"Silence Can Kill": Strengthening Surgical Teamwork to Save Lives in Nakuru, Kenya
In Nakuru County, a new simulation training program is teaching healthcare teams not just how to operate, but how to work together when seconds count.
While healthcare workers receive extensive training in technical skills—such as operating, administering anaesthesia, and suturing—the critical skill of working effectively as a team is often overlooked.
The SURGfund-supported project, “Obstetric Safe Surgery in Nakuru County,” is on a mission to improve maternal and perinatal outcomes for over 25,000 women annually. Implemented by a consortium including the GSF, Jhpiego, and AIC Kijabe Hospital—in close collaboration with the Ministry of Health—the project focuses on delivering safe, timely, and respectful caesarean section care across five key facilities.
An important part of this initiative is the Mobile Obstetric Simulation Training (MOST) program. MOST goes beyond technical skills to address a critical gap in emergency care: how teams interact under pressure.
Participants and instructors during a simulation exercise.
From Training to Practice
Building on previous mentorship in Safe Caesarean Section, AIC Kijabe Hospital delivered the MOST program to four facilities between August and December 2025: Nakuru County Teaching and Referral Hospital, Naivasha Teaching and Referral Hospital, Bahati Sub-County Hospital, and Molo Sub-County Hospital.
In total, 38 multidisciplinary participants—including medical officers, doctors, clinical officers, nurses, and anaesthetists—were trained together, reinforcing a strong, team-based approach to emergency care.
Building Skills Through Simulation
Moving beyond theory, healthcare workers tackled realistic management scenarios for postpartum haemorrhage, hypertensive disorders of pregnancy, maternal and neonatal resuscitation, and anaesthesia complications.
These realistic simulations and structured debriefs were critical in strengthening not just clinical skills, but also leadership, crisis resource management, and the confidence to speak up.
“People are taught how to operate, how to give anaesthesia, how to suture. But nobody teaches them how to work together.”
Airway Management Skills Station at Naivasha Teaching and Referral Hospital.
Improved Readiness for Emergencies
Across all sites, participants demonstrated improved knowledge and confidence, with clear commitments to applying these lessons in their daily routine practice.
The MOST program continues to be a vital pillar of the Obstetric Safe Surgery in Nakuru County project, supporting Kenya’s national efforts to reduce preventable maternal and neonatal deaths by equipping frontline providers with practical, lifesaving skills.
“If I see the patient is losing blood but the surgeon is not reacting, I have to speak up: ‘Doctor, I think we are losing blood.’ I say it respectfully, but I say it clearly. Silence can kill.”
Optimized Obstetric Training Scenario focused on standardized patient simulation setup as a realistic maternity experience at Nakuru County Teaching and Referral Hospital.
About this Project
The Obstetric Safe Surgery - Nakuru County Project (OSS Nakuru) is a targeted intervention designed to improve maternal and perinatal outcomes for women across Nakuru County, Kenya. This project strengthens the local health system by implementing a hub-and-spoke training model to build surgical team capacity, improving referral networks, and enhancing data quality for decision-making. It is implemented by the Global Surgery Foundation (GSF) and Jhpiego, in partnership with AIC Kijabe Hospital and in close collaboration with the Ministry of Health of Kenya and the Nakuru County Government.
About the Funding & Implementation
This project is supported by SURGfund, the pooled financing mechanism of the Global Surgery Foundation (GSF). SURGfund is the world’s only pooled catalytic funding mechanism for strengthening surgical care systems. In addition to SURGfund financing, GSF provides strategic implementation support to ensure long-term sustainability.
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