Ogita Austine (Interviewer): First of all, I'm a Ogita Austin. I'm part of the team at A15 Productions and we're doing a documentary to commemorate the 50 years that the University of Nairobi has achieved the pharmacy school. That is, could you kindly start by introducing yourself?
Dr. Tom Menge: My name is Tom Menge. A pharmacist by training. Currently, I serve as the head of the Directorate of Health Products and Technologies at the Ministry of Health.
Ogita Austine: Thank you so much. Which years did you do your pharmacy training and which memories do you have studying pharmacy back then?
Dr. Tom Menge: I finished my pharmacy training in 1992, that is several years back. I completed in 1992 and started my internship in 1993. I think the fondest memories of pharmacy is coming together as a group of people who are extremely competitive and still trying to move forward in the competitiveness. I got to know new people and all of us were coming into a profession that we did not have a very clear understanding of what it was way back in 1992. I believe most of us used to choose pharmacy based on its competitiveness in the choices of courses that you'd be able to do and not really because you had a mentor or somebody you are looking up to or somebody who advised you to do pharmacy. Indeed most of my classmates did pharmacy because they did not want to do medicine and they had the grades to do it. That is my memory about the choice of pharmacy as a career. We needed to find out for ourselves what pharmacy is all about and we were venturing into a field that was not having very many practitioners by the time we joined in 1988 as undergraduates and finishing. I remember our lecturers used to tell us go out there and make money. Pharmacy was introduced to us as a commercial profession as opposed to any other form of health profession.
Ogita Austine: You’ve served in hospital pharmacy practice for several years. Could you kindly describe the evolution of the hospital pharmacy practice in the country and any landmarks that you recall?
Dr. Tom Menge: I joined the Kenyatta National Hospital in 1995 as a pharmacist at that level. I believe from the time that I joined Kenyatta National Hospital as a pharmacist, our main work was in the area of dispensing. So you would be assigned a dispensing pharmacy without really a very good description of what you are doing on a day-to-day basis. Again at the time that I joined the profession, it was assumed you know what you are doing. I can recall an experience in my internship when I was posted as an intern at Machako's hospital that was in 1993 and my experience for internship was a bit unfair because the only thing that happened is that the pharmacist was there knew that there was an intern coming and therefore he had opportunity to take his leave. So you do not recall a time where you are handed to responsibilities or you had somebody mentoring you into the profession because you are very very few. But through the time that I've been in Kenyatta National Hospital, we were able to move on from a time of dispensing and managing pharmaceutical records to a place where we incorporated the concept
of of patient care and therefore we joined our doctors in ward rounds and for me I very particularly remember that that almost did put me into trouble because my Head then wondered why I am incorporating myself into ward rounds. What am I trying to show?
But we have moved on from having pharmacists in patient ward rounds to a place where we have specialization and therefore today we have pharmacists who are branching out to various areas of specialization especially in the space of hospital pharmacy and especially in hospital pharmacy we’ve had most of the courses that have been offered at the University of Nairobi really enhancing more than any other sector hospital pharmacy practice and therefore clinical pharmacy has been one of the courses that has been very very particularly useful for persons who want to enhance their career in hospital pharmacy and apart from that we’ve had other opportunities like in the pharmacovigilance all of those courses have really helped us in that area but apart from specialization and I'm glad and proud to say that our designation within the hospital practice recognize specialization and therefore we have our designation showing the type of specialty that you are and it’s equivalence for our colleagues in medicine and dentistry and therefore we are moving now from a place of specialization recognition to practice and again I'm proud to say that we've evolved in Kenyatta National Hospital to allow pharmacists then to have practice licenses that for me has been the evolution from dispensing, to patient care, to specializations and now to practice.
Ogita Austine: Do you think your studies at the University of Nairobi adequately prepared you for hospital pharmacy practice? What could be improved for future pharmacists?
Dr. Tom Menge: Well I don't I don't really blame the training at the University of Nairobi at that time because the and I primarily believe that an undergraduate training prepares you for general practice. It allows you to fit into any sector. We cannot be able to really say that an undergraduate course should prepare you for a certain area of pharmacy practice. However, having said that, being in hospital pharmacy gave a distinct advantage because unlike all other sectors in pharmacy practice I think more emphasis is made in making a pharmacist who is ready to deal with patients, as opposed to a pharmacist who for example is useful in pharmaceutical manufacturing or any other sector. So hospital pharmacy has got an advantage because the kind of things that you're taught in your undergraduate does prepare you for that. However, most of the time when you join a hospital you’re expected to be a manager and that is an aspect that was completely lacking in my training and you really needed to learn on the job. It also does not anticipate that you are going to be bombarded with medical records and various types of record keeping or systems of accountability. I believe that the training still really focuses on somebody being able to deal with medical conditions and situations and be able to know the medicines that need to be used in a given situation and yet when you go out there the pharmacist is expected to be a manager, the pharmacist is expected to be astute in knowing how to manage inventory. I do not know whether the university really should be able to concentrate on that but in my current capacity you then realize that there is a very important need for us to be able to prepare our people even after they’ve trained their primary courses on issues of management.
Ogita Austine: Thank you so much. We can continue from where we stopped. Apart from hospital pharmacy, are there other pharmacy practice sectors that you have been involved in?
Dr. Tom Menge: I have had the privilege of working, I believe for the past 30 years in various sectors within pharmacy. One of the things that I’ve realized is that the pharmacist is already at a place of advantage because you can be able to work in many areas. I have been actively in hospital practice for close to 20 years of my life and after that I transitioned to an opportunity to work within the hospital in a sector that deals mainly with partnerships, infrastructure development and resource mobilization. That was a very good transition for me because then I was able to transition to a decision-making position in management within Kenyatta National Hospital. My current assignment I focus on issues of policy so I currently head the directorate of health products and technologies within the Ministry of Health and that is a singular body that is charged with two main responsibilities and that is in the area of policy development in the area of health products and technologies and specifically pharmacy and also in capacity building then the other health care workers are on issues of management of health products and technologies.
Ogita Austine: Maybe the other role that then I could say is — I've also had the privilege of serving in the Kenya Medical Supplies Agency within the board where we were primarily responsible for restructuring the Kenya Medical Supplies Authority and also putting the various reforms that went... could prepare KEMSA for the things ahead. Very hefty roles indeed.
Ogita Austine: Could you kindly summarize the key contributions that you’ve had to the growth and development of pharmacy training in hospital pharmacy practice and the other sectors that you’ve been in?
Dr. Tom Menge: For me the biggest contribution that I had in hospital pharmacy practice is to be able to bring the hospital pharmacists together in forming an association that we call the Hospital Pharmacists Association of Kenya. HOPAK has been really instrumental in meeting the needs of hospital pharmacy practitioners and I believe it has been one of the most successful associations of pharmacists in the country to date, but even in that role, the role has not only been recognized within the country but we have had opportunity at the International Federation of Pharmacists who were called very early within the establishment of HOPAK to be able to sort of like set the scene worldwide for the establishment of hospital pharmacy and therefore one of the more active sectors within the Federation of International Pharmacies FIP has been the Hospital Pharmacy sector. I'm glad that I was involved in the setting up and the direction on what is expected of our hospital pharmacy practitioners.
Ogita Austine: What would you say has been the impact of technology in the hospital pharmacy practice and possibly to you as an individual?
Dr. Tom Menge: Thank you. One of the things that I can say is that when I joined pharmacy practice everything was manual and I remember even our first publication of the Kenya National Formulary, which was done at Kenyatta National Hospital, was typed and then retyped and published as a paper copy. And I remember my very first contribution to a publication was just after that when we were able to do an abridged version of the Kenya National Formulary. I believe that pharmacists are the most ready health care professionals who are ready to absorb technology. Today if you go to a hospital where you need to change from paper-based system to an electronic system, the pharmacist is going to be the first person who is going to understand what is going on and therefore technology has really enhanced our role. Today we are able to monitor the trends in consumption and the needs for medicines through technology. Today we can use technology to do stocktaking. We can use technology to manage inventory. One of the things that I did in my tenure is to be able to digitize the Kenya National Formulary. I believe it is still the only publication within the Ministry of Health that has been digitized and therefore you can be able to access the Kenya National Formulary via a QR code. And therefore today you are able to access all of the information that you require at the click of a button. Technology has helped pharmacists even at hospital level. Most of the hospitals that are modern today are dispensing using technology and inventory is done through that. Technology has also made us now even get to a place of saying that there is need for us to review the legal framework to enable electronic inventory, electronic patient records, electronic data to be accepted and one of the things that we did very recently in our pharmacy and poisons board is to ensure that the new rules allow a person to have electronic records as valid as a paper-based record. That’s a very big transition for pharmacy.
Ogita Austine: How has your training and practice in pharmacy impacted society?
Dr. Tom Menge: One of the things that I am proud of is the contribution that I have made in transitioning pharmacy from a product-based profession to a service-based profession. And we did that by ensuring that we emphasized more on specialization and also mentorship. I've had an opportunity to be able to teach toxicology at master's level at the University of Nairobi. I've had opportunity to be able to contribute to the curriculum. I've had opportunity to be able to serve in the board and in Senate to approve various curricula. All that has really helped to ensure that the training and practice of pharmacy is focused more on a profession than a business. Today I see more pharmacists wanting to go and work in hospitals, wanting to work in Ministry of Health, wanting to work in policy areas and that for me is a great contribution to pharmacy.
Ogita Austine: Could you kindly comment on your contribution to the development of pharmacy practice at the national, regional and international level?
Dr. Tom Menge: Thank you very much. At the national level I think I did mention about the establishment of the Hospital Pharmacists Association of Kenya which was a very very good platform. It’s been able to be used in policy development. I remember even when we are developing the Kenya Essential Medicine List, we used the HOPAK platform to be able to bring our pharmacists together to be able to discuss on what should be done. But one of the things that we have done even at the national level is to be able to set up a unit for health products and technologies and this is now being adopted across all the 47 counties. Today in every county we have persons who are called County Pharmacists and County Health Products and Technology Officers. And they are implementing policies that have been developed at national level. Regionally we’ve had an opportunity to be able to offer guidance, support and even mentorship to various countries around us, especially in the Eastern Africa region and even in some parts of the continent. Internationally we have had opportunity to be able to support even the development of the hospital pharmacy chapter within the International Federation of Pharmacists. That is my contribution.
Ogita Austine: Thank you so much. What is the one thing that you wished you had been able to achieve and you haven’t?
Dr. Tom Menge: I think I will still go back to mentorship. Mentorship is an area that I really wish I could be able to concentrate more on. I would want to have a mentee who can be able to say that I decided to do pharmacy because I saw what Dr. Menge is doing. I would want somebody to say that I wanted to go into policy because I saw what Dr. Menge is doing. That has not happened. But I really believe that even though it has not happened today, we can still be able to influence those around us and I look forward to a time when I retire and I am able to take up a full mentorship role to be able to impact those pharmacists that are around me. I also wish that more pharmacists could be able to go into politics, more pharmacists can be able to go into leadership positions and decision-making positions. I believe the time has come for us to get out of our pharmacies and be able to say that we want to run sectors, we want to run organizations. And I believe if I can be able to see a pharmacist as a governor, a pharmacist as a member of parliament, a pharmacist as a principal secretary, that would be a big achievement.
Ogita Austine: Thank you so much. If you were to retire today, how would you want to be remembered?
Dr. Tom Menge: I want to be remembered as somebody who developed others. I really believe that even with all of the things that we have achieved, what matters most is what you have deposited in others. I want to be remembered as somebody who contributed to the success of other people. Somebody who mentored other people and somebody who left behind better pharmacists than I am.
Ogita Austine: Finally, what is your vision for the next 50 years of pharmacy training in Kenya, especially hospital pharmacy?
Dr. Tom Menge: I would want a situation where we are able to train differentiated pharmacists right from undergraduate. I want us to train people who are going to come out and go straight into certain areas of specialization. I want us to be able to improve in the area of research. I want us to be able to go into product development, I want us to be able to expand our training to go into areas of pharmacogenomics. I want us to be able to incorporate our traditional medicine and indigenous knowledge and convert it into products. And most importantly I want us to get pharmacists who are universal thinkers, who are going to not just look at practice in Kenya but be able to think globally and act globally.
Ogita Austine: Thank you so much. Finally, kindly send a message of congratulations to your fellow alumni at the University of Nairobi Pharmacy School.
Dr. Tom Menge: It’s been an amazing journey. Fifty years of pharmacy training is no mean achievement. From our pioneers like Professor Guantai, Professor Kibwage and all the people who have gone through the school of pharmacy at the University of Nairobi, this is our moment. We need to come together, we need to celebrate and we need to say that we are proud of what we’ve been able to achieve. For those who are coming behind us, continue in the journey. For those who are in front of us, please mentor us. And for all of us who are in this together, I believe that pharmacy practice in Kenya will never be the same again.
Ogita Austine: Thank you so much, sir.
