Prof Rachel Musoke: She pioneered Kangaroo Mother Care in Kenya

She retired at 76, having worked as a neonatologist at the Kenyatta National Hospital almost all her life.

A neonatologist specialises in caring for newborns, especially the sick or those born prematurely.

Prof Rachel Musoke, a lover of music since childhood, has inspired many in not just paediatrics, but neonatology too.

Her journey in medicine was indirectly influenced by her brother who suggested the subjects she should take in her senior school.

That was in 1950s in Uganda where her class at Gayaza High School happened to be the first to teach Physics and Chemistry.

The only medical school in the entire East Africa was the University of East Africa Makerere College, which she joined in 1964. She was among eight girls in a class of 60 students. Of eight girls, Prof Musoke was one of the only two Africans.

Despite the racial differences, they created a strong bond such that they would celebrate each other’s strengths, gains and special days.

It was during her internship that her journey into paediatrics began after she was posted to the paediatric department where she chose to remain after one year.

She earned her master’s degree at Makerere in 1971 and proceeded to the UK for her neonatology fellowship and has since been to different schools across the globe, taking various courses, including the Comprehensive Paediatric HIV Care course.

“I had left my husband in Uganda not knowing I would not return there. Something happened at that time and my husband decided to come to Kenya and that is how I ended up not going back,” recalls Prof Musoke who hails from the Nsenene clan which translates to a special kind of grasshopper.

And hop she did, from Uganda to Kenya where she started working as a paediatrician and a consultant neonatologist at the Kenyatta National Hospital.

Back in Uganda, she was part of the Kampala Singers choir and she transferred her passion for music to Kenya where she became a member of the Nairobi Music Society.

Most of the music was classical but also included other genres from the different communities that made up the choir. She remembers the day they were asked to sing a song from their own communities and the region and they had songs in Chinese, Japanese and German among other languages.

“Of course I sang one from my home Uganda,” she says, adding that music is a uniting factor.   

Her love for music has been passed on to her firstborn son, a music director at Kampala Music School. His first degree though was in civil engineering.

According to her, music calms one down, and she would sometimes sing for her young patients at Kenyatta.

Taking care of babies born with weight of less than a kilogramme is not an easy job she says, explaining that there were times they would lose them, especially due to lack of the right knowledge and equipment.

Despite the major challenges, there were inspiring stories of children who survived and which kept her team going.

It was gratifying meeting them later in life; all grown up yet when they were born, “people would wonder, ‘you mean this is a person?’” 

She recalls meeting one mother and son in the US and the mother told the son then taller than the mother “this is the doctor who took care of you when you were less than 900 grammes.”

However, not all mothers were lucky, but they left knowing the doctors did their best to save their babies.

Because of this, the use of kangaroo care for mothers became necessary.

Prof Musoke pioneered this method of caring for babies until they gained weight, by ensuring they were well fed, and the mothers were always there for their children.

Kangaroo mother care originated from Bogota, Colombia, where a team from Kenyatta was sent and upon return, founded the Kangaroo Mother Care at the referral facility.

In the early days, Prof Musoke recalls how mothers came in between feeding, and would sit with the babies for kangaroo care before Save The Children equipped it to the leading full-time kangaroo care despite myriad challenges with resources, for which they were forced to improvise.

The many doctors in paediatrics and neonatology she has inspired term her as a strict mentor.

“I have no regrets at all,” says Prof Musoke. “Some may say I was strict and they are telling me now, but I do not think I would have done it differently. I was only following what we were taught in medical school, that one had to follow specific things for specific things to happen.”

Dr Wairimu Kimani, one of the mentees and now a neonatologist at KNH, joined Kenyatta as a volunteer pediatrician and it was Prof Musoke who helped her solidify the decision to do neonatology. 

Dr Douglas Makewa, the head of Paediatrics,  also praised her perseverance in the face of shortage of simple things like soap and “she used to ask us to bring small remnants of soap from our homes to wash our hands.”

Dr Irene Inwani, the Director of Clinical Services at Kenyatta, recalls how Prof Musoke introduced her to the most vulnerable children living with HIV.

“Professor has been taking care of children at Nyumbani Children’s Home as part of her community work and when I joined KNH, she asked me to help her,” said Dr Inwani.

Prof Musoke says it was not easy working with children living with HIV since, in the earlier years, there was no technology and many died prematurely.

But with the advent of ARVs which “was administered with no assurance of continuity in the 90s some survived and are now adults.”

As she drove off to retirement in her vintage car out of Kenyatta National Hospital, Prof  Musoke received gifts, including the statue of a woman doing Kangaroo mother care, which she says will be a good reminder of all the little ones she looked after in the kangaroo position.