Dr Ogutu is a Consultant Cardiothoracic Surgeon at The Aga Khan University Hospital, Nairobi. He holds a degree in human medicine, a diploma in emergency medicine and is a specialist in adult cardiac surgery.
What does a cardiac surgeon do?
In Germany where I trained and worked, and most of mainland Europe and UK, cardiothoracic and vascular surgery were a combined qualification. But, the two have since evolved into distinct sub-specialities. A cardiac surgeon performs surgeries of the heart and its vessels. These include coronary artery bypass surgery, repair and replacement of heart valves, surgery of the aorta (main vessel transporting blood from the heart to the rest of the body) as well as repair of heart defects. Paediatric cardiac surgeons perform surgeries on children born with congenital diseases that may include malformation of the heart vessels, valves and other structures within the heart. Thus, paediatric and adult cardiac surgeons are further distinct sub-specialists. Thoracic surgeons perform procedures mainly involving the lung and its cavity, while vascular surgeons specialise in surgical procedures of vessels located further away from the heart.
What ignited your passion for human medicine?
When I was nine, one of my cousins who was expectant went into labour when I was alone with her. I managed to get help from two elderly ladies who, after overcoming some minor complications, successfully delivered the baby. I wished that I would never again find myself in a situation where I am unable to help someone facing a life threatening condition. That incident sparked my interest in medicine. However, as I went through medical school and learnt more about the human body, I developed passion for medical matters of the heart rather than gynaecology.
Why do you mentor others?
I was mentored by very good surgeons. If I did not have that mentorship, my view of cardiac surgery or even my interest would not be as deep as it is today. Through the mentorship, I was guided to make the right decisions along my career path. Even right now, I still engage my mentors when faced with difficult situations or when I have to make difficult decisions. Medicine is not a one-man show. There is always someone who has seen, knows or has experienced something which you have not. Having a mentor helps you develop in your field.
What critical moments defined your career trajectory when you were in your 20s?
Making the decision to study medicine in Germany in my early 20s is one of them. It was a challenging move because even though I had studied a little German in school, moving there meant learning and studying in a setup that was completely German. I took that as a challenge and went ahead to enroll at a German university. It was not a walk in the park, but I do not regret.
The second was becoming a cardiac surgeon. Cardiac surgery is a very competitive subspecialty in medicine. It takes a minimum of six years of training and several surgical procedures for one to qualify to become a cardiac surgeon. At some point in my fifth year, I considered pursuing a different subspecialty. My mentor at the University of Augsburg (Prof Michael Bayer) was very encouraging, and reassured me of his support through the remaining part of my training.
What are some of greatest lessons you have learned about the profession so far?
As a doctor, the patient is at the centre of everything you do. I especially appreciate it when patients ask questions because it shows they want to fully understand their condition and the treatment I am offering. It is my duty to fully explain the procedure to each patient before they consent to it. It is very important for the patient to be mentally and emotionally balanced, and to accept the treatment and possible consequences prior to any procedure.
Teamwork within medicine is another important thing I have learnt. You learn a lot from your peers. At Aga Khan University Hospital, cardiologists, anaesthetists, and cardiac surgeons have a weekly team meeting where we discuss cardiac cases and come up with the best evidence-based treatment options for patients.
What would you say to a young doctor who would like to get into your sub- specialty?
Medicine is a fulfilling career as long as you are not egocentric. It also takes a lot of time, effort and resources. But if somebody is really interested, they should be patient, hardworking and persistent. The work itself includes long hours performing surgeries, which in some cases are very challenging. You need to be prepared to encounter all these challenges, both physically and mentally, at all times.
What did you struggle with the most as a young doctor?
I spent most of my earlier years as a doctor in Germany, where I was often the only young black doctor in the different departments I worked in. Things weren’t as easy for me compared to my German colleagues who were much more fluent in the language. I occasionally had to prove my worth as a doctor, unlike my German colleagues who were automatically perceived by some patients as capable.
In what ways do you think the government can increase the uptake of cardiac surgery sub-specialty among younger doctors?
By providing training for more surgeons in cardiac surgery, and facilitating training partnerships with leading cardiac surgery institutions around the world. This will contribute towards producing world class Kenyan surgeons. I don’t see any reason why we should lag in Africa as far as skills and human resources and knowledge is concerned. What is lacking is the opportunity to develop these skills.
The government should also offer competitive perks and incentives that will attract the many Kenyan specialists abroad to return and serve the country. Secondly, provide facilities and equipment locally allowing these highly qualified specialists to provide quality treatment to patients while maintaining and developing their skills and knowledge. Further, we need centres of excellence in this country. A private-public partnership between the government and the Aga Khan University Hospital, for example, would significantly improve cardiac specialist services for our population and beyond our borders.
Having worked in First World countries, what should we do to improve local healthcare?
Some surgeries performed in Kenya cost twice as much as they would in Germany. Almost all consumables required for the procedures are imported and the costs are directly borne by the patient. The government can reduce these costs through taxation exemptions, price control regulation and policies, allowing direct imports from manufacturers to health institutions performing highly specialised procedures revising private health insurance policies, and encouraging local manufacturing of medical and surgical consumables. That way, healthcare will not only become affordable, but also accessible. BY DAILY NATION