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 me to what it means to help another human. Dr. Matonda is a dermatologist at Coast Provincial General Hospital in the Comprehensive Care Clinic (CCC). The CCC treats cases of chronic illness such as Human Immunodeficiency Virus (HIV), Acquired Immunodeficiency Disease (AIDS), and tuberculosis. Dr. Matonda’s role was to address and treat the secondary skin illness these patients would face. The first day I was with Dr. Matonda, a elderly gentleman walked in the door, not for an appointment but to see Dr. Matonda. His skin was covered with lesions like I had never seen, and Dr. Matonda began to ask him how he was and if he had found time to have lunch. After realizing he had not eaten, Dr. Matonda began to probe him about what he would want for lunch, then giving him two fold of what he asked, sent him to the canteen with a doctor’s note from him. Without explanation, he brought in the next patient. Dr. Matonda then explained how he knew the previous man. He had come to the doctor with a severe case of leprosy a year ago and Dr. Matonda realized that he was homeless and was struggling with substance addiction. Dr. Matonda acknowledged the simplest, yet profound piece of information – that an addict rarely has money to spend on food, and if he does not eat the medicine for the leprosy will not take effect. I sat there in awe of the story of their relationship and how Dr. Matonda was so humble about who he was to this man. In those days with Dr. Matonda he embodied how being a doctor comes second, and being kind to fellow man first. Measuring success in medicine is tricky when life and death is a consequence of your practice but Dr. Matonda taught me one line that I will take with me through my career to judge daily how I am as a provider – “see how they are happy, that means I am happy too.”
In reality, as individuals raised in western culture, it is rare to think that money cannot fix a problem and in a sense, money cannot fix anything to do with the medical system in Kenya. If money is donated, it is quite easy for the money to seemingly vanish due to government corruption. Understanding how to aid a developing country long term is difficult if there is no research done or experience had. The exposure I had made it apparent how frequently my train of thought, even if meaning well, is focused on short term rather than long term. To truly aid a country, to prosper in medicine, to make a difference at all our actions must be directed toward a long term goal. Focusing on the long term is the only way to create sustainable change. Due to my newfound knowledge, I can make more educated decisions in the future on how to be of true sustaining change within healthcare.
All the lessons I learned over this internship will continue to mold me as a person and future clinician. Gaining a deeper understanding of global healthcare has been a privilege, but also necessary for me to develop into a physician that will treat and think holistically in medicine. I will be forever grateful for my time and experiences in Kenya and would be overjoyed to return to Coast Provincial General Hospital and Mombasa in the future.