Demand for paediatricians growing in Kenya

BY VICTOR ADAR

Bearing in mind that raising children might be a nightmare to some parents, it is important to engage services of experts. It is more telling when there are individuals who believe in traditional healers, and others who bet on the Bible. Of course it all depends on problems that one is seeking to solve. 

Stories of mums who take their children to herbalists because of stomach infections, flu or fever are many and diverse and with the current socio-economic uncertainties, the conventional hospital may not be first on the list of a parent whose child or children are sick. Are Kenyans failing to act decisively because of lack of awareness on hospitals that mainly focus on children?

Polycarp Mandi, a consultant paediatric gastroenterologist, and director of paediatrics at The Moi Teaching and Referal Hospital (MTRH) says that engaging services of a paediatric is all it takes to put stops to anxiety, a factor that gives most parents sleepless nights. More often than not parents fail to see compelling reasons to see a paediatrician who is as important to a child as a physician is to an adult patient or a gynaecologist to an expectant female. 

Dr Mandi is on the driving seat of a directorate that is based at Shoe For Africa Childrens Hospital (SFA), which is part of the MTRH complex, and offers most paediatric medical and surgical subspeciality services that include paediatric cardiology, paediatric neurology, paediatric nephrology, paediatric HIV, paediatric gastroenterology, neonatology, and paediatric adolescent service. On the surgical side, the hospital tilts focus on paediatric surgery, paediatric orthopaedic surgery, paediatric urology, paediatric burns, and paediatric neurosurgery.

Memories of how in his youth he loved the sciences and discovering things and trying to understand nature, and had always desired to be a doctor are still fresh in his mind. Sure enough, the Nairobi born doctor who grew up in a “simple” middle class family joined medical school from 1984 to 1989. The first of five siblings, his follower brother and him were put under intense pressure to excel. Today, he is one of only seven paediatric gastroenterologist in Kenya, with five of his equals based in Nairobi and one in Mombasa.

To him, SFA is the largest public stand-alone children’s hospital in the East and central Africa region and indeed second only to Red Cross Childrens Hospital in Cape Town, South Africa. While the medical and surgical units and the emergency and ambulatory clinic are in SFA, the newborn unit is located at the Riley Mother and Baby Hospital, a short distance away from SFA. He spoke to Victor Adar on paediatric gastroenterology, one of the super speciality fields in Paediatrics. 

What is paediatric gastroenterology? 

It entails the study of diseases of the digestive system, which extends from the mouth, down to the stomach, intestines till the anus. It also includes the liver and the pancreas.

We are seven Paediatric gastroenterologists in the country, five in Nairobi, one in Mombasa and me based at The Moi Teaching and Referral Hospital in Eldoret. I see patients from the western part of the country that is Nyanza, Western and Rift Valley. The children I see are mostly referred from fellow Paediatricians from the region. The seven of us work as a team, exchanging notes and ensuring that our patients can be seen by any of us.

What inspired the career choice?

10 years into my career as a paediatrician, I noticed a gap in the understanding of childrens abdominal issues. In particular “tummy pain”, a very common complaint but whose causes were not always apparent, leading to frustration of both parent and we the doctors. This inspired me to delve more into the field. 

Is it an area you would advice someone else to consider?

It is an area I would recommend paediatricians to consider specializing in, because it is very busy and lacking in specialists; it, like other fields of medicine, is an area with a lot of research and also constantly evolving as new frontiers are reached.

A majority of Kenyans go through normal clinical visits, how important is a paediatrician to a child? 

Children are, as we say, not small adults, the ailments they suffer are unique to them and thus not any doctor can see them. They need a paediatrician, who is trained to manage childhood diseases. 

Physicians and patients can miscommunicate, and there are instances where a patient and a doctor aren’t on the same page. Do you face such challenges? If you do, how do you deal with them? 

Miscommunication can occur with patients if the doctor and patient are not on the same page for whatever reason. The commonest problem is when the doctor doesn’t provide enough information leading to misinformation and subsequently poor outcomes like noncompliance of medication. The patient has a right to information about himself or herself. I try to provide as much information as possible to parents concerning the patient and also for the child I give age-appropriate information.   

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