DR. IRENE WERU: ONCOLOGY PHARMACIST IN KENYA

I am an Oncology Pharmacist and Head of Clinical Pharmacy, Kenyatta National Hospital, Nairobi, Kenya. I grew up in the area popularly known as Eastlands in Nairobi. I attended early childhood education at Tana Day Nursery in Jericho Lumumba, started class 1 at Dr. Livingstone Primary in Jerusalem Estate before moving to Nairobi River Primary in Outering Road Estate.

I am a proud alumna of Limuru Girls School. I have a Bachelor of Pharmacy Degree (2001) and Master of Pharmacy in Clinical Pharmacy (2009) from The University of Nairobi.

I completed my Pharmacy Internship at Kenyatta National Hospital, Omaera Pharmaceuticals and Cosmos limited. My post internship posting was to Mwingi District Hospital where I worked for about two months before getting an offer to work at Kenyatta National Hospital where I have worked for about nineteen years and I love being a pharmacist but even more an oncology pharmacist.

As an Oncology Pharmacist, I take care of patients with cancer. I participate in multidisciplinary decision making on treatment of patients with different cancers, provide patient medication counselling which includes explaining treatment protocols, dosing especially for oral chemotherapy and expected side effects and their management to patients and their care givers. I also ensure doses are correct for individual patients as cancer treatment is highly individualized, prepare cancer chemotherapy and related medication for the patients and monitor for treatment outcomes as well as toxicity related to cancer treatment.

In addition to providing direct patient pharmaceutical care, management of health products and technologies is a key role of the oncology pharmacist. This includes ensuring safe and rational use, monitoring consumption, ensuring proper inventory management, and quantifying the medication and related health technology needs.

Treatment of cancer requires multidisciplinary team approach and collaboration. The pharmacist is a key member of the team. Oncology pharmacists work closely with oncologists, oncology nurses and nutritionists among other health care workers to ensure best outcomes for patients. We also work closely with the supply chain staff to ensure adequate supplies and with finance team to facilitate insurance approvals for patients. Collaborative research is another area where an oncology pharmacist works with others.

I have grown by collaborating with colleagues in oncology both locally and internationally. I am a member of the Kenya Society of Hematology and Oncology (KESHO), Hospital Pharmacists Association of Kenya (HOPAK), Pharmaceutical Society of Kenya (PSK). I am also a member of the International Society of Oncology Pharmacy Practitioners (ISOPP) and have been a director for the period 2020 – 2021 and Secretary 2021-2022.

I serve as a member of various national, regional, and international technical working groups and advisory teams including the Africa Cancer Coalition ChemoSafe Regional Technical Working Group, Pharmacy Advisory Council- Global HOPE Pediatric Hematology /Oncology Centers of Excellence and Coalition for Access to NCD Medicines and Products Technical Working Group on Demand Forecasting and
Quantification.

Besides Oncology, my other interests are hospital management, pharmacy benefits management, medicine formulary management and policy development and advocacy. I have completed short courses in these areas to enhance my skills. I love to teach and mentor others and are an honorary lecturer at the University of Nairobi.

Hospital Pharmacy practice has been fulfilling and challenging in equal measure. During my college years, I would never have imagined myself working directly with patients. The ward rounds were emotionally draining and always left me faint. I made my decision to work in hospital during internship.

The pharmacy internship program had three rotations. During my retail pharmacy rotation, I had clients doubt that I had  indeed completed pharmacy school. Many thought I looked too young to be a pharmacist. Then there was the industrial rotation, I saw professionals running to work in the morning to avoid being locked out when the industry gates closed, a practice that was common in industrial area. I thought it was dehumanizing.

I therefore arrived at the decision through elimination. Kenyatta Hospital had just adopted Clinical Pharmacy practice around the time I got employed.  Four areas had been identified to implement the services – critical care, surgical ward, comprehensive care clinics and oncology.

I was paired with a colleague in oncology as it was a broader area and I needed support to do the ward rounds. I quickly realized that the interventions needed were simple. The other healthcare workers appreciated my role on the team. That encouraged me and when the school of pharmacy started a Masters program in Clinical Pharmacy, I applied as I desired to sharpen my skills.

My biggest struggle in pharmacy practice in Kenya has been trying to justify for additional staffing and a fair scheme of service for pharmacists. However, I am glad that we have made great strides including the recognition of specialist pharmacists and I am hopeful the future will be better for the next generation of pharmacists.

Having better equipped training facilities would be key. Some of the things we learnt in school were abstract. I didn’t see a biological safety cabinet, for example, until many years after pharmacy school.

Outside of pharmacy, I spend time with my family and friends, volunteer at a school board and parents-teachers association and teach Sunday school. I love to take walks, dance, and watch movies.

I draw inspiration from the good book, the Bible, which has words of wisdom for daily living, and my faith in God. My biggest cheer leaders and support system are my family: my children, husband, parents, and siblings. Whether I am managing staff, resources, or patients, I am committed to serving as unto God. At the end of each day, I ask myself whether I did the bare minimum or went Above and Beyond the Call of Duty.

My advice to young pharmacists is that there are endless opportunities to practice pharmacy and they can only limit themselves. Pharmacists need to take up their roles, the world is waiting!

DR. IRENE WERU