Background: Church/mission hospitals and other non-government health institutions in
Kenya provide 30% of the healthcare needs, providing affordable care to the rural
poor. This review presents the surgical pathology to which a general surgeon working in
a rural Kenyan hospital is exposed through training and beyond. Additionally, some of
the rarer surgical pathology, ‘rare birds’, encountered during this period is reported.
Methods: In this retrospective study, all the surgical specimens submitted by the author
for histopathological examination over a period of thirteen years were reviewed and
analyzed. The findings are reported.
Results: The results of 1826 surgical specimens were divided into the major surgical
specialties that a surgeon working in this environment is exposed to. General surgical
specimens constituted 48.4% of the total specimens, while urology, gynecology,
maxillofacial/otolaryngology and ‘other’ specialties made up 34.6%, 7.8%, 6.7%, and
2.5% respectively. There were a total of 389 malignancies, of which 55% were in
general surgery and 31.1% in urology. Rare surgical pathologies encountered over this
period included acne conglobata, an intramuscular lipoma of the forearm, intraosseous
lipoma of the fibula, primary tuberculosis of the prostate gland and of the thyroid
gland, amongst others.
Conclusion: Church/mission hospitals currently present excellent opportunities both for
training and career development in general surgery and related disciplines.