Spring Break Study Abroad Programs in Multiple Countries

This program was a great experience in exploring global health differences and disparities, gaining shadowing experience, and immersing myself in a different culture. The mentors were very welcoming and supportive, even checking in on us when we seemed down or quiet. Hilda in particular checked in on us frequently. The food was 10/10, and the kitchen staff was very hospitable. I enjoyed Dr. Shazim's collaboration with the program, where I learned a great deal from his knowledge and experiences. He was always witnessing to discuss clinical experiences and took it upon himself to give us new facts or wisdom. Additionally, I enjoyed the effort put into the cultural treks, and the mentors always encouraged us to explore while giving us tips on staying safe in the area. I appreciated the gated location of the residence with a guard and locked doors in keeping us safe at night. I gained a lot out of observing the public health system and the impact that access, socioeconomic status, health literacy, local diseases, etc. has on a population's health outcomes. I tend to be a shy person as well, and so this opportunity helped me grow out of my comfort zone a bit in getting to know the other interns and the staff at CGTRH, as well as exploring the city. Lastly, I appreciate that IMA enforces the ethical standards of students participating within their scope of practice. Because the vast majority of interns are students with minimal to no experience, it did feel as though not much of an impact was made from us to the hospital, at least for my duration (except for the medical clinic, where I felt useful). Everyone comes into this world with nothing. Most people spend their whole lives working to have something—then leave this world with nothing again. So, your soul must gain more than your hands. That sentiment has come to define the way I view my daily life after my internship in Mombasa, Kenya. I've always struggled to find my passion and purpose. Yes, I have things I enjoy doing, but nothing defines who I am as an individual. It's something I’ve prayed about for as long as I can remember but never quite felt to come to fruition. That changed during my time in Mombasa. I found the importance of being a part of a community greater than myself and the impacts small actions can have on others for an eternity. I can truly say it set me on the path to becoming a better version of myself—a better future physician and a better friend. I witnessed the beginning of life, formed lifelong friendships, and saw the end of life. The full cycle. And through it all, I was challenged to value every part of my life more deeply. Birth. As Dr. Shazim would say in every debrief, “Let’s start at the beginning of life. Maternity.” Before arriving at Coast General Teaching and Referral Hospital, I was pretty determined to become a pediatrician. I have always been somewhat apprehensive about going into a specialty where death was on the line, and admittedly I had never stepped into a surgery prior to theater 2 at Coast General. Thus, I have spent most of my shadowing hours in a pediatric clinic. However, surprisingly, the maternity ward quickly became my favorite rotation. I could directly see my feelings about Kenya correspond to labor. Mothers spend months preparing to deliver their babies. They feel everything—excitement, fear, anxiety. There’s always an adrenaline rush. No one knows exactly what will happen, but the mothers, nurses, and physicians prepare for the moment a baby finally comes into this world expectantly. That’s exactly how I felt arriving in Kenya—a rush of emotions and so much uncertainty. A dream I’d held since high school was finally coming true, but I had no idea what to expect. The culture shock, the unknown, the lack of healthcare resources—it was all very real. But the maternity ward shaped me into the kind of physician I want to become. Witnessing a woman’s intense pain during labor to then peacefully hold her newborn is a moment I will carry with me. Despite the challenges of pursuing a career in medicine, like labor, being a part of some of the most shaping and important aspects of someone’s lives will make it worth it. In Mombasa I thought I’d be most influenced by the physicians, but it was the strength of the women that inspired me. They made me want to be the best physician I can be—for them. From C-sections to natural births, witnessing the beginning of life reminded me that nothing is guaranteed. I walked away with a new calling: to pursue a career in obstetrics and gynecology. I looked back on my journal entries for my rotation in the maternity ward, and I couldn't help but smile. The women I directly got to help, either by stretching with them during labor or holding their hands, I will always remember, and that empathy I learned while in Kenya will shape me into the best physician I can become. Friendship. Throughout my life, many people have influenced me. I’m a firm believer in “friends for different seasons”—some friendships fade, and some stand the test of time. Friendship is an impactful aspect of a person’s life and shapes who they are and become. In Mombasa, I saw the true value of friendship: in patients, mentors, fellow interns, and strangers. Growing up, I attended the same private school from kindergarten to senior year. I graduated with seven people, and I was not challenged to step outside my comfort zone and interact with different types of individuals. However, during my time in Kenya, I was able to reflect on different friendships I had encountered and truly what I had learned from other individuals in my daily life. There were friends who rallied together after tough shifts at the hospital. Friends like Hilda and Michelle, who made Mombasa feel like home. Patients who opened up to me—confided in me—as if we had known each other for years. Strangers asking me what I was doing in Mombasa and fully welcoming me into their city and culture. There were friends who became like family. I watched physicians rally around one another to care for a community in need. That kind of camaraderie—rooted in compassion—deepened my belief in the importance of human connection in medicine. According to Harvard Medical School, medicine has somewhat lost its human connection due to technology: “At its best, being a doctor is an extraordinary and intimate privilege. We build relationships with our patients and see them through times of both joy and suffering; our relationships with each other help us through the same. It's hard to do that in a way that's truly satisfying when we spend most of the day at the computer screen” (Harvard Health, 2016). At Coast General, resources and technology are very limited, and these physicians and nurses must communicate with the patients and peers, which depends on human connection and in turn often creates a more positive experience for the patient. I specifically saw this at the medical clinics, as physicians had limited resources but collaborated and did their best to help every individual, which is something I deeply admire. Death. I wasn’t prepared to see someone take their last breath. I expected panic, sadness, maybe fear. Whenever I have had a loved one die in the past, I usually view it in a negative way. But the death I witnessed was peaceful—like the patient was ready. In a strange way, that’s how I felt leaving Mombasa. I expected to be in tears, not ready to leave the place I had called home for the past month. But instead, I felt peace. Peace that I had experienced something life-changing. Peace that I had grown spiritually, emotionally, and personally. Peace that I had found friendships that would last a lifetime. In a way, this feeling of “death” will stick with me as I start my career to become a physician. The feeling of peace is advice I can pass onto others who are losing a loved one. Death is inevitable, but while in Kenya I learned it can also be peaceful. Death does not have to have a negative connotation, but the narrative of death can be changed for the better. “If you think about it, life is nothing but thoughts, and our thoughts come from the mind. Our thoughts are an internal path leading us somewhere. To the next thought, the next idea, the next life. Everything is created with thought—emotions, designs, and theories. Where thoughts lead us is the most important thing; it’s our inner path leading to freedom or suffering” (At Peace With Death | Bennington College, n.d.). The people in Kenya were steadfast in their faith, and this helped me realize that in some way we are all just walking each other home. I feel like this is an important lesson to take with me in my journey to become a physician, as I have to come to peace with death and help loved ones keep moving forward in their lives. Souls. Souls tie people together. A soul is what makes someone who they are—and it’s shaped by every experience, every relationship. Kenya changed my soul for the better. I poured into others. I learned patience. I experienced a completely different culture and let it shape me. In the pediatric outpatient ward, I met a young girl named Nora who became obsessed with a balloon glove I made for her. That small gesture—something so simple—brought her joy, and in turn, filled me with joy. It made me more aware of how even the smallest acts can have a big impact on someone else’s soul. Yes, Kenya was culturally different from my small town in Georgia. But what struck me most was the people—their outpouring of love and gratitude. They valued what they had. They didn’t take life for granted. In the Western world, we often measure worth by material things—by how much we have, not by how full our lives are. But in Kenya, I saw the meaning of the phrase “Make sure your soul gains more than your hands.” Even amidst poverty and corruption, people remained faithful, grounded, and fulfilled. That lesson is one I’ll carry for life. Before Kenya, I struggled to articulate my "why" for medicine. My answer was something generic—“I enjoy helping others.” But now, I understand it's deeper than that. Medicine isn’t just about helping others—it’s about having a soul-level impact. What I saw, experienced, and endured in Kenya wasn’t easy. The children begging for food outside our Ubers, the lack of basic life-saving devices in the hospital, and people dying due to lack of ICU beds. None of this was glorious, but the community of people that rallied around each other was. Despite differences in ethnic and religious backgrounds, I saw new mothers look out for each other and their newborns, which is a testament to the people in Kenya and the type of person I want to be for others in my life and when I become a physician. Following my arrival home from Kenya, I was asked to speak at church about my experience. I gave my presentation about my time in Kenya and the ways Mombasa and Coast General impacted my life. I will still struggle to put into words the impact the experience had on me. However, unbeknownst to me, the sermon directly following my speech was about souls. About how people have started to value what they materially have in this life over friendships and the impact they have on others. But whenever one dies, none of those materialistic things goes with them, but their soul does. The experiences and impacts that others have on their soul go with them to their next life. Thus, I realized that the impact Kenya had on my life will stay with my soul forever, and consequently the impact I had on others will stay with their souls. Those who connect medicine with the soul are the difference between a good physician and a great physician. The main physician I saw this connection in was Dr. Faruk. Spending the day with him in the diabetes and thyroid clinic, he taught me the importance of finding my voice and passion in medicine that subsequently has an impact on others' lives. He is starting his own nonprofit to help children with type 1 diabetes get access to insulin. This is something he is passionate about and will have an amazing impact when accomplished. Dr. Faruk is an inspiration for me, as he is the physician I want to become. A physician who is not in it for the money or for the fame but is in it for the direct impact that they have on others' souls and daily lives. As Sir William Osler said, “The good physician treats the disease; the great physician treats the patient who has the disease” (Centor, 2007) International Medical Aid has shaped me into the physician I want to become. My time in Mombasa taught me the importance of understanding each patient’s story and beliefs, and the responsibility I have now to leave a lasting impact on everyone I meet. These challenges and lessons will stick with me forever and my growth as an individual is all accredited to my experience in Mombasa, Kenya.

This trip was truly life-changing and inspiring, and I am very thankful for all of the staff for their amazing support through the process. I loved everything—the food and culture were beyond amazing. I want to give a shout out to my bestie Janet; she accompanied me through my weekend treks. I had a blast with her, and I’m so glad she’s the one that went with me. I never felt unsafe during my time in Kenya, and for that I am so appreciative. I think one of the most positive experiences I made on this trip were the friendships I made, but also the community outreach events we had. There was nothing more eye-opening than going to underprivileged communities and providing the extra support that they desperately needed, which is proper healthcare. I am so blessed to have been able to experience something like this with such a well rounded program. Thank you!! The first time I heard about IMA, I was immediately intrigued. I remember seeing the program, and it fueled my curiosity that had been growing ever since I thought about doing an internship. The idea of actually getting accepted into such a program felt almost far-fetched. I have never taken the time to apply to anything like this before, so the idea of stepping into this opportunity was so thrilling yet nerve wracking. I was lucky enough to have a supportive circle around me—people that encouraged and reminded me that I was capable of doing anything I set my mind to. With enough convincing, I applied. In my mind, I thought, “What’s the worst that could happen? I don’t get accepted—or I could end up having the craziest experience in Kenya.” Fast forward a couple months, and I find myself at the Royal Suites residence, staring in awe at what the next three weeks of my life would hold. I was greeted by a wonderful group of peers and staff, and from that moment, I knew I would be in good hands. Walking into this program, I had some experience as a medical assistant in a neurology office. However, that was completely different from what I encountered at Coast General Teaching and Referral Hospital. I vividly recollect the first day I arrived at the hospital, knowing I would encounter far more striking cases than those back home. During my time there, I rotated through the Emergency, Pediatrics, and Surgery departments, and I also participated in night rotations at least once a week in other departments. Before beginning, I received an orientation that included discussions on what to expect in terms of medical cases, as well as the local culture and customs. I was told that healthcare in Kenya was severely understaffed and poorly supplied due to location and financial reasons (Cultural Approaches to Pediatric Palliative Care in Central Massachusetts: Kenyan, n.d.). I was also informed that many patients present with advanced stages of illness, often as a result of financial constraints or religious beliefs. During my time in the Emergency Room, I saw many patients that would arrive with advanced cancers, severe infections, and untreated wounds. When asked about the situation, the most common response was that they simply did not have the money for treatment. Others would say the nearest medical facility was too far from their homes, requiring them to strategically plan when they could make the trip. One response in particular really struck me: a patient’s family explained that they were relying on prayer to heal their loved one, believing it was best to let God provide the cure. As a believer myself, I was impacted and inspired by that statement. However, it was hard to reconcile because many of the situations I saw needed urgent attention. In those moments, it felt challenging to accept that faith alone was being relied upon in circumstances where timely medical care was critical. There are many traditions of healing and medicine that Kenyans use. Various natural remedies are commonly used such as African potatoes, rooibos, and the hoodia cactus. Additionally, there are rituals that are performed for spiritual healing. For example, shells, bones, and stones are used to communicate with ancestors or spirits to learn more about the patient’s health condition (Brooke, 2023). When I was in the hospital I never encountered someone that firmly believed in these practices, but I heard from the nurses around that it was used by many patients. In terms of patient care, I witnessed a wide range of cases. Being in a public hospital, I observed severe understaffing as well as lack of essential tools equipment. There were many moments when I would instinctively look for an instrument we would normally have back home, only to find it unavailable. In those situations, we often had to improvise and make do with what was already on hand. I vividly recall one night during a shift a patient began coding. One of the nurses was desperately searching for a BVM (bag valve mask), going drawer by drawer in an attempt to find one. The search took four or five minutes, and by the time the mask was finally located, the patient had already been declared deceased. I don’t know if the patient would have survived had the mask been found and used sooner; regardless, the situation highlighted the critical lack of necessary resources. Another example of improvisation was when gloves were used as tourniquets, which led to supplies running out more quickly. I remember one shift in the PICU, I was reminded that one of the mothers that gave birth to two beautiful boys was in intensive care due to birthing complications. One of the nurses approached me and one of my peers, asking if we were interested in feeding the babies. Without hesitation, we both agreed. I have never fed a premature baby before, so I was incredibly nervous and assumed there would be a machine of some sort. I was wrong. We had to use a syringe, carefully letting the milk independently go through the tube. This process was time-consuming, as we had to hold the syringe up in the air to allow the milk to flow, which took roughly ten to fifteen minutes. At times, the milk would get stuck in the tubes or even harden, creating additional challenges. I remember hearing that these methods were used back in the day, so it wasn’t uncommon—just time-consuming and requiring extra attention. Typically, Nairobi and the Central Province are considered to offer the best public healthcare, while the North Eastern Provinces are generally more underdeveloped in terms of medical infrastructure and resources. There are private hospitals in Nairobi that are very respected and known to be top tier (Healthcare in Kenya, n.d.). After all that I have learned during this trip, I returned home with a deep sense of appreciation for the healthcare providers I had worked alongside, as well as a strong desire to continue learning more about global healthcare practices and the challenges faced in resource-limited settings. Witnessing the dedication of the healthcare providers who worked tirelessly despite limited supplies and overwhelming patient needs gave me a deep sense of respect and admiration for their commitment to their patients. I recall all of the conversations I had with the providers and students—one thing was clear: they all shared a deep love for the field. They acknowledged that their work could be challenging and frustrating at times, yet none could imagine doing anything else. There was genuine passion and grit behind every single provider, evident in the care they provided and the dedication they showed to their patients. I witnessed what it was like to think quickly on my feet and rely on the limited skills I had. These experiences taught me that healthcare isn’t just about medicine—it’s about human connection, understanding, and trust. I will be sure to bring these lessons into my career by prioritizing empathy, effective communication, and cultural sensitivity. I’ve always had a deep passion for healthcare, shaped both by my childhood interests and personal experiences. This trip has only intensified my passion, leaving me with a strong desire to learn and do even more in the field. I fully plan to return to Kenya and work at Coast General once I am a certified Physician Assistant, so that I can gain more practical experience while contributing to the healthcare system and properly helping patients in need. My time in Kenya was transformative. It exposed me to the realities of healthcare in resource limiting settings, challenged me to develop critical thinking skills and adaptability, reignited my passion for healthcare, and strengthened my commitment to pursuing a career as a Physician Assistant. I am determined to apply all that I have learned in every aspect of my future practice—fully dedicated to serving patients with compassion and cultural competency while continuing to seek opportunities to learn and grow as a healthcare professional. Beyond the clinical skills, this experience taught me the importance of patience and resiliency. This applies to myself and the patients. I learned how small gestures like listening, showing empathy, and providing reassurance can have a profound impact on the patient’s wellbeing and steps to recovery. Allowing myself to see how other providers navigate such a challenging system inspired me to think of more solutions and think proactively about improving healthcare, even in similar situations where resources are limited. I have gained an appreciation for proper teamwork and collaboration. It was refreshing to see how providers rely on one another to manage heavy workloads and ensure the patients’ comfortability—some demonstrated it better than others. This experience has diligently motivated me to approach my future career with a humbled mindset of service, humility, and continuous growth. Every patient encounter is an opportunity to make a meaningful difference. I am now more committed than ever to properly advocating for patients, embracing diverse perspectives, and integrating proper cultural competency in all aspects of my future practice.

My time in Cusco was amazing, and I really appreciated everything and all the staff who took care of us. Juda, Manuela, and Surabhi were all very helpful when it came to asking them questions about the program, and they were equally helpful when we asked questions about Cusco, such as restaurant or shop recommendations and how to navigate around the city. I have no complaints with any of the doctors; all of them were super nice and answered any of our questions. Particularly, Dr. Silva and Dra. Yadhira stood out to me, and I really liked their approach to medicine. Lastly, I participated in the Machu Picchu trek, and I want to shout out Hans and Raul, who were our guides. They were amazing and very accommodating. I am a slow hiker, so Raul stayed back with me and my friend so that we wouldn't get lost or be unsafe. They were also very fun and did karaoke with a few of us after the trek, which is forever going to be memorable for me. Overall, I have no complaints with any staff. I also want to shout out Victor for being the best driver, and all of the staff in the hotel for all their hard work. My experience being a pre-Physician Assistant intern through International Medical Aid (IMA) in Cusco, Peru is an experience I will be eternally grateful for—not only because it was a determining factor in why I want to pursue medicine, but also because I learned so much from the social and medical culture in Peru. A reason I applied specifically to the Peru location is because I never hear much about South America as a whole in U.S. media, and if I do hear about it, they only mention the “dangers.” However, the three weeks I have spent here gave me so much growth and knowledge about Peru. I was able to connect deeply with the mentors and other locals in the city of Cusco, and getting to talk to the doctors about their experience in the medical field was eye-opening. Coming to Peru was like finally understanding the expression, “Don’t knock it till you try it,” because all my preconceptions were erased and replaced with true knowledge of the culture and the socioeconomic structure. Ever since I was younger, I was always interested in the medical field, and as I grew up, I started to become more and more aware of how medicine is run in the U.S. I am lucky to have grown up in a household where we are able to afford sufficient insurance, so personally, I have never dealt with the hardship of large medical bills, but through personal research, I have learned how difficult it is for people of low socioeconomic status to get proper insurance and medical care. In the United States, healthcare is not free, but as I learned in Peru through our cultural presentation sessions, all Peruvians have the right to universal healthcare. Though I did not know this before coming to Peru, I was not shocked. It is rarer to see countries that do not provide free healthcare, such as the United States. One of the largest ongoing debates is whether the U.S. should pivot to a universal healthcare plan; some of the disadvantages include “significant upfront costs and logistical challenges,” while the advantages could create “a healthier populace and thus, in the long-term, help to mitigate the economic costs of an unhealthy nation” (Zieff et al., 2020). Due to the U.S. having an extremely advanced healthcare system that can offer some of the best care and procedures for extremely unique cases, many people disagree with the idea of offering a universal plan because it will create more complications in how healthcare should be divided. However, the latter perspective suggests that having an option of universal healthcare will create a healthier America and illness in our population will decrease. Furthermore, in Peru, the way healthcare works is that everyone has access to universal healthcare, but if they are employed, they can opt in to affordable insurance that gives them access to more advanced hospitals such as EsSalud, which is a division 3-1 center. The level of care there is not entirely comparable to the advanced care in the U.S.; however, these hospitals provide general and some specialized care, which is considered high level. The highest level of care in Peru is division 3-2. These centers contain sub-specialized fields and are only found in the capital, Lima, because it is the most populated city (International Medical Aid, 2025). This is unfortunate because if someone were to have a unique medical emergency, they would have to be rushed to Lima to get quality care, while in the U.S., it is common to live closer to hospitals with specialized care. During our time with IMA in Cusco, we also made a short trip to a nearby rural city called Casacunca, where we held a community clinic to help and provide medical attention to the citizens of the city. As we learned in our clinical debriefing sessions, most of Peru’s population is in the large cities such as Lima and Cusco, but there are a vast number of rural cities that, unfortunately, rarely get medical attention, so it was amazing that we were able to assist those who deal with this misfortune. Through my American perspective, I initially thought it was so unfair that people who live far from major cities hardly ever seek medical attention from doctors, and I believed it was almost diabolical that the government hasn’t expanded and created more large hospitals in these regions. However, as I learned by being in the rural cities in Peru, a lot of the citizens do not go to physicians and/or do not believe in Western science and instead prefer herbal medicines and advice from shamans/healers. This is because they strongly believe in the powers of traditional medicine, and access to it is more proximal (van Soeren & Aragon, 2016). In contrast, in Cusco, more people tend to turn to Western medicine because they have access to it, and the EsSalud hospital and many clinics we shadowed at are examples. In an even larger contrast, in the United States, we are the pinnacle of Western medicine—so much so that we try to cure anything and everything with medicine or medical treatment. The U.S. also spends the most out of all wealthy countries on healthcare, which allows us to have many advanced hospitals and medical technology throughout the country. However, we still see a lot of problems with the health of our citizens (PFPG, 2022). Even with this level of spending, we see high infant mortality rates, unmanaged diabetes, and more (PFPG, 2022). This shows that maybe Western medicine is not always the cure for medical problems, and instead there should be a balance between traditional and Western medicine. In one of my classes in college, I learned how if someone is pre-diabetic, instead of instantly starting insulin doses, they should invest in caring for their diet by cutting out artificial sugars and eating more protein. Ultimately, from my knowledge of Western and traditional medicine, I believe that they are both valuable and people should research both when they are looking for a “cure” to what they have. Additionally, through the IMA program, we had weekly presentation sessions, and in one session we specifically discussed the disease burden in Peru. One large takeaway I had from this presentation was that many people die from disease annually in Peru, and some of the main diseases that are killers in Peru are completely managed here in the United States. From the lecture, we learned about the most common communicable and non-communicable diseases found in Peru. Communicable diseases are transmitted between people or other organisms, and the common ones in Peru are malaria, dengue, tuberculosis, and acute respiratory infections (International Medical Aid, 2025). Non-communicable diseases are not spread from person to person, yet they arise due to the individual’s behavior, and the most widespread ones in Peru are hypertension, diabetes, and COPD in adults and anemia and malnutrition in infants/children (International Medical Aid, 2025). Two diseases that stood out to me from being in the lecture and staying in Peru for three weeks were tuberculosis and anemia. According to the lecture, there are about 27,000 cases of tuberculosis (TB) annually in Peru. In the U.S., we have less than half that rate annually, at around 10,347 cases reported by the CDC in 2024 (CDC, 2025). One possible reason that could explain why the U.S. does not experience as many TB cases compared to other countries like Peru is because of our widespread healthcare system. Again, as I have mentioned earlier, U.S. healthcare is considered to be one of the most technologically advanced and is well known for having extremely specialized care. This is most likely the reason why we do not see as many cases of TB, and if we do see them, there is less chance of it leading to mortality. In Peru, healthcare is not as widespread, and what I mean by this is that large hospitals with specialized or sub-specialized care are only seen in the most populated cities. If people are diagnosed with TB in a rural city, they will have to travel long distances to get specialized care in a hospital, and if they can’t afford the travel or do not have access to travel, they have to treat themselves the best they can. This is why TB is extremely prevalent in Peru specifically, and the reason why TB is one of the most deadly diseases in Peru, causing an estimated couple thousand deaths annually (International Medical Aid, 2025). This is why Peruvian healthcare should be more accessible, and this can start with the government allocating more funds to build more division 3 hospitals throughout the country, not just in major cities. Anemia was another disease that I became more familiar with through this internship. Working alongside the doctors and nurses in the EsSalud hospital, I learned that anemia has a different detection threshold in Cusco, Peru in comparison to the U.S. and even other cities in Peru, such as Lima, due to the high altitude. In Cusco, Peru, a detection of 11 mg/dL or below in the hemoglobin is considered anemic, but in the U.S. it is 13.5 mg/dL for men and 12 mg/dL for women (International Medical Aid, 2025; American Society of Hematology, 2025). The high altitude causes there to naturally be less oxygen in your blood because there is less oxygen in the atmosphere, and that is why anemia has a lower threshold in Cusco than in other cities/countries—because Cusco stands at about 12,000 ft, being one of the tallest cities in the world. Anemia is also highly prevalent in infants and children in Cusco, and this is due to malnutrition. Children in Cusco do not eat enough red meat and, in general, have poor nutrition, and I was able to actually see this while shadowing in the pediatric and nutrition departments. Fortunately, most of the doctors I worked with explained that anemia usually goes away after about 3–4 years of age, so it is able to be managed, but they did explain that malnutrition is something that is very common in infants throughout all of Peru, and this is the larger problem. Malnutrition comes with a lot more problems than anemia such as irregular bowel movements, thermal issues, dehydration, and even mortality. Chronic malnutrition in infants in Peru is at levels of 11.5%, and in the U.S. it is about 1%, which shows that our government has more control over infant malnutrition. However, according to the USDA, 1 out of 5 children in the U.S. lack food security, so the statistics on chronic malnutrition could be fluctuating regularly depending on the state of the economy (International Medical Aid, 2025; USDA, 2025). Ultimately, infant malnutrition should not be something prevalent in any country, and it should always be a priority that children have access to sufficient nutrition and meals. To conclude, my pre-Physician Assistant internship with International Medical Aid was life changing and taught me more about medicine and myself. I learned exactly how passionate I am about medicine, and I am grateful that I was able to learn in a new environment where I experienced medicine in ways that I have never seen or heard of before. Now, as I pursue my future career, my perspective on medicine and patient care has broadened, and this is for the better because I can approach medicine with the structured U.S. mindset and also the more interactive Peruvian mindset. I will always remember my time in Cusco, and I cherish it. Thank you for giving me this outstanding opportunity.

Overall, I loved the program. I loved how all the doctors were inclusive. On off-clinic days, the program mentors always had an event planned, which was so nice. Being able to learn about the city and tour around was great, and I loved all the food they offered. I want to thank the mentors for being flexible with the interns. They would ask daily who was going out to eat and who was eating at the accommodations. The mentors were always concerned about our health if we did not feel well. I remember the day I got sick—Juda and Manuela kept checking up on me to make sure I was okay. I really appreciated their concern and willingness to help us. Manuela did a great job letting me know who was going to pick me up for my trek, and all the drivers were on time. Big shoutout to my trek guide, Hans. We got to know each other very well and really enjoyed the lunch spot he picked out for us. During my three-week internship with International Medical Aid (IMA), I gained a vast variety of knowledge and experience that has permanently impacted my medical journey. One of the most memorable moments of my internship happened at the community medical clinic. We traveled to Casacunca, a small village in the highlands of Anta, where I gained knowledge on how doctors diagnose patients based on their symptoms and physical examination. I also observed how doctors provided exceptional patient care with limited resources. Having the ability to apply my acquired knowledge of physical examination under the supervision of a physician and contribute to essential healthcare access was my favorite part. Furthermore, this experience is one I will carry with me throughout my medical journey to becoming a physician assistant. It helped me understand the importance of patient care, cultural sensitivity, and the value of healthcare access. At the beginning of the internship, I was excited and curious to see how the clinical rotations were going to be organized. I was looking forward to being hands-on and eager to learn from all the medical personnel at the hospitals and clinics. I have a healthcare background—my mother is a medical assistant, and I work at Stanford Health Care—but my patient care experience is limited. Moreover, I was indecisive about my career path in medicine at the beginning of this program. I have a bachelor's degree in Economics, and starting a career path in medicine would mean I would have to go back to school and start over. My plan is to become a nurse to gain patient care hours and then become a physician assistant. By the end of the internship, I was confident and certain my plan was the right one for me. One of the most important lessons I learned during this program was that patients are not just data or markers you read from an exam. They are human, just like us, so we must take the time to get to know them. This made me realize that becoming a nurse before I become a physician assistant is the right path for me. While shadowing the doctors in the IMA program, I learned something new in each rotation and gained an immense amount of experience in general medicine, urgent care, ultrasound, wound care, and pediatrics. Starting with urgent care, working with Dr. Pedro was great. The environment was fast-paced, as he only had about seven minutes to see every patient, but he always took the time to explain the key points to the interns after seeing each patient. During my time with him, we had a patient who came in with complaints of fever, dry cough, and throat pain that had lasted four days. The patient's oxygen saturation was at 88%, which is normal in Cusco. Dr. Pedro explained that the elevation causes physiological changes to the body. We see these changes not because there is less oxygen at higher altitudes, but because of the change in pressure. With the decline in barometric pressure and the ambient partial pressure of oxygen during ascent, the partial pressure of arterial oxygen and the oxygen saturation are reduced (Luks & Hackett, 2022). I was able to observe this change as soon as I started to walk around Cusco. I was out of breath and felt my body working harder to breathe. As we continued to examine the patient, Dr. Pedro auscultated the patient's lungs to check for any abnormal sounds. Dr. Pedro allowed the interns to participate, and we all heard a crackle in the patient's breathing. This moment stood out to me because I was able to put a sound and label on what abnormal sounds could be during a lung auscultation. When the patient was asked if they were taking any medicines for the cough, the patient said yes, they were taking antibiotics. However, the antibiotic the patient mentioned was indicated for someone who had a cough with phlegm, not the dry cough the patient reported. Dr. Pedro then highlighted the pharmaceutical problem they face in Peru. A pharmacist in Peru can prescribe antibiotics based on someone's symptoms. This causes an issue for doctors, as many patients don't need antibiotics for their illness. From this rotation, I learned that the environment and background of a patient become as important as the symptoms you see present. In addition, although Dr. Pedro had limited time with each patient, he made sure to answer all of the questions the patient had. “It's important to get to know the patient and understand them so they trust you and feel comfortable sharing their history with you,” Dr. Pedro would say. The more information you have, the better evaluation you can assemble, which is especially valuable in a setting where healthcare access has its barriers. These barriers can differ from country to country. Some are systemic differences, and others are economic differences. Having the opportunity to shadow at EsSalud helped me understand these differences. I have the privilege of working at Stanford’s Emergency Department, where resources are abundantly available compared to other hospitals. When shadowing at EsSalud, doctors highlighted the limited amount of resources they have to work with. They don't have every specialty at their disposal, so they work with what's available. One of the systemic problems they face consistently is the use of antibiotics. In Peru, pharmacists are allowed to provide antibiotics to patients without a prescription. Doctors are not supportive of this practice, as the patient could be taking medication that does not treat the illness they have. Many infections are caused by viruses, and antibiotics will have no effect on them because antibiotics are prescribed for bacterial infections (What Happens If You Take an Antibiotic You Don’t Need? | UNC Health Talk, 2024). I recall Dr. Fabrizio teaching us the Centor criteria to determine if an infection is viral or bacterial. The Centor criteria had different components in which you awarded a 0 or a 1. If the total came out to be greater than or equal to 4, then the doctors would consider the infection bacterial. This is when the use of antibiotics becomes most practical. Having this understanding of antibiotics has helped me educate my family members. My father is from Mexico, and they have the same type of pharmacy system. Throughout my childhood, I would visit my family in Mexico, and having the ability to discuss my complaints with a pharmacist and then obtain medicine in the same moment was something I always viewed as beneficial. However, after interning in Peru, my perspective has changed. I now remind my family to be cautious about going to the pharmacy right away when we visit Mexico. I advise them to see a doctor first so they can be evaluated and prescribed the right medication. As patients have easy access to antibiotics and are exposed to consuming so many, it's concerning that patients can become antibiotic-resistant. A study was carried out analyzing 10 hospitals across Peru to see the effects of antibiotics given to patients in a hospital setting. About 900 patients were given antibiotics, and around 70 percent of those patients were prescribed antibiotics as empirical treatment, with only about 4 percent of those prescriptions being effective (Rondon et al., 2023). Although this study does not address the specific reason why so many Peruvians are antibiotic-resistant, when I asked the doctors at EsSalud, they all attributed it to the easy access to antibiotics. Patients can simply walk over and obtain medication based on their symptoms from someone who is not licensed to prescribe. Over time, patients have taken so many unnecessary antibiotics that they have become antibiotic-resistant. Comparing this system to the United States, back in 1951, the US government passed the Durham-Humphrey Amendment. This amendment categorized prescription drugs and over-the-counter drugs, with the intention of preventing harm to patients. Prescription drugs would be monitored by licensed medical professionals, and over-the-counter drugs would be available to patients at any local pharmacy (Harrington & Jarrell, 2024). This amendment laid crucial groundwork in controlling access to antibiotics and many other drugs within the United States. Furthermore, another factor that has contributed to the control of antibiotics is antibiotic stewardship programs. These programs aim to optimize the use of antibiotics and minimize the harm caused by unnecessary use (Centers for Disease Control and Prevention, 2024). With programs like these in place and with political influence, the United States is able to control a problem other countries are still facing. The pharmaceutical industry is not the only systemic difference between the United States and Peru. The next topic of discussion looks at the economic differences between the two. During our lecture series with Dr. Fabrizio, he educated us on the economic differences between the healthcare systems of the United States and Peru. In the US, hospitals rely on private funding and public funding. Private funding comes in the form of private insurance companies and patient out-of-pocket payments. Public funding usually comes from government programs like Medicare and state-to-state insurance programs like Medi-Cal. My eyes lit up during this part of the presentation, as I deal with insurance as part of my job at Stanford, and I understand the struggles with funding. Most patients do not understand how insurance works. They think that by paying their monthly premium, they have nothing else to pay. Unfortunately, that is not the case. Some insurances have deductibles, and insurance companies want you to pay out-of-pocket to meet that full amount. However, there is another part of your insurance that many do not know exists, which is your out-of-pocket maximum. This number is the amount of money your insurance company wants you to pay out-of-pocket before they start covering all your medical expenses. So, in addition to paying your deductible, you must also meet your out-of-pocket maximum. When patients receive their estimate for their emergency visit, they are astonished by the high amount. The reason the bill is so high is because of the out-of-pocket maximum that patients are not aware they have. Consequently, patients have shared with me that the high bill is a reason they do not seek medical attention at times. Not everyone can cover the thousands of dollars it costs to be seen in the emergency department. It's always a tough conversation to have with a patient when they are dealing with an illness, accident, or injury, and my job requires me to collect payments from patients. Now, looking at public funding programs like Medi-Cal, which is insurance for low-income individuals and families in California, there are both benefits and setbacks. Patients with Medi-Cal insurance will have their emergency visits covered, but when they want to see a primary care provider or specialist, that becomes difficult. Patients insured by Medi-Cal have to see a primary care provider within the network before they see other doctors. These in-network doctors are usually based in small clinics around the communities and don't typically work at these clinics for very long. Patients have a hard time building a relationship with their primary care provider because they will see them a couple of times in the year, and by the following year, they have a new doctor. Patients have shared with me that they prefer Stanford's doctors, but their insurance makes it difficult to see them. There are even times when patients obtain an appointment, but at check-in, we have to inform them that their insurance has denied the visit. If they want to pay out-of-pocket to see the doctor, we have to advise the patient that they might lose their insurance coverage if they proceed. This can be a very frustrating process for the patient and is a reason why patients don't continue with their medical care. In comparison, the economic problems Peru faces are a bit different. When it comes to funding, they rely on public funding and insurance to cover the costs. Public funding comes directly from the government. In 2009, the government created universal healthcare for all Peruvians to address the health inequities and disparities in its most vulnerable population (International Medical Aid, 2023). Peru's healthcare system is divided into different sections. The Ministry of Health (MINSA) provides services to patients under universal healthcare. Social health insurance, or EsSalud, is a medical service that is paid for by patients' employers. Lastly, there are private clinics that typically receive their funding from patients paying out-of-pocket for their services. Many would think that having universal healthcare would solve healthcare access problems, especially for the most vulnerable and poor populations, but this is not the case. Although these services are built to help, access to these locations is still the biggest problem. Another complication is the distribution of funds from the government. When I asked our mentors in the program what they thought of the government, no one was in support. Some of the things they mentioned were the inconsistency of presidents and the misuse of funds. A study was completed in 2020 about the use of funds, and they found that 3.4 billion soles (1 billion US dollars) was not used (Rolf Erik Hönger & Montag, 2024). These funds could be very useful in many different areas, from healthcare supplies to healthcare infrastructure. No one’s healthcare system is perfect, and both systems could use improvements in different ways. Learning about each country's economic differences was interesting. There was always new information I learned throughout my internship. During my rotation at the private clinics, I observed how to perform an arterial blood draw and how doctors use it to obtain a more accurate read on a patient's oxygen level. Being able to see this in person was fascinating, and the lab technician explained all the new information in a simple manner. However, the patient interaction that stuck with me the most was with the community medical clinic patients we saw at Casacunca. Seeing doctors travel hours to provide care to people in rural communities, all while doing it with a smile, has shaped my perspective on being a healthcare provider. Being a provider is not only about giving care to those who can access it or afford it, but also about providing care to anyone, because everyone should be cared for regardless of their social or economic background. At the community medical clinic, I worked in general medicine with the doctors and attended to a mother and her son. The mother came in for a headache, and her son came in for throat pain. I was able to improve my communication with patients as I completed the lung exam and checked if the patient had any tonsillitis with the supervision of the doctor. Having this opportunity helped me better understand the importance of communication in the medical field. You want to make sure the patient understands how to take care of themselves once they go home, and being able to communicate that with your patient is essential in medicine. Being a part of the community medical clinic was my favorite part of my internship with IMA. Not only do I feel I made an impact in this community, but likewise, this community has made an impression on my future goal to become a physician assistant. In closing, this internship has shaped the way I will approach my medical journey. All of the rotations helped me understand the importance of patient care. The lecture series from the doctors improved my cultural sensitivity, and the community medical clinic helped me recognize the value of healthcare access. My career goal is to become a physician assistant. Before, this idea was up in the air. I was thinking of becoming a nurse first and then seeing if I still wanted to go back to school. After being around providers for three weeks, I have never been more certain that being someone who can diagnose and care for patients is my ultimate goal. I want to have the knowledge and autonomy to care for patients and help them understand what is going on with their bodies so they can care for themselves as much as I will. My next steps are to complete my last couple of prerequisites and apply to nursing school. If I don't get accepted in my first round, I will transition into working as an EMT, CNA, or MA to gain patient care experience and then become a physician assistant. Additionally, working in a rural community has sparked my interest in rural medicine, as it resonates with my family background. When we were in the Casacunca community, I felt at home. My father grew up in a village where you would have to drive for hours to seek medical care. I aim to study rural medicine or conduct research and be able to go back to my father's town or Peru as a physician assistant to provide care. I have already talked about applying to IMA again as an official provider with some of my IMA classmates. Not only do I want to provide care in a hospital or clinical setting, but I also want to travel to provide care to those with limited access. Healthcare should have no barriers and should be accessible to all. I intend to contribute to this belief by sharing my knowledge and being part of medical humanitarian programs throughout my medical career. This program will have a lasting impact on my medical journey, and I cannot be more thankful to IMA for allowing me to have this life-changing experience.

This experience in Peru has changed my view of not only healthcare but also life. The things I have learned are valuable not only to my future working in healthcare but also as life lessons. The doctors I worked hands-on with were all incredibly helpful and understanding. The culture I experienced will stick with me for a lifetime. My internship with International Medical Aid in Peru deepened my knowledge of healthcare and strengthened my resolve to work in the field. Being exposed to a healthcare system that is very different from the one in the United States has influenced who I am and the kind of healthcare professional I want to become. I was able to fully immerse myself in a different culture during this two-week trip, analyze the differences between healthcare systems, and observe a wide range of patient relationships. I will use the important experiences and knowledge I gained as I work toward becoming a physician assistant and developing into the best healthcare provider I can be, committed to combating healthcare inequities. The healthcare systems in Peru and the United States differ greatly. Infrastructure, equipment, and resources are some of the primary distinctions. The healthcare system in the U.S. benefits from significant funding, modern infrastructure, advanced technology, and a wide range of services. Despite having a highly developed healthcare system, access in the U.S. is often limited by insurance status and socioeconomic class. In contrast, Peru’s healthcare system faces major challenges, including older infrastructure, limited funding, and inadequate equipment—particularly in low-income communities and rural areas. Some Peruvian hospitals lack the specialized physicians that many patients may require due to these financial constraints. With limited resources, many hospitals do not have access to modern medical equipment, advanced technology, or even some basic supplies needed to evaluate and treat patients. The United States is said to have 95.58% access to modern technology, which is 27% more than Peru’s 75% (National Master, 2025). However, Peru is said to have 62.5% healthcare cost, which is 36% more than the United States at 45.81% (National Master, 2025). These percentages highlight just a few of the disparities between the healthcare systems in Peru and the U.S. During my internship, I was able to witness some of these differences firsthand. Compared to the United States, Peru has a higher prevalence of natural medicine. Instead of relying solely on pharmaceuticals, as is more typical in the U.S., many people in Peru advocate using natural methods to treat illnesses or wounds. Coca leaves, for instance, are strongly recommended as a treatment for altitude sickness, whereas in the U.S. a prescription medication is usually required to alleviate the condition. Another example is maca, which is said to help prevent or manage anemia due to its high iron, protein, and vitamin content (Peruvian Medicinal Plants, 2022). In contrast, prescribed medication or supplements are typically used to treat anemia in the U.S. Before traveling to Peru, I had never seriously considered using natural remedies to heal a variety of illnesses; I always assumed it was more of a placebo effect. This experience showed me how Peruvian and American approaches to treatment differ. During my time in Peru, I witnessed how medical professionals respected their culture and customs by treating patients with more conventional methods while also accepting and incorporating natural or traditional therapies. I learned to respect a patient’s culture and traditions while still offering a professional medical opinion, which can help the patient receive the best care possible. Traditional medicine was widely used when providing care in the Maras community. Although conventional medicine may often be more reliable or offer faster relief, allowing patients to continue using their traditional medicines helps them maintain their beliefs and gives them a sense of identity—both of which are essential for a patient’s overall well-being. I was also able to observe the distinctions between Peruvian rural and urban areas when delivering care in the rural town of Maras. I went to and helped at a day clinic run by IMA in Maras, which was about an hour and a half away from Cusco. My doctor and I saw about fifteen people and provided them with basic medical care. The patients in the rural and urban communities differed significantly. Due to the lack of resources in remote areas, many people had to endure illness for weeks, months, or even years before getting assistance. Delays in seeking treatment can lead to delayed diagnosis, which can mean that a patient’s condition is advanced and treatment is more difficult or sometimes impossible. This can result in increased rates of illness and mortality, contributing to Peru’s high burden of disease. The United States and Peru also differ in the diseases that are most prevalent in each country. In Peru, anemia is very common in children. About 7.3% of children ranging from ages 6 to 35 months have anemia (Alfonso Accinelli, Alfonso Leon-Abarca, 2020). In the United States, anemia prevalence is lower at 3% (Iron Deficiency in the United States, 2022). This is a major difference between Peru and the U.S. The leading cause of death in the United States is heart disease, with 680,981 deaths attributed to it (CDC, 2025). In Peru, noncommunicable diseases are the leading cause of death, accounting for 102,145 mortalities (World Health Organization, 2022). These differences show distinct challenges within each country’s healthcare system. My internship with IMA has transformed the way I look at healthcare. It has taught me to advocate for better care and preventative measures for all communities. It has opened my eyes to worldwide disparities within healthcare systems. By witnessing these disparities firsthand, I feel even more encouraged to continue my commitment to becoming a healthcare provider. With this new understanding of patient interaction, preventative care, and advocacy for a better healthcare system, I am committed and excited to use my newfound knowledge to provide the best care possible to all patients. This experience has deeply impacted the type of provider I plan to be. It has taught me the importance of compassionate, patient-centered care, and it has strengthened my determination to help reduce healthcare inequities wherever I work in the future.

With hotel accommodations located just a 15-minute walk from the Plaza de Armas, I was right in the center of the city. The location was also close to so many delicious restaurants and cafés where I could enjoy local cuisine. Safety never felt like a concern, as transportation was provided everywhere we went. The hotel was comfortable, and if we had any trouble, our mentors were always available. Am I on the right path? Is healthcare the best place for me? These were questions I asked myself constantly before my time with IMA in Cusco, Peru. Here, I was exposed to various specialties, shadowing doctors, engaging with patients, improving my medical Spanish, watching a surgery, and being a part of a rural health clinic. All of this instilled confidence and trust in myself. I know more than ever that healthcare is the path for me. That’s all thanks to IMA. Before I boarded my plane to Peru, my path still looked blurry. I had only experienced alternative medicine, worked with physical therapists and chiropractors, and went to school with the original plan of becoming a dietitian. When I decided that dietetics was not for me and I began my pursuit of becoming a Physician Assistant, I was nervous, a little unsure, and quite overwhelmed with all the prerequisites just to apply to schools. Alongside that initial fear, I knew I would have to forge my own path and make my own connections, as I am the first person in my family to enter the medical field. Most people I know going into the medical field have some idea about what specialties they’re drawn to, but I was filled with uncertainties. The purpose of my first international trip alone to Peru was to determine if medicine was for me or if I needed to find something else. Originally, I was hesitant about leaving home and going to a country where I knew I would have to use a language I had barely used since college graduation. I kept reminding myself how I always wanted to use Spanish in my future career. What better way to get comfortable with it than an immersive experience abroad? At least that’s what I thought. Upon my arrival, I quickly realized how rusty my Spanish had gotten, though with some rest, rehydration, and food, I felt ready for my first day Monday morning. My first day started in General Medicine with Dr. Pedro. In general medicine, I saw a variety of cases and had the opportunity to listen to heart and lung sounds to determine abnormalities and get to the root of the patient’s complaint. While performing these tasks, I realized how broad general medicine truly is. Many patients came in with a variety of problems—some for monitoring their medication, others for back pain, and some needing referrals to doctors with further specializations. I was shocked by the extensive knowledge that general medicine doctors need to have to provide care to their patients with such a wide range of issues. The following day, I was in geriatrics. Geriatrics surprised me. From my time working in an assisted living facility, I knew that older patients tend to have multiple medical conditions requiring multiple medications. I found it very impressive how the doctor quickly evaluated labs and made changes to medication lists and instructions on when to take them. It was second nature for her and seemed to require little thought to ensure that the medications were administered at the correct times. Although impressive, it was a little overwhelming to see the speed at which she worked and to imagine how a future in healthcare would require the same confidence from me. She did take the time to explain everything she was doing and allowed me to help with taking vitals and listening to lung and heart sounds. This calmed my nerves. It was interesting to hear the differences in these sounds between an older and a younger person. One thing that stood out to me here was how everyone’s blood oxygen saturation was below 90%. In the U.S., this requires immediate attention, but she explained that in Cusco, these values were normal and healthy. This is due to the low atmospheric pressure at higher elevations, decreasing the binding between hemoglobin and oxygen in the blood (Matthew, 2023). Geriatrics was also where I was introduced to traditional Peruvian attire. Many older women came into the exam rooms with more than five skirts, called polleras, tied around their waists, aprons with a big pocket draped in front of them, and bright, colorful blankets called mantas hanging behind them, holding their belongings and sometimes even children (Merotto, 2021). Topico was by far one of my favorite rotations, where we worked with the nurses. It was a fast-paced environment with multiple things happening all the time. We hardly had a second to sit down, but it was packed full of learning and patient interaction. The nurses here were very kind, and the one I shadowed was a fantastic teacher. She taught me how to draw up injections. Using one hand to hold the syringe while simultaneously drawing the liquid proved to be a difficult challenge. She explained every step in performing the injection—from disinfecting the injection site, stretching the skin, injecting at the cross-section of the iliac crest and top of the hip, aspirating the needle to ensure that you were not in a blood vessel, and finally injecting slowly to reduce the discomfort the patient might feel. She also described the uses of different medications that were administered there every day. Here, I developed a thorough understanding of the common pains, wounds, and problems that the community of Cusco dealt with and got to see it all firsthand. Although I loved my time in topico, obstetrics was my number one. We discussed the growth and development of fetuses, evaluated growth through measurements of the mothers’ uteruses, and listened to fetal heartbeats. Becoming a part of the patient’s journey into parenthood was magical. I didn’t expect to enjoy this specialty so much. I began to see my future in healthcare more clearly and found myself fully engaged in each visit, trying to soak up all that I could. My favorite memory in this unit was with a patient who was about 28 weeks pregnant. During the visit, the obstetrician needed to palpate the mother’s stomach to feel the position of the baby. After doing so, she turned to me, grabbed my hands, and guided me to locate two little feet and the baby’s head. It felt amazing to be able to feel the little invisible human, and in that moment, I realized I might want to do that in the future. The last mentionable rotation was surgery. Maybe because of my love of Grey's Anatomy, I always saw myself working in an OR. Although I’ve tried to find opportunities in the U.S., observing surgeries is difficult to arrange, and being able to see one after wanting to for so long filled me with excitement. We were fortunate enough to watch a patella fracture repair. It began by administering an epidural to numb the lower half of the patient’s body, leaving him awake. Before this, I had only heard of brain surgeries where patients were kept awake, so I was shocked when I realized that this patient was going to remain awake the entire time. What surprised me most about my first surgery experience was how poorly I was able to handle it physically. I thought that I would have no problem watching a surgery, but I quickly found that I was wrong. It might have been a combination of nerves, excitement, and discomfort, but I felt nauseous and lightheaded through just about the entire process. Even so, it was an important learning moment. I realized that becoming a healthcare provider also means understanding your limits, working through them, and giving yourself grace as you grow. Another component IMA included in my time in Peru was being able to provide care to the rural town of Poroy. In Poroy, I saw firsthand the lack of medical knowledge and access to adequate care that affected the lives of the people living there and that of their children. Early on in the clinic day, there was a little girl and a father who came up to the doctor I was with for a consult. The father was concerned about his daughter’s teeth, which caused her pain when she ate. She was just four years old. When she opened her mouth, it was full of cavities. We later learned that she had never been taught how to properly brush her teeth. This broke my heart. What made it worse was that there were many other children just like her that day. A study conducted to compare adolescent oral hygiene in Cusco, Lake Titicaca, and Lima found that 97.65% of their participants in Cusco had dental caries of varying degrees, and 20.81% were severe (Llano-Pérula, 2020). They indicated that these values were likely due to little oral hygiene knowledge. In Poroy, I witnessed the importance of rural healthcare and the need for health education, and I want to be a part of more health clinics in the future. Outside of the clinical experiences I had with patients and providers, I was also able to develop my skills and techniques. I had a refresher on CPR, learned how to perform abdominal, heart, and lung exams, learned how to intubate a patient, and learned three common types of sutures and how to do them. Since then, I have purchased a suture kit to master the knots I learned. My time shadowing the doctors was amazing. In the U.S., this is a very difficult opportunity to find, but with IMA, I was able to be with the doctor, assisting them while caring for people in the community. I was exposed to a variety of specialties and found what areas excite me the most, giving me a better idea of where I want to end up. There are so many options out there, and it’s easy to get lost and stressed about which one is the right choice. My time with IMA allowed me exposure to those options and solidified that I am on the right path. Because of this experience, I am more confident than ever that I will make a great healthcare provider.

My time as a Pre-Physician Assistant intern with International Medical Aid (IMA) changed me from the inside out. I went in with very few expectations, eager to embrace whatever was in store for me. I was so happily surprised with the overall program and felt so individually cared for throughout it all. The residence was such a safe, comfortable place where I felt cared for. One of the chefs, Grace, went out of her way to introduce herself to me on the very first day and make sure that I had eaten and enjoyed the food. She always greeted each intern with a smiling face and so much intentionality. My room was such a great space, and it exceeded all expectations. I always felt seen by the mentors, and they accommodated every need throughout the entire journey. I really appreciated the balance that we were given between learning and rest; while we had deeply meaningful experiences at Coast General, in clinical simulation sessions, through lectures, and at community outreach events, these were often a lot to take in, so I was grateful for ample personal time to reflect, unwind, explore Mombasa, and bond with fellow interns. Janet and Hildah were also so welcoming and personal, and they both were so great at organizing the two weekend trips I went on. Thank you so much to IMA for everything; you made this experience so life-changing and comfortable! Two words describe my overall experience as an intern for four weeks at Coast General Teaching and Referral Hospital (CGTRH) in Mombasa, Kenya: adaptability and humility. When the ENT doctor I was shadowing had her otoscope stolen and there were no funds to buy another, we used a headlamp. When a patient tested positive for cholera but there was no room in an isolation ward, we created a makeshift room for her outside. When a patient had never been seen for his heart condition and had arrived at the Emergency Department with end-stage heart failure, and there was nothing the providers could do to help, we made him as comfortable as possible and comforted his family members. As a volunteer, I worked with the local physicians to understand the best ways to provide care in a place where resources, sanitation, and health literacy are minimal. I learned that medicine is more than diagnoses; it is compassion for the person at large and resilience through obstructions. No medical education, shadowing experience, or laboratory curriculum can prepare you for the moment that a mother is lying in your lap on a cold hospital floor, hysterically crying after losing her two-year-old daughter to cholera. In that moment, explaining the physiology of the disease and treatment methods could not offer any support; I could only provide pure, compassionate human connection. This scenario occurred during my recent medical internship in Mombasa, Kenya, where resources, sanitation, and provider attention were minimal, causing the daughter to pass away from an illness that would have been preventable in the United States. As we watched her child die, I held on to the mother as she collapsed and continued to hold her through her grief. As I cried alongside her, periodically wiping her tears with my scrub top and answering her phone calls that came through from family members, I felt utterly heartbroken and helpless. More than anything, I was forced to reflect on the stark differences between healthcare in Kenya and the US, and how the diseases people face are vastly different from what I am used to. While I have worked in clinical settings at home, where many of the patient presentations are elective, noncritical forms of preventative medicine, many of the cases I interacted with at Coast General Teaching and Referral Hospital (CGTRH) were end-stage disease or emergency cases. I witnessed necrotizing fasciitis, malaria, chronic kidney disease, heart failure, enlarged malignant tumors, an electrocution injury, and Meig syndrome. Each of these was a captivating occurrence that not only taught me an extensive amount, but also opened my eyes to a new side of medicine I had never before encountered. In our “Disease Burden in Kenya” lecture, Dr. Shazim explained to us that a large majority of diseases historically present within the country are tropical illnesses (IMA, 2025). During the clinical debrief on this same day, we also learned about the intersection between healthcare and climate change that plays a drastic role in the distinct disease qualities between the US and Kenya. Cholera, specifically, is preferential to specific water temperatures, salinity, and humidity, making the bacteria more likely to live and survive in conditions like those in Kenya as opposed to the US (Lipp, 2002). While human immunodeficiency virus (HIV) is not necessarily a product of the climate, it is considered a tropical illness due to its prominent dispersion within countries of the tropics (American Society of Tropical Medicine and Hygiene). I had no prior knowledge of this virus aside from the minor details covered in my Microbiology course. During our tour, the stigma and tension behind this diagnosis were strongly apparent to me when Dr. Shazim highlighted the fact that we could not refer to HIV by its name, but rather as retroviral disease (RVD). Furthermore, patients were treated specially in the CCC, a special ward for HIV treatment where, even within its walls, the words could not be spoken. On my first day in the hospital, a clinical director told me to “assume each patient is HIV positive until proven differently” (IMA, 2025). Even with such a widespread presence, this disease is heavily looked down upon, and patients refuse to accept it as a diagnosis. Thus, it leads to a multitude of greater complications, as it destroys essential immune CD4 cells and makes individuals more susceptible to other illnesses, namely tuberculosis or chronic cardiovascular disease (HIV Gov, 2024). Because of this, HIV was consistently in attendance in each unit of Coast General throughout my internship. It was constantly lingering as a possibility in each provider’s mind, as well as my own. I quickly learned how to take this disease into account and factor it into corresponding diagnoses in order to attain a full picture of the patient and provide the best care possible. This came into great display during my last week of my internship, when I was in the maternity unit. Each mother was classified by her relation to HIV, as the virus is automatically transmitted in the birth canal to the fetus. By no fault of their own, the baby is then automatically a carrier of this illness, leading to a greater spread of it throughout the country. It was saddening, yet powerful, to witness the existence and effects of this virus in real life, as it is something that is commonly cited in medicine but not commonly seen throughout the United States. I was surprised and grateful to learn that there is antiretroviral therapy that people can begin to reverse the effects of this devastating disease, yet cost and limited healthcare literacy continue to be major barriers that inhibit people from receiving the care they need, as is the case for nearly every individual I interacted with in Coast General. A lack of health literacy, resources, and funding towards medicine leads to widespread impacts that bleed into every facet of the healthcare system in Kenya. One of the hardest moments I endured in Mombasa was on my very first day as an intern. I had been placed in the Accident & Emergency unit, where there was a surge of patients following a rainstorm the day prior. Right at the end of the shift, when the three of us interns were already drained and overwhelmed from the morning, a case came in who quickly coded in front of us. The clinical directors and clinical officers were all attending to other patients in the back, and the student nurses in charge did not know how to administer CPR. As we interns jumped in to help, we were frustrated when we found out that the oxygen mask had a tear and the only AED in the unit hadn’t worked in months. We were all left helpless, watching as this 18-year-old boy passed away traumatically. As someone who had never witnessed death with my own two eyes, I was frozen in place. It felt like life was moving around me, but I was at a standstill, brokenhearted and powerless in the moment. The three of us with IMA left, unable to verbalize to one another or the rest of the interns what had happened. Initially, I was angry—angry at the lack of provider attention; angry at the fact that they had an AED that didn’t even work; angry that the nurses had not been trained in CPR; and angry that this boy would never get to live the life he deserved. I will be the first to admit that it was incredibly difficult to go back to the hospital the following days and try to be present within my rotation. I found my mind silently criticizing everything and trying to find fault with the Kenyan healthcare system. Fortunately, I had the two other interns who had witnessed this scene, as well as supportive mentors and other clinical directors, to help me get through this barrier. The “Current State of Healthcare in Kenya” lecture opened my eyes with the fact that 5% of the total national profit of the country goes into healthcare. This was followed up by the statement: “Most healthcare funding goes to top hospitals rather than primary care or community health centers, so there isn’t much focus on preventative care” (IMA, 2025). Furthermore, we learned that Coast General cares for a primary population of 700,000 people and also a secondary population of 2 million. I remember being shocked by these truths, and immediately my perspectives were shifted. Rather than frustration towards the system at large, I felt newfound empathy for both the patients and the providers. I was able to realize that it is not the fault of the hospital workers themselves that resources, time, and skills are sparse; rather, there is a nationwide systematic malfunction that is cost-ineffective and inhibits the capacity of the caregivers. With such limited funding, there is no way that the hospitals can have updated equipment, consistent training sessions, or adequate attention from all of the providers. Moreover, the public hospitals are overpopulated in general, but especially with patients who are being seen for the very first time with chronic diseases that have progressed beyond management levels. A qualitative research study led through Health Promotion International identified several key factors as causes of low health literacy throughout Kenya: traditional cultural practices, religious beliefs, inadequate sources for medical advice, inaccessibility to caregivers, cost barriers, and personal responses to illness (Robbertz, Kim, et al., 2022). Without preventative care or basic understanding, citizens allow their maladies to develop past a point of return, and there is often nothing that can be done. While this, in itself, was still incredibly frustrating to me, I was able to enter into my clinical experience with a newfound lens. I saw that the providers were doing all they could, and they were even more defeated by the lack of consideration by the federal government. Coming full circle, this stuck out on my very last shift in the hospital, when I was engaging in a night shift in the Emergency Department. A patient came in with heart failure and COPD, having never seen a healthcare professional for either of these illnesses. I was working closely with the Clinical Director assigned to this case, and I directly witnessed the toll that this situation took on him personally. When asking him what he would do for the patient, he told me that, due to the lack of space in the ICU and end-stage progression of this disease, there was nothing that could be done. He explained that resuscitation “would be a legal formality rather than a helpful procedure” and “all that can be done is to watch his vitals and attempt resuscitation at the last minute” (IMA, 2025). I could visibly see the pain in his face as he explained the emotional and personal hardship of under-resourcing on the providers. He told me that he often feels helpless and takes failure personally, when it is really a result of systematic faults and inadequate healthcare access. Amidst all of their efforts, a single medical professional cannot take on the weight of these issues themselves, and there is clearly a federal transformation that needs to occur for every Kenyan citizen to receive the care they deserve. After hearing this analysis, many family members and friends questioned if and why I still wanted to go into medicine, a career that is quick to repeatedly break one’s heart and challenge one’s faith. Few other careers allow for such depth of connection with others; through immense vulnerability, suffering, celebrating, and intimacy, healthcare providers are able to share in people’s most significant moments. They are consistently called to consider it joy in all things, knowing that each trial brings a new level of depth that lasts far beyond the fleeting moments of this world. It is apparent to me that being a provider is my vocation; my intellectual passion for medicine as well as a love for caring for people align in perfect harmony in this profession. I realize that as a PA, I will not be immune to the many challenges that come with healthcare. My title may read PA-C, but ultimately I am a servant, and I am committed to use my gift of a medical education to serve in all capacities. Through my four weeks as an intern in the Pre-Physician Assistant Internship Program with International Medical Aid, I learned more about medicine, humanity, and myself than I ever thought possible. As I returned to life in the United States, I found it challenging to fit into my previous patterns, as I had changed in such drastic ways. While I initially went to Kenya to serve the people there, everyone I encountered instead helped me in forms that I can’t quite articulate. Seeing first-hand the disease burden, hardship of life, and difficult conditions completely rewired my perspectives. What stood out most was each person’s endurance amidst trials, and their overwhelming joy that filled even the darkest moments. The ways in which I live and practice medicine have been forever altered, and I have a profound gratitude for all that is accessible to me in the US. Still, I greatly miss the vibrant life in Mombasa and yearn for the day that I can return to this beautiful country. I will forever cherish the four weeks that I was lucky enough to spend as a student at Coast General Teaching & Referral Hospital, and I credit International Medical Aid with so much of who I am today.

My experience with IMA in Kenya was nothing short of memorable and deeply reflective. It reaffirmed my purpose for wanting to attend dental school. From the moment I arrived, I was warmly welcomed by Michelle and Teddy, whose kindness immediately put me at ease. The kitchen staff, especially Joshua and Maria, went above and beyond- helping me open my charger adapter and telling me, “We are here for you.” That simple gesture made me feel truly at home. Whether it was baking donuts with Erastus or building meaningful friendships with the other interns, every moment contributed to an unforgettable experience. I’m also incredibly grateful to Naiomi for coordinating everything so seamlessly and always being available to answer any questions. One of the highlights of my time was the community clinic- an opportunity I almost missed due to a flight change. I’m so glad I made it. There, I was able to contribute by recording teeth numbers during oral diagnoses and cleaning instruments for extractions. It was in this clinic that I truly saw the heart of IMA’s mission in action. This experience was especially meaningful to me, as I hope to one day practice dentistry in a charitable manner.

Participating in International Medical Aid’s program in Kenya was a truly transformative experience, both professionally and personally. I had the opportunity to shadow physicians and healthcare professionals at Coast General Hospital in Mombasa, gaining firsthand exposure to global healthcare challenges and delivery in a resource-limited setting. From the moment I arrived, the in-country support team made me feel safe, welcomed, and well-oriented. IMA’s staff were consistently responsive and approachable. They ensured that all volunteers understood local customs, safety protocols, and expectations in clinical settings. We had weekly check-ins, and the team was always available to address any concerns. Despite being in a new country, I felt incredibly safe throughout my stay, thanks to the reliable transportation, secure housing, and clear communication from the local coordinators. IMA did a great job preparing us with pre-departure materials and continued that level of support on the ground. The accommodations exceeded my expectations. The volunteer housing was clean, secure, and comfortable, with amenities like running water, Wi-Fi, and mosquito nets. Meals were delicious and diverse, offering a great introduction to Kenyan cuisine. The kitchen staff also accommodated dietary preferences and restrictions without hesitation. The clinical shadowing was eye-opening. I rotated through various departments such as maternity and pediatrics. I observed cases I would likely never encounter in my home country and learned to appreciate how medical professionals innovate and adapt under constrained conditions. One particularly memorable moment was observing a C-section where the team maintained high standards of care despite limited resources. I also appreciated the cultural immersion opportunities provided, including excursions to historical sites, safaris, and time spent in local communities. These moments added depth to my understanding of healthcare in Kenya by allowing me to witness the social and economic factors influencing health outcomes. The program strengthened my desire to pursue a career in global health and gave me a more nuanced perspective on the importance of healthcare equity. I became more adaptable, empathetic, and aware of the cultural dimensions of medicine. I also believe that, through volunteer outreach initiatives like health education days, we made a small but meaningful impact on the community. From a young age, I felt an unshakable pull toward the medical field. My white coat was never far from my shoulders, and the plastic stethoscope that draped around my neck felt like a symbol of something bigger, something I couldn’t yet fully explain. I would transform my dolls and stuffed animals into patients, performing makeshift surgeries on them as if I were already a seasoned doctor. Even my dog, who was far too old to escape my ministrations, became my loyal patient. My family played along, offering their arms for bandages, pretending they had broken bones or caught the flu, while I took it all in with a fierce sense of responsibility. It was in seventh grade when my sister asked the question that everyone asks: “What do you want to be when you grow up?” Without hesitation, I said, “I want to be a doctor so kids like me can feel safe and healthy.” I know many kids make fleeting promises to become doctors, only to let those dreams fade. But for me, even then, it was never just a passing thought. It was a passion that felt destined, something I’ve carried with me ever since. When I first considered a career in medicine, I never imagined that a Physician Assistant (PA) was an option or even that the profession existed. It wasn’t until I found myself in the hospital one day, expecting to see a doctor, that I was instead greeted by a PA. At first, I didn’t realize the extent of responsibility and autonomy this role carried. But the more I learned, the more I discovered how much PAs actually do, from assisting in surgeries to diagnosing patients, ordering tests, prescribing medications, and performing physical exams. This role offers the perfect balance: the opportunity to be deeply involved in patient care, but still working collaboratively with doctors. The ability to specialize in different fields, combined with the flexibility to work in diverse settings such as hospitals, clinics, private practices, and urgent care centers, made me realize that this is exactly what I’ve been searching for. Suddenly, my path became clear. I knew this was the profession I wanted to pursue, one that would allow me to contribute meaningfully, grow continuously, and make a real difference in healthcare. I knew I was destined for healthcare the moment I didn’t hesitate to save a life. It was Halloween weekend in 2022. My friends and I were standing outside the bar, waiting for a ride home, when suddenly, the sharp crack of a crash split the air. I turned around and froze. A man lay unconscious in the street, blood spilling from his body, while a motorcycle lay in pieces just a few feet away. Without thinking, I ran straight to him. Later, I learned he’d been hit by a motorcyclist, but in that moment, it was clear only one thing mattered: getting to him. I dropped to my knees beside him. He wasn’t breathing. Blood was pooling around him. I grabbed his wrist, searching for a pulse. Nothing. A rush of adrenaline surged through me, and without hesitation, I started chest compressions. Another person appeared beside me, panic in their eyes. “What do I do?” they asked. “Two breaths every thirty compressions,” I instructed, barely looking up. I could hear the sickening sound of his ribs cracking under the pressure, but I didn’t stop. I couldn’t. We kept switching, exhaustion creeping in, but we pushed through, each compression a desperate plea for life. Time seemed to stretch and warp as we kept going, our breaths shallow, our hands working in sync. Finally, we heard the distant wail of sirens. The ambulance screeched to a halt, and the paramedics rushed in to take over. I stood up, my hands slick with blood, and looked down at them, bright red and trembling. A police officer approached me, his gaze steady as he placed a hand on my shoulder. “You did great,” he said, his voice firm but filled with something more. “You may have just saved that kid’s life.” In that moment, everything shifted. I felt a sense of certainty wash over me; this was no longer just an instinct. It was my purpose. From that moment on, I knew this was meant to be. There was a moment, not long ago, when I truly questioned whether I was cut out for this profession. About six months ago, I was helping a nurse with a blood transfusion. She casually asked, “Do you get squeamish around blood?” Without hesitation, I said, “No.” I figured, having donated blood countless times and seen my fair share of bloody injuries, I’d be fine. But then, as the nurse started the procedure, she pulled out this long, 12-inch needle. With a swift, almost aggressive motion, she drove it into the patient’s arm. The pain was immediate and intense. The patient screamed in agony, but because he was on a ventilator, no sound came out. In that moment, I froze. My body went ice cold, and I knew exactly what was happening. I’d fainted before, and I could feel all the signs: my limbs tingled, my legs started to give way, and my vision blurred, fading into stars. Desperately, I turned my head away, trying to block it out, taking deep breaths to keep myself steady. I knew I had to leave before I collapsed, so I whispered to the nurse, “I need to get out of here or I’m going to pass out.” But she quickly responded, “You can’t, or he’ll bleed out.” I fought with everything I had to stay focused. But suddenly, the room went black. My legs buckled, and I crashed to the floor, hitting my head hard. When I came to, I was surrounded by a crowd of nurses, all staring at me. Embarrassed and shaken, I made my way to the break room and broke down, overwhelmed with doubt. “How can I be a PA if I can’t even handle a simple procedure like this?” I thought. Then, a nurse walked in and asked what had happened. I explained, feeling humiliated. She smiled and told me a story. “When my brother broke his nose,” she said, “there was so much blood pouring out that I passed out. My mom told me, ‘How can you be a nurse if you can’t handle blood?’ But here I am, 10 years in.” Something about what she said stayed with me. “Don’t let one moment define your future,” she told me. “Keep going.” From that day on, I’ve carried her advice with me. Every time doubt creeps in, I remember her story. It became my motivation, proof that even the toughest moments can become stepping stones toward achieving something greater. I never imagined that choosing the path of becoming a Physician Assistant would lead me to this internship, an experience that completely reshaped the way I see medicine, privilege, and the reality of global healthcare. Before this, my understanding of healthcare was largely rooted in what I saw in the U.S., a system full of flaws, yes, but still one with access, options, and a certain level of expectation. But nothing prepared me for what I would witness during my time abroad. One of the first things that hit me was the line outside the hospital—dozens of people, some waiting for hours just to see a doctor for a single minute. That kind of patience, that desperation, shook me. And it wasn’t just the wait times. It was the staggering lack of resources and staff that made me stop in my tracks. When I learned that there was only one neurosurgeon and one cardiologist in the entire country, I was stunned. Then came the numbers: a nurse-to-patient ratio of 1 to 70, and a doctor-to-patient ratio of 1 to 13,000. For comparison, in the U.S., it’s about 1 to 5 for nurses and 1 to 400 for doctors. I was speechless. In the maternity ward, a nurse explained to me how their scope of work stretched far beyond what we’d expect in the States. They did everything: suturing, delivering babies, examining placentas, because there simply weren’t enough midwives or doctors to do it. The only thing they couldn’t legally do was diagnose or prescribe a treatment plan. They had no choice but to stretch themselves thin. In some cases, heartbreakingly thin. One nurse told me how, during critical shifts, they’d sometimes have to make impossible decisions, choosing who had the better chance of surviving, because they didn’t have the time or resources to save everyone. They had to let go of patients who were fading, simply because they didn’t have the luxury to sit beside them in their final moments. I remember watching a woman undergo a labial laceration repair after giving birth. Lidocaine was scarce, so it was diluted to conserve every drop. I’ll never forget the sounds: sharp inhalations, low groans turning into cries, the way her fingers gripped the edge of the bed as her body trembled. The pain was visible in every part of her. It was like the anesthetic barely worked, and yet it was all they had. Back home, I work in a hospital where nurses often talk about being overwhelmed with five patients instead of three or four. I’ve heard the frustration, the burnout, and the complaints about skipped breaks and long hours, and I don’t dismiss any of that. But after seeing what I saw, I can’t help but think: some of us need a reality check. We forget how much we do have. We forget that access to clean instruments, consistent medication, and specialized staff is a privilege, not a given. We take so much for granted. This experience didn’t just show me the cracks in the global healthcare system. It lit a fire in me. It made me realize that being a PA isn’t just about diagnosing or prescribing. It’s about being adaptable, compassionate, and resourceful even in the most limited of settings. It’s about seeing the patient in front of you, not the chart. And sometimes, it’s about bearing witness to pain—real pain—with the humility to learn from it. This was more than an internship. It was a wake-up call. And I’ll carry that with me into every patient room, every diagnosis, every decision I make in the future. I spent my first week in the maternity ward, a deliberate choice driven by a deep curiosity about the female body and the intricate process of childbirth. On my very first day, we were led upstairs to the operating room. The moment I stepped in, a wave of cold air hit me, sterile, sharp, and unforgiving. The room was tense, thick with anticipation. A woman lay on the table, visibly trembling, not from the temperature alone, but from the shock and fear coursing through her. Then the surgeon walked in. She carried herself with unshakable confidence, as though she had done this a thousand times, and maybe she had. The sudden blast of upbeat music filled the room, lifting the heavy silence. It was unexpected but oddly comforting, a tactic, I realized, to keep the energy high, the mood steady. The procedure began. What felt like 15 minutes stretched into an hour; time warps in places like this. The surgeon moved with precision, almost like she was dancing through the motions, each action flowing from muscle memory. But nothing about the procedure was gentle. I watched as she made the first incision, then began pulling and tugging with force to open the abdomen. It was raw, intense, and real. That’s when the nausea crept in. The room started to spin ever so slightly. My arms and legs tingled. Lightheaded, I fought to stay upright. I didn’t want to miss this. I didn’t want to be that person who had to step out. But my body gave me no choice. I slipped out quietly. By some miracle, I returned just in time. The room was still. And then a sharp, powerful cry filled the air. A newborn. Her lungs were strong, her presence undeniable. It was one of the most profound moments I’ve ever witnessed. From cold steel and silence to life and sound, all within a single breath. It was nothing short of extraordinary. After experiencing that, the next two C-sections were amazing to watch from start to finish. I felt like I could handle seeing anything. My second week was spent in the Pediatrics ward, a world entirely different from Maternity. In Maternity, we celebrated new life, the joy of arrival. But here, we faced the fragile thread between hope and heartbreak. It wasn’t about welcoming a child into the world anymore; it was about fighting to keep them in it. The first thing you notice when you walk in is the sound—not soft coos or lullabies, but the piercing screams and cries of children in pain. Then you see the mothers, weary, worried, clutching their sick little ones with tired eyes that have known too many sleepless nights. It was hard to approach the children without fear reflecting on me. To them, we weren’t helpers; we were strangers in white coats who brought needles, pain, and confusion. I could feel their distrust, and it made me feel helpless. I wanted to reach out and let them know I was there to help, not hurt. I wanted them to feel safe, even in the scariest place. That feeling, that longing to be a comfort in the chaos, is exactly why I chose this department. Because in pediatrics, medicine isn’t just about charts and treatments; it’s about connection. It’s about kindness, magic, and making space for laughter even in the midst of fear. Someone once said, “Children may forget what you say, but they’ll never forget how you made them feel.” That’s the truth of pediatrics. Sometimes, the most powerful medicine is simply making them smile. A silly face, a warm hand, a few minutes of pretending the hospital bed is a rocket ship—it changes everything. Children fight hard. They recover fast. They believe in magic. And in pediatrics, you start to believe, too, that maybe, just maybe, anything is possible. It was 8:40 AM when we stepped through the doors of the pediatric emergency room. Almost immediately, I sensed something was wrong. A commotion behind a curtain in the corner of my eye pulled me in. I moved quickly toward the noise. Behind the curtain was a little boy, or so I thought. He looked no older than six or seven. I later learned he was thirteen. His body told a different story. He had pneumonia and was dangerously susceptible to secondary illnesses like meningitis and anemia. His frame was skeletal, every rib visible beneath pale, stretched skin. His abdomen was distended, a stark contrast to the rest of his frail body. Malnutrition had taken a cruel toll. Two nurses were performing CPR—fast, hard compressions—and I could hear the crack of ribs with each push. They were tiring. Without hesitation, I stepped in. Thirty compressions, pause, glance at the monitor. Flatline. Silence. A breath held. Then nothing. Again. And again. Twenty minutes passed, but it felt like an eternity. I pressed a stethoscope to his chest, hoping the monitor had missed something. Still nothing. No heartbeat. No murmur. Just silence. We checked his pupils. Black, fully dilated. No response. No reflex. His brain was gone. There was no life left in that fragile body. We called the time of death: 8:59 AM. That number is etched into my memory. I will never forget it. And then came the part no one can prepare you for: the mother. She entered through the curtain, her face shifting instantly from anxious hope to unspeakable grief. Her knees buckled. She collapsed to the floor, sobbing uncontrollably. Her cries filled the room and pierced through every layer of calm we tried to keep. We stepped out, giving her space. But the sound stayed with me. He had so much life ahead of him. And yet it was taken not by something rare or untreatable, but by something entirely preventable. If he had been in the United States, his outcome would likely have been very different. Routine vaccinations could have protected him from the infections that weakened his immune system. Early medical care could have treated his pneumonia before it became severe. Nutritional programs, regular checkups, and access to antibiotics, oxygen, and intensive care could have given him a fighting chance. Even his severe malnutrition, so apparent in his fragile body, would likely have been addressed long before reaching this point. In the U.S., a child like him wouldn’t just be seen; he’d be saved. This experience gave me more hands-on exposure than I ever expected. But more than that, it exposed me to the brutal reality of healthcare inequity and the devastating cost when basic needs go unmet. Medicine is more than procedures and protocols. Sometimes, it’s about witnessing a loss that never should have happened and carrying it with you so it never happens again. After my week in the Pediatrics ward, something clicked. For the first time, I felt a real sense of direction, a clear understanding of not only what I wanted to do, but why becoming a Physician Assistant is the right path for me. That week, I rotated through three different pediatric settings: two days in outpatient, two in inpatient, and one unforgettable day in the pediatric ER. Each offered its own lessons, but it was those first two days in outpatient that lit something up in me. It wasn’t just interesting; it was fun. Surprisingly fun. I’ve always had a thing for puzzles. I find myself doing mini puzzle games all the time—during car rides, in waiting rooms, even while half-watching TV. There’s something so satisfying about taking scattered pieces and fitting them together to reveal the bigger picture. Outpatient care felt exactly like that. A child walks in with a list of symptoms, sometimes vague, sometimes oddly specific. You ask the right questions, listen closely, and examine carefully. You take all those disconnected pieces—the fatigue, the rash, the cough that won’t go away—and slowly, you build a picture. You work backward from the clues, solve the case, and figure out how to help them feel better. It’s medicine, yes, but it’s also a puzzle. And I loved it. Working alongside the Physician Assistants during those outpatient days was eye-opening. There was an ease to the way they moved—calm, confident, efficient. They listened to their patients, made swift yet thoughtful decisions, and always stayed one step ahead. Sometimes they’d already guessed the diagnosis before even starting the physical exam. It wasn’t rushed; it was refined, like muscle memory earned through years of practice. Watching them, I could see a glimpse of my own future. I imagined myself in their shoes: solving puzzles, guiding patients, making a real difference. It didn’t feel out of reach; it felt like the right fit. That week didn’t just reaffirm my career path. It gave me something more powerful: clarity. And for the first time, I could truly see the future I’ve been working toward. On my last day, we held a mental health awareness clinic at a local high school. One of the activities we did was simple on the surface: a piece of paper divided into four prompts—“I feel…,” “Because…,” “I wish…,” “I will….” The students filled them out anonymously and handed them in. Most were what you’d expect: stress about exams, pressure from home, friendships, the usual teenage chaos. But then I read one that stopped me cold: “I feel sad and scared because I like boys (I’m gay). I wish my friends and family would accept me. I will try to figure it out.” That was it. Just a few words. But behind them was a storm of fear, isolation, and incredible vulnerability. I sat there, holding the paper, unsure of how to even process what I had just read. This wasn’t a cry for attention; it was a silent scream from someone hiding in plain sight. What hit me hardest was realizing just how dangerous that confession was, even anonymously. I hadn’t fully grasped how severe the consequences of being gay could be in this country. Homosexuality isn’t just stigmatized; it’s criminalized. A person can be expelled from school, fired from their job, refused medical care, violently attacked, evicted from their home, or sentenced to up to 14 years in prison. And that’s not even counting the emotional trauma of being rejected by your own family. That student, whoever he is, is living a life of secrecy, fear, and constant self-monitoring. Just being seen could ruin everything. And he’s only a teenager. I wish I could have helped him. I wish I could have told him that he’s not alone, that his identity isn’t something to fear. It wasn’t long ago that being gay was illegal in the United States, too, and was only decriminalized in 2003. And same-sex marriage didn’t become legal until 2015. It’s easy to forget how recent that progress is. For millions around the world, it still feels impossibly out of reach. In Kenya, public pride parades are rare and dangerous. LGBTQ+ activism is heavily restricted. There are no laws that protect queer individuals from hate crimes or discrimination. The fear is not just cultural; it’s legal, physical, and endless. Reading that note reminded me why mental health advocacy matters. It reminded me that healing isn’t always about medicine; sometimes it’s about being seen, being heard, and being safe. And it reminded me that change takes more than time; it takes courage, protection, and people willing to listen to anonymous cries for help and say, “I hear you.” This journey has deepened my understanding of medicine beyond clinical skills and textbooks. It’s shown me that being a Physician Assistant is about more than just treating illness; it’s about listening when someone is afraid to speak, acting when others hesitate, and showing up fully, even in the hardest moments. I’ve witnessed the power of empathy in a crowded ER, the strength of resilience in underserved communities, and the urgent need for equity in global healthcare. I’ve seen how a single act, whether it’s saving a life on the street, holding a child’s hand, or reading a note from a student too afraid to be themselves, can ripple out and change lives. I am no longer the little girl with a plastic stethoscope and big dreams. I am someone who has seen the beauty and the brutality of medicine and who is ready to step into this role not just with knowledge, but with compassion, purpose, and unwavering commitment. Becoming a PA is no longer just my dream; it’s my calling.

Participating in the International Medical Aid (IMA) internship program in Mombasa, Kenya, was one of the most formative experiences of my academic and professional life. My time interning at Coast General Teaching and Referral Hospital not only solidified my passion for OB/GYN but also deepened my understanding of global health disparities and the importance of compassionate, culturally competent care. In-Country Support and Staff: The in-country support provided by IMA was exceptional. From the moment I arrived in Mombasa, I felt cared for and supported by the entire team. All of the mentors were approachable, knowledgeable, and always willing to answer questions or provide guidance, both in the hospital and outside of it. I especially appreciated their attentiveness when I was feeling under the weather; Mitchel always checked in on me and made sure I was okay, which meant a lot being far from home. I want to give a special shout-out to Hilda, who was absolutely awesome to be around. Her energy and warmth made the experience even more memorable. I especially enjoyed hanging out with her during the safari; she was fun, supportive, and made the trip memorable. Safety: Safety was a major concern of mine before arriving, but IMA did an excellent job maintaining a secure environment. Our housing was guarded 24/7, and we were advised on areas to avoid, appropriate dress codes, and how to navigate the city respectfully and safely. I never felt unsafe, and knowing that IMA was always reachable in case of emergencies gave me peace of mind. Accommodations and Food: The accommodations were clean, comfortable, and conducive to rest after long days at the hospital. Rooms were shared with other interns, which fostered strong friendships and a sense of community. The meals provided were consistent, nutritious, and offered a mix of local and international flavors. Having home-cooked meals prepared daily made a huge difference in helping us stay energized and healthy throughout the program. One of my favorite memories was getting to help the pastry chef bake cinnamon rolls and a cake for the other residents. Even though most of us didn’t have strong baking skills, he was incredibly welcoming and made the experience fun and relaxed. It was a small but memorable moment of connection and hospitality that made our temporary home feel even more like a community. Clinical Experience and Impact: The clinical rotations were diverse and eye-opening. I was exposed to several departments, including pediatrics, internal medicine, surgery, and maternity. I found myself deeply drawn to the labor and delivery ward, where I observed numerous births and even had the chance to assist in some non-invasive ways under supervision. This was where I discovered my true passion for OB/GYN. However, this area also exposed one of the most challenging parts of my experience: witnessing the lack of empathy in some clinical interactions. While technically proficient, many staff lacked bedside manner, rarely acknowledging mothers post-delivery. While this was difficult to witness, it also shaped my own understanding of the kind of provider I want to be: one who prioritizes both clinical excellence and compassionate care. Additionally, the resources in the hospital were lacking. From reusing supplies to patients having to bring their own bedsheets, the lack of basic necessities was an ongoing challenge. These experiences gave me perspective on the privileges of the healthcare system in the U.S. Community Impact and Cultural Insights: The program’s connection to the community was one of its strongest features. We weren’t just observers in a hospital; we were invited to engage with a broader conversation about healthcare access, economic disparity, and public health education. Many of the patients we encountered lived in poverty and were unaware of the healthcare services available to them. This highlighted the need for more than just clinical care; it underscored the importance of community outreach and education. IMA’s local partnerships and involvement in community projects show their commitment to making a sustained impact, not just hosting interns. This part of the program helped me understand that healthcare must be holistic, starting long before a patient enters a hospital and continuing long after they leave. Personal Growth and Long-Term Impact: This experience transformed not only my academic path but my worldview. I entered the program as a Pre-PA student, still exploring specialties. I left with a clear vision of becoming an OB/GYN and pursuing medical school instead of the PA route. The emotional and ethical insights I gained from this experience, especially the importance of empathy and equity, are lessons I carry into every patient interaction as a CNA and will continue to prioritize throughout my career. Since returning, I’ve shadowed OB/GYNs in the U.S. and found the same aspects of the field that inspired me in Kenya; emotional connection, variety, and challenge are just as alive here. That consistency across cultures affirmed my decision to pursue this path. Final Thoughts: I am incredibly grateful to International Medical Aid for facilitating such a meaningful, safe, and eye-opening experience. The combination of clinical exposure, cultural immersion, and ethical reflection has had a lasting impact on me as a future healthcare provider. While there were challenging moments, especially in observing disparities and resource shortages, these were necessary for growth and reflection. To anyone considering this program, I would strongly encourage them to go with an open heart, a respectful attitude, and a willingness to learn, not just about medicine, but about humanity. The impact this experience had on me was profound, and I know it will shape the kind of physician I become.

International Medical Aid truly pushed me to my limits in the best way possible. I learned so much during my time in Mombasa. Much of what I learned was medical, but I also took away a different perspective and mindset. I quickly learned that when being immersed in different cultures it is very important to understand why they do things the way they do and appreciate it. This experience will most definitely make me a better healthcare worker, along with a more well rounded person.

This program exceeded my expectations. The program is very well organized and I really liked how there were things planned every day for us to do whether it was mandatory or an optional tour. The residence was extremely safe; I never once felt unsafe. The food was incredible and the staff were very good with accommodating people with food allergies. All of the staff at the residence were extremely friendly and were always welcoming to any questions or concerns. This program has made a huge impact on me and on the way I view healthcare delivery. It has taught me a lot about Kenyan culture and shown me how to be creative when there is a lack of resources. I really respect all of the providers in Coast General and am so happy that I had the privilege of being able to shadow them and learn from them.