Brett Shaffer

These blog entries are the views and opinions of the residents during and after their international experiences, and do not necessarily reflect the opinions or positions of VIA or VUMC.

Week 1
Jared and I arrived in Kijabe early Sunday morning. We stayed in Nairobi the first night in a nearby hotel and woke up to a lovely breakfast, then had a stroll to a local market to get ingredients for the first week of dinners. We had an approximately one hour drive to Kijabe from Nairobi and got to see beautiful landscapes and scenery along the way. The main road/highway quickly turned from a busy urban setting to rural, with the occasional police checkpoint. We quickly arrived to the dirt roads and potholes of Kijabe and knew we were near the hospital.

The first evening we settled in our new home and toured the hospital. The "anesthesia house" is surprisingly large—a 3 bed, 2 bath home with all of the necessary utilities. We enjoyed a well-seasoned pasta dish with Italian sausage followed by a much-needed rest.

The next day we woke up and went directly to the hospital. The ORs were starting and we started our primary roles: ensuring patient safety and assistance with teaching the Kenyan anesthetists. Jared and I familiarized ourselves with not only (new to us) old drugs used, but also a miscellaneous collection of ventilators, all with different knob locations, switches, and controls. We felt fortunate that we only had to learn the mechanics and operation of one type of anesthesia machine and ventilator at a time in the US.

Another prominent difference we've noticed in patients here has been the rarity of the patient with numerous comorbidities. Patients tend to have one primary issue for which they require surgery; for instance amputation for diabetes, thyroidectomy for hyperthyroidism, removal of a neurofibroma. Whether this is because many conditions are less frequently diagnosed here or patients tend to be healthier, time will tell.

Week 2
Over last weekend Jared and I traveled to Naivasha and Lake Nakuru, where we experienced safari by vehicle, water, and walking. The safari experience was amazing and we saw numerous species including zebra, impala, waterbuck, water bull, rhinos, hippos, countless birds, velvet monkeys, baboons (one of which jumped into our van!) Fun fact, "safari" in Swahili translates to "journey" in English.

In addition to our safari exploration, Jared and I were excited to expand our wireless connectivity with Safaricom cellular service. We can now download Netflix movies and watch them in the evening. We're basically at home now in Kijabe!

Patient care has of course continued throughout the week, along with countless assessments of senior KRNA students who are nearly ready to finish their curriculum. We continue to see pathology that is much more advanced and untreated here in Kijabe compared to Nashville. This is commonly in the form of a mass/tumor that has advanced distortion of airway anatomy, presenting unique consideration for anesthetic management.

Jared and I have taken on the morning lectures for KRNA students. Every morning we run an hour-long lecture to either teach or review concepts that students have had difficulty understanding. It's exciting to see students progress and apply the content they've learned throughout the week to their clinical practice.