MCH Surgical Fellow heads to Kenya

 In March, when many head south for spring break, Dr. Robert Baird will also board an airplane, but he won’t be heading to a fancy beachfront resort; he’ll be heading to Kijabe, Kenya for a month. He won’t get much R & R either, but he will get a lot of O.R. … time that is.

Dr. Baird is the MCH’s Pediatric Surgical Chief Fellow. Part of his two-year fellowship curriculum includes the option of completing a four-week stint in the BethanyKids Pediatric Surgery Unit of Kijabe Hospital Kijabe Hospital under the supervision of Canadian surgeon and missionary Dr. Dan Poenaru. This opportunity is unique to the MCH.  It was the vision of Dr. Sherif Emil, Director of the Division of Pediatric General Surgery, who wanted to make the MCH program unique among the 40 training programs in North America, by incorporating 3rd world training into its fellowship.

Far from viewing this training as a burden, Dr. Baird says he is looking forward to the opportunity which will take him outside his comfort zone. “I expect to learn a lot. It will be one heck of a culture shock. I’ll see a different way of doing surgery under extremely difficult conditions,” he says. 

The type of surgeries will be in some ways similar, in other ways very dissimilar, to the work Dr. Baird is doing at the MCH. He’ll be assisting Dr. Poenaru during surgeries to correct congenital abnormalities such as anorectal malformations, congenital diaphragmatic hernia and esophageal atresia. There will also be surgery on children with solid cancerous tumours. However, he will be working in an environment of severely restricted resources, one where children often present with very advanced stages of their disease.  He will also perform many procedures, such as urologic and neurosurgical operations, not traditionally performed by a pediatric surgical trainee in North America.

“I expect the big difference to be the resources at our disposal such as supplies and equipment. While the diseases we treat will be the same, the approach to care will be very different,” he says.

Another major difference between the two countries is that Canada has a universal health care system while Kenya does not. Dr. Baird points out that in Canada, if a parent notices a small change in their child’s health, they will likely seek a medical opinion. Thus diseases and health problems are diagnosed early when they are highly treatable. In Kenya, however, Dr. Baird says patients are likely to seek medical advice much later when the diseases have had a chance to advance. And many have great difficulty getting any medical care.

It actually isn’t easy for a pediatric surgical fellow to leave for a month. His absence will not only have an impact on the hospital but it will also have a major impact on his family. His wife Naomi, also a physician, and their two young children, Sean and Caitlyn, will head out to Vancouver for the month where she has family.

As for the hospital, the General Surgery team will have to step up during Dr. Baird’s absence. Given that he works about 80 hours per week and participates in about 50 surgeries per month, he will be missed. However, because all the attending staff in the general surgery division felt so strongly about the importance and potential benefit of this rotation, they were willing to put in the extra work to support the junior fellow during Dr. Baird’s absence.

The Montreal Children’s Hospital has had a relationship with Dr. Poenaru and the Kijabe hospital for the last 15 years. MCH general surgeons Drs. Jean-Martin Laberge and Sherif Emil have both been to Kenya to assist Dr. Poenaru, and provide pediatric surgical services.  Dr. Poenaru completed his residency at McGill, his fellowship at Ste-Justine. He originally worked at the Kingston General Hospital in Ontario and taught at Queens University, but during the past few years, he moved his family and his practice to Kenya.