Western aid workers, well-paid and trained to help in Africa in crisis situations, leave the country, airlifted out, as the poor men and women on the street stood up and opened their hearts to the sick and wounded.”

Six men were implicated heavily in the post-election violence. Known as the Ocampo Six, they just presented to the Hague for an international trial. Per the Kenyan paper, the Daily Nation–“The events which led to the charges stem from the violence which engulfed the country after the disputed Presidential election of December 2007. A total of 1,133 people were reported to have been killed and nearly 600,000 displaced.”

Hopefully, things won’t get ugly again. The story notes, “Presiding judge Ekaterina Trendafilova said the court’s attention had been drawn to signs of a new bout of violence through articles published in Kenyan newspapers”.

Well in any event, I’ll be praying about my role in all this. Life is no easier on this side of the pond.

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