a good day

Moody (Mahmood Qureshi) picked me up early am to travel to Aga Khan Hospital for our surgery. I found it fascinating to work with anesthesiologists from Rwanda and Jordan, neurosurgeons from Kenya and Uganda, all gathered to learn the procedure for trigeminal neuralgia that I have been didactically teaching the last several days. They were very excited as was I. They all wanted at least some hands on time. We treated all three patients successfully. For those non-neurosurgeons among you this is a procedure that for various reasons cannot always be completed. Today all were successful. It was handing the neurosurgeons a new toy only much more. Statistically there ought to be 1500 new cases of trigeminal neuralgia in Kenya each year, and yet hardly any are being treated. They all wanted copies of my lecture from yesterday and have already arranged CEU meetings for the neurologists and dentists in Nairobi and Mombasa to try and get the word out.

Below are concrete barriers in the road to be negotiated after passing security check at the Israeli embassy.

After the first of three cups of tea I was finally returned to my hotel for a welcome afternoon off. Worked my my talk for grand rounds tomorrow on spinal cord injury (thanks to JDC for the core, but he won't recognize the finished product) and then finally ventured out for a walk after the front desk assured me it was safe as long as I was back by 5:00. Incidentally my lovely country hotel is across the street from the Israeli Embassy; you cannot imagine the guards, concrete barriers, concrete walls etc. Each time we ascend the street to the hotel the car must stoop for a security check of the trunk and back seat of the car.

I walked two miles or so, stopped in a neighborhood place for lunch and returned for more work on my talk and to await being picked up by Moody for dinner.

Moody is of Pakistani descent (from the days when it was part of India). He is Muslim. His father came to Kenya with his brother to work on the railroad in early 20th century. The brother returned to India. Moody's father stayed here, ultimately returned to India to marry a woman his parents had chosen, then returned to Kenya where Moody was born. He has three children, all physicians. He and one other felllow are the best trained of the 12 neurosurgeons in Kenya (2 retired). Moody is very polished and proper and has organized a multi-country residency program in East Africa with tentacles that reach around the world. His residents have been to Turkey, Japan, South Africa and the U.S. There was a team from Johns Hopkins here just a few weeks ago (actually working in Eldoret in northern Kenya). In the past year that has also been a team from Duke.

Paul Young, a neurosurgeon in St. Louis who has been here 10 times, has invited (and 10-12 have accepted) the guys from Rwanda, Uganda, Tanzania, Ethiopia and Kenya to gather in St. Louis the first week in March. He is paying for all hotels and foods. Each of the locals are paying their own way, though in most cases they have obtained the funds from their governments.

Moody and I had a superb and very unusual Indian dinner at a fine place in the Intercontinental Hotel downtown.

Tomorrow is my last day of work. I will go to neuroradiiology rounds in the am at the Kenyatta Hospital, then out to Aga Khan to see my post op patients. In the afternoon I am giving grands rounds to all the surgery departments at the University of Nairobi.

I'm still trying to tie together loose ends for a trip this weekend. Transportation is the problem. A car and driver will give me more flexibility, but ends up being quite expensive and leaves a 6 hr drive back to Nairobi next Tuesday. I can fly everywhere by puddle jumper but then need taxis/drivers to get to various places and apparently that is not always reliable (car break down, there can be bandits on the road, etc.).

Bye for now.