Kenyan Pain Clinic

So it seems that I have unknowningly helped start the first pain clinic in Kenya. People are coming from all over (even larger metropolitan places) to Kijabe, as we are the only physicans that offer epidural steroid injections. Our treatment scope is limited (by space, resources, imaging modalities and time), but we have also started performing blind sacroiliac joint injections (not done in the US without image guidance because not reliable placement). So now we treat mostly radiculopathies, myofascial pain syndromes, and sacroiliac arthopathies.



As part of my mission, I also had the privelage to lecture to the KRNAs and student KRNAs (see earlier blog for acronym meaning). They are technically very good and are as bright as they come. I would attach a picture of the class (but internet is slow). They main topics discussed were neuromuscular blockade and local anesthetics.



We also expanded their regional anesthesia understanding. We demonstrated successful, stimulated needle axillary blocks, interscalene blocks, and lower extremity blocks including sciatic, femoral, and ankle. This may not sound like a big deal, but with perioperative mortality around 20% nationally, less is definately more. And safer. That is why 80% of surgery here at Kijabe is done under spinal (after it sets up and the block height is stable, less vigilance is required than general anesthesia). These trained KRNAs will go to rural hospitals and educate/promote safer anesthesia and surgery.



As you have probably gotten from emily's blogs, this has been an excellent experience, both personally and professionally. We have helped influence a continent and forged friendships that will last a lifetime.