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 few hospital rotations, I saw more differences than I could count. Each new patient that we saw demonstrated the complex of complications between socioeconomic class and political power. From the pediatric to the psychiatric ward, I could see how a lack of effective policies impacts people of every age, race, gender, and illness. In the labor ward, not only were women rushed through the birthing process, but the babies they carried had higher risks for complications due to the lack of care leading up to their birth. In Kenya, 4% of mortality is caused by preterm birth complications and another 4% occurs due to birth asphyxia and trauma (WHO and UN partners, 2015). Though relatively short compared to a lifetime, the prenatal and birthing periods have long-term effects on a child’s development and overall well- being for the rest of their life. For example, one study found that co-exposure of various nutrition-related factors “were together responsible for about 35% of child deaths and 11% of the total global disease burden” (Black et al., 2008). In the U.S., women choose specific OB/GYNs, pregnancy diets, and birthing conditions to ease the painful process and ensure smooth and safe deliveries. In Kenya, women do not even receive local anesthetic before their vaginas are cut diagonally in an episiotomy. Due to a lack of both time and money, the doctors and nurses at Coast General must perform dangerous procedures to decrease the likelihood of further complications. While these professionals usually perform procedures in the safest way possible, the fact remains that patients cannot access the safest and least painful healthcare possible.

My third week began with one of the most difficult days of my life. As soon as another intern and I walked into the surgical ward, a bubbly male nurse asked us to assist him in changing the bandages of a burn patient. Putting on a brave attitude, we stepped into a small room reserved in the very back of the ward, immediately humbled by the odor of rotting, burnt flesh. There in front of me lay a boney, miserable, rigid woman ready for another two hours of unimaginable pain. We learned from the nurse that she had been injured a few months ago when one diagnosis had spiraled into another. During an epileptic episode, she had fallen into a fire with no one to save her and lost part of both arms as well as most of the skin on the front half of her body. Having been rushed to the hospital, the accident and emergency staff diagnosed her with burns on 30-35% of her flesh. Now, even months later, she shook violently as the bandages peeled off with her newly dead skin. Flies swarmed every inch of smelly, open wound. We attempted to fan away both the flies and the heat that the tropical air brought, but there was very little we could do to ease the difficulty of her situation.

At the time, I couldn’t help but wonder how she could live through the pain. It’s hard toimagine how she had dealt with the agony not only in those two hours but in the two months that had led up to my interaction with her. Supposedly, the state I saw of her was one of healing and progress. Soon she would be healthy enough for a skin graft and she could return to her “normal” life. But what would prevent the same situation from unfolding again? She still had a psychiatric disability. She still lost function of both arms. She still had the traumatic memory of helplessly burning alive. What was to prevent a similar incident from happening again, not only to her but also to others in similar situations? It seemed that no matter what she survived, she would never lead a fully-abled life with the care and safety that she deserved.

I realized that a doctor or nurse could only do so much to fix the problem at hand. In the world of medicine, the physical problem reveals the product of the accident itself. When lookingat the bigger picture, however, the accident itself reveals how one’s standard of living andchronic health issues can drastically damage the quality of the rest of their life. These healthcare facilities not only need more human and material resources, but the world also requires better healthcare policies if each person is to receive the quality of life they deserve. As ProfessorKokwaro of Strathmore Business School puts it, “the problem in Kenya is not [necessarily] lack of money…. [It] is actually efficient use of the resources we have” (2017). Money must bemanaged better in order to provide people the healthcare they need and to support the work of their healthcare providers. Thus, it is the management of healthcare within the society that needs to change, not necessarily the healthcare or the society itself.

In addition to the global health awareness I gained, I also learned more about who I want to be in relation to it. My whole life up to this point has been anchored by healthcare. For the thirteen years that I did gymnastics, I had to listen to both my body and to the doctors and therapists that took care of it. After my career came to a sudden stop, I lacked a part of me that I had always known. I still had to go to the doctor and see my therapists to manage chronicinjuries. But without the sport, I didn’t have any techniques to work on or a strict schedule to stick to or a team that depended on me. I felt lost. I felt useless. I didn’t know what to do with the skills I enjoyed practicing. But then I began observing surgeries. On my very first day in the theater, I observed three neurosurgery procedures. Surgery combined the skills I sought to practice and perfect: using knowledge of how the human body functions to problem-solve a leaky dura tear, working as a team to place a VP shunt within the thin skin of hydrocephalus patient, and even perfecting the fine motor skill techniques needed to cleanly suture a messy wound. Though neurosurgeries can be much more complicated, I felt a sort of adrenaline rush from the technical variety and creativity of these procedures. It was as if I was once again flipping through the air.

For the first time in a long time, I have a clear sense of direction in my studies. A career in healthcare and surgery have interested me for a while now. But it was only in understanding the medical tragedies and the poverty in Kenya that I was able to gain insight into the future that, at one point, I could only imagine. I can see more clearly now why poorer people have poorer health outcomes. Though some problems seem to have obvious answers, my time in Kenya showed me how deep-rooted their sufferings are. At the core of every surface-level issue, we face complex, systemic challenges that affect each and every person in each and every society. Unfortunately, it is how the world is and became to be. However, because we run the system, we also hold a certain responsibility to deal with and learn from its consequences.

All in all, my trip to Kenya held more lessons than I could comprehend in a mere month and a half. I immediately saw many differences between the ways that Kenyans and Americans live. However, it took time, bravery, and heartache to completely understand the culture of the country and the types of changes it needs. From culture-shock to gory surgeries, I gained experiences that will leave a mark on my heart and fascinations in my mind for the career to come. I love the people that I happened upon, and I am so unworthy of the love I received. I want more than anything to go back and drastically change the lives of those suffering. But I am forever grateful for the short opportunity to see into the lives of so many people and learn from the most beautiful of countries.