Helen Li, MD

Nominated From: Kenya-Moi University

Research Site:Moi Teaching and Referral Hospital; Eldoret, Kenya

Research Area: Surgery/Surgical Access

Primary Mentors: Dr. JoAnna Hunter-Squires, Dr. Seno Ivan Saruni

Research Project

Management of hernia disease through the surgical cascade at a Kenyan National Referral Hospital: A mixed methods patient centered study

Hernia disease is one of the most common, surgically curable afflictions globally, and the unmet need for these repairs remains large. In LMIC settings, factors including a labor-intensive workforce, higher rates of emergent surgeries and limited access to minimally invasive surgical (laparoscopic) options all play a role in increased hernia rates. While most hernias can be repaired by a simple, outpatient procedure, untreated hernias can lead to significant morbidity, productivity loss, or financial catastrophe in otherwise healthy individuals and their families.
We seek to develop a deeper understanding of hernia disease in our setting by identifying risk factors for hernia disease within our patient population and evaluating the current standard of care at our hospital. We also seek to follow the patient experience in receiving hernia treatment through the surgical “cascade”, from pre-operative work-up, intra-operative procedure, and post-operative recovery. In doing so, we hope to expand the understanding of surgical needs from an isolated hospital-centered perspective, to one that involves the community and the person as a whole.

Research Significance

Surgical disease has often been viewed as a hospital-centered and isolated instance in a patient’s medical history. In reality, surgical care is a “cascade” of events, ranging from pre-operative work-up, intra-operative procedure, and post-operative recovery. This longitudinal view acknowledges the important partnership between patient and surgeon which must continue far outside the operating room. Our research explores this surgical “cascade” through the lens of hernia disease as a representative of general surgery pathology. Developing a more comprehensive understanding of the needs of surgical patients in LMIC settings, both in the hospital and the community, can create a foundation on which future policies can be built to achieve universal surgical care.


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