About 20 years ago I was born “Nameless” in a Hospital in Berlin. My mother vanished one day after my birth and left me at the hospital for adoption. As good luck seemed to be part of my life from the beginning, I was soon adopted and called Anna Minkwitz. With my newfound parents I moved to the suburbs of Berlin, close to my new grandparents and extended family. Growing up there, my parents allowed me to live a life of great privilege that included going to an international school to learn English, moving abroad as an exchange student for a year and lots of travelling throughout Europe, Africa, and America. Especially, the family trips throughout Africa had a great affect on my personality and upbringing and thus I decided to apply to International Medical Aid in Kenya after working in hospitals in Germany for a year now and attaining my EMT license.
Getting accepted into the IMA pre-med program was a great honor and throughout my 6 weeks in the program I learned more than I could have ever asked for. At Coast Provincial General Hospital (CPGH), I started out in the New Born Unit (NBU) with Dr. Juthy. She took me under her wing and I felt sorry for bothering her with my million questions about the different clinical pictures: which diseases were very common, which were rarer, how they tested for the diseases and the treatment plans. I also asked many questions about the Kenyan healthcare system and Dr. Juthy always took her time in answering my questions thoroughly. She also helped me draw comparisons to Germany as she has worked in Germany as a Doctor for some time doing an internship and so we could draw parallels between the two healthcare systems together. One day for example, there was a highly septic new born, that had been transferred to CPGH from a different clinic, which needed to be ventilated as it could not breathe on its own. So, for my whole shift I ventilated the new born by hand as there was no ventilator available, this is the first time I encountered the magnitude of the lack of resources.
Following the NBU, I rotated in the Emergency Room (ER). I didn’t really have a mentor there, as doctors always dropped in and out of this department but I did manage to make this an everlasting learning experience that strongly assured me that starting medical school in March 2019 is the right decision for me. In Emergency I had many learning by doing experiences and I could draw from my EMT knowledge to assist the doctors and nurses. As an EMT at home you must think on your feet and always be ready for the unexpected, this helped me in a lot of ways at CPGH as the emergencies rolling could be anything from minor issues to actual life-threatening problems and the shortage of resources and staff made it hard to keep up with all the cases. Here I learned about the lack of insurance coverage within the population and the struggle the patients face when having to come up with the money for a CT scan for example. Coming from a country where everyone is insured by the government at no cost, I learned to appreciate what I had been given by just being born in Germany. While I surely shouldn’t apologize for this privilege I, by all means, have grown more aware of it and as a future doctor I hope I will be able to give back.
Working in the ER, I got to witness and assist many interesting cases that did not only better my understanding of the Kenyan healthcare system but also the culture. Especially, the different way of viewing death in Kenya vs. Germany was a unique experience for me. One day I witnessed a 4-year-old arriving at CPGH’s Emergency room after a tuktuk accident. The patient was on her way home from school, when she was hit by a tuktuk, so the tuktuk driver brought her to a local hospital as the child was badly injured. Unfortunately, the hospital was ill equipped for such severe traumas, so they sent the injured child away without stabilizing her first and suggested the tuktuk driver to take her to CPGH. When they arrived, the child was already dead, and I ended up just cleaning up the blood as far as I could so the parents didn’t have to see all the gory. When the mother arrived, she was miserable but also accepting of her daughters passing and said that if this was God’s wish she must let go and comply. One of the nurses their explained to me later that the high child mortality makes death a much more present thing throughout the country, so it is almost expected that one may lose a child. This struck a nerve in me, as my adopted parents had lost child doing pregnancy before they adopted me, and they still struggle with accepting this loss.
Subsequently I rotated in the Operating Room. There I worked especially close with Dr. Peter, the plastic surgeon at CPGH. This was probably one of my favorite learning experiences, as I have been very interested in pursuing a career in reconstructive plastic surgery and I could draw from my experiences in Germany working in multiple plastic surgery departments in various hospitals, including Germany’s biggest burn unit. Dr. Peter showed me how to be innovative and creative when in lack of resources. I learned how one can amputate a leg without a tourniquet and how to do a make-shift tourniquet from bandages. He explained and showed me how to do skin grafts when you don’t have a meshing device, how to harvest skin without an automated skin shaver, how to make vacuum wound dressing without the actual vacuum machine and many more things. As he is the only plastic surgeon in all of hospital, seeing him work without a team of plastic surgeons assisting him, without surgical nurses that have been trained to assist in plastic surgery was also very impressive. As Dr. Peter and I worked well together and as he mentored me far beyond what I ever expected we have now decided to create an exchange program for doctors with a plastic surgery department in Germany that we are now working on together. I hope that this project will help the plastic surgery departments in both countries to learn from and with each other and to improve patient care in the long run.
Besides the work at CPGH, I also learned a lot thru the outreach events that IMA organized, and I was happy to also organize a few community outreach projects. I especially liked working with the Gender Based Violence and Recovery Centre (GBVRC), because this opened my mind to the issue of defilement in Kenya and the resulting unwanted pregnancies and sexually transmitted diseases. Through this Centre I also met the paralegal Mary, who helped me organize an outreach in the Mikindani Area to educate the youth about gender-based violence in this at-risk area. As I have returned to Germany now, I’m continuing communicating with the GBVRC to fund their projects to raise awareness and build safe shelters for children that have experienced defilement by a family member.
All in all, IMA in Kenya was a program with unlimited options. Phares and Bella, the program coordinators, were more than willing in helping me realize all my plans and dreams for this experience. My time at CPGH taught me many things some of them being: how to connect with patients when you don’t share the same language or culture, how to be more proactive and take initiate, how to work around a lack of resources with creativity and how to cope with drastic situations. The outreach programs like the mobile medical clinics or hygiene clinics installed a sense of confidence in me and my medical knowledge and taught me to take on more responsibility. I learned that you can not only see the human as a biological structure, but you must see the person as whole with mind, body and spirit in unity. I feel more certain than ever that a profession in health care is the right choice for me as I don’t only like working with patients and assisting them in difficult times, but I also learned that taking initiative and taking on responsibility doesn’t scare me it empowers me. Seeing doctors that work well in a team and some that don’t, I also understood more and more what it means to work in a team where sometime a life is at stake, and that to obtain the best patient care everyone needs to take a step back from their own personal wishes and focus on what is best for the patient. Thus, I hope to be a doctor someday that is reflective, balanced, open-minded, determined, creative and always ready to learn more.