GUEST EDITORIAL

Global Health

Mary B. Taylor, MD, MSCI

Mary B. Taylor, MD, MSCI

Mary B. Taylor, MD, MSCI
Professor of Pediatrics
Suzan B. Thames Chair, Department of Pediatrics
University of Mississippi Medical Center
Jackson, Mississippi

We often take for granted our access to healthcare. As a physician working in an under-served part of our country, it seems that we are always in need of more – more providers, more equipment, more resources. I have gained a much clearer perspective of “need” as part of a pediatric cardiac surgical team serving Tenwek Mission Hospital in rural Kenya. In pediatric cardiac critical care, we can all appreciate the value of a team. The power of that teamwork becomes abundantly clear in a resource-poor mission providing nearly the same complex care that we provide in this country. We have made this annual journey to care for infants, children and young adults with congenital and rheumatic heart disease since 2008. 

Kenya child patientThe mission hospital itself was established in the 1940s and has grown into one of the largest mission hospitals in East Africa. Full time medical missionaries lead the day-to-day operations of this busy medical center, caring for thousands of patients and educating nurses and residents. Short term missionary groups help to staff some of the specialty areas. The “cardiac camp” began as a vision in 2008 during a visit by pediatric cardiologist, Dr. Mike Liske from Tennessee. The need for congenital and rheumatic heart care was overwhelming. In those first years, we screened hundreds of patients over the course of a few days to identify those deemed sick enough, yet safe enough, to undergo life-saving reparative valve replacement surgery. From the beginning, a large part of the mission has been education, with a vision of “teaching a man to fish” – giving the Kenyan providers some tools to enable them to care for their own one day. We have worked with the Kenyan staff to build their team providing OR nursing, post-operative care, perfusion, anesthesia and even surgery. They have developed a cardiac surgery fellowship training program and have graduated two surgeons.

Kenya Clinic

What started as a mission to operate on 10-15 patients per trip with RHD has evolved into screening and operating on younger and younger children with congenital heart disease – AVSD, VSD, ASD, Tetralogy of Fallot in a seven-year-old, truncus arteriosus in an eight-month-old, complex coarctation of the aorta. Our visiting team now operates for two weeks on patients with congenital heart disease (our smallest – 4kg operated this year) and the larger children and teenagers with RHD are operated throughout the year by the Kenyan team led by the full time cardiac/thoracic surgeon, Dr. Russ White, with his Kenyan trainees. Plans are now in place for construction of an 80,000 square feet Cardiothoracic Center at Tenwek – the first dedicated heart center in all of Africa. Our team has expanded to include people from all over the US and Canada and several other “cardiac camps” have spun off from these beginnings. In 2019, three pediatric teams traveled to Tenwek for four weeks of surgery. Our team has operated on 173 children (124 congenital and 29 RHD) with a mortality rate of 5%. The on-site permanent program has performed mitral and aortic valve replacements on over 300 patients with RHD. We have also performed several interventional catheter procedures in the past few years including aortic and pulmonary balloon dilation, balloon atrial septostomy and PDA Amplatzer device closures. Data analysis is ongoing for reporting results in the literature including a study of Coumadin use and aspirin use in valve replacement patients. 

Our annual mission to Kenya is one of the highlights of my year. The joy in the faces of the parents and children is inspirational. Witnessing the growth of a sustained program to serve East Africa for years to come has been the realization of our vision. 

Back to top