My experience in Mombasa was life changing. The people I met and all that I learned while working at CPGH was irreplaceable. I worked in the nutrition department at CPGH and saw so many different types of conditions and learned so much about the health care system in Kenya. The support from the International Medical Aid’s staff was amazing. Bella and Husna were always there when I needed something and I felt like they truly cared about my well-being and experience. The food at the house was AMAZING to say the least. I am a pescatarian and don’t eat poultry or red meat and they were so accommodating! Their fish was so delicious and tasted so fresh. All of the cooks were so sweet as well and they even let me use the kitchen one night to bake chocolate chip cookies! International Medical Aid and my trip to Kenya was truly amazing and I can’t wait till I get to go back one day. The impact this experience had on me will last a life time and I hope the knowledge I gained will help me with my future career to change the lives of those around me. Growing up, I never knew what I wanted to do. I looked at my friends who were so sure of their passions and their future, but when I looked at myself, I was stumped. The one thing I was always sure of was that I wanted to help people. “But how can I do that?” I would ask myself constantly. Then, in 10th grade, I was diagnosed with the autoimmune disease, Type 1 Diabetes. This changed everything. One thing I learned quickly after being diagnosed was that there were a lot of different medical professionals involved in the management of this disease. Every three months I would visit an Endocrinologist, Dietitian (RD), Therapist, and a Certified Diabetes Educator. During these appointments, I was always intrigued by the Dietitian and found it so fascinating how foods and the nutrients can affect our body on a molecular level. This was when I knew how I was going to help people, as a Dietitian. When I arrived in Mombasa in June of 2019, I had no idea what to expect. I have taught nutrition classes to low income families in the area where I live, and I figured this might be similar to what I might see in Kenya. When I went into Coast Provincial General Hospital (CPGH) on that first Monday, I had no idea that what I would see there would forever change my life and my perspective on health care. During my time at CPGH, I was working in the Nutrition department. I shadowed Dietitians and Nutrition interns in almost every department of the hospital, because nutritional support is needed everywhere. The differences between nutritional support in the United States and Kenya varies greatly, as well as the conditions seen in the different hospitals. During my first week at CPGH, I spent… Read More “Forever Changed My Life and My Perspective on Healthcare”
I stumbled up International Medical Aid’s website while looking for an opportunity to gain experience in the healthcare field. This program stood out to me because the internship was unique in providing insight to specific health care roles. As a Pre-PA student, my experience up to this point was limited to working as a nursing assistant in a brain injury rehab and in an emergency room. Although these experiences were valuable in forming the foundation for my career goals, there was a whole other side of healthcare that I had yet to see. I was curious to learn more about how healthcare in other countries differed from that of the USA. Out of curiosity, I decided to apply for International Medical Aid’s pre-pa internship. After a few months, I received the news that I was accepted. I was terrified, but excited at the same time. I had never traveled alone, but I needed to push past my comfort zone and learn more about the world outside of my two-story suburban home. Without hesitation, I booked my ticket and flew to Mombasa, Kenya. To my surprise, Mombasa was very similar to my motherland, India. I felt at home as we passed by colorful buildings and street vendors. When I was given a tour of Coast Provincial General Hospital for the first time, I was shocked at how different the hospital was from a typical American hospital. One of the first places we visited was the NICU. The incubators were filled with up to four babies, and the staff was extremely limited. There were two to three nurses in charge of over fifty babies! I learned that the nurses depended on the mothers to tend to their children because there is not enough staff to watch over all of the infants. I could only imagine what I would see next. I was placed in surgery the first week and shadowed Dr. Hasan. We went patient to patient, and I saw cases that I had never seen in America. During our disease burden lecture, we learned that the most common cases that you will see in a Kenyan Hospital are “malaria, respiratory diseases, skin diseases, diarrhea, and accidents” (Disease Burden Lecture, n.d). Patients are at a higher risk of acquiring these illnesses because of their environment and living conditions. Dr. Hasan emphasized how important it was to touch the patient instead of solely relying on scans and verbal complaints. I admired how the team of surgeons worked tirelessly to assess and treat each patient in an overcrowded ward with no air conditioning. When I asked Dr. Hasan why he chose to work in a public hospital instead of a private hospital, he explained that these patients were in dire need of medical attention, and it was important for him to serve the needs of the public community, especially those with low-incomes. “Public hospitals have the most accessible and affordable care for populations, but they are also the most under-resourced and have higher rates… Read More “So Glad That I Took the Leap and Applied for International Medical Aid”
Medicine has always been my passion, however the road to get into medical school is a tough and competitive one. My purpose for volunteering abroad was to learn, encourage, and remind myself the reason why I decided to take this road. Being a pre- med student in Canada can sometimes get discouraging since we get absolutely no clinical experience or courses related to medicine, besides basic science. Even volunteering opportunities at hospitals are narrow and not really hands-on. Having said so, I will be forever grateful for the opportunities that International Medical Aid offered me and the inspiration and courage they seeded in me to pursue my dream with more determination than ever. The reason why I have chosen medicine is to help others to the best of my abilities. I was born and raised in Honduras, also a developing country, and ever since I participated in brigades there, I was motivated to dedicate my life to serving those in need. World Health has always been an interest of mine, so I was thrilled to get to know Kenya and have the opportunity to immerse in a healthcare setting that I was not accustomed to. This internship not only challenged me but also gave me significant insight and preparation to work under difficult circumstances and scarce resources. I was fortunate to work with incredibly knowledgeable doctors who were patient enough to answer all my questions. There were several scenarios that I will carry with me throughout my career. During my week in Radiology, we saw numerous relatively young patients (20-45 years old) with traumas and diseases that were never treated properly and had only grown worse over time, up to a point were a full recovery was nearly impossible. For instance, a 3 year old boy was referred to Coast General Provincial Hospital. He had lupus, but he was not treated properly nor diagnosed with lupus on time. He had recurrent fevers and was only treated with ibuprofen for the fever specifically. Unfortunately, when a patient has lupus, they are more vulnerable to get infections since the disease weakens the immune system. As a consequence, the patient developed cerebritis (bacteria entered the brain through his sinuses) and this caused hydrocephalus. Dr. Valerie explained that the CT scan already showed irreversible brain damage that would most likely result in dementia. The only plan of treatment was now a shunt to release the pressure caused by the excess fluid. This case was a quintessential example on the importance of having the equipment necessary to properly diagnose a patient and giving adequate treatment as early as possible. In Canada, cases like this would rarely happen since detailed lab examinations are made to rule out any other diseases, patient follow-up is reachable, and treatment technologies are exceedingly advanced. In this situation, the patient’s mother did not have the healthcare knowledge nor the economic freedom to visit a doctor as often as desired. The National Insurance Hospital Fund offers two types of memberships, the one… Read More “This Internship Gave Me Much More Than I Could Have Ever Asked For”
In July of 2019, I went to my first health-related experience abroad as a medical student. I spent four weeks in Mombasa, Kenya, shadowing physicians from the country’s second-largest public hospital, and learning about the Kenyan culture and healthcare system. My goal through this experience was to learn and understand how a country, different than my own, manages public healthcare, to perceive how culture plays a part in healthcare, and precisely what role I can assume, as a future doctor, to better global health care. I firmly believe that a great doctor cannot be limited to their home surroundings to treat a patient holistically. They must be knowledgeable about different cultures and beliefs and the way that disease manifests in different ethnicities and backgrounds. My trip to Kenya had the sole objective of putting me on the path to becoming, what I regard as a great doctor. Similarl to Brazil’s public healthcare sector, Kenya has four levels of public healthcare services: primary, secondary, tertiary, and urgent. During my time in Mombasa, I got to experience the functioning of the tertiary healthcare level, being that I was shadowing physicians at Coast Provincial General Hospital (CPGH). The first thing I grasped about public healthcare in developing nations such as Kenya is that underfunding is generalized in the healthcare system. This, likewise, happens with public healthcare facilities in Brazil; however, the tertiary level is usually better funded if the city is large enough or if the hospital attends to a large number of individuals, but still underfunded nonetheless. Whereas, here we had the second-largest public hospital in Kenya and there were only three nurses per shift working in an ICU with over ten beds (usually in ICUs it is necessary to have one nurse per bed) and that was the only public ICU in the whole county district, portraying that even though this hospital clearly attends to a vast group of people, it still did not receive the funds to hire more hospital staff. This understaffing issue depicts something that I took for granted for a long time about Brazil’s public system: in Kenya, there are two doctors for every 10,000 Kenyans, whereas solely in the state of Bahia (my state in Brazil) there are 13.5 doctors per 10,000 citizens. I always thought that my state was considerably medically understaffed, but after realizing that my state had almost seven times as many doctors for 10,000 people than an entire country, that put things in perspective for me. One thing that I learned once I immersed myself in the Kenyan healthcare system that surprised me was that public healthcare is not free. This took me by surprise because I come from a country in which everything in the public health sector, ranging from surgeries to hypertension medication, is free. And I assumed that it would be the same in Kenya because 37% of its population is living below the poverty line. During my time at CPGH, I witnessed people that could not afford to… Read More “Experience Will Make Me A Better Doctor”
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”
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.
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 Iwas 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. This was such an incredible experience. I learned so much about myself and what I am capable of doing. I grew in my self-beliefand determination to practice personal excellence. My experience in emergencies in the A&E, ICU, and Labor Ward has given me the confidence that I can act well under pressure and in fact, I enjoy it. I am a strong patient advocate. This experience has taught me that I am ready to change from practicing in the operating room to another specialty. This experience has also reinforced my passion and desire to work in Global Health. Additionally, I learned that qualitative research is valuable in understanding the social networks among people and environments, and I wish to deepen my research skills. I learned so much about myself, however, my path is still unclear. Wherever my path may lead, I know that it was guided by the experiences shared with International Medical Aid at Coast General Hospital, and for this I am grateful.
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”
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 neighbourhood 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 valued having a combination of time in the hospital with time in the community. My favorite days were when we would visit schools and have hygiene clinics and medical clinics. 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!
As this was my first trip alone, I was a little scared of what I might encounter in Kenya. However upon landing, Benson and Brian were very sweet and I felt already secure. When I approached the resident I felt safe to know that there was a security guard at all time and there were also cameras outside the door. The resident was clean and comfortable. Naomi and Joshua were amazing. They were super sweet and accommodating to whatever I needed. They’re energy and continuous smile was pleasant to see in the morning. Benson was very accommodating when it came to seeing the city and always asking for feedback, which I really liked! The program was very organized. The time table helped to know what and where I should be at all times. There were a lot of rotations and so I was able to get my first pick. The mentors at the hospital were very helpful and asked a lot of questions. I found this experience to be very educational. All in all, my time in Kenya was eye opening. This experience was a validation for me that I want to be in the medical field and I want to be helping people in every way I can. I want to use my knowledge on how they treat patients and expand it to other countries that are way less developed. I have learned balance and not dependency. To further elaborate, I want to be able to talk with patients and understand their symptoms as well as looking at labs and testing to decide on a conclusive diagnosis. It takes a lot of practice to be able to spot diagnosis a patient as there are many diseases and similar symptoms. This trip has made me realize that I am eager to learn. I didn’t know the answers to many questions asked by the interns and medical officers due to the fact that I simply didn’t learn. But when the medical officers were asking questions I was motivated to think outside the box. I was able to adapt to their style of thinking to figure out how to diagnosis a patient. This is a skill that I learned via this internship and I plan on expanding my knowledge even further. Not only do I want to become a PA and be able to provide care for those needed, I also want to teach and educate patients. As mentioned before education is key for prevention. I strongly believe that educated youngsters can play a huge effect in promoting good health. A story to tie with how a simple education can go a long way is the Red Cross. This name is a commonly known world-wide and it all started by a simple businessman, Jean-Henri Dunant who organized local relief assistants to partake in basic wound care for hit soldiers. This act of selflessness has saved many lives and now currently Red Cross has over 97 million volunteers saving lives on a daily… Read More “Experience Validated My Desire to Pursue Medicine”
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 neighbourhood. 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. Travelling 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 “IMA’s program is the best decision I ever made”
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 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 being there everyday. The next thing I learned was that my passion for helping people was greater… Read More “By Far One of the Greatest Experiences of My Life”
About 20 years ago I was born “Nameless” in a Hospital in Berlin. My mother vanished one day after my birth and left me at the hospital for adoption. As good luck seemed to be part of my life from the beginning, I was soon adopted and called Anna Minkwitz. With my newfound parents I moved to the suburbs of Berlin, close to my new grandparents and extended family. Growing up there, my parents allowed me to live a life of great privilege that included going to an international school to learn English, moving abroad as an exchange student for a year and lots of travelling throughout Europe, Africa, and America. Especially, the family trips throughout Africa had a great affect on my personality and upbringing and thus I decided to apply to International Medical Aid in Kenya after working in hospitals in Germany for a year now and attaining my EMT license. Getting accepted into the IMA pre-med program was a great honor and throughout my 6 weeks in the program I learned more than I could have ever asked for. At Coast Provincial General Hospital (CPGH), I started out in the New Born Unit (NBU) with Dr. Juthy. She took me under her wing and I felt sorry for bothering her with my million questions about the different clinical pictures: which diseases were very common, which were rarer, how they tested for the diseases and the treatment plans. I also asked many questions about the Kenyan healthcare system and Dr. Juthy always took her time in answering my questions thoroughly. She also helped me draw comparisons to Germany as she has worked in Germany as a Doctor for some time doing an internship and so we could draw parallels between the two healthcare systems together. One day for example, there was a highly septic new born, that had been transferred to CPGH from a different clinic, which needed to be ventilated as it could not breathe on its own. So, for my whole shift I ventilated the new born by hand as there was no ventilator available, this is the first time I encountered the magnitude of the lack of resources. Following the NBU, I rotated in the Emergency Room (ER). I didn’t really have a mentor there, as doctors always dropped in and out of this department but I did manage to make this an everlasting learning experience that strongly assured me that starting medical school in March 2019 is the right decision for me. In Emergency I had many learning by doing experiences and I could draw from my EMT knowledge to assist the doctors and nurses. As an EMT at home you must think on your feet and always be ready for the unexpected, this helped me in a lot of ways at CPGH as the emergencies rolling could be anything from minor issues to actual life-threatening problems and the shortage of resources and staff made it hard to keep up with all the cases.… Read More “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! 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 Provincial General Hospital physically and financially. Along with the many differences in healthcare, Kenya’s culture and religious status made an impact on me as well. The first things I noticed when I entered the city of Mombasa were the people—with their heavy accents, fluent Swahili, and the many hijabs being worn by citizens. My first… Read More “Incredible Experience, Can’t Wait to go Back to Kenya”
My experience of Kenya through this program was amazing, not only because of amazing people I was able to meet, but quality of the program and enriching opportunities I was able to participate in. Food from the house was amazing, safety was not a concern for me (because it’s safe around the house!), people are amazingly welcoming, and unforgettable experiences! I was able to further enrich myself in the field of medicine, especially plastic surgery. By jumping into the scene, I was able to first-hand experience what the physicians may handle daily.
My Invaluable Experiences both Inside and Outside the Hospital Reinvigorated my Fantasy to Become a Field Doctor
This experience was honestly better than I had hoped or imagined that it could be. The Program mentors and IMA staff were absolutely incredible, super accommodating, and worked super hard to make sure that I got the absolute most out of my experience. I came into this program not entirely sure about my desire to go into medicine and I have most definitely come out of this program more inspired and motivated to pursue a job in medicine. I came to Kenya on June 13th, 2018, hauling the hazy childhood dream of becoming a field doctor. The doubts and insecurities that arose from my freshman year of college had bombarded that once luminous vision. Thus, my International Medical Aid internship would ultimately serve to either crumble or invigorate those lingering ambitions. The priceless knowledge I have gained from medical staff, peers, and Kenyan natives has spurred my desire to grasp onto my dream of becoming a field doctor with new clarity. Although, I observed many fascinating clinical cases, I found that the most powerful lessons came through the questions I asked from my observations. At Coast General Hospital, I had the incredible opportunity to learn from the medical staff and observe cases I would not be able to see in US hospitals. Some of the most notable clinical cases I observed included Cholera, Malaria, Hydrocephalus, Organophosphate Poisoning, and Gastroschisis. I learned how to take and read vitals and how to set the oxygen levels for oxygen masks and nasal cannulas. However, the most impactful lesson came from the woman with Herpes Zoster in Surgical Ward 7. She left a burn untreated which was sadly a common occurrence. Eventually, the burn became septic, she contracted shingles, and the entirety of her midsection became one festering wound. As I watched the nurse carefully peel away the dead skin from her oozing breast tissue, I could not comprehend the amount of physical and emotional pain she must have been experiencing. There were no psychologists around to talk her through the body dysmorphia she must have been feeling. And yet, she barely showed any signs of physical or emotional pain except for a wince or two. It was baffling to me. I later learned the cultural norm in Kenya is not to visibly show pain in response to physical pain but it’s customary to openly display emotional pain in response to death, which is the opposite of the cultural norms of the United States. That newfound information caused me to speculate whether pain catastrophizing, which is the tendency to describe a pain experience in more exaggerated terms than the average person, is caused more by genetic or cultural factors. When I get back to school, I hope to do more research in this area and propose a cross cultural psychological study about the factors that contribute to pain. My Invaluable Experiences both Inside and Outside the Hospital Reinvigorated my Fantasy to Become a Field Doctor Additionally, something of interest I noted was the lack… Read More “My Invaluable Experiences both Inside and Outside the Hospital Reinvigorated my Fantasy to Become a Field Doctor”
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.