The program is made possible through AMPATH, a partnership between Moi University, Moi Teaching and Referral Hospital and the AMPATH Consortium, which is made up of 15 academic health centers worldwide and led by IU. The model enables faculty and trainees from IU to engage with Kenyan counterparts. Consistent with the philosophy and practice of AMPATH and unique among surgical global health programs, the medical exchange is reciprocal, providing support for surgical residents from Kenya and Indiana to train on each campus.
“Our goal is to offer IU plastic surgery residents the most comprehensive global surgery experience in the country,” said Brian M. Christie, MD, director, Global Plastic Surgery Program and assistant professor of surgery at the IU School of Medicine Department of Surgery. “We want the next generation of global surgeons to have the tools and relationships they need to partner across the world to provide safe, effective and affordable surgery for all in need.”
Currently, the global plastic surgery rotation is offered to two IU residents annually, with plans to accommodate more residents in the future. Plastic surgery residents join a team of IU School of Medicine faculty who live and work full-time in Kenya for four weeks of training. They also work alongside surgical faculty and trainees from Moi University School of Medicine. The rotation is designed to be educational and touch on advanced techniques to build everyone’s knowledge.
To participate, IU plastic surgery residents must be in their 4th, 5th or 6th year of residency. Selected residents stay at IU House, a gated, secure community of homes in Eldoret, Kenya, which is managed by IU Center for Global Health.
Plastic Surgery Chief Resident Julia Cook Beresford, MD, completed her rotation in the fall. While in Kenya, she worked on trauma reconstruction, infection management and nerve reconstruction, collaborating with both IU’s Christie and Gregory Borschel, MD, the James Joseph Harbaugh, Jr. Professor of Plastic Surgery, as well as MTRH physicians, Moi University faculty and registrars (residents). She also would check in with patients pre-operation and post-operation.
“This definitely strengthened my interest in global surgery,” said Cook Beresford. “The rotation is wonderful. Collaborating with the Kenyan surgeons on patient care has been a very educational experience, and I am so happy that I am able to be part of this endeavor. I’d like to thank the division of plastic surgery, Dr. Christie and Dr. Borschel,” she added.
A couple of major takeaways for Cook Beresford were how surgeons at MTRH work with fewer resources, adapt and deliver excellent care to their patients. They take a holistic approach to patient care, as many of the home-support services that we take for granted in the United States are not available in Kenya.
“The surgeon would take a good account of what the patients could do from home,” Cook Beresford said, before they discharge the patient, often prolonging their stay. She said they must critically evaluate the use of resources and apply their ingenuity. “It’s pretty incredible to be able to fashion a nerve stimulator from a very common piece of anesthesia equipment.”
Cook Beresford enjoyed weekly educational presentations at IU House with other visiting trainees and faculty. She was also delighted to reconnect with Dr. Beryl Munda, the first Kenyan surgical registrar (resident) to complete a rotation at the IU School of Medicine through the division of plastic surgery.
“It’s great to see people like Dr. Munda, people who really take pride in our work, to see her in action as chief in her role,” Cook Beresford said. “It was a lovely experience.” She is happy to see the opportunity for reciprocal exchange between her Kenyan counterparts and IU.
Munda had similar sentiments of her global experience on the IU medical campus in Indianapolis.
“Every rotation was amazing,” Munda said. While in Indianapolis, she rotated in trauma, general surgery, robotic surgery, plastic surgery, hepatobiliary and breast reconstruction. “I feel like I’m changed as a person – and also as a physician, as a medical provider. I have the desire to do more.”
Dr. Paul Mwangi, chief medical specialist at Moi Teaching and Referral Hospital, said the reciprocal exchange between Indiana University School of Medicine and MTRH has expanded the hospital’s surgical capacity and has led to improved outcomes.
“The IU hand collaboration,” Mwangi used as an example, “has opened up an exciting new chapter in the management of hand surgery not only in Moi Teaching and Referral Hospital, but in Kenya. This has led to improved outcomes for patients, for example, in management of brachial plexus patients, traumatic hand injury patients and more.”
Adrian Gardner, MD, associate dean for Global Health and director of the IU Center for Global Health said this bilateral education exchange of trainees and staff is a foundational component of the AMPATH partnership, which has been in existence for more than 30 years.
Together, AMPATH has:
- Trained more than 2,200 learners (more than 1,000 from IU School of Medicine)
- Earned $210+ in research awards with 1K+ publications
- Expanded care to treat infectious diseases such as HIV and tuberculosis, adult and pediatric oncology, diabetes, cardiothoracic surgery, orthopedics, burn care, mental health and more
“This exchange provides unique opportunities for shared learning and partnership building between IU plastic surgery residents and surgery registrars in Kenya. The end result will be improved care for patients in both Kenya and Indiana,” said Gardner.