Sunday, September 24, 2017

Orthopedic Surgery in Rural Kenya

Kyle Stephens is in his final year of orthopedic surgery residency in southeast Michigan. He and his wife Jennifer recently spent time at Tenwek Hospital in southwestern rural Kenya this past January. This was their first trip to Africa and Kyle’s first orthopedic mission trip. They currently live in Warren, MI, a suburb of Detroit, with their three sons, Garrett (7), Luke (5), and Bryan (3). Kyle regularly writes about his adventures on his personal blog.

Orthopedic surgeons are needed desperately in the mission field. As a medical student, I didn’t know this was the case. I almost decided not to pursue orthopedics because of my mistaken assumptions and not knowing how or if God would use me to work within His kingdom overseas as an orthopedic surgeon.

Through a series of emails, conversations, and prayer, I stumbled upon an article on World Medical Mission’s website about Dr. Daniel Galat, an orthopedic surgeon who had gone through the Post-Residency Program with Samaritan’s Purse and now lives and works with his family in a small town called Bomet, Kenya. Dr. Galat invited me to visit and work with him at Tenwek Hospital, and I am forever grateful for the opportunity. I had no idea what to expect since I had never set foot on African soil prior to this trip, but Tenwek far exceeded my expectations.

Tenwek Hospital

Tenwek Hospital Kenya World Medical Mission

Dr. Stephens and two staff from the operating room prepare to go into surgery.

Tenwek Hospital is a 300-bed referral center nestled among the beautiful farms and hills of southwestern Kenya. A large yellow sign with the words, “We Treat. Jesus Heals,” welcomes every visitor with an invitation to join in a mission unconstrained by the separation of body and spirit so prevalent in western medicine.

Tenwek is blessed with staff members dedicated to the work of God’s kingdom within vocations ranging from internal medicine, pediatrics, general surgery, thoracic surgery, ophthalmology, obstetrics/gynecology, and orthopedic surgery. Visiting physicians from all sorts of specialties rotate through on a short-term basis including neurosurgery, radiology, surgical oncology, and gynecologic oncology just during my visit alone. During just one week of my stay, a thoracic surgeon performed a heart valve replacement, a neurosurgeon removed a brain tumor and washed out several intracranial infections, we in orthopedics performed multiple complex pelvic fracture surgeries, and a surgical oncologist removed an enormous abdominal tumor.

The orthopedic department is staffed by two full-time orthopedic surgeons who, along with many outstanding physicians in training, manage enormous workloads with more fractures than most American trauma centers see. During my short stay, I was involved in more than 35 surgeries that ranged from femoral and tibial shaft fractures, complex pelvic fractures, hand and upper extremity fractures, gunshot wounds, bone infections of young children, and fractures neglected for far too long.

The majority of these patients were victims of road traffic accidents that occur when bad roads, lax or absent traffic laws, young taxi drivers, herds of livestock, and overstuffed vehicles meet with often disastrous consequences. Many of these injuries are compound fractures. Many are delayed in arriving to the hospital, often requiring several days to make it to Tenwek for care. This makes for an incredibly busy, challenging, and yet rewarding experience for any orthopedic surgeon, regardless of level of training and expertise. I had no idea that an “orthopedic missionary” could be so busy.

Orthopedics & Medical Missions

Tenwek Hospital Kenya World Medical Mission

Dr. Stephens and Dr. Mbute prepare to repair a broken leg.

Discussions about medical missions do not typically include orthopedic surgeons. Most stories that come out of developing countries involve patients with infectious diseases such as HIV, tuberculosis, malaria, cholera, and a host of other terrible diseases and the devastating impact they have on people’s lives. Femur fractures, tibia fractures, and other musculoskeletal injuries are rarely mentioned in such conversations. Before my trip to Tenwek, I saw no reason for orthopedics to have a place at the table of discussions about these seemingly insurmountable medical needs of the poorest people on the planet. I was wrong.

The poor suffer a disproportionate amount of the disease burden throughout the world. Infectious diseases and traumatic injuries alike occur far more often among the poor than they do in the wealthy and privileged. Traumatic injuries (fractures included) claim 5 million lives, more than AIDS, tuberculosis, and malaria combined. Countless more are disabled as a result of injuries that could have easily been fixed had an orthopedic surgeon been nearby.

Femur fractures (i.e. fractures of the thigh bone) are one of the most common injuries seen. In most developing settings, femur fractures are treated with traction (i.e. attach weight to the leg and hang it off the end of the bed) requiring the patient to be in the hospital for one to two months. The majority of these fractures occur in young males, often the financial providers of their households. For them to not be able to work for several weeks or even permanently in more severe cases has disastrous consequences for their families and children, often forcing them into a state of poverty that may not be reversible. Tenwek, and other places like it, have been blessed to be able to care for such injuries such that patients are discharged a few days after surgery rather than after several weeks.

Tenwek is truly a blessed place poised to bless the people of southwestern Kenya for many years to come. The people with their huge smiles and warm hearts, the Kenyan culture built on strong family units and hospitality to others, the sheer beauty of the mountains and farms among which Tenwek Hospital is nestled, and the quality of medical care they provide all leave an indelible mark on anyone brave enough to visit.

I am one witness among countless others of the wonderful work being done for God’s glory at Tenwek Hospital. My life and dreams for the future have been changed because of my time at Tenwek, and I am certain that all who have visited and all who will visit will be blessed by whatever time they spend there. By God’s grace, I pray that many more trips to Africa and Tenwek Hospital are in my future. Tenwek Treats. Jesus Heals.