The urologists worked in Kisumu at Nyanza Provincial General Hospital (NPGH), which has been in existence for more than 100 years. NPGH is the referral hospital for the province, serving over 12 district hospitals in Nyanza and the neighboring districts in Western Province and Nandi. There are currently no urologists on staff at NPGH or the district hospitals, which serve a population in excess of 5 million people; thus, there is a great need for the urologists’ services. The urologists primarily performed surgeries. Screenings took place in anticipation of the urologists’ arrival so that the physicians would be able to maximize the time spent by performing as many surgeries as possible. The type of surgeries the physicians performed included the following:

(i) prostate; (ii) orchidectomy; (iii) and to a lesser extent -- correcting malformations in kids (constructing a new urethra) and treating fistula

• Leading an outreach clinic: NPGH is responsible not only for treating and screening urban residents, but also for the surrounding and outlying areas. The hospital will provide transport each day to this peri-urban area and will arrange for screening of patients and everything else required.
   
• Carrying out some surgeries: The urologists will perform similar surgeries as on the first trip to NPGH.
   
• Teaching one or more grand rounds: Using several interesting cases that the team has seen and/or operated on to teach from, to help train residents and possibly interns and medical students.
   
• Construction of one or two primary schools in a surrounding village.

In addition, Knock is working with United’s contacts among equipment and medical supply vendors to get much needed medical equipment and supplies donated in anticipation of the trip.

Knock hopes that this is just the start of its Medical Missions Program and, working with its partners, United and the Earth Institute, anticipates sending at least one group of physicians to one of the sub-Saharan cities annually in the coming years.

Knock Director, Bruce Cohen, reflects on the trip: “Without question one of the greatest moments came when we went into recovery on Thursday morning to check on the patients treated the previous day and the 4 year-old girl who had a 5 kg (about 11 lb.) tumor removed from her stomach was sitting in bed crying. For the uninitiated, this might be cause for great concern, but not for the two doctors who spent 6 hours operating on her the previous day; her crying was almost as much a sign of recovery as a beating heart.”