My Time in Kenya, by Dr. Michael Wong, Chief resident 2022-23

In October 2022, I had the privilege of working with Saving Mothers, a nonprofit organization dedicated to eradicating preventable maternal deaths and birth-related complications in low-resource settings. Here is an account of my experience:

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This was my first medical mission trip. We arrived in Nairobi, Kenya, and the next day, took a small charter plane to West Pokot. 

West Pokot was rural, quiet, and enchanting. We stayed the week in a compound owned by the governor. I felt honored, at times out of place, as we unloaded our luggage and I became more familiar with the talented team of providers I would be working with.

Our group was led by Dr. Tara Shirazian, who founded Saving Mothers and has spearheaded global women’s health missions for over a decade. Our focus during this trip was to aid women in need of gynecological surgery.

We would arrive at the aptly named operating theater on our second day. There were two rooms – one for Dr. Grancaric, one for myself. The rooms were rather large, lined with off-white tiles and with high ceilings, and enclosed by large swinging doors that looked more fitting of a western saloon.

We took mental and physical inventory of the available equipment. Much of the equipment shared vague similarities to ours. Much more was simply not available. However, I was comforted by knowing that cases were performed for years prior to us arriving, with equipment, without equipment, and every gradient in between. 

I looked at my watch. First cases would be starting soon.

It truly was analogous to theater. Like stagehands, we frenetically prepared the rooms, contouring unfamiliar equipment and molding it to our needs. My room lacked electricity. Dr. Grancaric’s room was without a source of oxygen. Amidst us scrambling for equipment, cursing under our breath, and accidentally placing ourselves in-between workplace hazards (240 volts will liven up the morning), our patients waited patiently outside, unaware of the chaos behind those large swinging doors, sitting quietly on small folding stools and charmingly believing we had things under control.

The metaphorical curtains came up, the doors opened, and we made it work, like everyone before us.

When the anxiety of whether or not I could provide safe anesthesia receded, I became more present. 

We had wonderful patients. Patients who lived for years with chronic 4th degree perineal tears and fistulas, extensive uterine prolapse, or bleeding fibroids with an alarmingly low blood count. Many had been waiting enduringly for our surgical camp, sometimes for years. They were kind and stoic, unmoving during spinal anesthesia. As I laid them down, they turned their head and  stared intently at me, unwavering, during the entirety of the case, and I would try my best to console them under the soft rolling tide of the blue surgical drape.

In between these cases, it was not uncommon to be stopped by other women who traveled from afar in hopes of being seen. Though there were weeks of outreach and preamble prior to our arrival, and a pre-operative screening day before our first day of surgical cases, it was clear there was much more demand. We tried our best to accommodate.

Stopped, seen, booked, case completed. 

The normally dreadful perioperative cycle had been pruned to anesthesia evaluations in the hallway and procedures done the next day. 

The last case of the day would be finished and I wheeled the patient to the recovery area. I would find a nearby home-made blanket, thick, untamed, at times much larger than the patient themselves, and adorned with bold, colorful patterns. I would give a thumbs-up to the patient, or a nod, and couldn’t resist from instinctively telling the patient a few reassuring words such as “All done!” and “Surgery went great!” knowing these foreign words meant much less than a familiar smile. 

Returning to my now empty operating room, I’d see Dan, our scrub tech. He was tall and thin, older, with thick black glasses and had long sandy hair held back by his scrub cap. This was his third trip, and unlikely to be his last. Musically inclined, he also was our DJ, his music blasting from his portable speaker, which he propped up in a gray plastic kidney basin. We sang along to Queen as we finished cleaning our respective workstations before leaving to meet the rest of the team.

Packing our equipment in an old and rugged Toyota SUV, we were embraced by the setting sun. The hospital rested on a hill, overlooking rolling and densely lush green hills that were now being covered by an amber glow. We took the short 10-minute drive back to our compound, passing smiling and curious children, make-shift storefronts with sheet metal roofs, and livestock lining the road. The air was crisp and sharp, weaving through the rolled-down windows. 

Arriving home, we were warmly welcomed by the staff who had, without fail, food prepared in large rectangular steel containers. I would grab a plate and we would all sit and have dinner together, consisting of dishes such as sauteed cabbage, flat-breads, lentils and shallow-fried meats. Some nights we would play games, where layers of staunch professionalism would melt away to inappropriate hilarity and never-to-be-repeated pantomiming. 

At the end of the night, we would all return to our respective rooms. As I laid on my firm bed, draped with lightly pink and orange mosquito nets, all I felt was immensely grateful.

Faculty and residents have the opportunity to participate in International Medical Missions, specially in Kenya and Dominican Republic.