A simple question without a simple answer. Regardless of who is asking or how the question is asked, my answer always seems to come up short. It always seems to be half of an answer, and generally, I leave a “why” conversation feeling like I have not done adequate justice to our calling. The answer is out there, it is close, I can almost grab it and make sense of it, but in the end my words fall short.
But, on January 9, 2015, the 2nd PAACS graduation at Tenwek Mission Hospital graduated two new, fully trained general surgeons and the answer to the “why” question came into sharp focus. Access to basic health care remains a big problem in many areas of the world. Certainly we have gotten a glimpse of the repercussions of difficult-to-access healthcare during our time in Kenya.
For example, breast cancer is a common problem in Kenya as it is in the U.S. Most breast cancer patients who I treated in the U.S. were diagnosed at an early stage, usually with the help of a mammogram. More often than not, mammograms did the job of detecting cancers before they could even be felt. My experience here has been quite different. Most women are not seen until their cancers are large and protruding through the breast with extensive spread to lymph nodes. Mammograms are generally not done. In the U.S., we would treat these advanced cancers with chemotherapy, first, in hopes of shrinking the tumor; however, access to chemotherapy for patients is usually very difficult due to financial constraints and the distance required to travel. The end result is that a common cancer that could be potentially cured in the U.S. results in many early deaths in Kenya.
With the recognition that millions of individuals in Sub-Saharan Africa do not have access to basic healthcare also comes the question: why? The answer is complex. However, one of the fundamental issues is the lack of qualified healthcare providers. The World Health Organization has recognized this as such an important issue that it started the Global Health Workforce Alliance to advocate and support the development of a global healthcare workforce. The World Health Report 2006 suggested estimated threshold numbers of skilled healthcare providers that are needed to provide for reasonable access to healthcare. The latest report from GHWA indicates that 83 countries still fall below this threshold, and these countries are mainly located in South Asia and Sub-Saharan Africa. Kenya remains one of these countries. For comparison sake, the U.S. has 117 skilled providers for every 10,000 people, roughly 10 times the number in Kenya.
The Pan-African Academy of Christian Surgeons (PAACS) is an example of one of the organizations that is working in Africa to increase the number of trained surgeons. Currently, there are 10 PAACS programs, including Tenwek. On January 9th, Drs. Jack Okumu and Elijah Mwaura completed the five-year program at Tenwek. In addition, both of these young doctors received special honors from the credentialing body that certifies surgeons in East Africa. They are both now serving here in Kenya, with Elijah working at a mission hospital in central Kenya that was in need of a surgeon.
There are 15 young doctors currently training through PAACS at Tenwek. They are not just numbers to us. They are not just answers to a problem. They are friends and colleagues. We work with them weekly in challenging medical settings; share meals with them; discuss the Bible and life and problems together, and celebrate their weddings and births. And, so for us, being a part of graduation has been a highlight of our time thus far at Tenwek. It is exciting to see how God will use these two men, and those coming behind them, to build his Kingdom in East Africa. – Angela Many
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