Every year, more than 30 UW Medicine residents journey 9,000 miles to Nairobi, Kenya. Working alongside Kenyan practitioners and students in conditions very different from those found in Seattle clinics and hospitals, they gain crucial skills and expand their clinical knowledge. They are part of CEPI, the Clinical Education Partnership initiative, an innovative global program improving healthcare in Kenya and the U.S.
A 25-year partnership between the University of Washington and University of Nairobi sparked this innovative initiative. CEPI connects medical residents across disciplines to create a teaching hospital. The UW is one of the first U.S. universities to maintain such a long-term relationship in Kenya, establishing capacity building and training for Kenyan and UW practitioners. “The problem with so much development work is that you just drop in, and that was great for a month or two months,” says Dr. Carey Farquhar, CEPI Director.
The Global Innovation Fund is helping to expand CEPI with a new partnership between the UW’s Schools of Nursing and Public Health, the University of Nairobi, and Naivasha District Hospital. The new initiative is led by Dr. Pamela Kohler, an assistant professor in nursing and public health. Her initiative is expanding CEPI to include nursing students and practitioners.
The team aims to partner UW nurses with graduate nursing students from a Kenyan university. UW students get multidisciplinary training, working with physicians and residents, and learn much from the Kenyan nurses. “In resource-limited settings [like Naivasha District Hospital], nurses are about 80 to 90 percent of the healthcare workforce,” says Kohler. “A nurse in a rural setting is going to do more than a nurse in a hospital where there are more physicians available. They see a lot and manage a lot.”
To maintain continuity in the CEPI partnership at Naivasha District Hospital, CEPI and UW Medicine have taken the unusual step of posting a full-time chief resident at the hospital. The chief supervises medical residents who come for four weeks to teach and live in Kenya. With someone on-site year-round to strategically plan and evaluate, uninterrupted by constant shifts in personnel, the program makes a lasting impact, says Farquhar. The addition of nursing students – with the help of the Global Innovation Fund – will amplify the UW’s impact.
Dr. Kristen Hosey, a clinical assistant professor in psychosocial community health, led the first group of nursing students to Kenya in summer 2015 as part of a faculty-led Exploration Seminar. Six graduate-level registered nurses from UW Seattle and Tacoma gained first-hand experience in Kenya, working alongside nurses, midwives, physicians, clinical officers and community health workers from Naivasha. They also engaged in quality improvement projects, program evaluations and health education campaigns with their local partners to address health and capacity needs in Naivasha.
“What we’re trying to do, and where nursing fits in, is give our [residents and students] the opportunity to see a wide range of clinical activities, but also be sure they are doing something useful,” says Farquhar. “I always said I’d never create a program that’ s just a medical tourism program. [CEPI] residents are able to give a lot back.”
The Global Innovation Fund supported a meeting between UW and Kenyan collaborators to work through complicated benefits and challenges related to this new, multidisciplinary global partnership. “It gives us the opportunity to bring everyone together in one room and think through issues with scope of practice and licensing, and what the role of the nurse looks like with a graduate student there,” says Kohler. The meeting builds on Farquhar and Hosey’s efforts, and aims to expand opportunities to University of Nairobi and Jomo Kenyatta University of Agriculture & Technology nursing students and practitioners to participate in future CEPI partnerships.
CEPI residents also make a financial investment in the program, which is financed through grants and departments, and by the residents themselves. The program provides secure housing, transportation and cell phones to participants, but flights and daily expenses are out of pocket costs. “I would love to have a grant from a donor so that we could fund this without having to transfer the costs,” says Farquhar.
Kohler, Farquhar and Hosey say their close and lasting relationships with Kenyan partners are central to the program’s success. “For me it’s the people,” says Farquhar. “[They] are really motivated. They are well trained, educated, intelligent, have good ideas and can work with you on these problems. You can see the fruits of your labor.” Together, the UW and Kenyan partners are driven to improve health outcomes and improve clinical education – in Kenya and the U.S.
Learn more about the Global Innovation Fund and other global opportunities.
— Indra Ekmanis and Sara Stubbs, Office of Global Affairs