In this volunteer profile, Dr. Mark Lee reflects on his placement with RCPCH Global Links programme in Kenya.

Mark’s main focus while in Kenya was on service improvement, and sharing knowledge and experiences with his Kenyan colleagues. This involved a mixture of clinical work such as leading ward rounds and running outpatient clinics, as well as formal teaching sessions, simulation training and quality improvement projects/audits.

Mark developed a curriculum of key paediatric topics that was covered on a twice weekly basis in formal seminars using a problem based learning format to maximise the involvement of the interns. There was also bedside teaching that focused on clinical skills in small groups, with the most popular sessions being real-time simulation training which was a new concept for most of the interns.

The first time I coordinated a simulation training, I asked one of the interns to assess the breathing in a scenario where a 3 year old has arrived in A&E with difficulty in breathing. The intern told me with a completely straight face, that the patient was not breathing because it was a mannequin. After the initial hilarity had passed and I had done a better job of explaining the concept of simulation training, that same intern then became the biggest advocate of the sessions and would regularly take a lead in training new interns.

During his placement Mark helped to make significant changes at the hospital, including the setting up of a triage system, meaning the sickest patients were fast-tracked to A&E rather than waiting for hours in the queue to be seen in clinic; however, the  placement was not without significant challenges:

The patient volume and workload is hard to imagine but speaks volumes for the accumulated experience the local doctors acquire in a short period, all of this without being paid for months on end! The hardest aspect of my time in Kenya was dealing with the absence of the NHS and a free at the point of delivery healthcare system. It was difficult to see patients not getting the correct blood tests, antibiotics or radiology scans because they weren't able to pay for them. With the cost of a CT scan at about £65, this was unaffordable for the majority of the locals.

Like many overseas volunteers, Mark stated that he’s picked up new skills that he is now using back in the UK.

I'm more acutely aware of service improvement and potential quality improvement projects in my NHS hospital. With the lack of resources for investigations, I had to rely on my history taking and clinical examination skills which made me a better clinician. Anytime spent working in a low-resource setting will highlight how lucky we are to have the NHS. In addition, being exposed to high intensity environments where patients often present very late into their illness, and very sick, is invaluable experience that can only make you a better doctor.


RCPCH Global Links is working in partnership with institutions in Kenya, Uganda, Myanmar and Sierra Leone to deliver health worker training and improve child health care. You can watch a short video about the programmes work in Sierra Leone here.