For every 1.1 million people in Kenya, there is one orthopedic surgeon. This is a far cry from the World Health Organization’s recommended ratio of one1: for every 100,000. As if that is not enough, most public hospitals lack adequate equipment and operating theatres to handle orthopedic emergencies, even when a surgeon is present.
Traffic accidents are also on the rise in Kenya, which means more injured in road accidents turning up in emergency units across the country needing orthopedic care. Statistics from the 2018 National Traffic Service Authority (NTSA) indicate that about 1.3 million Kenyans are involved in road accidents each year. From January 2015 to January 2020, injuries from RTAs increased by 46.5%.
Dr. Isaac Kingori is a Kenyan- trained orthopedic consultant working at one of the busiest surgery units in the country, Kijabe Hospital, who has seen the issues facing orthopedic care in the country first hand.
“I start my day at around six6 am when I begin ward rounds for patients that I have either admitted or taken to the OR,” he describes. “. The ward rounds also serve as teaching sessions for residents, medical officer interns rotating in the unit, and clinical officers. After this, I will supervise a learning session where the residents make case presentations. This is another teaching opportunity.
“At about nine, I will proceed to the theatre to start on my cases. Depending on the list, I might conduct between four to eight surgeries. This is also determined by the severity of the cases. On a normal day, I will be in the OR until five to six pm when my day typically ends.”
Dr. Kingori says being in the operating theatre gets his adrenaline pumping. “Most times, you are either saving a life or restoring functionality and hence improving quality of life,” he notes. “This comes with a lot of gratification that is hard to express in words. Of course, it also comes with significant risk, which is always at the periphery of your mind. Y; you might lose a life or cause irreversible damage should anything go wrong. But being an optimist, I always choose to focus on positive outcomes.”
Compared to other facilities, Kijabe theatres are decently equipped, notes Dr. Kingori. “Sometimes we lack ideal equipment to use or face challenges when the sterilization unit is out of order. Otherwise, it is generally an exhilarating experience for me.”
Not every day is typical though. On some days, Dr. Kingori could be in the OR well past midnight. On some days we have clinics where we screen and schedule patients for the OR,” he says. “Our clinics are usually very busy because we are a referral hospital. Being a consultant, I will supervise all the clinic rooms while attending to my own list of patients. This is yet another teaching opportunity that I embrace wholeheartedly.”
Once a week, Dr. Kingori does a 24-hour call, and once a month he is on call for the entire weekend. This being a busy facility, most calls are usually hectic,” he says. “Fortunately, I am usually the last one to be paged on the pecking order; I am only called to attend to ‘serious matters.’
Dr. Kingori’s orthopedic interests focus on the spine and pelvis. Kenya has a large aging population that is somewhat neglected. “I take this as both a challenge and opportunity to improve the quality of life of this vulnerable demographic.”
Dr. Isaac Kingori
Being an orthopedic surgeon in Kenya is challenging. “As you might be aware, our healthcare system as a country is struggling,” says Kingori. “Most of the public health facilities are understaffed and inadequately equipped. Patients have to travel for long distances to be able to access decent healthcare services.”
The cost of orthopedic surgeries in Kenya range from $ 2,000 to $4,000. For many patients, this cost is beyond their budgets making the service inaccessible to them. Sometimes patients struggle to raise the money that is needed for treatment and this means that their treatment is either delayed or the surgery can’t be conducted at all. “Not being able to offer my services to needy patients is perhaps the most disheartening part of my work,” he says.
Another significant challenge is accessing orthopedic tools at an affordable price. “In Africa, the cost is always an issue,” he says. “When these tools have prices that are through the roof, orthopedic surgeons are forced to opt for cheaper tools that may not be as efficient or effective. It would be good if orthopedic tools were reasonably priced to make them more accessible to Kenyan surgeons.”
Dr. Kingori says he derives a lot of satisfaction from knowing that he is making a difference in the world each day. Kijabe Hospital is a faith-based healthcare facility that serves a population that would otherwise not be able to access good quality healthcare. “By offering my services at such a facility, I help to make a difference in the lives of many vulnerable patients.”
Arbutus Medical is dedicated to providing safe surgery for all, making orthopedic care accessible for all, and alleviating the greater burden of injury. The affordable orthopedic tools designed by Arbutus Medical make surgery more easy and affordable to access in low-income countries like Kenya.