Innovating Otolaryngology – Head and Neck Surgery in western Kenya
This project is a 2020 recipient of grant funding from the Royal College’s new International Development, Aid and Collaboration (IDAC) program. This grant supports projects that improve health profession education and local capacity in low- and middle-income countries.
A partnership between the University of Alberta and the Moi Teaching and Referral Hospital (MTRH) in Eldoret, Kenya, aims to improve access to Otolaryngology – Head and Neck surgical care for more than 15 million people in the region.
MTRH is one of only two public tertiary referral hospitals in Kenya; but it is underequipped in personnel, training, resources, time and infrastructure to meet the head and neck surgical needs of the population it serves. This means that for many surgical procedures that are considered routine in the developed world, MTRH must either refer patients out of the region or leave patients undertreated. The Royal College IDAC funding is contributing to a possible solution.
After a short introductory course and some hands-on cases, local surgeons are quickly able to pick up and adapt newly learned endoscopic ear surgery skills, a massive step forward to decreasing reliance on expensive surgical microscopes. (Submitted photo)
Developing sustainable practices
In 2018, MTRH and the University of Alberta undertook a needs assessment of the hospital’s Otolaryngology – Head and Neck Surgery program, working through a partnership between MTRH and the Otolaryngology group at Indiana University through the Ampath Consortium. Together, the three teams developed a project plan to address MTRH’s areas of highest need.
“Our goal is for MTRH to manage its own surgical oncology for head and neck cancer, advanced airway disease and surgery, and advanced endoscopic ear disease within a few years,” said André Isaac, MD, FRCSC, a pediatric otolaryngologist, member of the University of Alberta’s Office of Global Surgery and one of the project leads.
Dr. Isaac explained that the project’s fundamental value is its plan to equip MTRH surgeons and physicians with sustainable procedures and practices. One major barrier to effective head and neck surgery in low-resource countries is the discipline’s high reliance on advanced technology. “Our solutions are designed to circumvent this problem, which means the surgeons will be able to work sustainably,” said Dr. Isaac.
Reimagining what is possible
As one example, Dr. Isaac’s team will work towards replacing expensive microscopic ear surgery with affordable endoscopic ear surgery. “It’s about reimagining, from the ground up, what is possible and putting those practices in place.”
Other priorities include a formalized airway course, improving pathology reporting and laying the groundwork for a residency training program.
Due to COVID-19 and travel restrictions, a number of project activities originally planned for earlier this year have been delayed. Some activities have since restarted, while others are waiting for an appropriate and safe time to resume.
