By Alfred Otieno

Amref’s Specialist Surgical Outreach Programme held a week-long orthopaedic camp at Nyabondo Mission Hospital in Kisumu County, Kenya, where it provided specialised surgery and consultation that ends on 2 February 2019.

The outreach is the first of seven planned for 2019. It is sponsored by the Amref Health Africa Specialist Outreach Project in partnership with Nyabondo Mission Hospital. During the clinic, patients from the western part of Kenya were treated, travelling from places as far as Lodwar, Kitale, Trans Nzoia and Bungoma, as well as nearer regions like Kisumu, Kisii and Kericho.

According to Orthopaedic Surgeon and Trauma Specialist, Dr. Charles Nyakinda, who is involved in the programme, not all patients who come to the outreach require surgery. First, assessment takes place, during which the specialists determine the course of treatment and prepare surgical lists. In the previous clinic held in December 2018, only 47 out of more than 80 patients required surgery. The rest were given prescriptions and provided with medicines before being sent home.

Initially, the outreach was meant for children below 12, but due to the need among the adult population, it has opened up the clinic to people of all ages. However, priority in the scheduling of operations is still given to children suffering from congenital diseases or physical abnormalities present from birth.

Older children with acquired conditions are the next group treated. After that, both children and adults suffering from injuries such as fractures are treated. The fourth group treated consists of adults with age related illnesses, where procedures such as total hip replacements and knee replacements are performed. Those with bone infections are treated last to prevent the spread of diseases to other patients.

Records from the outreach show that regular operations at Nyabondo Hospital started in 2009, with the highest number of patients undergoing surgery being seen in 2013 when 97 patients were operated on by specialist surgeons from 23rd to 27th December.

Typically, the volunteer medical team consists of a surgeon, three nurses and an anaesthetist, while the staff at Nyabondo Rehabilitation Centre provide other support services. Occasionally, a trainee surgeon is present so as to gain experience in accordance with the programme’s goal of increasing future access to medical services in the country. Amref sends drugs, surgical equipment and other medical supplies, further providing transportation for both the supplies and volunteers either by vehicle or by air under the flying doctors initiative.

In order to make treatment affordable, different parties contribute time, labour and resources. The volunteers do not charge patients for their expertise and are only paid a stipend by Amref, which also pays for their accommodation and transportation. Staff volunteers are drawn from private and public hospitals, as well as universities such as Kenyatta University, the University of Nairobi, Maseno University and Egerton University.

A team from the Nyabondo Mission regularly goes to Catholic Missions in surrounding regions to inform people of the outreach, after which the Missions arrange to bring some of the patients. Other patients are brought by the Association for the Physically Disabled of Kenya. The rest, who come on their own, are advised to use their NHIF coverage by staff at the medical camp.

The Amref Health Africa Specialist Outreach Project has been taking essential medical and surgical services to rural and under-served hospitals across Eastern Africa since 1957. According to the Amref Annual report for 2016, the project has benefited 300 hospitals in eight African countries since it began.

The Nyabondo outreach has grown from holding two to seven medical camps annually due to the high demand for specialist surgical services in the region. Recent camps have gone well, with all 47 surgeries in December having been successful.

This year, reconstructive surgery by Dr. Peter Oduor will take place from 21st to 29th March. More specialist surgery clinics will be held from 15th to 19th April (orthopaedic), 17th to 21st June (reconstructive), 11th to 16th August (orthopaedic), 27th to 21st October (reconstructive) and 8th to 13th December (orthopaedic).