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 emotionally difficult to meet patients who were unable to pay for the treatment they needed and to see priority given to patients who could pay. It was also difficult to adapt to a system that lends freedom to students to practise their skills on real-life patients as I am used to the western style that does not allow students to practice certain skills until after graduation. Although I was never pressured into performing any task or procedure that I was not comfortable with, I did feel spurred to keep up at times. I am all the more grateful for experiencing this style of learning (a sort of “learning by doing” practice) as I would never have seen this in my home country and feel this experience has made me more adaptable in pressurised environments. Moreover, as distressing as it was to see patients turned away for lack of funds, it was interesting to see how healthcare is provided when it is not accounted for by a single-payer system (like the NHS).
Following my first week shadowing staff in the Internal Medicine ward, I was to observe in the Casualty and Surgical wards. The surgeons in the operating theatre had no qualms at all answering questions and actually prompted and invited questions. Similarly, the doctors and nurses in the Casualty ward pushed me to learn as much as I could from each individual case, providing me with hands-on experience. I found my time in these departments to be particularly enjoyable and feel I learned the most during my time spent there, owing to the willingness of the doctors and nurses to educate and involve me. Looking to the future, I would like to think that, having experienced first-hand the value of enthusiastic teaching, I would endeavour to emulate this quality during my time as a professional.
Prior to my experience with IMA, I was hesitant in belief that medicine was the right career for me, primarily because I felt that I would not be good enough to contribute to the field, or even if I were good enough, that I would not have the resources to pursue this career. However, working with the staff at CPGH, who have become so excellent in their profession in spite of the plethora of hardships they have had to overcome in order to gain their education, has imbued a sense of duty in me. It would be narrow-minded to say that it would be impossible for me to become a doctor in the UK when these doctors have achieved so much in the face of obstacles greater than those that I face.
Despite the myriad of systemic differences in healthcare between Kenya and western society, the ultimate objective of curing the sick remains universal. With this, I can say with some certainty that my experience with International Medical Aid has solidified my resolve to pursue a career in medicine. The question now remains, where would my efforts be best placed? In the sterile comfort of the NHS in my home nation, or the visceral grit of healthcare in the developing world?