“I Left Australia to Serve My People”: Dr. Florentius Koech’s Return Transforms Neurosurgery in Western Kenya

 

At a time when many highly skilled professionals choose to remain abroad, Dr. Florentius Koech, one of Kenya’s leading neurosurgeons, made a bold and uncommon decision: he returned home.

Trained at the University of Nairobi and later in Australia, Dr. Koech is the Founder of Tophill Hospital in Eldoret, a facility now renowned for advanced brain and spinal surgery. His journey back to Kenya in 2008 marked a turning point for neurosurgical care in Western Kenya and beyond.

“When I came back, there were only seven neurosurgeons in the entire country, and none was based in this region,” Dr. Koech recalls. “I chose to return because I believed that is where I would make the greatest impact.”

From Australia Back Home

After qualifying as a neurosurgeon in Kenya, Dr. Koech travelled to Melbourne, Australia, in 2004 for fellowship training at the prestigious Alfred Hospital. What was meant to be a short period of specialised training turned into nearly five years of practice and mentorship.

 

While Australia offered financial stability and world-class facilities, Dr. Koech says the needs back home weighed heavily on him.

“I was doing well abroad, but people back home were suffering without neurological services,” he said. “Service mattered more than comfort.”

Building Neurosurgery in Eldoret

Upon his return in 2008, Dr. Koech established the Neurosurgery Department at Moi Teaching and Referral Hospital (MTRH). At the time, the department was virtually non-existent.

“For years, I was the only neurosurgeon there, working day and night,” he said.

Through advocacy and training, the department has since grown to seven neurosurgeons, dramatically improving access to specialised care across the region.

 

Founding Tophill Hospital

Recognising the need for modern equipment and better surgical outcomes, Dr. Koech co-founded Tophill Hospital the same year alongside his wife, a paediatric cardiologist, and another director.

The hospital invested heavily in high-end technology, including advanced MRI and CT scanners and specialised neurosurgical equipment such as the Pentero operating microscope, which allows surgeons to see structures magnified nearly 100 times.

“This technology improves outcomes because you can see what the naked eye cannot,” Dr. Koech explained.

Today, Tophill Hospital employs nearly 150 staff, including 15 doctors and about 60 nurses, and serves patients not only from Kenya but also from Uganda, South Sudan, and Rwanda, positioning Eldoret as a growing hub for medical tourism.

A Philosophy of Service

Despite the hospital’s growth, Dr. Koech remains grounded in a service-first philosophy.

“Medicine should not be purely commercial,” he said. “Sometimes a patient may not pay, but the gratitude they show — even bringing a chicken — is priceless.”

He believes Kenya must invest in and trust its own healthcare systems rather than sending patients abroad.

“If we support homegrown facilities, we will go a long way,” he said. “The money we take to India or Europe can be used to strengthen our systems here.”

 

Lessons from Abroad

Reflecting on his time in Australia, Dr. Koech says the greatest lesson he learned was resilience.

“You have to work twice as hard to be accepted,” he noted. “But it taught me honesty, focus, and commitment to patients.”

As a “daring returnee,” Dr. Koech’s story stands as a powerful example of how skills acquired abroad can be used to transform lives at home.

“I came back to serve my people,” he said. “And I believe that decision has made all the difference.”