Dr James Kirimi is a maxillofacial surgeon and CEO of Meru Teaching and Referral Hospital.
On weekdays, I wake up at 6 am and start the day with a word of prayer, then I check my emails and reply to the urgent ones. I then read a book for 30 minutes. Three times a week, I do a short exercise routine in my house or take a short walk around the estate. Thereafter, depending on the schedule, I might then leave for work by 8 am. Luckily the hospital is a 10-minute drive from my home.
My workplace is a Level 5 public hospital in Meru County. It is the county referral hospital for Meru County and at least three other neighbouring counties. It has a 360-bed capacity and a daily average out-patient attendance of 700 patients. It has a workforce of over 500 full-time employees. The hospital provides routine general medical services like outpatient services, accident and emergency, medical lab, maternity services, and x-ray/imaging services. It is the only public facility in the Upper Eastern region offering specialised services such as MRI Imaging, oncology/chemotherapy, laparoscopy/minimal access surgery, maxillofacial surgery among others. It also serves as the teaching hospital for medical learning institutions such as Kenya Methodist University, Meru University, and KMTC.
Usually, some of my days start off by attending to administrative issues in the hospital, meeting my executive management team and clearing my in-tray. The better part of the morning is reserved for meetings with my team at the hospital and also with the heads of health county departments. I keep the mornings open to attend to external partners who routinely visit the hospital. I might also begin the day by reviewing the maxillofacial patients in the ward either before or after surgery together with my surgical team.
This helps me to ensure their treatment is going on well and that those being prepared for surgery are ready. Once this is done, I proceed to my office for administrative duties. Wednesday mornings are reserved for my out-patient maxillofacial consultant clinic, while Thursdays are reserved for surgeries in the operating theatres. Sometimes I am forced to hold short meetings in between surgeries when urgent matters arise in the office.
It is right to say that I have two jobs; albeit with one salary. As a maxillofacial surgeon, I love the immediate impact that my surgeries have on patients. Any surgeon will tell you how gratifying it is to see your patient the day after surgery and them in good spirits. It is indeed humbling knowing you have impacted someone’s health directly. The fact that I do surgeries on the face, makes my work visible and good outcomes are always a joy. As the Hospital CEO I love the fact that I have this opportunity to make a change in health services delivery to the people of Meru county and others from elsewhere. I gain satisfaction from the knowledge that the hospital provides health solutions to hundreds of people every day.
As a maxillofacial surgeon, my biggest challenge without a doubt is cancer that presents late, which sadly is often the case. These patients come when little can be done other than palliative care and that breaks my heart. To see the hope in their eyes die because I am not able to give them help they so desperately need is heartbreaking.
Also, managing the public’s and patients’ perceptions and expectations about a public hospital like this one, has not been easy. In a resource-limited setting, often services are overstretched resulting in the perception that we are not delivering. Having to refer patients to KNH for some specialized treatment has been one of our key struggles. However, with the expected completion of an ICU and HDU in the hospital in December, I am confident this challenge will have been addressed. Another of my great challenges has been the inability of patients to afford care.
A majority of the local wananchi do not have health insurance and when they need medical treatment they are unable to afford. On a monthly basis, this hospital has to release over 100 patients who are unable to pay their hospital bills.I urge Kenyans, in general, to enroll in NHIF even as we await the rollout of Universal Health Care by the national government.
My evenings are for unwinding and recollecting the day’s events as well as planning for the following day. This I do over a cup of coffee – I love brewed coffee. Other times you will still find me at the hospital until late at night either attending to patients, doing surgery or some administrative duties. Whenever I can, I try to sleep as early as possible; before 10 pm, so that I am ready for the next day. My winding down routine is usually a book and evening devotion. It is not unusual to be interrupted in the middle of the night to attend to a medical emergency or administrative matters that require my attention.
I enjoy reading books and at any given time I have at least 3 books on my radar. Currently, I am reading A Short History of Time by Stephen Hawkins, The One Thing by Gary Keller and Kwani? by Binyavanga Wainaina. I prefer non-fiction writing and I particularly like science books and African writers like Yvonne Adhiambo Awour, Tony Mochama, and Chimamanda Ngozi Adichie. I, of course, grew up reading literary greats like Ngugi Wa Thiong’o and Chinua Achebe.
Weekends are for family. Saturday morning breakfasts are a feast with my wife and three children. Often, it turns into a brunch. Thereafter we always try to find an activity that involves us all and spend some time thanking God for the many blessings. The kids love swimming and often you will find us in the swimming pool on sunny afternoons. We also love cycling in the neighbourhood and I play a bit of soccer with my eldest.