What You Didn’t Know About Dr Florentius Koech: The Neurosurgeon Who Chose Service Over Comfort

At a time when many of Kenya’s top medical specialists pursue lucrative careers abroad, Dr Florentius Koech made a bold and uncommon choice—he returned home. Today, he is celebrated as the lead neurosurgeon and founder of Tophill Hospital in Eldoret, but behind the headlines lies a story of vision, sacrifice, and an unwavering commitment to transforming healthcare in Kenya.

Dr Koech began his medical journey at the University of Nairobi, where he trained as a general medical doctor before pursuing specialization in neurosurgery—a field that, at the time, was sparsely populated in Kenya. In 2004, he travelled to Melbourne, Australia, for fellowship training at the renowned Alfred Hospital, one of the country’s top neurosurgical centres. The fellowship, initially intended as a short-term training programme, evolved into nearly five years of advanced practice, mentorship, and exposure to world-class medical systems.

Australia offered him professional comfort, financial stability, and access to cutting-edge technology—opportunities that many doctors in Kenya can only dream of. Yet, the pull of home was stronger.

“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.”

Returning home in 2008, Dr Koech was faced with a healthcare landscape that was ill-prepared to meet the growing needs of patients with neurological conditions. He joined Moi Teaching and Referral Hospital (MTRH) and established the neurosurgery department, which at the time was virtually non-existent. For years, he was the only neurosurgeon on staff, working tirelessly day and night to meet the overwhelming demand.

“For several years, I was the only neurosurgeon there, sometimes operating almost around the clock,” he says. “The patients kept coming, and the system simply could not cope.”

Dr Koech’s efforts laid the foundation for what would become a thriving neurosurgical unit, now staffed by seven neurosurgeons, dramatically improving access to specialized care in Western Kenya. The expansion of the department has also allowed for training and mentorship of new specialists, ensuring the growth of the profession across the country.

However, it was a tragic national crisis that truly inspired Dr Koech to envision a new kind of medical facility. During the 2007-2008 post-election violence, he witnessed the human cost of a healthcare system stretched to its limits—patients sharing beds, infections spreading due to inadequate facilities, and families desperate for treatment.

“I saw people fighting for survival in a system that wasn’t equipped to help them,” he says. “Those moments stayed with me. I realized that Kenya needed facilities that could provide both advanced care and dignity.”

That vision gave birth to Tophill Hospital later in 2008. Alongside his wife, a paediatric cardiologist, and another co-director, Dr Koech co-founded a hospital designed to fill critical gaps in neurosurgical and specialized care. The hospital invested heavily in advanced medical technology, including MRI and CT scanners, and neurosurgical equipment such as the Pentero operating microscope, which allows surgeons to see structures magnified nearly 100 times—enabling precision that was previously impossible in the region.

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

Tophill Hospital has since grown into a leading medical facility in Eldoret, employing nearly 150 staff, including 15 doctors and 60 nurses. The hospital performs over 800 surgeries annually and serves patients not just from Kenya, but from Uganda, South Sudan, and Rwanda, positioning Eldoret as an emerging hub for medical tourism in the region.

Despite the growth and reputation of the hospital, Dr Koech has maintained a philosophy that prioritizes service over profit. “Medicine should not be purely commercial,” he says. “Sometimes a patient may not pay, but the gratitude they show—even bringing a chicken—is priceless.” He is equally dedicated to making advanced medical care affordable. By sourcing high-quality surgical supplies at lower costs without compromising standards, he has expanded access to neurosurgery for patients who might otherwise not afford it.

Dr Koech’s contribution extends beyond clinical practice. As a lecturer at Moi University’s medical school, he mentors young doctors and encourages them to pursue innovative approaches to healthcare. “Many young specialists dream of starting clinics, but few realize how difficult it is to grow them into hospitals,” he says. “I share my experiences so they can learn to overcome challenges and build sustainable institutions.”

Another lesser-known aspect of Dr Koech’s work is his emphasis on empathy and human connection. While highly skilled and technically proficient, he believes the heart of medicine lies in compassion. “Being kind doesn’t always come naturally, but it’s essential in healthcare. Patients trust you when they feel cared for,” he says. At Tophill Hospital, this ethos is embedded in training, patient care, and organizational culture.

Dr Koech’s story is also one of resilience and innovation. From navigating limited resources to pioneering advanced neurosurgical services in a region where they were virtually non-existent, he has redefined what is possible in Kenyan healthcare. His efforts demonstrate that private practice, when guided by vision and service, can be a powerful driver of national development.

Tophill Hospital today is more than a medical facility; it is a symbol of what dedication, expertise, and vision can achieve. For Dr Koech, it represents a promise kept to his country—a commitment to bring world-class neurosurgical care home.

Dr Florentius Koech’s journey is a testament to the profound impact of choosing service over comfort, vision over convenience, and empathy over profit. While many know him as the head of one of Eldoret’s leading hospitals, few know the full extent of his struggles, sacrifices, and relentless pursuit of excellence—a story that continues to inspire the next generation of medical professionals in Kenya.