• December 6, 2017

    A Life-Changing Mission

In November 2017, I spent three weeks in Kijabe, Kenya, serving as the hospital pathologist through World Medical Missions. It was an incredible experience, as well as humbling and eye-opening. I had always wanted to serve in international health, but I wondered, what could I do as a pathologist? 

When I started to research opportunities, I was surprised to learn that there is a great need for pathologists in much of the developing world. Among several options, I chose to go to Kijabe Hospital, which serves Kenya’s poorest and neediest people. It has a bed capacity of 363, numerous outpatient clinics and nine OR suites. The hospital is staffed by both Western and Kenya-trained physicians and surgeons. There is no full-time pathologist, so volunteers are relied upon.

The Anatomic Pathology Lab

The anatomic pathology lab consists of a gross room, a processor and a microtome (circa 1970). There is a sign out room with three microscopes, a small library and a digital camera for sending photos for consults. Specimens can wait in the gross room for days with a gap in pathologists and some samples come from remote clinics with inconsistent delivery. The lab processes about 4,000 surgical cases per year, plus PAPs, FNAs and blood smears. When I arrived, there was a week backlog of specimens.  

While there, I signed out about 300 surgical cases, plus about 80 PAP and cytology cases. There was an incredible variety of cases with a tendency to most being malignant. Several were very memorable (choriocarcinoma, very rare gyn tumor, on day one)! Almost every prostate biopsy I saw was cancer.

The Value of Pathology

Patients are very lucky to have pathology in Kijabe, since much of Africa does not have any anatomic pathology, and specimens are simply discarded. This makes for many sad stories. We looked at a breast case from a 26-year-old who had a lumpectomy six months prior that had been discarded without a pathologic diagnosis. Now she was back with a high-grade, triple-negative ductal carcinoma.

But with the sad stories are happy ones. We had a young female patient with a large ovarian mass. The surgeon was convinced it was cancer, but her tumor markers were not elevated. It was an endometrioma, and we saved the patient from unnecessary adjuvant treatment.

Through this experience, I realized the priceless value that pathology brings to medicine. Here in the United States, we may take it for granted. It was incredibly empowering to go somewhere that I was the only person who could do what I do for hundreds of miles. I will go back, as I felt useful and needed. Please consider serving too.

The #Give2Every2 Campaign

I challenge my fellow pathologists to give two weeks of volunteer service (or cover service for a colleague to go), or give $2,000 every two years to help countries in Africa and other areas of the developing world to build a lab (start-up costs are high and are the largest barrier to bringing pathology in most areas).

I am happy to discuss opportunities to give or serve in Kijabe or other places at Stacy.Hinson@UTSouthwestern.edu.