African experiences of humanitarian cardiovascular medicine: a Kenyan perspective.

The burden of cardiovascular diseases (CVD) is on the rise in Kenya; this is in tandem with that of other non-communicable diseases. Most cardiovascular services are available in the main cities (Nairobi and Mombasa), but almost non-existent in rural and other urban centers. In an attempt to bridge this gap on service delivery, humanitarian activities have been developed over the years by various interested parties. Three models of humanitarian activities are described. The first model (hereby referred to as Model 1) is a school-based rheumatic fever and rheumatic heart disease (RF/RHD) prevention outreach program which offers diagnostic, preventive, educational and curative services to primary and secondary school children in various parts of the country. The second model (hereby referred to as Model 2) is a hospital-based cardiovascular outreach program located in Kericho, a highland tea growing region that has long been perceived as a "hot spot" for CVD. The third model (hereby referred to as Model 3) is a fixed clinic-based cardiovascular outreach in Kisumu, the lake shore town, about 400 kilometers west of Nairobi. THESE PROGRAMS PROVIDE: prevention services, early detection and prophylaxis, facilitation for further treatment, follow-up, early disease management, staff motivation, training in basic cardiology skills and increased local awareness of CVD to clinicians in there far-flung centers. Data from these programs is also presented, with two of the programs reporting Kericho County as a 'hot spot' in RF/RHD. Despite various challenges, the future is still bright with sustainable initiatives.