A mission trip to Kenya: Challenge, success and heartbreak

american society of anesthesiologists

A guest column by the American Society of Anesthesiologists, exclusive to KevinMD.com.

Mission must have always been in my blood, but it took me a while to discover it. I considered going on a mission trip to Bungoma, Kenya, in 2009, but the timing coincided with one of the major conferences at the New York State Society of Anesthesiologists. The conference won the first time, but the second time around I was willing to deal with the consequences of my absence. I knew I had to go.

My church had been taking a biennial trip to Bungoma for more than a decade. Over the years, a clinic was established that was staffed by a physician assistant, nurse, laboratory technician and pharmacist. I had heard about the great work they were doing and though anxious, I was filled with anticipation to do my part. As a practicing physician anesthesiologist and pain medicine specialist, I knew the work would require more than just these skills but also draw on skills and knowledge I acquired in medical school, my intern year and from my colleagues.

In December 2011, after approximately 36 hours of traveling, flying from Syracuse to New York, New York to Dubai, Dubai to Nairobi, Nairobi to Kisumu and then a two-hour drive to Bungoma, our team arrived tired but full of hope. Most of our luggage was filled with supplies, which needed to be sorted and consolidated for our work over the next several days.

After months of planning, our team of two physicians, two nurse practitioners, two nurses and our support team arrived to the clinic on our first full day to find that hundreds of physicians across Kenya were currently on strike over a wage and equipment dispute. Aside from the private hospitals, we were the only health team available in the area. Luckily we had the support of the local physician assistants and nurse practitioners who came to support our endeavor and enabled us to see the hundreds of patients seeking medical care.

Over the next three days, I was the pediatrician treating the familiar asthma and allergies and the unfamiliar malaria and typhoid, I was the internist treating hypertension and diabetes and I was the nutritionist having learned quickly about their cultural diets and revamping the common dishes to something healthier for the patients with diabetes. One patient population in particular gravitated toward me: the chronic pain patient. This was challenging as I knew I could certainly provide care for these patients in my normal environment, but I was now stripped of my ultrasound, C-arm and MRI reports. And yet I so desperately wanted to help these patients.

During the next few days I successfully completed intraarticular injections for chronic knee and shoulder pains with lidocaine and steroids, giving temporary relief to those who were suffering. I was able to provide samples of topical NSAIDs and lidocaine and in a few patients, samples of tramadol. This was done knowing that these patients could return for care after we left. However, the heartbreak of not being able to help everyone or to provide education to the teams there daily continues to haunt me.

I plan to return this year. This time I will be better prepared. My unrealistic goal is zero pain among patients. However, I will be very happy if I can in some way help every patient and contribute to the great work the clinic is doing in Bungoma.

Donna-Ann Thomas is an anesthesiologist.

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