New Chinese-built hospital commissioned by our Team.

We safely returned healthy and well from Gatundu after another thoroughly enjoyable experience. The weather incidentally was appalling with monsoon conditions most days making for flooding and hazardous driving conditions. We witnessed some terrible RTA's including one fatality one evening.

Our team consisted of 1 Consultant surgeon (Deji Olojugba), 1 junior doctor from England (Hina Bhutta), 1 resident from New York (Teah Qvavadze) and myself (John Pickering) and 2 nursing/ODA colleagues (Vicky Clark and Sue Daly).

 

 We encountered no problems at the airport at either end, in fact British Airways did not charge for an additional 2 boxes of 23kg. In Kenya airport we paid the 50 dollars visa fee and retrieved the boxes from the luggage carousel. They stopped and asked what was in our boxes (I had 10) and I explained it was medical equipment for humanitarian work and they just waved us through. We were picked up and transported to the Rainbow Ruiru resort hotel arriving around 11pm. The next morning after breakfast we transported our boxes to the hospital where we were met by Betty who was keen to show us around the new hospital that had recently been opened by the Kenyan President.

Unfortunately, we were the first people to use the new theatres. To be honest my view is we would have been better in the old one. We spent the whole of the Sunday trying to clean the place because of the water damage caused by recent torrential rain. Everywhere was covered in brown/red mud. The hospital and operating theatres did not look as if they had been commissioned at all. There was no equipment whatsoever either, other than 2 new operating tables and 2 anaesthetic machines, neither of which worked as there were no gases available. There were no trolleys other than an old rusty thing that had been sent over from the old theatre. The operating lights were also far too low. Nothing was working properly including the air conditioning which never worked at all. We cleaned as best we could, unpacked our equipment and made up some sets with instruments I had taken out. We could only find 2 sets from last year.

The doctors spent the day assessing the patients and we returned to the Rainbow around 7pm. The next morning we arrived at the hospital around 07.50 but encountered the same problem as we did last year in that there were patients but no hospital staff, so we were delayed until they came in. Then of course we had the difficulty of it being the first time any of them had been in the new theatre. We had to wait until the anaesthetic staff tried to get some cylinders so they could get one of the machines running. We couldn't even start a local anaesthetic case because we had to wait for instrument sets to be autoclaved.

Eventually we got running with local anaesthetic cases in the other theatre and after a couple of hours the anaesthetic team had managed to get a machine working.

The whole week was beset with problems. The electricity supply was intermittent at times with the operating lights going out for long periods and we had a number of autoclave delays. In total we performed 42 cases but unfortunately had 2 returns to theatre for large haematomas. We took some time out on Thursday finishing at 2pm as Deji had relatives in Nairobi who put on a dinner for the team. Unfortunately we were stuck in traffic for over 3 hours before finally arriving. We never finished before 7pm most days. Our main surgeon Deji Olujugba was absolutely first class in his training of the local junior doctors who were keen and eager to learn and Teah Qvavadze was excellent and helped out in any way she could.

I took and left a diathermy machine but this is the only one they have that works and I've a feeling it will be moved round the hospital. I also took disposable gowns and drapes but would imagine they will all be gone when the next team arrives. I took local anaesthesia, oral antibiotics and paracetemol of which we used a fraction of. We ran out of gowns on Friday as they were using them for their own emergencies which meant we had a delay until they managed to find or autoclave some of their own so we could continue working.

 

 The whole new hospital is bizarre. They have a 12 bedded ITU with no clinicians and no equipment but more importantly there is much left unfinished, working properly and shoddily built. The door frames protrude from the floor making it impossible to wheel patients round on trolleys but that's probably just as well as they haven't got any anyway ! After 1 weeks use it was looking really shabby with the door seals falling off. We talked to Betty and Patrick on the importance of keeping it clean and it was good to see them making an effort to do this during the week.

I am going to try and get some basic equipment together, stainless steel trolley etc and get them shipped out so they can throw all of the old rusty things out. If I were you I would stick with the Rainbow hotel. It's comfortable and makes a big difference after a long day to be able to have a shower, WiFi and some reasonable food. We paid 5400KS per night.

Saying all of this we had an absolute ball. We were a great team and the patients as always were so grateful. That at the end of the day is why we go and why we are already planning to go back next year and take a bigger team, hopefully to include Magdi Hanafy. With the lessons learnt from
this year's trip we feel we could do a 100 or so procedures.

 John Pickering

Team Leader