“I wanted the opportunity to learn more about health care and health systems in different countries,” said Titus Ng’eno, a Master of Science in Global Health candidate, of his decision to come to Duke. “The Duke global health master’s program offered an ideal combination of rigorous training, incredible mentorship and a rich environment of ideas.”
Born and raised in Nairobi, Kenya, Ng’eno received his Bachelor of Medicine and Bachelor of Surgery (equivalent to an MD) at the University of Nairobi. After working as a medical officer in Kenya, Ng’eno became an internal medicine resident at Duke University. It was there that he discovered the Global Health Pathway for Residents and Fellows—a program administered by the DGHI-based Hubert-Yeargan Center for Global Health—and had the chance to dive deeper into his passion for global health with the Master of Science in Global Health.
Finding DGHI in Eldoret
Titus had always been interested in health. While at the University of Nairobi, he became particularly interested in non-communicable diseases and cardiovascular health research. As a medical officer at the Moi Teaching and Referral Hospital in Eldoret, Kenya, Ng’eno worked with patients in the inpatient and outpatient services, mostly focused in the cardiology, pulmonology and internal medicine departments.
"Non communicable and chronic diseases are a huge health burden globally. I found a field of medicine I enjoyed and an opportunity to make a meaningful impact,” he said.
Moi University is one of DGHI’s priority partners, and Duke faculty and staff were working with their Kenyan partners at the time to develop the first cardiology fellowship training program in the country. Duke faculty members noticed Ng’eno’s outstanding leadership skills as he became heavily involved in developing the training program.
“Talking to the various Duke partners really got me thinking about how different health systems address health challenges such as non-communicable diseases,” said Ng’eno. “After that, I was drawn to the world-class faculty available at Duke University and their wealth of expertise and experience.”
Integrating Global Health with his Medical Studies
In 2013, Ng’eno was accepted as an internal medicine resident at Duke University. Already a strong advocate for providing sustainable, high-quality health care, Ng’eno wanted to complement his post-graduate medical training with his interests in global health.
“My passion for health policy and health system design grew,” said Ng’eno. “By learning about different health care networks in East Africa and the United States, I explored what worked well in one system and how it could be applied to improve another.”
In his second year of residency, Ng’eno enrolled in both the Global Health Pathway for Residents and Fellows and the Master of Science in Global Health program at Duke. The Pathway program offers physicians in post-graduate medical training the opportunity to expand on their current education by learning to address health disparities in developing countries. Ng’eno is among the 2015 cohort of five trainees who will combine Master of Science in Global Health classes with a mentored research project over the course of two years.
“I have had the pleasure of working with phenomenal people at the Hubert-Yeargan Center,” said Ng’eno. “The Center embodies passion towards advancing health education and addressing global health disparities.”
Researching a Novel Approach to Cardiac Rehabilitation
Ng’eno is currently conducting an implementation research project involving establishment of a cardiac rehabilitation program in Eldoret as part of his program requirements.
Cardiac rehabilitation, which is typically comprised of exercise, education and counseling, has been demonstrated to improve health outcomes and quality of life for patients. Unfortunately, though, cardiac rehabilitation is virtually nonexistent in Kenya, and the feasibility of developing this capacity has been largely unexplored. His study aims to find out which model of cardiac rehabilitation could work in Western Kenya.
“Especially in resource-limited settings, cardiovascular diseases are a huge health burden,” said Ng’eno.
Ng’eno will evaluate the potential use of home-based and institution-based cardiac rehabilitation models. The study will measure how well participants adhere to the rehabilitation guidelines at home and in the hospital and whether the protocols have a significant effect on quality of life and health outcomes.
“It has been an outstanding opportunity to return to the Moi Teaching and Referral Hospital and conduct research I knew was needed from my previous work as a medical officer,” Ng’eno reflected. “The outcomes of this project could potentially have a very real impact on how cardiovascular disease is treated in Kenya.”
Reflecting on DGHI and Looking Forward
“The mentorship, cultural exchange and training opportunities at DGHI have been priceless,” said Ng’eno. “I have been privileged to work with extraordinary mentors at Duke and in Kenya, who have been instrumental in getting this project off the ground.”
Ng’eno will be pursuing sub-specialty training in cardiology and plans to return to Kenya after finishing his training to help address the needs of patients, tackle non-communicable diseases and shape the development of adaptive health systems in East Africa.
“There is a growing need for a robust policy and academic framework that will guide the improvement of health care in this dynamic environment,” he said. “My time at Duke and DGHI has given me a solid foundation to pursue this work, and for that I am truly grateful.”
The mentorship, cultural exchange and training opportunities at DGHI have been priceless.Titus Ng'eno, Master of Science in Global Health candidate