Some of my lasting memories of growing up in Eldoret (Kenya) are the early days of AMPATH. I vividly remember the skill of artisans in the Imani workshop, the greenery of acres of AMPATH farmland, and the wonderful people who worked so hard to help establish the program. Of course, being a child at the time, some of AMPATH’s work was beyond my understanding. Now as a Slemenda Scholar, it has been an honor to revisit these memories with a better understanding of AMPATH. Indeed, while being a Slemenda Scholar has been an incredible learning and perspective-shaping experience as a budding student, the program has been transformative on a personal level as well.
In May of 2021, Dr. JoAnna Hunter-Squires and Dr. Manisha Bhatia described one of their research projects, still in the early stages. It involved surgery, international collaboration, artificial intelligence, and building models of the abdominal wall. I was fascinated and latched on for my Slemenda project. I did not fully appreciate yet that this project would unearth some roots that surely contributed to my interest in global health.
In recognition that some parts of the world, including parts of Kenya, may lack formally-trained surgeons to perform emergency surgeries, a team at AMPATH is working on developing an application that teaches general practitioners how to safely perform an emergency appendectomy. To assist with this project, I have been involved in developing the curriculum for the application, including building models of the abdomen and gathering expert feedback on the surgery. In the coming weeks we expect to start evaluating medical students, both in Kenya and Indiana, as they build the models and perform the surgery.
In between working on this project, I have enjoyed weekly seminars on global health (led by Dr. Dan Guiles) and meetings with other AMPATH leaders. In these sessions, I have come to learn new things about global health as well as reaffirm my appreciation for the AMPATH model. One particularly successful attribute of AMPATH is discussed on page 126 of Walking Together, Walking Far by Fran Quigley (an essential read for anyone interested in public health), “AMPATH has long since ceased to limit itself to HIV treatment … AMPATH’s lateral expansion from HIV/AIDS care eloquently addresses the concerns in the global health community.” It is this “lateral expansion,” specifically into surgery, that has enabled me personally to connect my experience as a Slemenda Scholar with the roots of my interest in global health.
In the early 90’s, I was born to a surgeon in a small rural hospital in southern Cameroon. My father, Dr. David Matthews, came to believe in the importance of surgical education in global health. As one of the few surgeons in the area, both the volume and scope of practice necessitated the training of general practitioners, medical students, and nurses in surgical procedures including appendectomies, caesarean sections, hysterectomies, laparotomies, tubal ligations, etc. These were common operations that often could have necessitated the transfer of patients to a tertiary medical center, but economic, infrastructure, and social realities often eliminated that as an option. It was evident that in the setting of rural hospitals, surgery was a necessary part of public health. One of the biggest lessons from this setting was that surgical education has a catalytic effect – one surgeon can perform only so many operations, but by training another, the ability to operate multiplies.
Believing in this catalytic effect, the opportunity to teach medical students by the hundreds drew my father to Eldoret, Kenya in 1996. As discussed in Walking Together, Walking Far, the IU-Moi partnership was well established at this point and convinced of surgery’s place in global health, he saw this relationship as an ideal situation. The surgeons trained at Moi University would staff hospitals all across Kenya and train the next generations of surgeons to come.
This summer, I have come to appreciate many new things about AMPATH including the aforementioned focus on “lateral expansion.” Indeed, this has enabled AMPATH to flourish where many programs falter. By focusing on more than treating specific diseases, the AMPATH model is able to flexibly adapt to its community while ensuring its programs have a solid foundation.
While the surgery partnership is just one of many examples of this in action, it has provided me the lens to appreciate the foundation and evolution of the AMPATH program as well as revealing my rooted interests in global health. As a Slemenda Scholar I have been privileged to connect a budding interest in global health with memories of Kenya, my father’s legacy in surgical education, and an exciting research project to increase access to surgical care.
Read more about the 2021 Slemenda Scholar experience from Cassie Anderson and Neal Patel.
