Kenya Diaries Part 1

July 1st. The day before we left:

We met on the KC campus at around 10:30am. This was so we could all meet each other again, but mostly to go over some last minute details about the trip & to pack the supplies suitcases. To be honest, not a lot of information has really been given to us up until this point. We know tidbits, things that were mentioned here & there by Dr. Desai (who is in charge of us students), but mostly details about the trip have been pretty bare minimum. I suspect either it is for security purposes or he doesn’t know yet himself.

We were there for almost 3-3.5 hours. We were given a rather long lunch (yay!), but for the most part we were pretty busy helping move things out of the storage closets that are kept for DO CARE trips/military students, condensing/packaging them for traveling, and packing them.

We ended up with 8 suitcases full of medical supplies and some donated clothes/toys/sunglasses. Honestly, majority of it was suitcase packing. We were each told to take one suitcase that we would be responsible for checking in and lugging around until we got to Kenya. I took a small suitcase, simply because I have absolutely zero, and I mean ZERO upper body strength. So my total baggage count is now 1 carry on (my backpack), and 2 checked bags.

We were also given a few small items that were on our packing list: a few Clorox wipes and some hand sanitizer. (We packed a shit ton of hand sanitizer). I had already packed a small container of it; but honestly, I gladly took more. We were also given paper charts to put in our carry on as this is what we will be using to chart with in Kenya!

I spent the rest of the day picking up some last minute things (again lol), making sure everything was packed, and I had copies/backups of everything I needed. I also purged my phone, tried to jimmy-rig adding a clip-on to my travel pillow so I didn’t have to shove it in my carry on, and hung out with my cat.

July 2nd. Leaving the U.S.

Dr. Desai asked that we meet at the airport at 9:45 am. He originally wanted us to all meet at 10am, but changed his mind before we left campus yesterday. And kinda just like you would normally check in at an airport, we all checked in together, got our tickets, and headed to the terminal.

First Stop: Minneapolis. This flight wasn’t too long honestly. I do get slightly anxious with flying, but I feel most of that is me feeding off everyone else’s energy. I mean, I’ve been flying almost every year since I was a wee tot; I know the ropes. But for some reason, every time I get on a plane without fail, my anxiety shoots through the roof. Once we arrived to Minneapolis, we hung out in the airport for about 4 hours until our next flight was ready to leave.

Second Stop: Amsterdam! This was my first every overseas plane trip. I’ve been to the Caribbean and Mexico, but honestly those flights weren’t that bad and were on the same hemisphere as where I live. This was a very long flight. We arrived around 8:00 in the morning the next day and oh lord Jesus I didn’t sleep a god damn wink. Ugh. But the plane leaving the US and heading to Amsterdam was nice and roomy, and this delta flight had free in-flight entertainment!

I may or may not have gotten teary-eyed in the middle of the night and started crying during my tear-jerking movie. I didn’t hear the end of it for most of the trip…

July 3rd.

We had a few more hours to kill in the Amsterdam airport (although honestly, I did nothing). We looked for some food and coffee. I had a killer headache from not sleeping, traveling, and dehydration. Everyone was freaking out looking for plugs for their phones. Our gate happened to be right next to an area of the airport that was under construction, so it wasn’t the most pleasant thing to be around either…

A few people had enough energy to go explore the airport. I hear they have a museum in there!

Then we finally left to head to Nairobi. This plane unfortunately was not as roomy. There was no inflight entertainment other than trying to see where our plane was located at on the map (which sometimes worked, sometimes didn’t). By the time we arrived to Nairobi, we got in really late.

Our options were as follows: try to stay up in a cafe at the airport after none of us really got any sleep, or attempt to go find a cheap hotel to sleep for a few hours…

We attempted the shady hotel thing. Arrived at some odd hour of the night and only got a possible 3 hours of sleep. We were advised not to shower at that hotel as our professor wasn’t sure of the water quality. Of course because I was in a strange new place with new sounds and I hadn’t adjusted to the time change yet, ya girl got zero fucking sleep.

You win some, you lose some I guess.

july 4th.

Woo! Happy Independence Day!

We got up bright and early to go back to the Kenya airport. We had to get on a very small plane that flew us to Kisumu. It was thankfully a very short flight, and we took off right before the sun rose. Watching the sun glitter over the clouds was beautiful on that flight!

Fresh off of our last plane ride.

Once we arrived in Kisumu we actually got off the plane and onto the jetway? But lord the views were breath-taking. The sun was still rising. The mountains off in the distance were beautiful. The mist was cooling. The air was fresh. You bet we took selfie after selfie and soaked in as much as possible!

When we finally arrived at the hotel that we will be staying at for most of our trip, we were all pretty exhausted. Due to the timing, we weren’t allowed to nap. Which royally sucked. So much sucked. All I wanted was some nice nap nap time.

We ran instead.

Yea, I felt that way too.

Then we finally got some noms courtesy of the hotel we were staying at, got to shower/unpack a bit or rearrange our stuff, and then went to go have a condensed session of learning physical exam skills, reviewing note taking, and osteopathic manipulative skills review.

Why you might ask?

Well, turns out we were going to clinic the very next day!

Eek! So we had to brush up on our skills. And let me tell you, I still suck at trying to find the optic nerve. IDK if I will ever learn that skill.

I hope ya’ll enjoyed this diary-style of post! I will try to remember everything that I felt and saw while on the trip in this format.

Cheers!

Kenya Series! Why Did I Choose To do a Medical Mission Trip?

Welcome Back!

I flew back into this side of the world less than 12 hours ago (at the time of writing this), and of course I can’t sleep to save my life… So I’m up writing this instead!

Doing a medical mission trip is a great way to get more experience outside of your traditional learning environment. As a current medical student, this is a great way to actually see patients and improve your clinical skills while still being supervised. The more medical experience you have, the less you will need to be supervised. If you are an undergraduate student, this is a great way to get experience via shadowing, observing, or helping with other tasks in the area.

As part of KCU, we worked with an established clinic outside of Kisumu, Kenya. We did not do a pop up clinic. The clinic we assisted/worked at is currently a non-profit organization in an area where getting medical help is more difficult. Prior to the clinic being built, the community was unable to either travel or afford to get medical help. Others didn’t want to know their HIV status or were worried about stigma. Since the clinic has been operating, more people have access to some healthcare, and the clinic assists with much more as well. Including: counseling services, rides to bigger hospitals, dedicated eye/dental days, assistance with scheduling surgeries or other consultations with outside hospitals, sponsorship programs for orphans and children to go to school, and assistance with parents for improving education. Not to mention the entire center is a safe space for kids to play at.

The clinic does charge to see patients, but it is usually very little. The fees are more of a “don’t take advantage of the system” then an actual fee. And if those seeking help cannot pay the small fee to get your name on the list, the fees are usually waived. If the patient needs additional medications/treatments/care, there may be more of a fee? I believe it was mostly to cover the cost of supplies, but in general most of the care was free. This tidbit wasn’t completely shared with us, but this was the most information I could muster from a few people.

Dr. Bonyo, Dr. Desai, Dr. Abraham, Marylyn, and the students on our first clinic day.

We worked with Bonyo’s Kenya Mission. Feel free to click the link to learn more about this particular clinic. KCU brings students here twice a year. Once for 2.5-3 weeks (which is the one I did) and another that is a longer rotation for 3rd and 4th year students. We worked along side local staff and physicians. There is always an attending on call. All of the lab staff, pharmacy staff, counseling services, and nurses were present at the clinic when we were there as well. Without the staff, we couldn’t have assisted and seen the patients that we did.

While we were there, it was advertised in churches as free health care which caused a massive influx of patients. This is not normally the flow that they see. When we come, we provide manpower; and the community advertises for them to see us so they can get anything taken care of while we are there.

It really is a win-win. The community gets care that they need or otherwise wouldn’t have attempted to get, and we get to improve our skills and be reminded of why we wanted to be physicians in the first place.

While reflecting back on the amazing time I had, I want to discuss my personal reasons as to why I chose to partake in this experience. So let’s talk about medical mission trips today!

Goals before my trip:

While deciding if I wanted to do this trip, I made a list of all of the things I wanted to accomplish while there. I wanted to assess what I felt I needed to improve on as a student and hoped that these could be aligned in some way with doing this trip.

  • The biggest reason I wanted to go was to improve my skills. I wanted to improve my ability to take a history. My ability to do a physical exam, and do so confidently. My ability to present to an attending like I would in my rotations and eventually as a resident. I wanted to improve my basic medical skills such as taking pulse, blood pressure, etc. Even though I had experience through SP’s my first year, I wanted the experience of not knowing the category of the chief complaint. I wanted to test and improve on how I could take care of patient that I had no idea why they were coming in and weren’t reading off a script.
  • I wanted to improve my compassion and my ability to see patients. And I wanted to do it without knowing that if I failed I could just repeat seeing a patient. This goes back to the SP thing, but it really is a completely different experience seeing real patients instead of the conjured ones you see in medical school for practice/assessment.
  • Confidence. I wanted to be able to take all of the above and try to improve my confidence in being a future doctor. Medical school is really good about beating you down or making you second guess your abilities. This trip was to help me realize that I can do this, and that I can get good at it in my future.
  • An experience of a lifetime. I had never travelled to the other side of the world before. I was scared shitless for this. Most people do not (usually) travel to developing countries for vacation. People think of going to Cancun, or Italy, or the Caribbean for vacation. I wanted to experience another country and all of its culture & the people.
  • On this note, I also wanted to be humbled. I wanted to be reminded that even though I have my problems, I wanted perspective that most of my problems in my cushy, developed country of good ol’ US of A were not nearly as difficult as those in a developing country.  The work and labor that I saw people do on a daily basis was astounding. Yet at the same time, it is their way of life and they know no different. I needed to be reminded of that perspective. And what a more perfect time than to do it after completing one whole year of medical school.
Why I chose to go with KCU?

Honestly, I’m a scared little bitch and was too afraid to go to the other side of the world by myself to a country that I had never been to.

Really, that was a huge portion of it. I knew KCU would guarantee as much safety as they could in another country. I researched several other companies outside of KCU to originally go with, and it came down to KCU and one other country. I mainly chose KCU’s trip for safety reasons.

The other main reason is I wanted to make sure I wasn’t going to unintentionally harm a potential patient. With KCU, I knew we would have a professor present with us to sign out and help us learn and treat patients. The added assurance that there was a licensed physician present who could help me learn and grow while still  making sure I didn’t kill or hurt my patient was a pretty great bonus. I could not handle the responsibility of seeing a patient on my own without someone else there after 1 year of medical school.

If you think you can do this without guidance, Imma slap you. You literally know next to nothing in patient care after one year of school. Knowing that there were attendings present helped foster growth. A theme I wanted to stick with on this trip. I was less afraid to learn and try something knew because I knew at the end of the day I would have guidance available.

I also knew that this was an established clinic that KCU had worked with for years. Knowing that I was going to assist in a clinic that existed and would continue to exist after I was going was something important to me.

What I learned:

So much. So, so much.

I’m not even sure I can really put this into words. But Imma try lol.

For one, I gained some confidence. My first two days in clinic I was super nervous; I felt like I had forgotten everything we had learned in our PCM course (or “How to be a Doctor” course) despite having gone over basic skills the night before our first clinic shift. I was scared and unsure how to handle having translators. I was scared to have to practice. We could only order limited labs and imaging was out of the question; so trying to manage that and understand it was new.

I was all of a sudden expected to act in the capacity of a resident per se without much prior experience.

And my professors could tell that I was nervous and not super confident when first starting. They gave me a lot of crap about that. But after day 1.5 I would say, I finally got into the swing of things. And I was KICKING ASS.

Confidence really does carry a long ways though. Your patients feel better when you are confident knowing that you can take care of them. My classmates all told me that I seemed to have it together and that I was kicking butt… even though I was seeing just as many patients as them. (Thanks loves!) And the clinic staff were more likely to help me if I was more confident in what I wanted.

The other obvious thing I gained this summer was improvement in my skills. I didn’t get to see as many patients in Kenya for varying reasons, but without doubt improved my skills in every aspect: osteopathic manipulation, physical exam,  presenting, and overall just owning what was given to me. I came back ready to rock and roll this year and was WAYYY less nervous to perform than I was first year.

But lastly, I gained a whole lot of perspective. My friends and family asked if I became depressed because of what I came into contact with in Kenya. Being an emotional being, I was also expecting that.

However, majority of the people I met and took care of were just happy and content with life. The kids were just happy to be playing. The elders were just happy to sit in the shade and talk and hang out. The women in the fields that we passed by every day to get to clinic were ecstatic just to get their picture taken.

Obviously, as majority of my classmates and I are Mzungu’s (foreigners; white), and we were met with sad stories in an attempt for us to give money. But overall, the people were sweet, friendly, and happy. While away from the US and my stressful life as a medical student, I was reminded of just how truly blessed I was to be where I am. To be in a country where my considered “necessities” are mostly luxuries in developing countries. That I too can appreciate the small and wonderful things in life, and be content on much less.

Like I said before, I am overflowing with what I have experienced in Kenya that it is hard to put it into words.

For undergrads:

I’m well aware that there are several students, particularly undergraduate students, who do “medical mission trips”. I put this in quotes because you likely haven’t learned any basic medical skills yet or have much in the way of medical knowledge. When this is the case, these trips are designed more for exposure with the added bonus of travel for you. You legally cannot do anything medical, and during these trips the company you are with likely won’t teach you how to do anything either. (There may be a few exceptions, but for the most part if you don’t know how to do something they aren’t going to take the time to teach you).

Because you cannot do much in the way of actual medicine, you will usually be involved in more global health tasks. Such as:

  • Teaching English
  • Doing epidemiology in the region you are in
  • Teaching on improved health practices
  • Assisting other medical team members who are seeing patients
  • Shadowing local physicians/observational roles
  • etc.

Why won’t they allow you to practice if you have no experience? 

Well. I’m so glad you asked. This topic is pretty irksome for me.

In the United States and most developed countries, you cannot practice medicine or do basic medical skills on another human being without training. Of any sort. Whether that is a completion certificate for EMT or nursing aide, OR a degree.

Which is my point exactly. 

You likely wouldn’t want to be worked on by a 20 year old without any medical knowledge. It isn’t fair, nor is it ethically right to try to take advantage of those in a developing country. So please don’t expect to be able to do something that you are not qualified to do in another country, just because they don’t have as strict of safety laws or ethics preventing it.

If you want to be a doctor, nurse, or PA and you think you can take advantage of another human in a different country, please bow out of medicine now. You will never ethically be able to justify doing this. 

But overall, doing a medical mission trip is a really great way to get your feet wet. Both before medical school and while currently attending.

I don’t suggest that this be your only exposure before medical school to medicine though. Try to be more well-rounded than that in your application. Having more than one experience (which many can be in your community) and increased exposure to draw on will always help you.

I hope you gained some insight on medical missions trips in the post. Feel free to leave a comment, share, or send me an email with any questions!