Kijabe Hospital is a 220-bed healthcare facility located ninety minutes north of Nairobi in Kenya. It was founded in the 1950's by an American trained physician who was born and raised in Africa. Of the 450 hospital staff, a little over twenty are from the US and Europe. The hospital has a fledgling government sponsored Family Medicine residency program which trains Kenyan physicians. Swedish/Cherry Hill Residents who declare an Area of Concentration in International Medicine and rotate to this site share in a cooperative educational experience with these trainees. "Teaching and learning from the Kenyan residents was one of the most rewarding aspects of the experience," states Ocean Williams (Cherry Hill R3) who recently returned from an international rotation to this site.
The life expectancy in Kenya is around 50 years, and the Kenyan government spends on average $25 per person per year on healthcare. The needs of patients are greatest in remote areas. HIV related issues, trauma and infectious disease are the most prevalent cases seen at the site. The hospital's greatest need is for physicians to staff their busy inpatient medicine service. "The Family Medicine educational experience at this site is very strong," states Ocean. "But people who want sub-specialty training can choose to focus on orthopedics, OB, or general surgery."
In addition to the hospital, the site operates several rural clinics staffed by a medical student, a dental student, a nurse and a resident. While on rotation, residents travel out to the remote villages one day per week to deliver a wide range of medical services to patients who come from all over Kenya and neighboring countries to receive care at these clinics.
An HIV community outreach program funded by PEPFAR and The Global Fund trains local volunteers to make home visits on infected patients. Residents accompany the volunteers on these home visits to go over medications, deliver care and provide patient education. "With a 7% HIV prevalence rate, Kenya is doing better than some African nations," says Ocean, "but more help is needed." Approximately one fifth of HIV positive patients are currently receiving treatment.
Residents who elect to rotate to Kijabe are assigned a host who sees to the task of welcoming them and assisting them with daily life. Housing is provided and almost anything one might need while in Kenya can be purchased in Nairobi, either upon arrival or by arrangement through others who are making the trip. Residents often rent the hospital van, sharing the $40-50 round trip cost with other passengers. Within a 5-minute walking distance, there is a duka (shop) that carries many commonly needed items, such as milk, eggs, bread and other necessities. Twice a week women come door-to-door selling vegetables and they often have other things for sale such as English muffins, tortillas, and samosas. No malaria prophylaxis is required at this elevation, although there are a few mosquitoes. Yellow fever vaccine is required to enter the country.
Swedish Family Medicine First Hill and Swedish Family Medicine Cherry Hill are working in collaboration to provide 2-month blocks of continuity to the site. Currently 3 residents from each program may rotate to the site per year. As more funding sources become available, we hope to increase that number.
Read the Kijabe Resident Blog for detailed accounts of residents currently rotating to this International site.