Why Dr Wambani is charting the way in specialty dominated by men

Kenya: In a male-dominated field, she has been the pioneer of sorts. Where few have dared tread, Dr Jeska Wambani chose, from her early childhood, that it was to be her destiny. The Chief Medical Specialist - Radiology at the largest referral hospital in the region, has taken it upon herself to give the best for the sake of her patients and also mentor many young doctors.

“My Standard One teacher Teresa Onzere, was an inspiration, in high schoo. My chemistry teacher Mr David Brooke, encouraged me to be the very best and while at the University Medical School, the anatomy teacher, the late Prof Kimani, amazed me by the amount of knowledge he had, and his prompt answers to my questions,” she says of those who nurtured her interests.

Her myriad research papers on radiology are a reference point the world over. The International Atomic Energy Agency in Vienna has sponsored Dr Wambani, who specialises in the reading and interpreting X-rays and other medical images, to do research aimed at developing a national screening programme.

“I love my job because of the ability to give a quality diagnostic image that takes into consideration radiation protection, transforms and leads to better and proper medical management in children resulting in a short hospital stay,” she says.

Dr Ambani is one of the founding specialists of this department at Kenyatta National Hospital (KNH) in 1992, and also at the Gertrude’s Children Hospital. She is the third African female radiologist at the hospital after Dr Onyango Akena and Dr Wambugu Milka.

On this Monday afternoon, ‘The Standard on Saturday’ team snaked through the crowded corridors of the Radiology Department to her office. The scene typified the enormous day-to-day that the doctor and her colleagues undertake.

Patients, some lying on the benches, others on stretchers, eagerly wait for their turn in the specially equipped rooms. Outside one of the rooms, expectant women wait for routine ultrasound tests to check the growth of the unborn.

Inside, she explains the critical role of her department in the October month of breast cancer awareness. Here is where diagnosis begins. “We have seen an increase in numbers of patients coming for screening from the awareness campaigns because as breast cancer begins, it is painless and it takes a personal decision to get checked, than wait for a painful breast with discharge in order to come to hospital,” says Dr Wambani, adding cases of advanced breast cancer have reduced in the last decade.

She clarifies that radiologists just don’t use x-rays to diagnose disease, but they also use many other specialised equipment such as ultra sound, magnetic resonance and nuclear to accomplish their job.

 

According to Dr Wambani, the initial tests that should be used to test for breast cancer must be selectively chosen, shifting from the simple ones to the more advanced ones, based on the levels of risks or results of the previous tests.

“We want to be careful when screening young girls and women of reproductive age because of their rapidly growing and involved systems, by ensuring the most affordable and efficient tests are used for screening before subjecting them to those with some form of radiation that are also more expensive,”Dr Wambani notes.

Positive results

During her years of practise, the youngest case of breast cancer she has diagnosed was a 16-year-old girl who she says she is saddened didn’t return after the positive results were given and the more common cases are women who average 50 years.

Her interest in this field had earlier seen her specialise in radiology for her postgraduate degree. This was after she had graduated from medical school at University of Nairobi in 1981, before securing a scholarship to study Imaging in children at a university in Cologne, Germany. She furthered her studies in Scotland and Hollandspecialising in breast imaging before returning home to be part of the team that began the radiology department, with the support of the late Prof Julius Meme, a former director of the hospital.

Her patients have been an inspiration. She, for example, celebrates the late Julia Mulama who suffered breast cancer after radiotherapy treatment of Thymoma (cancer of the thymus) yet she set up a national programme to address issues affecting cancer survivors.

“She was brave enough to start Kenya Breast Health Programme, and inspired me to think of a local customised breast cancer screening programme and breast clinic at KNH,” she says, adding that professionally, her role model is Prof Maryln Goske of the Society of Pediatric Radiology and Cincinnati Children’s hospital in USA, who started Image Gently Campaign that aims at creating awareness on exposure of radiation in children.

Now, she has been funded to conduct research on early breast cancer diagnosis using imaging both which will be driven at developing national imaging protocols in children using CT scans. Indeed, she is at home with highly specialised machines.

Dr Wambani takes ‘The Standard on Saturday’ through other methods used to diagnose breast cancer, each set up in specialised rooms secured by big metallic doors and with restricted access. It is evident of her passion as her colleagues drop files her way to review a patient.

One of the first stops at the radiology department is the ultrasound room where Dr Wambani explains that after finding a lump during self-breast examination, the next best option is to observe them using this method that uses sound waves to look inside a part of the body.

That this method is painless and does not expose the individual to radiation is the reason Dr Wambani best prefers it as a first screening test to detect breast abnormalities.

 

“Ultrasound is more affordable compared to other screening methods, and is the readily available method to diagnose a breast tissue problem,” Dr Wambani said. It costs Sh1,500 at KNH.

Dr Wambani advises women to start scheduling mammograms at age 35. However, if a woman has a family history of breast cancer, she should begin earlier, a protocol that is respected at KNH and advises that an ultrasound should initially be used with other tests to establish whether breast cancer is present or not.

At the MRI room, she introduces us to one of her colleagues Dr Mugi who is keen to explain that MRI scans use magnets and radio waves instead of x-rays to produce very detailed, cross-sectional pictures of the body.

Professional goals

Her most significant accomplishment is being a qualified pioneer in this field and the only one in public service for more than two decades, and serving as a Head of Department KNH for more than eight years, and also sitting at Radiation Protection Board as a chairman for ten years, while juggling roles as a young mother and wife to a surgeon.

“I was able to achieve my professional goals and give back to the society, and lead the establishment of state of the art imaging departments at KNH and Gertrude’s Hospital,” she says.

She also takes time to nurture young minds, having served as an honorary lecturer at University of Nairobi and Kenya Medical Training Centre with a personal drive to see more women join this speciality, which has bore fruit with KNH being home to more female radiologists to achieve the current status of three men and nine women.

As the interview draws to a close, Dr Wambani points out that nuclear medicine, where small amounts of slightly radioactive substances are injected into the body and special cameras used to see where they go, is also being used at this referral hospital in the treatment of some cancers.

Married to Dr Maurice Wambani; a urologiost, she says that breast cancer imaging is a pet subject in her family, openly discussed by her husband and two adult children citing the importance of families to encourage each other to get annual screenings in order to foster early detection treatment and management.