Keith Forwith

Innovative Thyroid Surgeon

Tenwek Hospital, Bomet, Kenya

For a general description of Tenwek, check out the Tenwek page on the PAACS website.

ENT at Tenwek is improving, but like most things in Africa very slowly! 

What’s A Trip To Tenwek Like For An ENT?

Well, that depends on what type of ENT you are! As an example, one repeat visitor brings her own microscope and ear sets when she comes and treats a lot of ear patients! I personally, don’t do ears at Tenwek for two reasons.  First, the equipment here is not adequate. The only microscope is an eye scope with only a 175mm lens. Which means the scope is so close to the ear that the instruments hit the scope coming in and out. Second, I really enjoy teaching the general surgical residents both in the clinic and in the OR (which at Tenwek is the “theatre”). So, my emphasis is on head and neck cases that use their general surgical skills and hopefully, challenge them along the way. There is a urology tower buy no sinus instruments so endoscopy is out. Additionally, since this is a PAACS site, the emphasis should be on cases that the general surgeons could learn from and do when they leave to practice in remote areas of Africa. 

A typical week is Tuesday and Thursday surgery clinic. Monday, Wednesday and Friday are available for surgery, but OT (operating theatre) time can be limited. There are 5 OR’s that are filled with 2 general surgery rooms, 2 orthopedic rooms and one left to share with other specialties. A full time urologist also serves at Tenwek so the theatre is busy most of the time! Coordinating a Tenwek visit with the long term missionary staff is critical!

Travel And Housing

It takes two and a half days to get to Tenwek. Typically, you’d fly into Nairobi from London or Amsterdam and arrive in the late evening. Travel outside the city at night is not recommended so there are two guest houses in Nairobi. I prefer the Mennonite guest house – the setting is quite nice for the first night in Kenya. If you come through World Medical Mission, a Samaritan’s Purse driver will pick you up from the airport, take you to the guest house, pick you up the next morning and drive you 3 hours to Tenwek.  It is strongly recommended that you not drive yourself! 

Housing at Tenwek is usually in the guest house where living conditions are quite comfortable. It is a 5 minute uphill walk to the hospital. Meals are provided during your stay.


ENT equipment at Tenwek

Equipment for our specialty can be challenging, so I hope to provide some ideas here to help. 

Big ticket items to donate

  • a flexible fiber optic laryngoscope for the ENT clinical officer (equivalent to a PA in the US)
  • a battery powered headlight for the clinic
  • a headlight for OR
  • a light source for the OR (one poorly functioning unit exist that sometimes works)

Small items to donate

Items can be used so long as they are brought clean. Many of the items that are disposable in the states are cleaned and used over and over again, usually until they break!

  • hand control bovies
  • suction bovies
  • metal or plastic Yankaur suctions 
  • Tenotomy scissors
  • small tissue scissors
  • small Debakey forceps
  • alligator ear forceps for foreign body removal, tube placement
  • lacrimal probes
  • McCabe dissector or equivalent for thyroid surgery
  • Green retractor or similar thyroid retractors
  • nerve hooks for neck dissections
  • bipolar (there is one unit for all 5 OR’s)
  • for the tympanoplasty set
    • Frazier tip suctions: 20, 3, 5, 7 ‘s
    • ear speculums: all sizes
  • large and extra large OR gowns (reusable)

Items to bring for your own use at Tenwek

  • powder-less gloves (if you need them)
  • OR gowns (if you can’t squeeze into a medium heavy cloth gown)
  • your own scrubs ( I bring 4 pair and launder them at the guest house)
  • items on the general list on the bottom of the PAACS ENT page