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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!

What’s In My Locker?

Hello MedHatters!

This week I wanted to share what I had kept in my locker as a first year. I will go over what was super useful (to me), what I would have replaced, and what I wish I would have had. Hopefully this helps guide you if you plan to use your locker as a first year student!

Now, I know most schools don’t have assigned lockers. On the KC campus, students have access to lockers that they can sign out. They need to bring their own locks and at the end of the year have to give up the locker. And once there are no more, you can’t get a locker. Since there are so many students on the KC campus (its not just medical students on that campus), getting a locker at any other time after the very beginning of the school year can be hard. At some schools you don’t have a designated space. In Joplin, we are a small enough campus that we all have designated lockers assigned to us. Each student is assigned one and encouraged to use it so our stuff isn’t all over the place. They come with locks and are given to you during orientation. It is yours for the first 2 years.

Currently, we have enough lockers that each club also gets a locker. So I have 2: my personal one and one for MAOPS (I’m on the board for this club). I’m sure once more students are on campus they will switch to not having club lockers. But I’m not sure how long that will take.

And no. Not everyone uses their locker. So don’t feel obligated to really use yours!

What I Had in My locker:

A blanket. I got a lot of flack for this at first. But you know what? It gets really cold on campus no matter what time of year it is. And I’m the type of person that is always cold (or gets cold easily). If I have to be here for class or to study, I want to be warm.
Lots of slipper socks. I have many pairs. It’s nice to keep my feet warm and I don’t have to wear shoes.
Gallon zipper bags. This was helpful for anatomy. Either to put my dirty/smelly scrubs in so it wouldn’t stink up my locker or to put my iPad in to take into lab with me! Definitely a must as a first year student for anatomy if you plan to bring your iPad into the lab.
Usually an anatomy atlas. I have Dr. Olinger’s pictured because it is easier to carry around, but I believe Netter’s stayed in my locker.
Spray/lotion. I would use this to help mask the awful dead body smell if I couldn’t go home and shower right away.
My “tool” bag. This had all the instruments that were “required” for first years. Honestly I did not need all of these… But I kept them in a bag in my locker since I needed to use most of them while on campus.

Not pictured: My otoscope & stethoscope. They are currently packed for my Kenya trip!

For the blanket and slipper socks, I would periodically take them home and wash them and bring them back. I did a lot of walking around in those socks while on campus and they did get dirty somewhat fast since I used them so often. But since I’ve dedicated those items to just use at school, its not like I was using them in my home. But don’t worry; they definitely were washed many times during the year!

What I had that I would Change:

I originally had my white coat in my locker. But turns out there wasn’t a ton of space for this. Also, I have a bottom locker. There were definitely times where I would hear people from top lockers spilling coffee, juice, energy drinks, etc and it would leak down to the bottom locker. Not a big deal most of the time, but I didn’t want that happening to my white coat.
I also originally had coffee pods in my locker. This is a great idea, except I got really cheap and nasty Walmart ones and turns out I didn’t really drink them because they were gross. Definitely recommend getting slightly better quality ones (we have 2 Keurigs on campus). OR some friends had instant coffee in their locker.
Sometimes I would put a spare change of clothes in my locker. I stopped doing that though simply because I live less than 5 minutes away from campus and could easily go home and shower or change and come back. For students who plan to spend longer days here, it may be a good idea to keep an extra pair of scrubs or extra clothes to change into.

What i wish i had:

Ibuprofen. Oh lord I needed this more often than I can remember. I would always tell myself to put some in my locker and then forget. Luckily there was always a classmate on campus that had a bottle of it.
Snacks. This is another one I wish I had. Sometimes I would just want something salty and snacky and wouldn’t have any. Some classmates had large bulk bins of snacks like this in their locker.

And that is basically it. Now, I spent a lot of time on campus. I mean A LOT. But if you aren’t one to really spend time on campus, then you probably don’t need to have this much stuff in your locker. E really only kept his tools/instruments in his locker. Sometimes he left his white coat. But really he just needed a place for his stuff during anatomy lab.

Bonus! What i kept in my car:

Yup, I went there.

I usually kept an extra jacket in my car. Mostly because I knew I would be cold during lectures or while studying even if it was balls hot outside. So I would just keep it in there to grab on my way into campus or if I needed to run out and grab it.

I also kept my Moore’s book in my car. Why? Well that thing is huge. And since we needed it for most anatomy courses (or at least parts of that book) I wanted to have it on hand. What if I needed it on campus and it was at home? What if I needed it at home and I kept it in my locker? You see my dilemma? So I kept it in my car. That way I could run out and grab it if I needed it.

Occasionally my blanket would hangout in my car if I would have it in class and didn’t want to drag it back into my locker before leaving. But those were the two main things that I kept in my car during first year.

Double bonus! what do i actually need for the instruments?

Now, I’m sure the school won’t be happy with me saying this. But like, you really don’t actually use all those tools. There will be third years who sell them at much cheaper but still somewhat pricy because most of those instruments are new.

Some people get much cheaper versions off of Amazon.

A lot of students just used other student’s stuff because they didn’t bother to buy it.

And then you have people like me that bought the tools but really didn’t use most of them (at least for first year).

Stethoscope: Yes. Yes you need this. You will use this the most. I had a cheaper one that an ex left me (he was an EMT for awhile) and I somewhat wish I would have gotten a slightly better one. But, I didn’t want to spend anymore money.
Reflex hammer: Yes you do use this. If you are going to buy this, get the rubber one, not the plastic one. I promise it will be less painful given the amount of times you practice taking reflexes with the rubber one. BUT! They do provide this one during your SP encounters. You may not be provided this during score 1 in second year though.
BP cuffs: Um, kinda. I know you need this more for second year for score 1. We needed it to practice on one another before our vital signs competency in first year and that is basically it. You get tested on the mannikins that have an attached BP cuff for this competency. So, you don’t all need to buy one since you are just using it for practice in first year. Also, all the rooms in Joplin have BP cuffs for your SP’s.
Otoscope: Honestly we just used this during one or two labs. We have attached ones in the SP rooms to use. Pretty sure you need it for second year though for score 1, but first year we didn’t do much with it.
Ophthalmoscope. Same thing. we just used it during labs. All the SP rooms have one in Joplin. Will likely need it for score 1 in second year.
Eye chart: Only used this during neuro lab and the first instrument lab in first year. They provided it during SP’s. Not sure if this is needed in second year? Will let you know.
Tuning fork: Same thing. Only used it during those 2 labs like the eye chart. It was provided during SP’s. Not sure if we need this in second year yet.
Otoscopy bulb: WE DID NOT USE THIS ONCE. Not at all. Really not sure why we needed to buy this. Maybe we will use it in score 1 but my god I’m not even sure we used it in the intro to instrument lab.

And I think that’s it for the instruments. A lot of what is on your list you will be expected to have for score 1 in second year (like I keep repeating). Even then, I’m not sure how much you will use. But sometimes when you do mass clinics like that you aren’t all doing it at the same time. So you may get away with just borrowing each other’s stuff OR borrowing from a first year below you.

So, you decide if it is worth buying all of this in your first year. You may get away with not needing it much and can borrow from other students. By the time you get to 3rd and 4th year, all of this will be provided by your clinics.

Hope this was helpful. Cheers!