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Ophthalmology in Mombasa City

Filed under: GEMx Regional Exchanges GEMx Student Reflections

Post by David Mutanga, a student at Mbarara University of Science and Technology [COESCA]

David Mutanga

Introduction

Lighthouse for Christ Eye Centre is located in Mombasa city. Mombasa city is the coastal city of the nation of Kenya which is in East Africa. Basically, Mombasa is known as an island. It has many historical sites such as the Fort Jesus, The big Tusks, the Swahili Arab old town, and the first restaurant in East Africa. This city is an international tourist destination.

Lighthouse for Christ Eye Centre is a modern Eye hospital in Mombasa, located in the coastal region of Kenya. It has ophthalmologists and clinical officers seeing a large volume of patients.

My reason to choose Lighthouse for Christ was that it is among the highest reputable hospitals in Kenya. It is also a good place for training because there is all the equipment’s required for eye check-up (e.g. visual field machine). There is very skilled personnel with Christ love ready to support students on their campus. As a result of all this, the number of patients seen in a day is always high.

Experience during the Elective

During my tenure time at Lighthouse, I had two days in OPD, three days at the theatre every week. Towards the end of the five weeks at the campus, I was given an opportunity to work with an outreach team which took place over 194 km away from Mombasa.

  1. OPD (Out Patient Department)

In OPD, I was working with a team of 6 staff. Amongst the six, I was with three senior ophthalmologists:  one senior OCO and others were technicians. Handling the patients at OPD, I always had someone to consult and there was someone ready to assist me as much as I needed. Because of this, I really have improved my skills in the Visual field and OCT interpretation.

David working with his colleagues.

  1. Surgery

The team in theatre apart from the surgeon is composed of a team of six technicians who are highly skilled. Throughout my time here, I did around 6 small incision cataract surgeries without close supervision and this increased my confidence in surgery.

-A one-week Phaco workshop with an international expert surgeon from U.S.A permitted me to know more about Phaco machines and it was my first time to appreciate that modern technology.

-During this elective, I did my first cryotherapy after excision to a patient with a conjunctival neoplasm.

-The one week outreach to the rural areas was a good experience for me and in fact, now that I’m coming from a rural area, I would wish that will be part of my work when I graduate.

During the one week camp, I was able to see more than 350 patients and around 68 mature cataracts were diagnosed for surgery.

  1. Weekends

Mombasa is a big city with significant recreational sites. I enjoyed the walk on the shore of the Indian Ocean and had memorable days of swimming. Commuting within the city is so easy because there are the three wheel motorcycles known as Tuktuk. You can easily move from one end to the other. Security wise, the city is well beefed up, apart from some areas where you see the streets young and old people. Though a big city, it has some parts of the city that is very clean and some very dirty.

To the South, you cross over to the mainland with a ferry. I tried it and during the peak hour, the passenger ferry boards thousands of people across. From the North, you cross by a Nyali bridge and to the west through a causeway.

David on a camel enjoying his weekend.

  1. Acknowledgments

-To GEMx and COECSA for providing funds to this Elective program.

-To the Medical Director of the Lighthouse Dr. Fredrick Korir (Senior Ophthalmologist – specialized in the Cornea), Dr. Ibrahim Matende (Pediatric Ophthalmologist) and all the staff of Lighthouse.

-To the Department of Ophthalmology Mbarara University of Science and Technology.

An Ophthalmology Post-Graduate Exchange Experience in Kenya

Filed under: GEMx Post-Graduate Exchanges GEMx Regional Exchanges GEMx Student Reflections Uncategorized

Post by Dr. Vrunaben Patel, a 3rd year MMed Ophthalmology resident from University of Zambia, who recently completed a GEMx Regional Exchange at the COECSA Institution,  Lighthouse for Christ Eye Centre, Mombasa Island, Kenya

doctor in front of care center

In front of Lighthouse for Christ  Eye Centre, Mombasa Island, Kenya

After all the pre-trip emails and detail fixing I finally sat on my flight to Mombasa, the full moon shining bright right outside my seat window. I was received at the airport by a friendly Lighthouse member of staff (got to read my name off a placard). Clean, convenient and safe housing was provided within the eye centre grounds.

THE EYE CENTRE EXPERIENCE

Day one at Lighthouse I met both the consultant ophthalmologists based there. I was shown around the whole centre by the medical director and introduced to all the staff. First word I learnt in Swahili was ‘karibu’=’welcome’ as I was greeted warmly by everyone, including patients I was introduced to. During my elective, I spent most of my time seeing patients in the general clinic as well as the cornea and paediatric clinic. Interesting cases I got to discuss with the consultants included persistent diabetic clinically significant macular oedema, neovasular age related macular degeneration, high myopia in toddler, solar macular burns, branch/central retinal vein occlusions, ocular toxoplasmosis, amblyopia, recurrent corneal erosions, corneal graft complications and viral illness related uveitis.

 

Doctor performing and eye examination on an adult patient

Examining a patient in general clinic

Doctor in scrubs performing surgery

Performing eyelid graft surgery

Had a few clinical meetings as well, some cases discussed were central serous chorioretinopathy, retinitis pigmentosa, oculocardiac reflex, and driver examination. My elective period included two weeks of screening patients and surgeries with visiting paediatric and corneal specialists. I got a chance to observe some penetrating keratoplasty surgeries, Descemets Stripping Endothelial keratoplasty and phacoemulsification; a totally new experience for me. Surgeries I did included 7 small incision cataract surgeries, 2 conjunctival growth excision biopsies, 1 pterygium excision and auto graft, 1 intravitreal injection, eyelid full thickness skin graft, anterior vitrectomy, examination under anaesthesia, and suturing corneal laceration/graft. I also did some dry and cycloplegic refraction using a phoropter for the first time.

plate with local cuisine

Local meal- ugaali and leafy vegetable

THE MOMBASA EXPERIENCE

Within walking distance of the eye centre lays the town centre of Mombasa Island. Stalls, supermarkets, places of worship all accessed easily nearby. Mostly I would be accompanied by a colleague from the eye centre while sometimes I was able to take walks around the town by myself and went to some local attractions like Fort Jesus. I also got to visit the public beaches on the mainland Mombasa and shopping malls. I was able to appreciate some similarities with Zambian culture- the matatus (mini buses) used for longer distances; ugaali (Nshima) and muchicha (leafy vegetable) as the staple meal. Other foods commonly found were cassava chips, dates, cashew nuts, mabuyu, and fresh coconut water.

OVERALL EXPERIENCE

Practice at Lighthouse was just like an extension of the work environment from Zambia though I missed having fellow registrars to interact with most of the time. The staff had different levels and exposure to ophthalmology training and so I had a good learning and teaching exchange. It was a minimum-stress environment on most days. I am sincerely grateful to the staff at Lighthouse for an enlightening and happy experience during my elective. I am also thankful to the GEMx team and my school for making this trip possible. Experience, be it that of oneself or of another, is definitely the best teacher and that is what this elective was for me.

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