Global Health Update

November 21, 2025

From Kristina Tebo, MD

Assistant Vice President, Office of Global Health Initiatives
Assistant Dean of Global Health, McGovern Medical School
Assistant Professor, Pediatric Hospital Medicine Division

 

Five people in the back of a bush taxi

L-R: bush taxidriver, Arrionna Dryden, MD, MS; Dr. Tebo; Alexandria Laws, MD; Andrea Pinto, MD

I wanted to give you an update of our recent month-long Global Health trip to rural Kenya involving three of our awesome residents: Alex Laws, Andrea Pinto, and Arrionna Dryden (med-peds). We had a fabulous month abroad filled with education and fun and were able to support the hospital in several ways, including bringing five bags of supplies.

Our pediatric time was split between a very busy newborn unit (premature infants and sick neonates) and a pediatric ward with several surgical consult patients as well. Some interesting cases included:

  • infants with extreme prematurity, NEC, respiratory failure, and BPD exacerbations
  • a neonate who had been strangled (but survived without sequelae) — thankfully the hospital has social workers to assist!
  • infants with congenital malformations including cleft lip/palate and Tetralogy of Fallot
  • childhood epilepsy leading to burns after the child fell/seized in a fire
  • many children requiring TB rule-outs
  • a child with abdominal TB (without pulmonary involvement)
  • typhoid fever and amebic infections

Collage of residents working to build a breathing device out of a water bottle

Arrionna was also able to spend about half of the month with the adult medicine team (led by a US-trained med-peds provider, Dr. Jack Strutner) where she had several interesting cases including severe malaria, HIV/AIDS, and a lot of COPD. We learned that almost all adult women over 50 years of age in this region have COPD due to indoor cooking over wood-burning fires.

During the month, we also completed several lectures, board-review sessions, simulated cases, and skills-training sessions as well. The residents were able to see nearly all of the Global Health Supper Club sessions come to life, and they were able to apply many of the skills learned over the past two years, including using bubble CPAP machines, placing IOs, building an MDI spacer from a water bottle, treating severe malnutrition, burn management, and neonatal resuscitations.

We were so grateful to have our Butterfly handheld ultrasound device, which was partially funded by the Department of Pediatrics educational grant. It was extremely useful throughout the month in evaluating critically ill patients, especially those too unstable to move to the X-ray room. Some case highlights included:

  • We suspected our micro-preemie (815g) had a pneumothorax after developing acute respiratory changes and chest wall abnormalities. The case involved difficult ethical and palliation discussions and the ultrasound data helped with difficult decisions.
  • We used it to discover a young boy had a large pericardial effusion which had likely developed over a two to three month timespan. He had been treated for severe pneumonia a few months earlier without resolution of symptoms, so our working diagnosis is pulmonary + pericardial tuberculosis. Thankfully, a pediatric cardiologist was available about two hours away and the patient’s family was able to pay for the transfer of care.
  • An adult woman was admitted after a near-fatal organophosphate poisoning. While she was in the ICU, we used the Butterfly to assess her cardiac function and volume status. Thankfully, she eventually made a full recovery after a day on vasopressors and atropine.
  • An ill neonate with severe IUGR had a sudden change in neurologic status and sodium derangements. We used the Butterfly to determine she had suffered a grade II IVH. The software allowed us to send de-identified images to some of our NICU contacts in the States who assisted with the diagnosis.
  • Another ill preemie with NEC lost all possible IV access. The ultrasound was used to assist with attempted central-line placements (unsuccessful, but we eventually got an IO). We were ultimately forced to treat her without IV access for several days — very difficult when the gut is unhealthy — and she was thankfully thriving when we left Kenya.
A group of people standing on red clay outside a house

At the end of their month-long trip, the group of physicians was able to do a home visit with the hospital’s social work team, which involved hiking up to the patient’s home on the side of a mountain.

After all the great learning, we finished the trip with 24 hours of rest and relaxation in Nairobi where we enjoyed hot showers, a safari drive, visited an elephant orphanage, fed giraffes, and saw a women’s empowerment center doing handmade beading.

Thank you so much to each one of you who has supported our global health programs and allowed us to have such a wonderful educational experience. The hospital was extremely grateful for the help we provided, and we’re looking forward to an ongoing partnership with them.