Story by Carter Mize. Photos by David Uttley.
From a forested hilltop in Kenya’s Great Rift Valley, the yelps, laughter and cheers of children playing soccer and other games can be heard well past sunset. Throughout the valley, kids congregate and tromp through villages with their friends and family for hours at a time.
Large groups of children are a common sight in Kenya. Over 20 million of the 53 million people living in the east African country are ages 14 and under. Around 60 percent of those children live on less than $4 a day.
When a child becomes sick or injured in rural Kenya, they often have few options to receive quality medical care. A ten-year-old who needs emergency surgery would have trouble finding a suitable clinic or hospital nearby. And by the time they could reach one, how could their family afford the bill?
Kenya, like much of Africa, is starving for pediatric healthcare providers for its growing child population. There are around 30 pediatric surgeons in the whole country.
That’s just a fraction of the pediatric surgeons in Texas—a state with around 140 pediatric surgeons for its 6.2 million kids ages 0-14.
The disparities are even more dire in other African nations. Sierra Leone, population 8.4 million, has one pediatric surgeon. South Sudan, with 12.1 million people, has none.
That’s why Dr. Britney Grayson, a Christian Health Service Corps pediatric surgeon, is working tirelessly to care for children at Kijabe Hospital—a 360-bed facility providing care for thousands of people in the rural areas northwest of Nairobi, Kenya.
Dr. Grayson isn’t just using her Vanderbilt education to care for patients. Kijabe, given its location, capabilities and needs, is a perfect place for her to train the next generation of African pediatric surgeons who can sustainably end surgical care disparities for children on the continent.
“When it comes to the lack of pediatric surgeons on this continent, I alone cannot solve that problem,” Dr. Grayson said. “Being a part of a training program allows me and all of us here to multiply our efforts and really feel like we are able to give more pediatric surgical care to the continent through training. That was really my draw here to Kijabe Hospital.”
Africa’s need for surgeons does not indicate a lack of willing students. Residents from all over Africa, including Burundi, Ethiopia, Sierra Leone and more, come to Kijabe for the high quality training provided by staff like Dr. Grayson and her colleagues.
A handful of young surgeons continually follow Dr. Grayson throughout the maze-like halls of Kijabe, observing her interactions with patients on rounds, answering pop-quiz questions before suiting up for the O.R. and stopping by her office for a chat about children under their care.
Teaching moments occur often and anywhere, and Dr. Grayson makes a point to instruct with enthusiasm and grace. The residents pay rapt attention, but without fear of speaking up with questions and commentary.
“[The residents] are the most gracious and humble learners,” Dr. Grayson said. “They don’t take this opportunity for granted. Most of them, especially the ones who have come from another country, didn’t know if they would ever be trained… either because there’s no training program in their country, or because, maybe there is, but they can’t afford it. They come here like sponges, wanting to soak up every bit of knowledge.”
CHSC and organizations like the Pan African Academy of Christian Surgeons and Bethany Kids, are working together within Kijabe to support pediatric surgical residents educationally and financially. The financial support is also crucial, as many residency programs in Africa cannot afford to pay providers in training.
However, one of the most important parts of their education takes place in Dr. Grayson’s home. The residents often meet up for Christian discipleship, led by Dr. Grayson, her husband Micah, and a myriad of other Christian health professionals working in Kijabe Hospital.
“It’s truly the Bible study [and] discipleship going hand in hand with our clinical care,” Dr. Grayson said. “That can help me relate to them better, especially in our clinical interactions, and perhaps model some of the skills they might need in the future in terms of caring for patients, dealing with patient loss and difficult patient outcomes.”
With Dr. Grayson’s help, the pediatric surgical residency program at Kijabe has produced highly skilled Christian surgeons who now work across the continent training others in the same manner.
Plaques of around a dozen former residents decorate the walls of Kijabe’s staff classroom next to Dr. Grayson’s office. Several new faces from the class of 2023 now grace the wall, including former pediatric surgical resident Dr. Mehret Enaro, who is taking her training back home to Ethiopia.
Ethiopia, like Kenya, is suffering from a severe deficit of pediatric surgeons; fewer than 50 for a country of around 49 million children ages 0-14.
“When you take care of children, the parents are trusting you with their most valuable thing in life,” Dr. Enaro said. “It puts a heavy weight on you to train the best way you can… Training in Bethany Kids helped me achieve those tools to be able to give the best care I can possibly give in this setting to these patients.”
The end goal of many of Dr. Grayson’s residents, CHSC, the Pan African Academy of Christian Surgeons, and Bethany Kids is to see their training efforts go viral in Africa, especially through the leadership of Africans themselves.
“God willing, I go back [to Ethiopia], start a training program, and do the same thing that I have benefitted from here,” Dr. Enaro said. “Training more pediatric surgeons who are spiritually and medically well-trained to take care of these patients.”
Dr. Enaro’s training also represents a radical social shift in Africa’s healthcare landscape, where increasing numbers of women are serving as physicians.
The continent still has a long way to go toward empowering women in healthcare. A World Health Organization study from 2019 found that women made up 28 percent of Africa’s physicians—the lowest percentage of any continent. In North America, women make up 46 percent of physicians.
Mission hospitals and their training programs are giving more African women the tools to practice medicine, which could have an outsized effect on regions with exceptional women’s and maternal health issues. But before these women can tackle those problems, they often have to overcome cultural barriers
“Through working with these ladies who are in training here it’s been really humbling to learn that basically all of them have been told not to do this,” Dr. Grayson said. “They have these gifts from the Lord, and they’ve been told not to use them, because [to some,] that’s not what the Lord’s calling on their life is.”
“It’s an incredible opportunity to encourage these women; to make sure that they don’t for any reason give up or let the pressures of society take over.”
This new, viral missionary training model has borne fruit in the form of highly-trained local physicians—but while the number of new African surgeons is encouraging on its own, their emphasis on Christian compassion toward patients distinguishes them from other healthcare providers.
Kijabe staff, including Dr. Grayson and the pediatric surgical residents make a point to routinely pray with patients, listen to their concerns, read scripture with them and share the love of Christ.
“Whenever you take intentional time with families, it shows them respect. And that’s… not always found in hospitals and clinics around here. Sometimes parents are just kind of ignored,” Dr. Grayson said. “In taking that extra time to sit with a parent to make sure they understand the diagnosis, make sure they understand how their child is doing that day- those opportunities, I think, are what makes the difference in the care that we provide here at Kijabe Hospital and Bethany Kids.”
“To me, the difference is Christ. Plain and simple.”
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Our Reserve Corps program allows healthcare professionals seeking to volunteer short-term to do so in a way that supports long-term Christian medical missions work. CHSC places healthcare professionals in a growing list of Christian hospitals across Africa, Asia, Latin America and other regions. Christian Health Service Corps works to improve access to primary healthcare, surgical services, and community-based disease prevention services. Non-Christian volunteers are accepted on a case by case basis but solely at the discretion of the hospital and CHSC team the volunteer will be supporting.
