Professor George Magoha, vice chancellor of the University of Nairobi (UoN), understands that the key to improving the tenuous state of health care in sub-Saharan Africa is to train and retain more doctors and other medical professionals.
Last week, Magoha led a 12-member UoN delegation, including the deans of its schools of dental sciences, medicine, and pharmacy, and directors of its schools of nursing and public health, on a fact-finding trip to the University of Maryland's (UM) Baltimore campus. "We came to strengthen our partnerships with the University of Maryland by visiting firsthand to our contemporaries in each of your schools, because this is one of the premier universities in the U.S.," said Magoha.
According to World Health Organization records, Africa has only 2.3 health care workers per 1,000 people, compared with the Americas, where there are 24.8 health care workers per 1,000 people. There is an estimated shortage of 817,992 health care workers in Africa.
The Kenyans' visit is part of a five-year, National Institutes of Health-funded Medical Education Partnership Initiative (MEPI) to the UoN in partnership with UM and the University of Washington.
Jay A. Perman, MD, president of UM, said, "My meeting with Professor Magoha confirmed my belief that there are a wealth of educational resources to be shared between the University of Maryland and the University of Nairobi, interprofessionally and within our professional disciplines. University of Maryland deans are working with members of the Kenyan delegation to enhance models of medical education, which will surely increase the number of new health care workers, and thus reinforce clinical and research capacities in Africa. Also, our faculty looks forward to student and faculty exchanges, and to more research collaboration that will strengthen the University of Maryland."
Robert Redfield, MD, director of clinical care and research at the Institute of Human Virology, School of Medicine, is the principal investigator for the UM under the MEPI award. He said that MEPI is the latest of several collaborations in Kenya. "As we move into the 21st century, if an academic institution wants to stand in the forefront of medical education, it needs a global perspective. This is best accomplished by strategic partnerships between the U.S. and partners in long-lasting relationships that enable both of those universities to meet their missions in health science and quality."
After a greeting by UM officials, the Kenyan delegation spread out across the 65-acre university where they visited UM schools appropriate to their professions.
Professor Isaac Kibwage, principal of the UoN College of Health Sciences, described their purpose in coming to UM. "The vice chancellor expects each of us to see how the training is done here." Kibwage said the delegation is particularly interested in "the issue of e-training, or distance learning, which we are now developing in a few units of our School of Dental Sciences." The UM Dental School is a world leader in dental education online.
During the greeting session, Evelyn Wagaiyu, dean of the UoN School of Dental Sciences, told Bernard Levy, DDS, MSD, professor at the UM Dental School, that most of her graduates practice in or near Nairobi, but that they also are needed in rural Kenya. The next day, Levy, who is the School's director of international operations and Dental School Dean Christian S. Stohler, DMD, DrMedDent, changed their plans for Wagaiyu's tour from mostly information technology to also include rural dentistry. They took Wagaiyu to the University of Maryland Dental Clinic, Perryville, in rural Cecil County, some 70 miles north of Baltimore. At the Perryville clinic, Wagaiyu met and talked with patients and students, and toured the facility.
The state-of-the-art dental clinic was completed last year and serves rural northeast Maryland where previously there had been a critical need for oral health care, especially for children. Levy said, "I think she left knowing that our many of our students, after experiencing Perryville, want to work in rural areas." As far as IT teaching, he said, "It lends itself to our site in Perryville. They aim the camera to the patient and I talk with the patient from [Baltimore]. Everything we are doing here is doable there. She was impressed."
Also at the greeting session, the dean of the UoN School of Pharmacy, Professor Grace Njeri Thoithi, expressed particular interest in the UM School of Pharmacy's post-market research on drugs and how they are being used by different population groups. Ilene Zuckerman, PharmD, PhD, professor and chair of the School's Department of Pharmaceutical Health Services Research, said, "We discussed the state of health services research at [Thoithi's] school and in Kenya. It sounds like we could collaborate by providing technical support and training for their faculty on health services research methods. This would benefit both our schools by enriching our programs with cross-cultural experiences."
At the UM School of Nursing, Grace Omoni, director of the UoN School of Nursing, said she was very impressed with the School's series of simulation laboratories where student technique is tested-from needle injection to birthing to rapid medical responses-on life-size dummies with simulated organs. "This is what we want to upgrade. The skills labs' use of cameras is very important." At the UM School of Nursing, instructors set up learning exercises for a student, then leave the simulation lab to observe them on video monitors in the next room. "This is good because I've seen half the time a student panics in the presence of the instructor," Omoni commented.
Earlier, Magoha and Kibwage met with Phoebe A. Haddon, JD, LLM, dean of the UM School of Law. They discussed supporting judicial training in Kenya, perhaps through a joint program supported by both universities. Haddon explained, "A number of our clinics address legal issues affecting families and others with HIV/AIDS. We could support opportunities to interact with the Kenyan university's clinicians who are addressing similar issues in their work. Our law school has been developing an international law clinic that has offered students on-site and live-client projects in Namibia, China, and Mexico that is possible to replicate elsewhere. I think we could develop rich opportunities for faculty and student exchange."
In Magoha's meeting with Richard P. Barth, PhD, MSW, dean of the UM School of Social Work, he expressed interest in UoN's desire to strengthen Kenyan society with education and training opportunities for future Kenyan social workers. "During our discussion he framed the idea of bringing that area of concentration out of their Department of Sociology and into the College of Health Sciences. [Magoha] explained that this would strengthen students' commitment to service and encourage their participation in an interdisciplinary approach to helping mitigate the health and social service needs of so many Kenyan citizens," Barth said.
Among Magoha's meetings with the UM School of Medicine faculty was his special request concerning herbal medicine research. "We had an excellent meeting and agreed to explore collaborating on pharmacognosy [the study of medicines derived from natural sources] and herbal medicine research, as well as them attending our course next spring in research methodology in integrative medicine," said Brian Berman, MD, professor of family medicine and the founder and director of UM's Center for Integrative Medicine.