How KNH doctors restored smile to orphaned boy by performing complex reconstruction surgery

KNH CEO Richard Lesiyampe, during the handover of Ian Baraka to his mother, Beesy Kinya after the boy underwent a successful reconstructive surgery to restore his face that was shattered by a bullet following a bandit attack along the Meru-Isiolo border in 2023. [Benard Orwongo, Standard] Kenyatta National Hospital (KNH) has successfully performed a complex facial reconstruction surgery on eight-year-old Ian Baraka from Isiolo, marking one of the most advanced procedures of its kind in Kenya. The groundbreaking operation restored the child's face, confidence and hope for a normal life after a gunshot injury left him severely disfigured. The delicate surgery, which took months of planning and several stages, was led by Professor Symon Guthua, the Lead Oral and Maxillofacial Surgeon from the University of Nairobi Dental School, alongside Dr Margaret Mwasha, the Lead Consultant Prosthodontist and Dr Andrew Okiriamu, an Oral and Maxillofacial Surgeon. They were supported by KNH's multidisciplinary teams from theatre, nursing, anaesthesia, post-anaesthesia, ENT, residents and prosthodontics departments. The patient-specific facial implant used in the procedure was designed and manufactured in Belgium using 3D imaging technology to replicate the missing facial structures. The total cost of the prosthetics and related materials is estimated at about Sh3.7 million, excluding the cost of stabilisation, intensive care, special feeding and theatre charges. Dr Lessan Joel, Head of General Surgery at KNH, said the hospital receives many complex trauma cases that require advanced reconstructive expertise. "Ian was referred to us from Meru after suffering a life-threatening gunshot injury," he said. "When he arrived, he could not use his face to eat or speak. Our first task was to stabilise him in intensive care, control infection, and build up his nutrition before we could begin reconstruction. What you see today is the result of careful planning, teamwork, and dedication." Dr Andrew Okiriamu, one of the Oral and Maxillofacial Surgeons in the team, explained the scale of collaboration that made the surgery possible. "When Ian came to us, he basically did not have a face," he said. "At one point, looking at his condition, you would not believe this transformation could be achieved. The collaboration involved contributions from as far as Belgium and Liverpool, and we must appreciate every member of the KNH team who played a role. The theatre staff, nurses, post-anaesthesia teams, ENT specialists, and ward staff all worked tirelessly to ensure Ian remained stable and infection-free after surgery." "The ENT team were crucial because Ian had no nose, meaning we could not operate with a breathing tube through the mouth," he added. "They performed a tracheostomy to secure his airway and allowed us to carry out the eight-hour surgery safely." Dr Mwasha described the operation as "the restoration of dignity and hope." "When Ian arrived, he could not breathe, eat or speak," she said. "We first had to secure his airway and feeding system, then began the long journey to rebuild his face using technology that allows the structure to grow with him." Ian was shot near the Isiolo-Meru border and received emergency treatment in Meru before being referred to KNH. "He came to us without an upper lip, nose or upper jaw," said Prof Guthua. "We had to reconstruct the mid-face, restore what was missing and ensure the implant would grow with him as a child. Now he can eat, speak and smile again." KNH's Acting Chief Executive Officer, Dr Richard Lesiyampe, praised the team for their exceptional work, noting that the procedure reflects Kenya's growing capacity for advanced surgical care. "Ian's surgery is a milestone. It shows that we can achieve world-class medical breakthroughs right here in Kenya," he said. "As management, we will continue to equip and resource our doctors so that more Kenyans can benefit from such excellence." Abbass Gullet, Chair of the KNH Board of Management, also lauded the doctors for their dedication. "Kenyatta carries a huge load for the rest of the country," he said. "Even patients from lower-level facilities seek help here, and our doctors never turn them away. The pressure is enormous, but they still deliver." Ian's mother, Bessy Kinya, expressed deep appreciation to the medical team and the hospital for their compassion and care. "I am very grateful to the doctors and Kenyatta National Hospital for restoring hope for my child," she said. "There was a time I feared Ian would never have a normal life, but today, seeing him able to eat, speak and smile again, my heart is full of joy and gratitude." The doctors performed the surgery pro bono, in what they described as an act of service and humanity. "None of us charged a single cent," said Prof Guthua. "This was about saving a child's future, not about money." The surgical team has also identified about 40 other patients awaiting similar complex reconstructions. These include victims of road accidents, cancer, gunshot wounds, and severe trauma who require implants or prosthetic work. Each case is unique, demanding patient-specific designs that come with significant cost implications. Dr Mwasha said Ian's recovery is still ongoing. "He remains under rehabilitation and observation," she said. "As he grows, we will make periodic adjustments to his prosthesis to accommodate facial development." The surgery was supported through both local and international efforts. Dr Branice, one of the doctors, ran two marathons to raise between Sh750,000 and Sh800,000 towards the cost of treatment. KNH has also sought further assistance from Safaricom Foundation and other partners to fund the remaining expenses and future stages of Ian's recovery. Dr Lesiyampe noted that such success stories demonstrate the power of collaboration between science, technology, and compassion. "This case is not just about a single surgery; it is about the promise of accessible, high-quality healthcare for every Kenyan," he said. The event concluded with optimism and pride as KNH celebrated the young boy's renewed confidence and the doctors' exemplary teamwork. "This is what we should be celebrating as a nation," said Gullet. "Amid all the challenges, we can see the brilliance, resilience, and compassion within our healthcare system." Ian continues to recover under close supervision.

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