Anesthesia – A Luxury

“If we don’t remove it, this child won’t go to school because her classmates won’t accept her.” Those words will stay in my memory for a long time.

As a physical therapist, I was grateful when we were given the opportunity to go into an operating room at Kijabe Hospital, a hospital about an hour outside of Nairobi. I had been in an operating room a few times, in the U.S. and in Australia, mainly to see ACL reconstruction and meniscal repair surgeries, but I had never been in an operating room in Kenya. Donning some scrubs, disposable shoe coverings, disposable head coverings, and masks, we walked respectfully into the room. A small child was on the operating table, a child with an encephalocele. An encephalocele occurs when the neural tube that contains the brain and spinal cord does not close completely in a baby during pregnancy. The brain and the membranes that cover it protrude through an opening in the skull. Surgery involves removing the abnormal brain matter, repositioning the remaining tissue in the skull, and in this case, taking bone from a rib to close the opening. We watched the final steps of the surgery as the power went off and on at whim. Then, while still in the operating room, the child started to come out of anesthesia.

Example of an encephalocele – before and after

Anesthesia is something we take for granted in surgeries in the U.S. According to the World Federation of Societies of Anesthesiologists, we have 30-40 anesthesiologists per 100,000 people in the U.S., but Kenya has less than one. I tried to picture this girl’s surgery without anesthesia, but I quickly stopped the thought. It was too painful to think about. That thought, however, gave me an increased appreciation for the work Health eVillages is doing. Health eVillages provides tablets with a digitized medical text library of anesthesia-related resources to students in Kijabe Hospital’s Kenya Registered Nurse Anesthetist (KRNA) Program. Students use these tablets during the 18-month training program and then take the tablets with them when they return to their communities. Sometimes they are the first and only anesthetist in their community. These tablets give them needed medical information at their fingertips, allowing them to provide safe and quality care to children like the little girl we saw, a girl whose life is now forever altered. No longer will she be ostracized by her peers. Instead, she will be able to go to school, play with friends, and live a normal childhood. We can’t change the whole world, but we can make a whole world of difference in one patient’s life….and then another…and then another.

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