It is Saturday lunchtime. The African sun is spectacularly
bright, the sky a calming blue, and the temperature a perfect 70.
I've just returned from a walk in downtown Eldoret. I've got my
weeks supply of "Chili Lemon" potato chips and cookies. I'll know
in an hour or two if I'll pay the price for not putting on
While the IU House is quiet right now, it has been a hectic week
with a visit from the Dean of the IU Medical School, the head of
the IU Simon Cancer Center, and the chairs of Medicine and Surgery.
This week also heralded the return of the IU medical students!
Everyone here is excited to have them back.
I'm here working with the Palliative Care team and we had the
opportunity to attend the Multi-disciplinary Cancer Management
Course sponsored by AMPATH and the American Society of Clinical
Oncology. The three-day course focused on proper management of
various cancers. I was excited to see the inclusion of palliative
care in the curriculum and encouraged when the majority of
attendees signed up for a breakout session on the topic. In fact
they had to add a second session to accommodate everyone! I was
honored to co-chair the session with Dr. Esther Muinga from the
Kenyan Hospice and Palliative Care Association. There was a
fascinating discussion on the challenges of communicating
recommendations for supportive care and hospice. There are clearly
distinct cultural differences around end of life, many of which I
am just now starting to understand. Nevertheless, there are many
shared challenges as we in medicine try to assure patients that our
focus is always about them and not just the disease. We may not
always be able to offer chemotherapy, but we can always provide
care to the person.
Every time I visit Eldoret my perspective matures, and it aged
significantly this week. Earlier in the week the team met to
discuss a potential research project aimed at providing hospice
support to cancer patients. Later in the week we met to see if
their work manning a 24-hour hotline for cancer patients should be
published in the medical literature. They wanted others to learn
from their experience. The next evening I had dinner with one of
the young hematologists. He was explaining some of the progress he
has had with acute leukemia patients, patients they were not even
offered therapy a year ago. He was clearly excited about his
results, but most amazingly he was thinking about how he could
develop a research protocol to improve care. As I began processing
these discussions, I realized how truly impactful AMPATH has been.
They have developed a unique environment where the Kenyan partners
are not just delivering care. They are embracing the academic model
to develop clinical excellence and promote advances. The challenges
here are daunting but the chance to work with my Kenyan colleagues
who are so dedicated to improving the lives of their countrymen is
truly inspiring. I am humbled by their dedication and honored to
contribute what I can.
Ken Cornetta, MD
Director, Inpatient Palliative Care
IU Health Bloomington Hospital
Professor of Medical and Molecular Genetics
IU School of Medicine