Mount Kenya University ( MKU) , the International Collaboration of Essential Surgery, Henry Family Advised Fund, Smile Train, the College of Surgeons of East, Central and Southern Africa (COSECSA), and Kenya’s Ministry of Health have partnered to contribute to national health systems strengthening that identifies gaps in health service delivery and processes and identifies priorities for improvement and strengthening, with the end result being an eradication campaign to facilitate the treatment of children born with congenital defects, mothers suffering from obstructive labour complications such as obstetric fistula, and trauma victims living with home, workplace or roadside injuries that can be easily fixed, preventing lifelong disabilities.
According to the co-director of the Henry Family Advised Fund, Dr. Jaymie Henry , the first country-wide effort will focus on a phased approach to eliminate the backlog of approximately 7,000 clefts in Kenya, beginning with a national surgical capacity study that assessed and qualified level 4 hospitals across 47 counties in Kenya and their surgical workforce to help deliver robust, safe and cost-effective basic and comprehensive surgeries, and ensure adequate availability of surgical equipment, trained health workforces and mobile/telehealth connectivity.
Correspondingly, case detection for neglected clefts, cleft eradication, and community health worker and surgical training will be piloted in Meru County to execute proof of concept for large-scale eradication of clefts in the country that will lead to the establishment of cleft centres of excellence at the county level and create a fast-track referral process from the community to Level 4 hospitals to county referral hospitals for pre-operative, surgical and post-operative care.
While giving a public lecture at MKU’s main campus in Thika, Dr. Henry said every day, people are dying or being disabled from medical conditions and simple injuries that can be averted with simple, one-time procedures. Of the 234 million surgical procedures performed worldwide each year, 75% benefit the richest people.
This means that in some countries, the global population receives less than 4% of surgical procedures, while in others, there is limited if any access to essential procedures that save lives and prevent life-long disabilities. “Neglected surgical diseases (NSDs) are conditions that have a public health burden for which cost-effective interventions currently exist. They include cleft lip and palate, cataracts, clubfoot, hernia, obstetric fistula, and neglected injury,” she further said.
The Henry Family Advised Fund founded by Dr. Henry and her husband Orion Henry promotes surgical interventions that save lives and prevent permanent disability and life-threatening conditions. It is a firm believer that essential surgery should – and can – be safe, accessible, and affordable to people worldwide regardless of income or geography. Essential surgery involves common and basic procedures that meet high standards of care even in limited resource settings and require only modest infrastructure.
Dr. Jaymie said MKU is collaborating with the Henry Family Advised Fund in implementing a pilot programme in Meru County that recruits and trains the community health workforce to identify and catalogue every patient with a neglected surgical disease using an innovative mobile telehealth application, for fast-track referral to a Level 4 Hospital. For the first phase of the pilot study, every child suffering from a cleft lip or palate will be referred for treatment by the partner organization, Smile Train.
MKU and the Henry Family Advised Fund are committed to working with Smile Train to train physicians in delivering robust, safe and cost-effective cleft surgeries, that will result in the creation of centres of excellence at the county level in surgical equipment, trained health workforces and mobile telehealth connectivity for fast-tracking patient pre-operative, surgical and post-operative care.
The Henry Family Advised Fund and its partners; College of Surgeons of East, Central, and Southern Africa(COSECSA), Smile Train, and MKU’s e-Health and Informatics Centre have signed an MOU with Meru County Government for piloting county-wide eradication of the backlog of neglected surgical diseases (NSDs). They include cases of children born with congenital deformities such as cleft lip and palate, cataracts, hernias, and clubfoot, women who have been disabled with a fistula in their noble act of giving birth as well as victims of untreated injuries because of violence, and road traffic accidents. Such victims do not have a chance to live a normal life unless they receive life-saving or disability-preventing procedures.
According to Henry Family Advised Fund Co-director, Orion Henry, their strategy is to identify the NSDs, map the cases to nearest level four hospital and treat the NSDs. Phase one will involve elimination of the backlog of all the existing cases of cleft lips and palates and subsequently move to the next category of neglected surgical diseases. Once the backlog of neglect surgical diseases is eradicated, they will include these conditions in a basic package of interventions covered under NHIF so that every child that is subsequently born will receive life-changing treatment, every mother who needs emergency or surgical care will receive it, while the injured will be cared for, regardless of their ability to pay.
He said the Meru County pilot eradication programme is scheduled to end by December 31st, 2018 after which the government will analyze the results and lessons learnt to help in scaling up the same in the other 46 counties in Kenya.