For more than 30 years, neurosurgeon A. Leland Albright, MD, has used his clinical prowess to give back. By 2010, four years into his pediatric neurosurgery professorship at the University of Wisconsin, he already had a number of annual short-term medical missions under his belt. It was then that he and his wife, nurse Susan Ferson, MSN, felt compelled to embark on a long-term medical assignment in Kenya — a full 8,000 miles away from home.
“It was a pinpointed experience,” he says of the intuitive nudging that led to the decision. “This overwhelming thought to go to Kenya came out of the blue. Later that month, Susan had the same inner conviction.”
Kenya, a nation bisected by the equator and nestled within Africa’s eastern flank, is home to 38 million people and only 15 neurosurgeons. All but three of the country’s neurosurgeons practice in its capital of Nairobi. Dr. Albright is one of two who work in the 5,000-resident village of Kijabe, focusing on a pediatric subspecialty at the church-owned Kijabe Hospital, which caters to the needs of impoverished patients.
“[Before we arrived,] we wrote to the leadership of Kijabe Hospital and said that we would like to come,” recalls Dr. Albright, who had spent 25 years as an educator and practicing neurosurgeon at Children’s Hospital of Pittsburgh prior to his teaching duties in Wisconsin. Kijabe Hospital officials feared that their treatment facilities, particularly the intensive care unit, would be overwhelmed by the influx of patients spurred by Dr. Albright’s arrival. “We had to agree to do no more surgeries than the surgeon who had been operating there already, but,” he says, borrowing a line from the 1989 film “Field of Dreams,” “we built it, and they came.”
For Dr. Albright, performing five to eight operations is all in a 12-hour day’s work. With the help of Humphrey Okechi, MBChB, a neurosurgical fellow trained under his tutelage, he completed more than 2,500 surgeries during his first two years in Kijabe.
“Sixty-five percent of these cases are related to hydrocephalus and spina bifida,” Dr. Albright says. He adds that since moving to Kijabe, he has provided guidance to 16 Kenyan and American neurosurgical residents, believing that “it is worthwhile for U.S. neurosurgeons to come to places like this to see the workload. In the U.S., they may see hydrocephalus and spina bifida cases occasionally, but in Kenya, they will see many times the number of these cases that they will never be able to see in the States.”
Uprooting a storied academic and clinical career for a multi-year stint abroad has come with a series of adjustments. But in 1980, as Dr. Albright prepared for his first-ever overseas mission (six months launching a neurosurgical program in Korea), a retiring missionary told him about the three keys to having a good experience during an expatriate humanitarian endeavor: low expectations, flexibility and a sense of humor. These keys, in addition to his own addendum of patience, have carried Dr. Albright through his treks, which previously included yearly trips to locales like Nigeria and Venezuela.
“When you’re in the middle of surgery and you ask for an instrument, then someone hands it to you and it’s broken, you just say, ‘Well, this is Kenya,’” he explains. “You get used to the fact that this is the way it is, and it’s not going to change.” Most of the surgical instruments used are donated by medical-device companies, universities and hospitals in developed countries after years of use. When encountering broken equipment, Dr. Albright resorts to techniques that are antiquated in the U.S., but are feasible in Kenya and lifesaving just the same.
In addition to supply setbacks, Dr. Albright also has encountered asocial custom that affects the way he communicates with nurses and patients. In Kenya, delivering bad news of any kind is a cultural taboo that requires delicacy, whether it is coming from a nurse who is hesitant to admit she did not administer a patient’s medication or from a doctor telling parents about their child’s grave prognosis. In cases of patients whose ailments are unresponsive to treatment, Dr. Albright summons assistance from the hospital chaplain. “We’ll talk to her in a private conference, and tell her that we have done everything we can,” he says, noting that the chaplain provides that patient support in handling those difficult conversations.
For a child with an untreatable condition, Dr. Albright sends him or her home with family, then offers to care for the child if there are signs of improvement later. “Most of the time, the baby will die,” he says. “But for 20 percent, they’ll come back [to the hospital] … and the infection will be gone.” Dr. Albright and Ferson also have extended financial assistance to families whose children can be cured, but are without any viable access to must-have treatment. “Sometimes, that’s when you use your own funds, but you can only do that for a couple of people,” he says.
While Dr. Albright’s initial intent was to stay in Kijabe until 2016, he notes that he is not bound to a timeline, and wants to ensure that the work continues after he and his wife return to the States.
“We don’t want to leave until there are two pediatric neurosurgeons who will continue the work,” Dr. Albright says.
In addition to his clinical practice and international presentations, Dr. Albright preaches sermons and pens daily e-mail meditations for a local church. He also sets mornings aside for regular prayer and Bible study, stating that while he always has maintained a dedicated spiritual practice, his spiritual connection has strengthened abroad.
“The structure [in Kenya] is so radically different than anything we had before,” Dr. Albright asserts. “Faith is a meaningful part of day-to-day life.”
For all the adjustments he and Ferson have had to make, the aim of their Kenyan leap of faith is clear.
“There’s a Bible scripture that says to let your light shine before men in a way that they see your good works and give thanks to God,” he recalls. “That’s our hope — that they see the love of God expressed to our patients.”
Published in the February 2013 edition of AANS Neurosurgeon.