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  1. Introduction


Kenya’s specialised surgical care needs have increased greatly over the years, and continue to do so.  This refers to the many surgical specialties and many Kenyan patients have been sent abroad for such specialised care because of the shortage of skilled surgeons. Thoracic and cardiovascular surgery tops this list, with particular reference to cardiac surgery. The costs involved are exorbitant, but can be reduced drastically with locally available facilities and expertise.


The general doctor-population ratio in Kenya is 1:7,100 compared to the recommended World Health Organisation figure of 1:600.  For the specialty of thoracic and cardiovascular surgery, the ratio is 1:3,500,000.  The latter ratio is bound to get worse if no training programme is put in place, despite increased production of general doctors from Kenyan medical schools.  This is not acceptable and denies the Kenyan population their bill of rights as contained in the constitution.


In many parts of the world, there now exist training programmes for Thoracic and Cardiovascular Surgery with the express objectives of improving and consolidating specialised patient care in this specialty.  Kenya has the burden of disease necessary for mounting a similar programme locally.  The Department of Surgery at the School of Medicine of the University of Nairobi, however, is the only one Department in the country with the capacity and capability of mounting such a programme.  This programme also fits well with the strategic and quality objectives of the department.

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