When operations in a rural hospital in Kenya are performed for free



The operating rooms of the hospital in the town of Maragua (central Kenya) are not usually so full. A dozen doctors operate six patients at once with cysts and tumors in a very advanced state, which now can finally be undone thanks to a Spanish medical mission.

On one of the stretchers, along with two other patients, they operate on Simon Mwangangi, a 4-year-old boy. Three and a half years ago he had a bilateral inguinal hernia that kept growing and, despite having no pain, his life was compromised. He stopped going to school before the teasing of his classmates when he saw that the viscera were coming out of hernia until he reached the scrotum.

His mother, Milkah Wankiru, could not afford to pay for the operation in the other hospitals. "They asked me 10,000 shillings (about 88 euros)," he explains to Efe from a small improvised postoperative ward waiting for Simon to wake up from anesthesia.

Milkah learned of the existence of the Spanish surgical mission on the radio, thanks to a promotional campaign of the Muranga County governorate, where this rural hospital has been growing thanks to international cooperation.

The mother made with her little one the 35 kilometers that separate the hospital from her city, Thika, to get free care.

"If they took this campaign to my area it would be much easier to go because now you have to come here. Sometimes you have to sleep and, if you don't have money, you sleep abroad," says the woman, who could not go to the hospital of Thika, the largest in the county, for its high prices.

The corridors and courtyards of the Maragua hospital are day and night full of people from different parts of Kenya who wait patiently for their turn to be operated in operating rooms that never see so much activity. The first few days, after the arrival of Spanish doctors, 1,500 people attended.

The surgical mission in that hospital is organized by the Vihda Foundation, which has been working for the development of the center since 2003, and has for the third consecutive year about thirty medical professionals from the Solidarity Surgery organization to operate free of charge to the maximum number of people in two weeks.

This time they have carried out 464 interventions, 48 ​​of them children, and 1,554 consultations. These figures represent a huge increase compared to the rest of the year, which show an average of 150 operations per month.

Emma Wangeli waits sitting under a tent next to the maternity building. He went last July, during the last visit of the medical mission, to see if the lump caused by the goiter in his neck was cured, but he was asked to bring medical tests.

Emma has spent the past two and a half years of useless and overpriced visits to public hospitals in Nairobi, where she resides. His case is the most common in the hospital, since it is an operation with risks that many surgeons do not want to assume.

"The professionals who treat this are very few, I am very happy that the 'wazungu' (whites) are here. I trust them," he acknowledges, without hiding his enthusiasm.

A SPECIALIST FOR EVERY 18,000 PEOPLE

This excessive confidence in Western physicians is the result of preconceived images and a lack of resources that make local doctors less prepared to deal with complex cases.

The situation is rooted in a major brain drain: the few doctors there are going to the private sector or migrating to other countries. Muranga County, for example, only has three specialists and a pediatrician for 900,000 people.

Nationally, in 2018, there were 6,394 registered local doctors, of which 2,591 were specialists. That means there is a specialist for every 18,000 inhabitants. In Spain, by comparison, there is one for every 338 people.

"It's not about retaining them, but about wanting to be there," explains Victorio Torres, pediatrician and director of the Vihda Foundation, who intends to "develop a strategy in a standard public hospital that influences politics."

Its work as a foundation is to collaborate closely with local workers and be a point of support and a focus of financing to improve the hospital infrastructure, its service and its prestige.

The ultimate goal is to achieve universal healthcare throughout the country, a process that is on the political agenda of the President of Kenya, Uhuru Kenyatta, and that has begun as a pilot program in four counties.

"I wish they could do it (all over Kenya) because some families are poor, bankrupt or have no job," Simon's mother laments.

According to 2015 data from the Kenyan Ministry of Health, 12.7% of patients do not seek medical attention and the economic cost of health is the main reason why in 2013 there were 2.6 million people at risk of poverty.

A DIFFERENT MODEL

Flip-flops, a glass and a bowl to wash clothes is the only thing that patients need to enter the hospital in Maragua, which, although their regular services are also paid, is presented as a safe space for the most needy.

Spanish doctors and nurses work with Kenyan students and professionals and try to transfer their knowledge so that in the future their work is not necessary.

The collaboration of the two Spanish organizations with the hospital and the Muranga county government is one of the advantages of the project, but there are difficulties that force all parties to adapt.

José Manuel Rodríguez, general surgeon at the Virgen de la Arrixaca University Hospital (Murcia, southeast of Spain) and president of Solidarity Surgery, acknowledges having learned that "nothing can be imposed on the environment in which you are going to work, what you have to to do is adapt to the needs and see what you can contribute ".

In addition, the Kenyan government is the one that "has a democratic mandate to solve health and disease problems," says Torres, so that there is no need to "take away their responsibility."

Currently, the relationship of Spanish organizations with the county governor is so close that a trip to Spain has been planned so that some professionals in Kenya can feed on new techniques and see another model of public health.

The Minister of Health of Muranga, Joseph Mbai, is positive with the change of health model and says that "all we have to do is make sure we have a financing system that is sustainable and durable."

. (tagsToTranslate) operations (t) hospital (t) Kenya (t) perform (t) free



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