Philip Ngujiri, writing for the Africa Brain Gains organization, points to a success story of talent, skill and technology.


African Returnee Inaugurates a Ground Breaking Practice

Dr Robert Mathenge's case epitomizes Africa's Brain Gain whose ideals have all along been promoted by the International Organization for Migration's (IOM) special programme that aims to bring back African professional to the continent. Through the Return of Qualified African Nationals (RQAN) - a programme that has so far assisted the return of more than 2,000 African professionals to take up jobs in Africa.

The programme has since been phased out and replaced by the Migration for Development in Africa (MIDA) that is considered more practical. The programme aims at helping African nationals to directly contribute to the development of their countries of origin.
IOM in cooperation with African sub-regional bodies such as the Economic Community of West African States (ECOWAS), the Southern African Development Community (SADC), the East African Community (EAC), and the Maghreb Arab Union (UMA) is developing partnerships aimed at reinforcing the links between migration and development in Africa.
Dr Mathenge, a trained percutaneous cardiovascular interventionist has introduced technology only found in south of the Sahara, outside South Africa. Until recently, he was the only trained heart and blood vessel specialist in Cardiovascular Intervention. The procedure applies to a range of procedures from the common angioplasty to any number of operation involving access to the body's circulatory through 'key' hole skin break using a catheter.
"Through this procedure, I'm able to treat and cure broad range of cardiovascular problems through relatively uninvasive technique. Benefits to patients include lower mortality rates than traditional surgery, quicker recovery periods, and reduced probability of complications as only local anaesthetics are employed," he says. By so doing, bringing the region at par with the rest of the world.
Coronary Artery Diseases (CAD) that often leads to acute heart attack and stroke are now very common in Kenya and the region, says Dr Mathenge. This increase has been brought about by change of lifestyles and the escalating incidence of disease like the diabetics and high blood pressure. The commonest pathological cause of coronary artery disease, by far, is the ageing process known as Atheroma; other much rarer causes are Congenital Abnormality of development of coronary arteries, or of the heart chambers, causing profound oxygen de-saturation; Syphilis, Aortic Valve Disease, and Embolism.
Before his return in 1997, treatment of coronary artery diseases was only made possible after being a tedious open chest surgery and general anaesthesia. The other alternative was to travel abroad for similar services now being offered by Dr. Mathenge. "I can successful operate a patient in the morning and in the evening he is as good as new. Necessarily, the patient need not take a scar home," he says.
Dr Mathenge got his training at the Minneapolis Heart Institute, US in the early 1980's. After his residency as was typical of young and prospecting African medical doctors, he had resolved not to come back home. "In due process, I arranged for my wife and daughter to join me in Minnesota." Though he had never intended to work and live in the US, the cost of coming back was prohibitive. In his sojourn in the US, and with much relish, he accumulated many books, manuals and equipment, not to mention another beautiful daughter.
All of a sudden, his return seemed elusive and was actually looking forward to permanently settling in the US when he came across some information regarding the RQAN programme). "Among other things, it provided air fares the entire family, in addition to shipment of my personal effects. It also provided six months of rental assistance to help me re-establish myself," he says. That is how the acclaimed doctor came back to Kenya.

Once in the country in 1996, he established Equatorial Heart and Blood Vessel Clinic in Nairobi the next year. In addition, he helped set up a Cardiac Catheterization Laboratory at the Nairobi Hospital that has helped improve the lives and fortunes of East Africans. Currently, he says that he totally overwhelmed by patients coming as far as the Democratic Republic of Congo.

However, this current position and status did not come on a silver platter- he earned it through hard work and endurance. Life was more difficult than he had anticipated. "Many old connections had been lost. I found it impossible to pick up from where I had left off," he says. Professionally, the task was even much harder. And being the only physician trained as coronary cardiovascular interventionist in the region did not make things any better. Not only did this bring new experiences in his life, but also a myriad of problems.
Establishing the lab that pioneered treatment in the cardiovascular field required over one year of meetings, training sessions and paper work. "Equipment was unavailable. I needed new nurses and technicians equipped with appropriate instructions. Not to mention the government's red tape that required processing of permits and approval."
It took him about two years to properly establish himself. Hospital administrators and practising physicians were skeptical of his qualification. "It was almost impossible trying to work with people who did not trust you. Both the physician and the patient didn't want to become the first guinea pigs."
His first patient, Titus Kimeu, now a retired civil servant only accepted his services because he had little options. "Dr Mathenge happened to the best option at that particular time," said Kimeu. After the painless therapy, which believed was incomplete set him on a robust lifestyle for the next three years. Still a doubting Thomas, in his ‘wisdom’ he flew to Madras, India, where he underwent an open chest surgery. "After spending a fortune and some time to recover, four months later the problem recurred. This is how I learnt the bitter truth that our own Dr Mathenge equals to ten out there."