Programme was very well run, with the local staff ensuring we were all coordinated in our placements and maximising learning opportunities. They were very helpful with arranging extra learning opportunities too, and I always felt comfortable to bring up any issues or requests. Really appreciated the extra local experiences and tours, I feel it was incredibly enriching to learn about the social and historical context of Kenya. The house was very comfortable and we were incredibly well looked after, from the room cleans to the large variety of delicious food cooked for us daily. The clinics and outreach gave variety to our experience, loved going to new places, meeting new people and learning new skills. Safari was well planned. The guides we had were excellent, the accommodation much more luxurious than what I was used to/expecting! A fascination with transcultural psychiatry was what initially set me on the path to want to become a psychiatrist, and an unforgettable six weeks in Kenya. All through medical school I was determined to work in infectious diseases. This abruptly changed in my final year thanks to an elective placement abroad. I chose to study malaria with Shoklo Malaria Research Unit in a remote area of Thailand helping the Karen refugee population. Soon after arrival I found that the organisation was so good at its job, there was barely any malaria left. Looking for additional work, I undertook antenatal clinics where to my initial confusion, nearly every woman was reporting ‘chest pain’, ‘breathlessness’ but with no underlying cardiac or respiratory causes I could determine. Probing further, it became apparent that many women were suffering from prolonged severe stress, having survived a civil war with ongoing uncertainty regarding their futures. Many could have met the criteria for depression, anxiety, post traumatic stress disorder (PTSD). Their presentations however were completely different from that in my native UK, mainly favoring physical somatic symptoms. I wondered if they would be picked up on a standard diagnostic questionnaire, which invariably were created based on Western, Caucasian patients. This fascinated me. How could the same diagnosis present differently across different cultures and peoples? Is this the same for all mental illnesses? I learned that day a new phrase – transcultural psychiatry – the study of how social and cultural factors can create, determine or influence mental illness. I wanted to discover more about this nuanced and multifaceted specialty, to experience more countries and cultures. After graduation and two relentless foundation years in multiple busy specialties, I was exhausted. I decided to take a year out before applying to specialty training and return to what made me first enjoy with psychiatry initially. IMA’s Kenya internship in mental health seemed the perfect fit. I wasn’t sure what to expect, but these last six weeks have both exceeded and challenged my expectations. CPGH – GENDER BASED VIOLENCE RECOVERY CENTRE (GBVRC) I had prepared for GBVRC by reading up on post sexual assault/rape guidelines beforehand, mostly geared towards adult victims. What shocked me on the… Read More “Last Six Weeks Have Both Exceeded and Challenged My Expectations”
My experience through IMA will forever be held in my heart. The impact this has made on not only my nursing career but also on a personal level is truly indescribable. My perspective on life has totally changed and I’ve learned to view things with in broader perspective and with an open heart to all people of all cultures. Nursing requires me to be competent in many things besides just skills. Patients rely on me as their advocate, their hand to hold when no one else is there for them and someone they can trust. My time in Kenya gave me a new perspective on how to do those things and be a better nurse to my patients. The clinical experience was almost better than my experiences at home. To be able to watch how nurses and doctors improvise to deliver the same care to patients at the standard level with limited resources was interesting but most importantly their desire to want to help people and to learn new conditions and treatments was very influential on me. It didn’t matter that they didn’t have many books to read about medical conditions or what level each professional was at they all worked together to formulate a plan of treatment which I think impacted me the most during my observations. The staffing at IMA was also above satisfactory. All of my mentors were so accommodating and always made sure we received the best of the best in our conditions and were very responsive to anything we asked or needed during our stay. The cultural treks I had the privilege to go on were AMAZINGGGGG!!! If you take this opportunity to travel to Kenya you simply must go on them, it is worth every cent you spend. I still sit back and reflect on my safari experience and I can still feel the “wow” feeling I had when I was in the jeep staring off into what felt like an endless world of animals and natural beauty! It is hands down the most incredible feeling to be out there in the natural environment of these beautiful animals and watch how they function without being held captive in a cage. An experience I truly never could forget. My time in Kenya is something I will always hold near and dear to my heart and continue to let influence my future career decisions. I hope to someday return and provide more care to those in need and expand my cultural competence even further as a Nurse Practitioner.
Before my internship with International Medical Aid, I was conflicted with my future career path. Since eighth grade I had my heart set on being a pediatrician or a family practitioner, but as I grew older I developed a new interest of public health and health equity. Recently, I have been struggling with combining my two passions. As I did more research, I discovered disaster relief medicine, international medicine, or work with communities who have inequitable access to health care are possibilities. In these career paths, I can practice medicine while creating more equitable and sustainable access to quality health care. But this past summer, I started to doubt my ability to take on the challenges of medical school – as its no easy task – and I was unsure if I was cut out for long hours, intense workload, and honestly, blood. Within a couple hours of my first day in the Labor Ward, I knew I could handle blood. I remember it clearly. By 10am Monday morning there had been four births and everyone was running around to deliver a baby, or placenta, suture up a woman’s tear, or taking care of a newborn. As I watched the blood drip onto the floor, I thought nothing of it except for excitement because I realized I could handle blood. My entire experience with this internship was discovering new abilities I had and how eager I was to use them in the future. Each day in the hospital brought on new surprises and challenges, but as I surpassed each one, I became more and more confident in myself and my future. My first surgery, a C-section, taught me that I crave to scrub in and suture up. As each minute went by, I slowly inched closer and closer wanting to get a better view of the surgery. I was ready to scrub in and learn as much as possible about the anatomy and steps of the C-section. My second week, I was placed in internal medicine and by the end I knew this what I want to do. I loved the variety of symptoms, diseases, and treatment in internal medicine and the ability to work with inpatients and outpatients. Doctors were always thinking and trying to figure out the puzzle of the patient’s symptoms. One of the most memorable moments for me was working in outpatient in the cardiac clinic. I loved asking patients questions and learning about their symptoms. On my second day in internal medicine, I was with an intern M.O. and she was going through a woman’s medical history and writing up her chart. The woman had posterior lumbar pain. Her abdomen CT scan showed that her right kidney was inflamed and she recently had a miscarriage and had pain in her lower abdomen. The intern M.O. stepped out to get a consultation about her CT scan and the patient turned to me and asked me if I thought her inflamed kidney was what caused her miscarriage.… Read More “Internship Has Motivated Me Beyond Belief”
Boarding my flight for Kenya, I didn’t know what to expect. I knew I would be in a hospital rotating through different specialties and volunteering during the week. I chose to observe a variety of specialties in order to expose myself to a variety of cases within the hospital. I also knew that I would get out of my experience what I put in. I went into this trip with an open mind and willingness to learn. I wanted to take this as an opportunity to motivate me in my academic career moving forward. I knew that I wanted to go to school to become a physician assistant, but I wanted to begin my exposure to medicine in an environment that is completely different from the United States. In doing this, I would allow myself to step out of my comfort zone in order to learn the most about not only medicine in Kenya, but also the way of life there. I could then also realize how fortunate we are in the United States to have access to so many medical supplies and to see how Kenyans adapt to supply and staff shortages. According to a lecture series that was presented during my orientation day in Kenya, the national poverty line for Kenyans is making less than 2 USD a day and about 40% of Kenyans are below this number. This means that 40% of people living in Kenya can’t afford basic necessities, let alone healthcare. This was a very tough concept to grasp but was very evident in my time at Coast Provincial General Hospital on many different occasions. I remember one of my first days at the hospital I saw a sign on each ward that showed the services offered to patients and the price. Most services were free, but not all. One of the interns I was with was baffled by the idea that a major surgery only costed the equivalent of 100 USD. To us, that seemed affordable and was surprising. However, the reality of the situation is that many people cannot afford that because it is 50 times more than the poverty line. This leads to patients not receiving surgeries or medications because of the cost. Another difference in the healthcare systems between Kenya and the United States is the method of payment for services. In the United States, if a surgery is needed or lifesaving medication is required for a patient, they receive the treatment and are billed later. Of course, this leads to a huge burden of debt from medical bills. According to a medical officer that I was observing in Mombasa, if the patient does not have the money up front, they do not receive care at CPGH. This was heartbreaking to witness as patients who had options for continuing care were trapped in a corner due to the price. However, this is the case for so many people who live in this country. The highlight of my trip was being able… Read More “Internships Allowed Me to Develop a Deeper Appreciation for Medicine”
From an early age, I dreamt of traveling to an African region, out of my comfort zone andinto a world of contrast. I’m not entirely sure why—perhaps I was transfixed by images from commercials or something that would show up on my TV—but it had been a very conscious goal of mine. I wanted to know why others were different than me. I wanted to see how they lived. I wanted to see if they actually receive Americans with smiles, just as the United States mediaportrays when describing our effect on Africa’s poverty. Admittedly, this image of Africa is what I expected. And to a certain extent, this is actually what I saw. Thousands of kids would overwhelm me with love and joy at hygiene clinics. Orphans would cling and wail as I said goodbye after just a short visit. People would see my scrubs and would actually thank me for coming to their under-resourced, under-staffed hospital (even though I didn’t benefit them in any way). While I stood amongst poverty, I still saw the joy and richness of Africa’s culture and Kenya’s particular beauty. However, American media could never portray exactly the experience that International Medical Aid gave me. Upon arriving in Mombasa, I was shocked by the beauty of the palm trees which shadowed the tin huts that impoverished Africans called home. Their middle class lives relatively similarly to the American middle class. However, simple cultural differences revealed how much harder those with power need to work to provide each demographic the life that they deserve. I remember not being able to look away from the streets of Mombasa on my first fewmorning commutes to the hospital. Each block featured something I wouldn’t see very often inAmerica. People driving toward each other on the wrong side of the road. Blind men being guided through traffic to tap on windows for spare change. Women carrying bags of maize ontheir heads while busting children on both the front and back. I couldn’t even begin to imagine what I would see in the Coast Provincial General Hospital, where so many of these people took refuge. During my six weeks in Mombasa, I sought to understand the root causes of various illnesses, disorders, and deaths in third world countries. I wanted to know why certain populations suffer from certain disparities, and why those disparities remain among certain populations for so long. How do areas within a progressive sphere still fail to meet the standards of equality that we claim to value for each member of society? This is a question that I had been tackling in America. Though our system claims to value a good life for each individual, not every member of society has equal access to quality healthcare. It seemed that we didn’t have allthe answers and that in order to find them, I would have to look at more extreme cases of poverty and inequality. This idea drove what would become a world-shaping experience for me. In my first… Read More “Roots of Change”
As I reflect on my experiences with International Medical Aid (IMA) at Coast General Hospital, I am reminded of an ancient African proverb, “seeing is different than being told”. This priceless Internship placement with IMA has shed more light onto this age-old saying. I am still in disbelief, as I reflect on my encounters with patients, healthcare members, and health systems. Some experiences were as if they were drawn straight from Global Health textbooks, while other clinical presentations were so uncommon, it baffled even the most senior of nursing staff. In the States, I have been a practicing Nurse in the perioperative environment for over six years. However, my desire to help others globally is what initially propelled me into the nursing field since I was a young girl. This ambition, lead me to complete my Master of Global Health in 2018. However, a deeper curiosity remained, to hopefully yet experience and expand my theoretical knowledge of Global Health and Nursing. This calling eventually lead me to Mombasa, Kenya with International Medical Aid. I came to Mombasa with a clear intention in mind. To explore whether I should pursue an advanced nursing degree in midwifery/women’s health or to pursue a non-clinical career in the Global Health field. I elected to be in the Labor Ward for 3 weeks and the Accident & Emergency (A&E) for a one-week rotation. I must report that my experience at Coast General Hospital has only complicated my decision in selecting a future career path. This internship has, therefore, taught me so much about the real experiences of the Kenyan people and their interactions within the health system. Additionally, I deepened a better understanding of who I am and what I am capable of, as I strive to contributor towards improving health globally. My clinical interactions and observations have shaped my revelations. The following paragraphs will highlight my most memorable experiences at Coast General Hospital and will subsequently uncover and provide insight into the lessons learned from each encounter. Surprisingly, I learned that I have sparked interest in Emergency Nursing. I was drawn to the uncertainty and the variety of the clinical presentations of the patients. I admired the necessary skills to quickly and correctly assess, diagnose and treat the patient. It became apparent how important the social structure is in ensuring treatment in Kenya. For instance, a middle-aged man was brought into the emergency department semi-conscious, after being severely beaten by mob justice. I was stunned to learn that once a patient is admitted into the A&E, a family member or someone is needed to act as a “runner”. This includes providing the necessary payments to ensure the delivery of life-saving medications and treatments. This form of payment before treatment is not practiced in the United States. I was also concerned by the ethical considerations, in the lack of compassion in treating this man. Some of the doctors chastised, or even delayed his initial assessment and treatment. This form of negligence, and outspoken disdain for… Read More “Priceless Internship Placement with IMA”
For the past three years, I have worked as a 5th grade bilingual Math/Science teacher in the southwest side of Chicago. I became a teacher through the program Teach for America, whose mission is, “enlist, develop, and mobilize as many as possible of our nation’s most promising future leaders to grow and strengthen the movement for educational equity excellence.” Although the United States of America is a developed nation, it is a country where racism still persists and is one of the main roots of a major challenge: educational inequity. Unfortunately, many children are still lacking the proper education and opportunities that can help them grow economically and academically, which then perpetuates their family’s low- income household. I have seen the ways that mismanagement of a nation’s economy can benefit some whilst hurting others. Something that I see lacking a lot in the low-income communities and their public schools, is a massive under resourcing of mental health professionals. My experience as a teacher, paired with my undergraduate degree in psychology, has made me want to pursue a career in the mental health field. Which is why, a year ago, I was researching mental health programs, especially those that would give me more experience working in underserved communities. I am specifically interested in being a school psychologist and working with students who have experienced trauma. The four weeks I lived in Mombasa, Kenya impacted me in ways I did not anticipate or expect. I went in with no expectation and had no idea what my experience was going to be include. Before my internship experience with International Medical Aid (IMA), I had very little experience actually shadowing or observing counselors, besides my psychology courses when I was still attending university. My first day at the Gender Based Violence Recovery Center (GBVRC) at the Coast General Provincial Hospital (CGPH) I met a couple people who either volunteered or worked at GBVRC. I was given a packet to read that contained the procedures that were to be followed whenever any survivors, patients, came to the center. Survivors would go through reception first and they had to come with a referral. Many times, it was just a paper they obtained from within the hospital, although some referrals came from the police station, depending on what the case entailed. Then, they would wait to be called into the Counseling/Triage room, where I was, along with whomever was in charge of counseling that day. After counseling, survivors are taken to the doctors’ room, where they are given a comprehensive head to toe examination, as well as taking specimen for investigation. From my experience the week I was in the GBVRC, I learned the importance of building rapport and about the opinions and ideas that still surrounds the topic of sexual violence. We never knew how much information the survivors were going to share or felt comfortable sharing; or any certainty of how quick they would explain what happened to them. I was able to observe and… Read More “Blessed with This Opportunity and All Its Teachings”
As I look back at my stay in Kenya this summer, I am struck by the incredible knowledge and experience I was able to obtain from my peers and mentors in the hospital. From seeing a natural birth for the first time to seeing neurosurgery on a 7-year-old boy, I realize the wealth of information I was exposed to. I am so grateful for the opportunities I was given to learn more about healthcare in such a different environment. During my internship, I learned how to be empathetic, sure of myself, and how to remain calm in high-stress situations. When comparing what I saw at Coast General Hospital versus what I have experienced in hospitals here in the United States, the biggest differences that jumped out were the state of medical issues presented, and the resources available to treat said issues. The easiest way to sum up the difference between the care I saw in Kenya and the United States is that in Kenya, the majority of treatment is reactive while in the U.S. the majority of care is preventative. In other words, illnesses were very advanced by the time a patient decided to seek help limiting doctors to do damage control for these people. An example of this is a middle-aged man who came into the emergency room for “foot pain”. When Dr. Ahmed removed his sock, it revealed a big toe that was almost completely black necrotic tissue. Looking at his patient booklet, I saw that the man was a diabetic and Dr. Ahmed explained to me that he clearly had not been taking his medication, causing this breakdown of tissue. There was little that could be done except for cutting away as much dead tissue as possible. Had this been any other toe, the entire toe would have been removed completely but since the big toe is essential for walking, Dr. Ahmed explained that it had to be preserved as well as possible. This case demonstrates the state of care I observed at Coast General because had this man came into the hospital a few weeks earlier, a doctor could have seen the beginnings of tissue breakdown and implored him to take his medication before the damage progressed. I believe this problem of patients waiting too long to get care can be attributed to two main factors: Accessibility and Urgency. Healthcare is simply not easily accessed by a large percentage of the population due to the proximity of hospitals, the cost of care, and the ability to leave home and family. There was a patient who came to the hospital with a cist the size of an apple protruding from his mandible. The doctor estimated that this had been growing for at least 10 years. When asked why he had never come for treatment before, the patient replied that he lives a whole day of travel away from the hospital and had nowhere to stay in Mombasa until now. The low concentration of good hospitals in rural areas… Read More “Program Taught Me So Much About Healthcare Delivery”
The administration was amazing and very accommodating and I made life-long friends among them. There was never a moment that I was in there company that I felt unsafe or frightened. The residence was great and despite the lack of infrastructure of the nation everything worked to the extent that I could feel sanitary and relaxed. The food and the kitchen staff were great. The way to really make it an amazing experience though was to put yourself out there and make as many friends as you possibly could. I am glad to know that I now have friends from all over the world. I loved the experience and found a new love for Kenya and its people that I never thought I would have. During my time in Kenya, I learned so much about how politics and cultural differences affect healthcare delivery and quality. Growing up in America, I don’t often consider the cost or availability of healthcare. Resources such as technology, equipment and supplies seem readily available to everyone. I trust that my healthcare providers possess the knowledge, skill and experience to preform medical miracles. In Kenya, I learned that my high healthcare expectations might be idealistic and non-universal. The Kenyan perspective on wellness, hygiene, cleanliness, disease transmission and triage differ greatly from what I see in the United States. The healthcare workers I encountered in Kenya are every bit as smart, compassionate and hardworking as those in America, but they work shorthanded and ill equipped. Nevertheless, the Kenyan people receiving medical care are less entitled than the American patient is. The faith, trust and gratitude Kenyan patients show inspires me. People in the U.S. often die from non-communicable, preventable diseases such as cardiovascular disease, diabetes and cancer due to our sedentary and abundant lifestyles. In Kenya, preventable diseases are also a serious issue. However, overeating and lack of physical activity isn’t what’s killing most Kenyans. Poor sanitation and lack of affordable medications contribute to the prevalence of communicable, preventable diseases such as malaria and HIV in a country already up against daunting challenges to delivering basic healthcare. Although the American healthcare system suffers from healthcare disparities, African healthcare appears even more imbalanced. As in the U.S., the African population’s health needs and access to care vary across different parts of the country. Socioeconomic status greatly affects the quality and accessibility of healthcare. The government is Kenya’s largest provider of healthcare. However, the public healthcare system is plagued by staffing and supply shortages. These shortages directly and indirectly impact patient outcomes. The average African citizen can’t afford to go to a private facility where qualified providers and adequate equipment are more available. Attaining equitable health services requires run-down public health care infrastructures to be revamped, management practices to be improved, priorities to be set for accountable and transparent use of resources and more skilled healthcare workers to be trained and retained (Benatar, 2013). When I entered the Coast Province General Hospital on my first day in Mombasa, I… Read More “Experience in Kenya Strengthened My Resolve to Pursue a Career in Healthcare”
My clinical internship in Mombasa, Kenya was the best experience of my life thus far. It has been a month since I have been home in the states, and not a day has passed that I have not dreamed of the people, culture, hospital wards, and the incredibly vibrant spirit that is Kenya. My whole family did not want me to come; they were afraid for my wellbeing. After fundraising the cost of my trip, they couldn’t have been happier when I assured them of my safety at the residence in Kenya. The entire staff went above and beyond to make us feel comfortable and at home during our stay. The hospitality and cooking were unlike any I’d ever had – we were so welcomed and loved. I learned more than I ever thought I would during my internship and rotations in the hospital. I spent every day with my jaw to the floor, in complete awe of my surroundings. This experience awoken my soul and changed what direction I want to go in healthcare. I would recommend this program to absolutely anyone. I greatly hope to go back. When I arrived in Kenya, I was wide-eyed, restless, and eager to breathe in every single aspect of Kenyan culture, tradition, and healthcare. I came into the program as a pre-nursing student and a Certified Nursing Assistant for the last year and a half, working back home in a nursing and rehabilitation home for the elderly. My only hospital experience was the 40 hours of clinicals that my program required for training. Needless to say, I had no idea what to expect. All I knew going into this experience was that it was going to change me. I severely underestimated how deeply it would. My first rotation in the hospital was in obstetrics. I saw a twin C-section in theatre on my very first day in the hospital and it was the most fascinating experience of my lifetime thus far. Throughout the week I had the pleasure of witnessing 15 babies come into this world. It was the most beautiful, raw, and touching experience I’ve ever been a part of and I felt as if I could stay there forever. Of all of the differences between Western and Kenyan hospitals and healthcare systems, I was most taken back by the procedures in the labor and delivery ward. One of the first things I witnessed was the extreme shortage of supplies. You had to hunt hard for a pair of gloves, there was no soap, and no hand sanitizer. I later found it to be odd when I worked in the ICU and ER and found that they had plenty of these products, which seemed just as essential during labor and delivery. They seemed to always be very busy, with a shortage of beds, thus explaining the reasoning behind their protocols. They did not come out and say it, but it seemed as if their goal was to get patients in and… Read More “Best Experience of My Life”
An unforgettable experience where I learned more than I have ever expected and grew to appreciate the Kenyan culture and history. Staff went above and beyond to make everyone feel at home and when accommodating requests. Residence was very clean and the food was amazing (both prepared by Chef Joshua and the restaurants we visited such as Mubins Cafe). The internship impacted me in ways I never expected. It taught me many lessons such as humbleness and appreciation and I left the country a different person for the better. I went on the Watamu Beach Safari and it was a great experience filled with adventure and education. I loved how we were able to have fun, try new foods (ex. local seafood) and learn something new such as the history behind the Portuguese Church and the Gedi Ruins. Some portions of the trip could have been longer such as when we went snorkeling and when we were able to get off the boat and into the water, but overall an amazing experience that I would definitely recommend to everyone.
My experience in Kenya was incredible. In terms of interning at CPGH, I was exposed to so many cases and learning opportunities, it was truly a once in a lifetime experience. The doctors and nurses were for the most part very helpful and instructive. The tours and treks I was a part of, shaped my stay in Kenya in so many ways. I was taught so much on the culture, food, traditions, current setbacks, etc. The knowledge enriched my outlook on the country I was staying in for over a month. Being able to go on the safari and experience the Lion King in real life was indescribable. The food, attentiveness, and care that I received while staying in the residency was truly was made the trip feel like home. Every person I interacted with made sure I was happy, fed, and had clean scrubs every day. I was able to help cook a few meals for the interns and I, Joshua was incredible. I am still in awe that I was a part of such an amazing program. My safari experience was truly phenomenal. Our tour guide Enok was the smartest and most well rounded person. He is the reason why I was able to see the Big Five on my weekend, which is not common. The hotels I stayed in were amazing, it truly felt like I was on vacation instead of an internship. I loved that the hotels had buffet like food services, it accommodated perfectly to my no meat diet.
Prior to beginning my internship in Mombasa at Coast General Provincial Hospital, I had completed approximately 200 hours of medical volunteering in hospitals around Los Angeles, California. I had never been exposed to serious illnesses or diseases with pneumonia arguably being the most serious condition I have ever encountered. Most of the patients I had seen and interacted with simply had some sort of upper respiratory tract infection or were simply stricken with diabetes or obesity. Looking back, I could not have imagined all that I would be able to view and learn while rotating through the different departments at CPGH. During the internship, I was happily placed into the Pre-PA Program where I hoped to gather knowledge and shadowing experience from Clinical Officers which are the equivalents of PAs in Kenya. As for the unique and remarkably memorable cases I had the privilege of viewing firsthand, there was certainly no shortage of them. My very first case was of a two-year-old boy who was suffering from Ricketts. I had only heard of the condition from textbooks and learned from my attending pediatrician that this was common among young children in Kenya. Dr. Siminyu passionately questioned, “I bet you’ve never seen that in America and I highly doubt you’ll ever see it even after you become a PA.” To be frank, he is probably correct. As my first case this was especially memorable simply since the condition is just so common in Africa and learning that just easily made it unbelievable to me. However, the case of Rickets is certainly not a case that will stick with me for the rest of my life as the one I am about to describe. My experience in being in areas of intense odors and smells is certainly above average in my opinion for a young college student. I have taken a class with cadavers and have grown accustomed to the smell of formaldehyde. In addition, I also visited the morgue on a few occasions at CPGH and witnessed some autopsies right behind the medical examiner. Nevertheless, none of this experience could have prepared me for the sight or smell I would experience with this patient. The patient was a middle-aged man who was suffering from a rare form of Tuberculosis called Pott’s Disease. This form of Tb usually affects the lower area of the spine and can easily spread to other areas of the body. In this patient, Dr. Hassan had to forcefully remove pus and other fluid from the patient’s inner right thigh. A rather significant and potent iliopsoas abscess had been festering for a period of three days now. The disease had unfortunately spread to this area of the body and had caused significant infection of the muscle and tissues associated in that region. The procedure itself was simple; squeeze out all the fluid. I have never smelled a worse stench in my life than the pus that was streaming from that man’s inner thigh. Dr. Hassan simply made a… Read More “Productive, Engaging, and Humbling Internship Experience”
“More than any information learnt (which can be forgotten)… it’s better the experience impacts your thoughts, whether it’s [learning to be] more careful of the resources you do have or just being able to empathize better – that, I think is more difficult for people to learn”. This statement was written to me from Dr. Jhuthi, a medical officer I had the privilege of shadowing in Coast Provincial General Hospital’s New Born Unit, and it beautifully captures how I feel my internship with Internal Medical Aid has impacted me. To elaborate, although I had anticipated learning medical terminology or procedural guidelines during my time in Kenya, I actually gained insight into my character and who I am more than anything else during the trip. More specifically, my experience with IMA has taught me how to be more open – open to new career avenues, open to learning the context of situations before judging, and open to listening to perspectives that are different from my own. Being a person who is not used to stepping outside her comfort zone, this lesson was incredibly valuable for me because it helped me to truly understand what it means to work in healthcare. I have never really considered becoming a therapist, counsellor, or psychiatrist. Before my internship with International Medical Aid, I did not even have a desire to set foot in a psychiatric ward. Yet, during my final few weeks in Mombasa, I found myself requesting to shadow at Port Reitz mental hospital, engaging in exciting conversations with my psychiatric resident roommate, and enrolling myself in a psychopharmacology class for when I returned back to school in Canada. Needless to say, I became fascinated with the fields of psychology and psychiatry during this internship. There were many experiences in and out of the hospital that helped me to realize this fascination, one patient encounter in particular being very impactful: a man came into emergency who had just tried to commit suicide. He had done so by trying to slice his throat with a knife. As he was rolled in on his stretcher, I saw some other interns around stare in awe at his trachea sticking out of his opened throat that contracted and relaxed with every strangled breath he took. What I was concerned about, though, was his face; tears were streaming down the side of his cheek, of course because of the injury, but as I looked at his eyes, all I could think of was what kind of emotional pain he must have been in. This was his second suicide attempt that week – he had tried to hang himself just a few days earlier – and it made me so upset to imagine not only what kind of state his mental health was in, but also the reason why he was not taken to a facility after the first attempt or monitored. In other words, although the immediate, main concern of doctors in the ward was to fix his throat,… Read More “Incredibly Valuable and Immersive Experience”
As a pre-Physical Therapy intern, I was one of the first interns to ever come to work in the Therapy Department; therefore, it was a new experience both for me, and the therapists that I worked with. Everyone was very open and excited to teach me everything from their treatment methods to their favorite foods. The amount I learned from each therapist in the department, whether I personally shadowed them or not, is immeasurable. On top of the success I had in my department, the relationships that I made with the other IMA interns was something that made my experience even more amazing. Sharing stories from our days in the hospital, having tough conversations concerning things that we saw, and exploring Kenya together is something that I will always cherish. Altogether, my experience with IMA was rewarding, impactful and life changing in many ways. Upon my arrival in Mombasa, Kenya, I was completely unaware of the impact that the International Medical Aid internship program would have on me as an individual, and further, an aspiring Physical Therapist. The culture in Kenya was overwhelming, in the best sense. It completely engulfed me and allowed me to explore the ins and outs of a foreign culture and healthcare system. My experience through this internship program provided me the opportunity to break down various barriers, allowing my perspectives and attitudes towards everyday situations to be transformed. Mombasa, being one of the two cities in Kenya that has major hospitals, has a public teaching hospital called Coast General Provincial Hospital. It is here where my internship began, and where I was able to learn from multiple different therapists to broaden my knowledge on Physical Therapy and foreign healthcare systems. My experience at Coast General, located in an area of extreme impoverishment, provided me with an environment that required me to understand and break down socioeconomic, racial, cultural and language barriers. The way in which Kenyans welcomed me into their country, and made sure I was learning everything that I possibly could, made me have a whole new respect for the way in which they live their day to day lives. Although I was from a different continent, and looked so different than the native population, I never felt as if I was a minority. I have always believed that people should be treated as human beings and not any differently based on their characteristics, and this experience allowed me to gain more perspective on this idea than I ever thought possible. I learned that being open and eager to learn about all groups of people enables individuals to gain insight and understanding of the world as a whole, expanding the capabilities and assets that such people have. I believe that having this desire and drive is important for Physical Therapists working in all settings, and I trust that it will benefit me greatly in the future. Through this perspective, I also learned the impact that a simple smile and wave has when there is… Read More “My Experience with IMA was Rewarding, Impactful and Life Changing in Many Ways”
My month in Mombasa, getting to work alongside so many other brilliant and encouraging inters, was truly an experience of a lifetime and was only made possible through the incredible love and support of the staff. The way they cared so deeply about every intern who walked through the front door, ensuring safety, proper hospital placements that matched each interns desires and needs, and being of major help in situations big and small, truly reflects their outstanding desire to make this a unique and memorable trip for all. From the food to the hospital, and the medical clinics to the beach and everything in between, allowed for one of the greatest months of my life. Leaving more full of growth in both my knowledge of medicine and culture, I wouldn’t trade my time here for anything. The most valuable aspect of this program was having the opportunity to rotate through multiple wards in the hospital. Before arriving, I never thought I’d even have an interest in orthopedics or in A&E. Yet after my week in each of those departments, I gained a new appreciation, love, and respect for both specialties, giving me the desire to keep all my options opened as I move on to the next stages in my desire to become a physician. My safari experience was out of this world. I never thought I’d be able to say that I had completed an African safari. Truly a once in a lifetime experience that I will cherish forever. Masai Mara was beyond beautiful and our driver was very engaging, allowing for the best possible time. During my time in Mombasa, Kenya, I’ve lived more life, gained more knowledge and experienced more medicine than I ever thought possible when initially embarking on this adventure. Through my month at Coast Provincial General Hospital along with my time at the International Medical Aid residence, I’ve learned what it looks like to care for people deeply; not only those that are sick, but those that express different beliefs, religions, lifestyles and cultures. I think the most valuable thing I’ve gained since arriving, has been the understanding that sickness is the universal connector, a lot like O- is the universal blood donor. The hospital is a place where everyone congregates, seeking care for a wound or disease that they most definitely don’t want. With that being said, I can attest that no patient at CPGH chooses to be there. That was made very clear during my weeklong rotation in the Accident and Emergency Ward. I saw patients with tumors the size of baseballs walk through the front doors. After a quick history, it was made clear that this patient’s mass had been growing for over 3+ years. Due to skewed beliefs of medicine, lack of money, and ignorance, led to case after case of patients arriving to CPGH with diagnoses far worse than they would have been if they had just shown up to the hospital when initially symptomatic. Yet, even in the… Read More “Incredible Experience With Deeply Caring Staff”
During my summer in Kenya, I worked through challenging cases with incredibly resourceful and intelligent providers at Port Reitz Psychiatric Hospital and The Gender Based Violence Recovery Centre. The standard of care was often unavailable due to financial constraints, but it took just as much mastery of medicine to provide valuable alternative therapeutic plans. The clinics were short staffed, compelling me to work to the limit of my medical knowledge in order to contribute meaningfully to the team. Working with these dedicated providers helped me appreciate the integral roles that creativity and critical thinking play in medicine. This was particularly evident in the case of a patient who was having a psychotic episode. This patient was exhibiting violent and bizarre behavior; he was completely non- functional and required 24-hour supervision. He was strong and lunging at providers during his entire exam. His four friends who brought him in had to hold him down the whole time. Socioeconomic factors complicated his care. It was very clear that he needed to be admitted, but he could not afford it. I had to figure out how to do inpatient management as an outpatient on someone who was very unstable. I prescribed him every injectable antipsychotic and benzodiazepine we had, but knew this would only be a short term solution. What would happen when he was home and they wore off? I also prescribed oral antipsychotics, mood stabilizers, and benzodiazepines and instructed his friends to give him this medicine while he was still calm from the injectable medications but not fully sedated in order to prevent aspiration. I may have treated him less aggressively if he was inpatient and being monitored, but keeping him calm while out in the community was a priority. I also had to think about the safety of the patient and others while he was at home. I instructed his friends to find his wife and two young children somewhere else to stay until he was stabilized. The patient was also a danger to himself, so I told them that he would need 24-hour supervision by enough men strong enough to hold him down, if necessary. I asked them to bring the patient back for close follow up. There were many other experiences that made me realize the difficult decisions practitioners in Kenya make daily. While working at the GBVRC, I found it important to learn both the guidelines made by the Ministry of Health in Kenya and understand why those guidelines were implemented. This too proved challenging. For example, as standard of care, metronidazole is recommended for coverage for Trichomonas as first line therapy for STI prophylaxis when Ceftriaxone and Azithromycin are given. However, in the recommendations made by the Ministry of Health, when switching to second line treatment with a fluoroquinolone and doxycycline, it is not recommended that you add metronidazole. I was never able to find any medical justification for this recommendation. I could only hypothesize that it has something to do with the cost-benefit analysis and… Read More “Rotations at Port Reitz Psychiatric Hospital and The Gender Based Violence Recovery Centre”
This year, I decided to challenge myself and push my clinical knowledge to its boundaries by working in an unfamiliar country with a different health-care experience than my country Qatar. I wanted to go somewhere that possessed little technological resources. Although some people may aim for more well-developed locations, I believe that learning starts from the patient’s bedside, by seeing, feeling, and listening. In my opinion, the lack of resources, tools, or laboratory and radiological tests challenge the doctors to use and rely on their own brains and to think in creative ways—something I do not often see in my country due to its wide availability of advanced technology, which can quickly give a definitive diagnosis. Because the future is difficult to predict, I decided to pursue this experience to prepare myself for all difficult circumstances. Fortunately, I found this program offered by the International Medical Aid at the Coast Provincial General Hospital. On the first of July, I arrived in Nairobi, the capital of Kenya. It was a difficult day. At the airport, I struggled to get my bags to another building, where I had to go check in my bags for my next flight to Mombasa. My bags weighed a total of 60 kg, and they fell from the trolley twice. At that time, I was already sweating heavily from the pressure of making it to my other flight on time. During those moments, I remembered my father’s advice to exercise in preparation for this trip, as things here are not as developed and comfortable as in Qatar. This was my first lesson from this trip; I needed to get stronger and healthier to be able to serve people as a health-care provider. When I first arrived at the CPGH, I noticed that the building looked old and that the roads were full of mud and unclean water. This was the total opposite to the hospitals back home, which are actually much cleaner and newer than five-star hotels. Nevertheless, I told myself not to judge the hospital from the outer appearance of its building but rather the people serving in it, as well as the availability of essential clinical tools. When I entered the hospital, I noticed that many departments had a sign on their doors stating the foundation or persons who have donated for the development of the department. I felt happy when I saw the names of countries, presidents, spiritual leaders, and others. During my time there, I saw many clinical signs I have read and studied about but never seen anywhere outside of our clinical books. Having this opportunity allowed me to see and examine things I have never seen in my country; it gave me an alternative way of learning that I never would have received in my country. I learned by touching, smelling, hearing, seeing and, most importantly, feeling. This way of learning is a more effective way of encoding these lessons into my memories because they are not pictures in a book.… Read More “My Trip to Kenya”
My Medical Officer (MO) and good friend Abdalla shared his philosophy with me after witnessing my heart twinge with pain alongside the 14-year-old girl sprawled across the ER table. His ideal has ingrained inside me and transcends all injustices I see— at CPGH, in child detainment alongside our southern border, in racial and gender inequity in the workplace, in the homeless shelter across the street from the Starbucks I frequent. But in that dusty corner of the CPGH ER, I understood the difference between witnessing injustice as a passive bystander and taking control of said injustice to learn from and better the debilitated victims. For most of my IMA peers, this call of responsibility transcended into a pursuit towards medical school. Me, I diverged. I entered IMA with an open soul and an undecided scholarship beneath the healthcare inequity umbrella. With an inclination to study infectious disease and global health inequity, I requested to learn in the CCC (comprehensive care unit) unit for the entirety of my stay, all while taking afternoon shifts in the ER, maternity ward, and NBU to enrich my studies. I soon came to the unsettling realization that hands-on patient care would not be my field of pursuit—I wanted something more, to upscale my actions, to treat populations rather than individuals, to be bigger, to do better. My call to action stemmed from observations of systematic injustice entrenched upon CPGH and accepted by the masses. A lack of a ventilator in the NBU ended the life of a newborn baby. Unwashed materials between patient rotations in the ER left many susceptible to infection. A lack of nutritional supplements in the CCC denied an HIV patient from increasing her BMI to a healthy level. These small pieces of the CPGH puzzle not only identify the many broken links in the chain of action, but also how widespread the issues are. Each fault can ideally be eradicated via simple intervention, more donations, or even more attentiveness. While all true, each imperfection relates back to the large injustices done onto the facility by lack of governmental upkeep, monetary corruption, and a disadvantageous starting place. Trained and qualified healthcare workers cannot care for their patients to the best of their abilities given the state of hospital resources. I visualized this injustice firsthand in the maternity ward. A woman in labor had no access to a Cesarean section due to a lack of available theaters; as such, she succumbed to a natural birth for forty hours. In another example, a cancer patient in need of radiation was referred to a hospital in Nairobi, which was the only facility in Kenya to offer such services. This patient could not afford a ticket to Nairobi nor the time to wait months for the next available appointment; as such, this patient’s health was sacrificed due to a lack of resources not only in CPGH, but also in all of Kenya. Besides health crises that stemmed from within the hospital, I also recognized the population… Read More “To work in healthcare is to have a good heart, but succeeding in the field requires a strong heart.”
This trip to Kenya was truly incredible, and has definitely both solidified, and encouraged my interest in medicine! I made some really meaningful relationships with doctors, nurses, and technicians at the hospital who took the time to teach me and engage me in their work. The mentorship I received at CPGH allowed me to not only learn how to do technical and hands-on tasks, but also how to be a confident and compassionate person in healthcare. As each day passed, I learned how to take advantage of my time here more and more, and play an active role in helping the staff as well as the patients! It took time before I was able to fully immerse myself in the hands-on experience, but when I did, I felt like I really found what I want to dedicate the rest of my life to! I learned so much in such a short amount of time, and got to see a lot of different perspectives and ways of thinking that I think other countries could really learn from! After working in the hospital, we would always come home to a lovely house, a very supportive staff, and amazing food! IMA really made sure we were well taken care of, and kept safe! IMA also gave us many opportunities to explore Mombasa, and see a way of life that is rich in spirits. Kenya has left a big mark on my heart and mind, and I am already thinking of when I can come back! The most valuable aspect of this program is the relationships you can and will make, both with fellow interns and the hospital staff. I have never formed such close bonds with fellow humans in such a short amount of time! In this program, you meet very like-minded people, who value the foundation of medicine, which is to simply help another human. We all understand the value of a life, and share a passion for coming together to help one another. Spending time with these kinds of people in both a working and non-working environment allows for close relationships to form! Moreover, relationships made with the administration, doctors, nurses, and technicians at the hospital have really made this program impactful. These are people who believe in you and your effort to come to Kenya and learn. With their busy schedules, they still make time to bring you places with them, explain concepts, and teach you how to be a great doctor. I will definitely keep in touch with the staff at CPGH, for they played a critical role in encouraging my eagerness and excitement to pursue a career in medicine! My trek experiences were nothing short of amazing! I went to Watamu and Diani Beach, and during both Treks, IMA did a great job of keeping us safe as well as giving us time to explore and have fun on our own. IMA offered many different activities, some of which were pre-planned, and they were some of my friends… Read More “Truly Incredible, and Has Definitely Both Solidified, and Encouraged My Interest in Medicine”
This internship has been the most challenging yet rewarding experience I have ever done. Due to the lack of some resources, it made it difficult for me to observe some patient cases. I have learned and seen more at CPGH than I would have ever thought was possible. Both Bella and Phares did everything in their power to make accommodations for me whether it was at the hospital or in Mombasa. In Kenya I never really felt unsafe. I was always in a group of people and never ventured out late at night. These three weeks have made me both mentally and emotionally stronger and will definitely guide me to be a better physician in the future. In my opinion the most valuable aspect of this program were the people at the hospital whether it was interns, residents, or even nurses; all of them wanted you to learn. Obviously, there was a language barrier so while they were doing rounds once they were done conversing with the patient they would explain what was going on in English. Or in surgery the lead surgeon would explain the anatomy, the precise steps he/she was doing, and why it was important. When looking at CT scans interns would explain the disease and show us where it was located on the x-ray. The little things that the staff at CPGH did to accommodate me made me have a better understanding of the medical field. Coming to Kenya to work at Coast General I knew there was going to be a lack of resources compared to what I had been used to seeing in the United States. Because of this the doctors had to rely on their clinical experience to diagnose their patients. During the hospital orientation, Dr. Aarif, who was in internal medicine at the time, had suspected that one of his patients had a multiple myeloma. The only problem was that he couldn’t obtain a bone marrow sample from his patient since he couldn’t afford the procedure. Therefore Dr. Aarif had to find another way to confirm that the patient had a multiple myeloma. I realized that if this exact case had occurred in the United States the doctor would perform multiple tests and use various forms of technology to diagnose the patient. I’ve realized throughout my time at CPGH that the doctors rely more on their medical knowledge compared to doctors from more well developed countries. While I was in the surgical ward I witnessed a specific case that confirmed my desire to become a physician’s assistant. The patient was a fifteen-year-old boy with neurofibromatosis. He had neurofibromas growing between his C1 and C4 vertebrae. Because of these tumors, the patient was basically a quadriplegic, he barely had any movement in his arms or legs. Neurofibromatosis is a genetic disease but neither of the patient’s parents had it. Because of this, the disease was caused by a mutant gene. Luckily, a neurosurgeon from California was at CPGH that week and decided to… Read More “Most Challenging Yet Rewarding Experience I Have Ever Done”
So Grateful for All the Things I Learned From My Doctors Both About Medicine and About Healthcare in Developing Countries
I loved my experience in Kenya so much. I never once felt unsafe from the moment I was picked up at airport. The food and overall accommodations exceeded my expectations greatly and I had no problems with the accommodations or food. My experience in Kenya had such a profound impact on me because I was able to learn so much about another health care system and I was able to get hands on experience with cases that aren’t common in the US. I kept a notebook with me every day in the hospital and everyday it would be filled with notes from the doctors I was shadowing. The doctors in Kenya are so intelligent and the language barrier isn’t difficult to overcome. I am so grateful for all the things I learned from my doctors both about medicine and about health care in developing countries. The most valuable aspect of this program is that you are able to do everything that the doctor does with the patients. You are able to go through the whole diagnostic process with the doctors and they will explain to you their thinking and ask you questions along the way. The doctors in the hospital are so creative and smart, and it is amazing to be able to get close to so many different doctors in all different departments. You are able to see cases that you would never see in the US and people often come into the hospital with multiple things wrong, which makes the diagnostic process more difficult. Being in the hospital really tests you and can really help you grow as a person and a professional in the medical field. The safari was amazing overall. I really liked the accommodations in Nairobi and the Mara Sopa Hotel. I don’t have any ideas on what to improve because I had such a great time on the safari that I wouldn’t change a thing!
My time here in Kenya was incredible. The residence allowed for us to truly get to know the other interns and spend time together. The location of the residence was great in terms of activities for us to engage in outside of the hospital. Safety was no question, and if there were ever any red flags we know that we could reach out to Bella or Phares. The food is fantastic and I cannot wait to make chapati when I return to the US! My placement in CPGH was so impactful on my education and future role in medicine. The mentors were so willing to teach and not only about medicine, but also about life in Kenya as a physician. The outreach events for the community is something that will never leave me, from the welcoming songs to simply filling up containers with medicine to disperse – it all made such an impact on me and bettering my understanding of global health care. Kenya truly is a beautiful place with even more beautiful people, that thankfully I got to know well! The most valuable experience to me would be to understand what it is like to work with minimal supplies. In the US, we tend to overuse supplies and make healthcare expensive do to all the resources we use. Here in Kenya, the lack of supplies has really taught me to think on my feet and be able to truly assess the patient and understand what is needed rather than what it done to prevent litigation in the US. America is viewed, as I came to understand from my time in Kenya, as the land of milk and honey. Unfortunately, that is not the case. Westernized medicine is costly and there tends to be more discussion of litigation than holistic treatment. There is an unhealthy, fast paced practice where patients feel neglected and doctors feel pressed to meet a quota. Kenya was full of knowledge and I gained experiences that I never would have elsewhere. I saw cases such as leprosy that I would rarely ever come across in the United States. It was incredible to see the physicians treat with such little access to supplies and recognize how easily as Americans we take for granted the access to resources such as electronic fetal heart monitors and electronic patient records. My time in Kenya truly opened my eyes to how misinformed I and many other Americans are of developing countries. We are taught to believe that areas are desolate and if individuals would donate money to the cause, life would become better. My time in Kenya grew me in my love for medicine, cultural awareness, and mostly a better understanding of what it truly looks like to help another. The practice of medicine in the United States has always been considered a noble career in which young children aspire to become a doctor from a seemingly simple idea of being able to help people. My time in Kenya truly exposed… Read More “Placement Was So Impactful On My Education and Future Role in Medicine”
Beyond Impressed by the Levels International Medical Aid Would Take to Ensure We Would Have the Best Program Possible
My mental health placement with International Medical Aid taught me so much about not just mental health and the mental health system in Kenya, but also about myself. I completed my placement at Port Reitz Mental Health and Substance Abuse Unit and I only wish I would have had longer. Port Reitz taught me strength by surviving and adapting to minimal standards of working conditions due to lack of funding. The undying support by the staff was above impressive considering the limited resources they have. Additionally, the stigmatization around mental health in Kenya was at the forefront of challenges experienced by staff and patients alike. It is very confronting to accept that for so many families they are related to ‘crazy people who have lost their mind’ to quote many family members directly. I have a deepened interest in creating awareness of mental health and mental illness in Kenya and other African or third world countries who deserve to be educated on the need for mental health facilities but also in order for them to understand their own family and community members who have been struck with mental illness. This is how I would like to shape my career, working in these respective countries to help combat the stigmatization surrounding mental illness, and Port Reitz has definitely helped me understand the need for this and the way that the families need to be educated. My first day was difficult and heavily confronting, especially seeing men in blue and white striped clothing in the isolation unit. The prison like structure at Port Reitz is a very difficult environment for staff to confidently and efficiently assist in the patient’s recovery. My second day created a change in me, when a young patient was walking beside me saying ‘don’t be scared.’ It was in that moment that I realised that perhaps my body language had shown I was reserved, and that was the last thing that I wanted the patients to feel. We had arrived at Port Reitz being debriefed that the patients could be violent, and that was the understanding that I had in the beginning. I wasn’t scared of the illness, but I was scared of the ideas about the patients that had been pushed onto me. The heavy sedation of the patients meant that I never actually saw them act out or be violent, and with me they were grateful, interested and always showed a smile. Their happiness was contagious because it was a little bit of hope that I needed to see in what could be such a difficult place to seek such an emotion. The staff at Port Reitz were so committed to ensuring I had a fulfilling experience, and I could not thank them enough for the time and effort they put into ensuring that I was gaining everything possible from my time there. But amongst my gratefulness, they were so thankful that I had been there, a feeling I could not comprehend as I could never… Read More “Beyond Impressed by the Levels International Medical Aid Would Take to Ensure We Would Have the Best Program Possible”
IMA has provided me with an experience that will stay with me for a lifetime. In the last three weeks, I have met physicians and hospital staff that have taken their time to teach me and my peers. In the US, it is incredibly difficult to obtain clinical exposure and experience, but the doctors and staff at CPGH welcome you with open arms and truly want you learn from their lessons. Although Kenya is a third world country and lacking proper medical resources, there is so much modern medicine in the states and abroad can learn from their practices. Apart from the hospital, the living conditions and IMA staff were wonderful. They care about each intern and strive to make their experience as perfect as possible. The food cooked by Wilson and Paul was amazing. The chefs introduced me to authentic Swahili cuisine, and I was never disappointed. The house keeping staff was kind, always keeping the IMA villas clean and tidy. The drivers and security were always so nice and managed to make me feel safe, whether we were at the villas or exploring the sites around Mombasa. Bella and Phares were my right hand me, as they were always there for me and the other interns, making our stay the best it could possibly be. Some of my favorite memories that I will take back with me were the community outreach clinics. Being able to interact with Kenya’s youth has a major impact on me, and I hope the feelings are reciprocated. Educating children on proper hygiene is so important, and I’m glad IMA encouraged us to get involved in the community outside the hospital. This program has introduced me to a myriad of people and taught me so much. I am beyond grateful for the experience this program has given me, and I encourage anyone seeking valuable medical experience to consider IMA. I believe the most valuable aspect of this program was learning how comprehensive medical care can be provided with Kenya’s lack of resources. In Westernized cultures, medicine has increasingly been dominated by technology. We rely on a plethora of tests in order to obtain a diagnosis and then continue to implement technology during the treatment of patients. This results in astronomical hospital bills that burden families for years after treatment. Kenyan physicians do things quite differently. Because CPGH serves such a poor population, the doctors refrain from expensive tests in diagnosing patients. Rather, physicians rely on their extensive knowledge to determine and care for the conditions patients present. While working with doctors in the obstetrics/gynecology ward and pediatrics ward, I was able to learn how diagnose and treat many conditions with the least amount of resources possible. If anything, I have truly realized that sometimes less is more. Despite the huge amount of money spent on healthcare in the United States, the Kenyan healthcare system still manages to do as much as, if not more in some cases, the United States in treating patients
Having recently graduated from a Master’s degree in Biology, I felt disenchanted by the experience of working in a research lab. To this end, I looked toward the more dynamic, high-pressure working environment of the hospital. I am fortunate enough to have been born in the UK, where I currently live, which means the National Health Service (NHS) is available to care for me if I fall ill. No questions asked and no bills to pay. The public-funded NHS will provide healthcare to all British citizens without discrimination. I applied for an internship with International Medical Aid (IMA) for two reasons; one, to further my understanding of healthcare in a system which is not paid for by the government; and two, to develop my skills working in complex, high pressure environments. This essay will explore the extent to which these objectives were met during my internship. Upon arrival in at Mombasa, Kenya, I was warmly greeted by Bella and Javan and instantly put at ease. They then took me to the villa I was to stay in, where Chef Wilson prepared a delicious breakfast for me. Rehema, the housekeeper, had a very comfortable room prepared for me. The welcoming nature of Kenyan culture was heart-warming and provided stark contrast to the lukewarm personalities found in British society. I was allowed the opportunity to rest for the first day before beginning my rotations at Coast General Provincial Hospital (CPGH). When Phares escorted me through the hospital for my first day on placement in the Internal Medicine ward, my first impressions of the hospital were mixed. It threw me to see patients left exposed on balconies or kept in close proximity to other patients with contagious diseases, especially if they had open wounds susceptible to infection, without barriers to inhibit contamination. Further to this, the long queues for examination and treatment were a new concept to me – in the UK, queues are avoided by employing more staff to ensure faster patient turnaround times and following strict procedures when it comes to organising appointments. Neither of these methods appeared to be employed at CPGH (presumably due to a lack of financial resources), resulting in consistently full waiting rooms. However, despite these differences, the similarity shared between Kenyan and British healthcare remained in how diligent and thorough the staff remained in treating patients. No corners appeared to have been cut in order to minimise expenditure, which surprised and reassured me. Before my arrival in Kenya, I erroneously believed that healthcare might be hindered by improper education of medical staff due to a lack of funding and investment in education, research and development. I found it impressive that despite the formidable difference in funding, the expertise of the doctors and nurses was not limited by this. The level of knowledge shown by the doctors, nurses and even students exceeded all expectations. In this respect, there was no compromise on patient care. As an intern, the working conditions in the hospital were trying. It was… Read More “My Experience with International Medical Aid”
Many months ago, before arriving in Mombasa, Kenya, I made both the best and hardest decision of my entire life. The internship through International Medical Aid was the perfect fit and one of the first steps along my journey of becoming a surgeon. I made the choice to independently coordinate, plan and pay for this experience myself. I clocked in extra hours at my work and acquired various side jobs to save enough money to be comfortable with each amount. Not only was I still in Massachusetts, but the internship was already teaching me responsibility and a sense of maturity that I will forever be grateful for. Once I arrived in Mombasa, the reception and the atmosphere of the program was something I have never experienced before. Right from the first minutes of arriving in Africa, Javan, who I became quite close with, had one of the best personalities I have ever seen; and from that moment on, I knew that I was meant to be there. As for the program directors, Phares and Bella, not enough great things can be said for both individuals. Their warm welcome and tireless work to accommodate all interns both in the hospital and outside the hospital was absolutely amazing. With my time in the hospital I was able to shadow and learn from many amazing doctors that work at Coast General Provincial Hospital. It was amazing to see the environment in which these professionals were able to work and the attitudes they carried to work; knowing very well that the environment was less than standard. The amazing part in which I learned the most can be categorized into one word: Innovation. To me, memorizing information is the easy part. Anyone is able to memorize a ton of words and definitions, whether it be medicine, music, or even a language. However, where I was able to learn the most is from how innovative each doctor was. The resources were quite limited in the hospital, so each case and each procedure had to be done in a way that was the most effective with what they had. The image that sticks in my mind the most is how the doctors established an IV line. In the United States, there are special rubber bands to help express a vein. However, from the innovation of the doctors in Kenya, a simple rubber glove wrapped around the arm did just as well. Little snapshots and moments like this is where I learned the most throughout my time in Kenya. Yes, the knowledge I gathered through research on each case was amazing, but being able to see how these doctors worked, and what they were able to utilize for each case and scenario is something I will be able to take with me through life. To learn the ability to scan what you have and think of more than one way to use an item is something that will not only help me in medicine, whether surgery or an… Read More “One of The Most Incredible Experiences of My Life and the Masai Mara Safari was Amazing”
My experience with IMA was both very positive and memorable in the entire four months I interned as a practitioner. I found the support of both Bella and Phares to be on point in that they were always available to address any questions and/or concerns I had – as well as proactively followed-up each and every time. Bella and Phares are very approachable and friendly individuals. My placement at the GBVRC at CPGH was definitely a highlight of my time in Mombasa, Kenya. As a Counsellor early in my vocation, I was able to both learn and practice even more so about trauma counselling, and how it applies to survivors of defilement and rape. I was provided with thorough shadowing and training for some weeks before I commenced counselling independently. In this placement, I was able to help fill a void, as the centre was understaffed. By taking on primarily counselling work, in the time that I was at Gender, it allowed the clinic’s Nurse (in-charge) to focus on medical exams, as she used to do both counselling and medical exams. I found the staff, Saida and Mary, very welcoming, accommodating, caring, and helpful at all times. Throughout my time with IMA, I always felt safe, whether at the residence, on the road, in the hospital, or elsewhere. I felt that IMA made safety a priority and we were briefed at the start of our internships about local safety and so on. By having Javan always drop us off and pick us up from the hospital was especially helpful. Javan was always very careful when driving us from place to place and his friendly persona was always appreciated. The guards at the residence too were always very helpful and caring towards us too. The residence was very accommodating and provided us with luxuries such as hot water, air-conditioning, and even wifi. I appreciate that the rooms were simple and shared as it allowed us interns to get to know others more. By sharing rooms, we also had to learn and practice balancing everyone’s needs, and adjusting/being flexible. We were fortunate to have housekeepers who worked hard in ensuring that our rooms, bathrooms, and laundry were up-to-date. Rehema, Naomie, and Victoria were very easy to approach and always very helpful. Chefs Wilson and Osman were wonderful chefs. They were both cooking for us a variety of local and international dishes for lunches and dinners. The chefs provided me with filling packed lunches too when I was at the hospital for longer shifts. The chefs would always take on board our dietary requirements as well as cook on request any meals that we might be craving from home e.g. pizza or a favorite local dish from Mombasa. The impact on me, that interning with IMA has left on me, can only be described as overwhelming (in a positive way). In the months that I was in Mombasa, I learnt so much about Kenya and its culture, Kenyans,… Read More “Very Positive and Memorable Experience”
This program is the best decision I ever made. The program mentors in Kenya helped me from the minute I got accepted to the moment I left. They were very approachable and friendly. I always felt safe during my stay in Kenya. The mentors go out of their way to ensure the safety of the interns. They provided us with tips that would further ensure out safety while they were not around. The accommodations were much better than I had anticipated. Our rooms were cleaned every day and we stayed in a very nice neighborhood. The food never disappointed. All of the interns looked forwards to meals as it was always something yummy. This program had a huge impact on me. I have learned so much about Kenyan culture and was able to see and learn a lot. I was able strongly notice the differences between Kenya and North America. With the help of hygiene and medical clinics as well as other outreach activities, I hope I made some impact on the communities we visited, they certainly made an impact on me. I believe the most valuable aspect was the interactions we had with the children at schools and within the communities. performing the hygiene clinics and medical clinics really opened up my eyes to what some of these kids are exposed to. Despite the exposure I faced at the hospital, being involved within a community was slightly more valuable for me. The safari was a huge highlight on my trip. It was worth every penny that was spent. The lodge we stayed in was beautiful. The food was great and our safari driver was hilarious. No improvements here. Going into this pre-dental internship with International Medical Aid, I didn’t know what to expect. Traveling to a foreign country alone and being completely submerged into their culture, I was very nervous. But, once it was all said and done, I am so happy I took on the challenges that this internship had to offer and I really did learn a lot. Everything that I learned over the month has further encouraged my interest in the dental field as well as opened my eyes to different cultures and newfound knowledge. The dental field within Canada is very different than that of Kenya. I have shadowed multiple dentists within my hometown and have never experienced such things as I have within just one short month as Coast General Provincial Hospital. The Canadian dental field generally focuses on cosmetic issues. Many procedures that are done are not completely necessary. What I originally liked about the dental field, over the medical field, is that slight changes in your oral health can make a world of a difference for one’s self esteem. The dental field does not typically consist of life or death situations and immediate emergencies. I went into the internship thinking I would see the absolute worst things. I was pleasantly surprised to realize that even though the systems are very different, they… Read More “This Program is The Best Decision I Ever Made”
The experience I had with IMA was entirely different than any health care or outreach experience I have had previously. Outside of hospital placements, it was wonderful getting to know the other participants on the program while learning about the culture of Mombasa, Kenya. The program mentors were phenomenal- extremely supportive and accommodated to my exact interests. They went out of their way to ensure I was having a good experience and had the opportunity to do everything I wanted to. The accommodations were very nice and in a very safe neighborhood and we had incredible meals prepared by the resident chef. Regarding hospital placements, the experience is what you make of it. You need to be ready to dive in, be proactive, and build relationships. I underestimated how challenging the hospital placement would be, in terms of how mentally and emotionally draining it was. There are things I saw and experienced in the hospital that have made a permanent mark in my mind. I gained valuable insight into how cultural differences impact health care, being aware of the way things are done differently due to either cultural differences or systemic differences. In many ways my mind grew, my heart expanded, and my heart broke. I am incredibly grateful to have had this experience, and I know it will stay with me. I am confident that this experience will forever change the person that I am and the nurse that I am. I went on the Masai Mara Safari and it was incredible. It was definitely worth the cost to do it. If you are going to Africa, it is something you need to do while you are there. My group had an amazing driver who educated us on all the animals we saw. We got right up close to so many different animals. The accommodations we stayed in were also extremely nice!
Participating in the IMA pre-medical internship has been a life changing experience for me. The program mentors, resident chef, and local support staff were always helpful and accommodated any need that I had. Working in the hospital definitely tested me in ways that I never imagined. I saw a lot, and I experienced a lot. Most of all, I learned a lot. Every doctor that I came in contact with was more than willing to teach me and allow me to interact with patients. Riding to Coast Provincial for my first day of rotations, I did not know what to expect. I was filled with feelings of anxiety and joy; I was about to embark on a once in a lifetime experience. As I made my way to the gynecology ward, many thoughts rushed through my head. What would I see? What would my mentor doctor think of me? I was greeted by the warm embrace of Dr. Rehema, and I knew that everything was going to be alright. My time spent at Coast General taught me so much. Not only did I learn about medicine, but I learned about myself. With each patient I saw in the hospital, I gleaned medical knowledge and learned about not only my humanity, but the humanity of the people around me. During my internship, I spent a large portion of my time in the wards dealing with women and children. In each of those wards, despite seeing women laboring, children in agony, and innocent newborns fighting for their lives, there was so much beauty and strength to be found. One of the first things you notice going being in the wards is the immense strength of the women; not just the strength of women in labor, or the mothers watching their children fight off illness, but of the female nurses and doctors. The female doctors displayed a level of confidence that I had never seen before. They were always sure of their work and what they knew; they were never afraid to speak up concerning a patient’s diagnosis and why their diagnosis was correct. Despite being fierce and knowledgeable of their field, every female doctor I came in contact with was kind and gentle with me as well as their patients. I could not always understand what they would say to their patients, but each doctor took their patient’s hand and gave them caring, reassuring looks. Where I was concerned, each doctor took their time to explain cases to me and ensure that I was learning something along the way. Being around these women taught me how I should be as a future physician: sure of my knowledge, yet humble enough to care for my patients and those around me. I learned an immense amount about myself during the four weeks I spent in Mombasa. The first thing I learned was that obstetrics and gynecology was my calling. I absolutely loved being in the labor ward and realized that I could see myself… Read More “By Far One of the Greatest Experiences of My Life”
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… Read More “I Learned More Than I Could Have Ever Asked For”
This program provided me with many unique opportunities and an incredible experience overall. The people in Kenya were extremely kind and accepting, and the children absolutely stole my heart. Every day was filled with beautiful scenery and Kenyan cuisine that I still daydream about–including chipati. Visiting the local communities during the medical or hygiene clinics was a blessing to me even more than it was to them. Seeing the different living situations for the lives of all these joyous people showed me just how unimportant and unnecessary that material things are! I hope that I can bring this new perspective to the many future teams/schools/jobs that I will be a part of in the years to come. I certainly can’t wait to go back to Kenya when I am certified and skilled enough to make a medical impact at their hospitals and in the community! The Masai Mara safari was a once in a lifetime experience. It was incredible to see these majestic animals in their domain! Our driver that we were placed with was humorous, kind, and got us some incredible shots. I will never forget this adventure! My internship with International Medical Aid allowed me to be a part of unique cultural situations that can only be experienced in Africa, exposed me to medical conditions that are rare in the Unites States, and taught me more about myself in one month than I thought possible. I now see the world through a different perspective in various situations and am better off for it. My experience, combined with my newfound knowledge, will also enhance my ability to inspire teams I am a part of in the future, and allow me to convey ideas or concerns sparked by this experience abroad. Healthcare delivery in Kenya is different from the United States’ hospitals in countless ways. The most pronounced differences that I noticed is the lack of technology, materials, and medicine/anesthesia. Due to this reality, I witnessed many doctors and nurses forced to improvise. In one case located in a minor theatre, the nurse could not find a scalpel with a handle, so the doctor had to use a clamp to hold onto the blade for the entire procedure. Also, due to the lack of available drugs, all mothers in the Labor and Delivery ward had zero access to pain killers of any kind. Another difference that took me a while to get used to is the Kenyan staff’s sense of urgency. For instance, a woman began seizing in the ER, and I watched as nurses stood by, looking unconcerned, until one nurse finally took some action several minutes later. In the states, the patient would have been monitored with multiple machines, alarms would have been going off, and a team of providers would have probably responded immediately. But I really admired the physicians and the staff I was fortunate enough to observe, and I hope someday I will be able to come back as a physician and help at Coast… Read More “A Unique Program and Incredible Experience”
My time in Kenya was incredibly eye-opening and worthwhile. The staff was excellent and very helpful. The residence was safe and comfortable. The food provided offered a nice variety and was always plentiful and fresh. Transportation to the hospital and cultural sites was efficient and safe. There is a whole team of people that cared about your well-being and your experience. They always checked-in to make sure that you were doing well and that your internship was living up to expectations. They were always willing to discuss life and culture in Kenya. Benson was particularly kind and compassionate–he really cares about what he does and about the experience the interns have. Husna was also extremely helpful and informative and Bella was always there when you needed something or had a question. An experience like this changes how you view the world and also makes you think about your role in it. I wish I could have stayed twice as long–there was so much more to do and see. Back at home, I think about my experience every day and can’t wait to go back.
Every aspect of the program can only be spoken highly of. The trip exceeded my expectations and there was no part of it I would change. Being an intern at IMA was a very amazing experience and it is something I will definitely recommend to others. The ability to shadow in such a different atmosphere from what you are used to is very rewarding. Not only were the experiences inside the hospital enjoyable, but outside of it as well. Getting to bond with the other interns was also an awesome aspect of the trip. Overall the IMA internship was a very unforgettable experience and if I can do it again in the future I will in a heartbeat.