New program introduced to train surgeons from rural Kenya

An international training program led by St Vincent's Hospital Melbourne aims to upskill doctors from rural Kenya in surgical techniques that will benefit thousands of patients with heart disease across the African continent – some of them young children.

(L to R): Dr Keith Dindi, Dr Matthew Read and Dr Andrew Newcomb at St Vincent’s Hospital Melbourne. (L to R): Dr Keith Dindi, Dr Matthew Read and Dr Andrew Newcomb at St Vincent’s Hospital Melbourne.

The newly established St Vincent’s fellowship exchange has been developed to support local surgeons from the area with skills to better equip them in critical surgery involving patients with oesophageal cancer and heart failure brought on by rheumatic heart disease.

Dr Keith Dindi, a cardiac and general surgeon at Tenwek, a 400-bed Mission Hospital in Kenya, is the program’s first participant.

“In this part of rural Kenya, the burden of these diseases is extremely high,” explains Dr Matthew Read, an Upper Gastrointestinal surgeon at St Vincent’s who has played a key role in establishing this unique training experience after spending time working at the hospital in early 2020.

“You don’t really understand the value programs like this can have until you visit and see the sheer numbers of patients they are dealing with. While we might see 50 cases of oesophageal cancer a year, they would see close to 700. Sadly, they even see oesophageal cancer in children as young as 11.”

Another major area of need is children with end-stage heart failure.

“I remember doing ward rounds there and seeing 15-year-olds who were going to die if they didn’t get their heart valve replaced or repaired,” Dr Read recalled.

Inspired by the work of Tenwek founder Professor Russell White, Dr Read approached St Vincent’s to introduce a study program that focused predominantly on training surgeons from Kenya in minimally invasive thoracic and vascular surgical techniques, where previously open techniques had been their only option. Management of ischaemic heart disease will also form part of the course content.

Dr Dindi commenced the 18-month training program in March this year and will rotate through the cardiac, thoracic, upper gastrointestinal and vascular surgical units at St Vincent’s Hospital Melbourne, while working closely with the hospital’s surgeons and staff. Coronary artery bypass grafts, keyhole surgery and video-assisted and laparoscopic surgery are among some of the new techniques and learnings Dr Dindi will gain through this experience.

He is also being skilled in management systems to improve patient flow and administration processes and the benefits of a multidisciplinary team approach in everyday practice.

Building a new future

A new hospital is currently being built at Tenwek that will also accommodate a cardio thoracic unit, led by Dr Dindi, to enable the treatment of more patients.

“Some of these heart patients just can’t wait and in sub-Saharan Africa, you’d generally find one cardiac centre for every 32 million people, so we get patients from everywhere across the region,” Dr Dindi said.

“It was essential that we expand our facility, but we also needed to grow our team of surgeons and skills.

“It just doesn’t make sense to have a new centre with lots of new equipment and not enough boots on the ground who are well-trained to utilise the equipment to serve the people. That is why this fellowship from St Vincent’s is so valuable to us.”

Dr Dindi is joined in Melbourne by his physician wife, Esther, who is currently working with St Vincent’s Research Directorate to learn about research governance and ethics that will prove beneficial when she returns home to work in the new hospital, which is expected to open in 2024 and be the second largest cardiothoracic hospital in Africa.

Inspired to care

Dr Dindi was born in Kenya where he lives with his wife and three children. He was inspired to be a surgeon from a young age and is excited to be part of this special training opportunity that he hopes will continue to grow and inspire others.

“When I was nine years old, I had a tumour on my neck. We had only one surgeon covering the district where I lived and I had to wait a long time to finally get the operation I needed,” Dr Dindi recalled. “When I finish my training here at St Vincent’s, I can return home to mentor and teach others. That fills my heart with much happiness.”

He said the kindness that he and his wife have experienced from the St Vincent’s community is something they will never forget.

“The impact is not just one surgeon trained; the impact of this program is lives saved and destinies transformed for ages to come. The ripple effect of what this fellowship program is doing is going to impact people across our continent in a very big way and for that we are really grateful,” Dr Dindi said.

Read the article from St Vincents Hospital Melbourne here.