Internships in Rural Areas, Cambodia

The program was more than I could have ever expected. When I first arrived in Mombasa, I did not know what to expect. I was not even sure there was going to be a sign from IMA waiting outside of the airport for me. But when I stepped out from the airport I was greeted by an IMA staff member with kindness and hospitality. The staff at the residence was more than helpful by doing laundry daily, providing excellent meals, and willing to help with anything us interns may have needed help with. The program mentors were always very easy to approach and some I have become close with after my time in Kenya. I appreciate everyone's kindness and help during my time in Kenya. At the hospital, I learned more about healthcare than I expected. The doctors were kind, and willing to spend the time to teach us how they were treating the patients. Many of the medical staff also provided us insight on the healthcare system in Kenya. The community in Mombasa was welcoming and everyone I met was nice. When doing the Women's Health clinics, I could immediately see the impact we had on the young women we talked with. I distinctly remember meeting a young girl at one of the school we went to for a clinic and she was asking me if I was a doctor. I explained that I was in school to become one and she looked at me with such excitement and explained that she dreams of becoming a doctor one day. Seeing the girls hope in her eyes to become a doctor makes me realize how much of an impact we have on the schools we attended. I made sure to tell her she could do anything she set her mind to, because I truly believe that. That exchange I had with the young girl is the best example of how much I see we have made an impact on the community, not only by teaching about Women's hygiene but also showing that these girls can pursue the careers they choose to. The experience I had with International Medical Aid was one that more than exceeded my expectations. When I first discovered IMA, I was unsure of how much I may learn or experience, but after reaching Mombasa, I discovered a program that taught me far more about healthcare than I could have imagined. Not only did I learn about the overall experience as a healthcare provider, but also what healthcare looks like in Kenya and some of the differences in the healthcare system between East Africa and America. I have gathered a new appreciation for healthcare providers, especially those in the Coast General hospital. Coming to Coast General, I was not sure what to expect especially on the Physical Therapy side because many of the other interns there were pursuing Pre-Med or Pre-PA. But I met many Physical Therapists that welcomed me with such kindness and taught me a great deal about what it means to be a Physical Therapist. During my days in Coast General I rotated between six different in-patient Physical Therapy areas of the hospital. Each rotation I worked with a different Physical Therapist and learned something new that I will continue to value through my time as I pursue a career in healthcare. I began my first three days in the medical ward of the hospital with Omar. Omar was kind and welcoming, and a wonderful teacher. He showed me to every patient that he had in the ward and discussed with me the details of their prognosis and how a Physical Therapist would treat the patients. Many of the patients we saw in the medical ward were stroke patients. Omar spent time with me and the other Kenyan Physical Therapy students discussing the physiology of a stroke. He taught me many details on stroke patients such as the etiology, risk factors, the two types of strokes, the clinical presentation, and how a physical therapist may help a patient’s condition when presented with a stoke patient. After this discussion, we went to see some of the stroke patients and Omar continued to ask me questions about how I think we should proceed when presented with a stroke patient that had developed hemiplegia. His openness to my own learning experience while I shadowed him in the hospital is something I more than appreciate. Some of the things that PT would do with a stroke patient would be passive physiological exercises. The goal of this exercise would be to maintain joint range of motion, blood circulation, muscle tone and more. The only reason I am able to list these details is because of Omar and his openness in sharing with me his own knowledge. I have shadowed Physical Therapists in America, but I had never been met with such eagerness to teach than the therapists I met in Mombasa such as Omar. After my first three days in the hospital, I had already gathered a new respect for not only Physical Therapists overall, but also the ones I had met at Coast General. The next rotation I had in the hospital was in the surgical ward with the Physical Therapist Joanne. In this ward I saw neurological and general surgery patients who suffered from things like cervical spine fractures, traumatic brain injuries, and severe burns. The PTs would often ask me questions to understand more of my own knowledge on the different cases that we saw. Most of the questions I was unsure of, and the PT would send me home with homework to do some research on the condition of the patients we would see. Even for the Physical Therapist to have me do research outside of the hospital is something I appreciate because it shows even though they have just me they still care for me to learn. One of the more memorable patients we saw in the surgical ward was Nickson. Nickson was a burn patient who suffered from severe burns on both of his legs. I had learned that he had been in the hospital for five months and is still far from fully healing. One of the main tasks of the Physical Therapist when helping Nickson was to apply pressure on his knees to help him fully extend his legs as that what something he was unable to do after being burned. Watching the patient-therapist interaction is something that I have appreciated. I learned though my shadowing the importance of a Physical Therapists encouragement and support especially with a patient that is undergoing severe pain in the process of physical therapy. In addition, there were time it seemed to me that the therapist should have stopped the pressure on the knees to help Nickson fully extend them, but what I have learned is that there would be no progress in his injuries if he was met with insufficient exertion. The experience I had seeing the work Joanne was doing with Nickson made me appreciate the mental strength of a PT. It is hard to see someone suffering in any form, but to be able to have the ability to encourage someone to continue to help themselves and get better takes much strength. Each day I would return to see Nickson I could see the progress being made and it filled me with optimism and hope. Although I could see his pain, I could also see how the work of a Physical therapist can truly help someone’s recovery process. The other rotations I was able to do were in orthopedics, Peds, NBU, and the surgical and medical ICU. These rotations each taught me something new about the importance and purpose of Physical therapists. Each therapist I shadowed showed me something new about how important a physical therapist is when it comes to someone’s recovery or stability. The ability to shadow in several different specialties of physical therapy allowed me to see what I may be more interested in as I continue to pursue a career in physical therapy. The area that I enjoyed the most was orthopedics. During my time in the orthopedic ward the physical therapist was more than willing to teach me about the duties of a physical therapist when it comes to orthopedics. The most memorable aspect of ortho was seeing difference in physical therapy management between pre-surgery versus post-surgery. In addition, seeing the x-rays of the bone fractures before and after surgery seeing the check x-ray. There is so much that the physical therapist taught me one the protocol of therapy when it comes to a patient with a fracture. On the third day in orthopedics there was a new patient with a femur fracture and the therapist asked me how I would begin to help the patient. From what I learned in the past days in orthopedics I was able to share with her what I thought would be important for a physical therapist to have the patient do. To be able to shadow a PT who was willing and able to teach me about the responsibilities of a physical therapist is one that I greatly value. My time at Coast General, shadowing each of these therapists has allowed me to learn far more about physical therapy than I could have imagined. With IMA I was able to attend weekly Women’s health or hygiene clinics that allowed us interns to connect with the community and provide knowledge of various topics. I was able to attend two Women’s health clinics where we attended secondary schools in the community and discussed the female reproductive system as well as educated the students menstrual hygiene. The clinics gave me an opportunity to have a better understanding of the limitations girls face not only in Kenya but globally when it comes to menstrual hygiene. During the clinic we made sure to keep the girls engaged by asking questions to have a better understanding of their knowledge on menstrual hygiene. Most of the girls had a basic understanding, but I could immediately see the impact we had being there and giving the girls more insight on this important topic. Each one of them had many questions to further their knowledge on Women’s health and continued to show their excitement at our presence at their school. After the clinic was over, we were able to hand out pads to the girls. As an American who has grown up privileged to have access to something like pads, I truly gathered a new appreciation for the opportunity to be able to supply these young women with something that can truly help them feel more comfortable with their natural cycles. Not only did I see how educating the girls on Women’s health and supplying them with pads impact them, But I also saw how our presence as students ourselves made an impact. At the second Women’s Health clinic there was a young girl who asked me many questions after the lecture was over and one of them was if I was a doctor. I explained to her I was currently in school to be a doctor, and she looked at me with so much excitement in her eyes and said she dreams of being a doctor one day. This exchanged showed me how much influence we may have on these young girls we can have just by coming to their school. Through reaching out to the community in Mombasa, we had a significant impact on the girl’s lives. The opportunity that IMA gave us to be able to have such an impact on the community is one that has allowed me to have a new appreciation for my own experiences in life and even more being able to share this knowledge with these young women. During my time in Mombasa, IMA presented us interns with several different global health lectures where we learned about the history of pre- and post-colonial Kenya, disease burden in Kenya, and the Kenyan healthcare system. Through attending the lecture on pre- and post-colonial Kenya I was able to grasp a better understanding of the culture and history of Kenya. The lecture taught me of some cultural differences between America and Kenya. One of these differences is the number of ethnic groups in Kenya compared to America. Kenya is a diverse country with 44 ethnic groups and almost all speaking at least two languages. This to me represents the rich culture of Kenya and during my time in Kenya it is important to think about how diverse the country is. Another difference is the economy and poverty in Kenya. While Kenya is continuing to develop as a nation, it was clear to me not only from the lecture, but also during my time at the hospital that there is a great deal of poverty. Many patients at the hospital were unable to financially support themselves to receive treatment they needed from the hospital. This challenge is something I saw the healthcare providers have to navigate as they are trying to care for their patients, but without financial support sometimes they are unable to. In addition to the differences in economy, I also learned of the history of Kenya. Learning about the history of Kenya is something that was important to me during my time with IMA. In order to fully immerse myself into the culture of Kenya, learning of the history is an important step. Through this lecture I was able to better understand the experience of Kenya through history and how it came to be the way it is today. The lecture is one I value and remember during my entire time in Mombasa and still even after I have left that has given me an appreciation for the culture of Kenya. An additional lecture topic that I found to be important to understand during my time with IMA is the Disease Burden in Kenya lecture. During this lecture I was able to grasp more knowledge on the main diseases that are seen in Kenya. I found this lecture to be the most important to use as a resource when in the hospital so I could understand more of what the healthcare providers are mainly treating, one of these diseases being HIV/AIDS. HIV/AIDS is a disease that many patients in the hospital have and as I learned in the lecture has one of the highest mortality rates in Kenya. The lecture also mentions that over 50% of males in Kenya have HIV. This statistic alone exemplifies how prevalent HIV is in Kenya. Learning about these facts made me have a better understanding of what healthcare providers may have to deal with in the hospital and even in the community in HIV prevention education in order to slow the rates of infection in Kenya. In addition, diseases such as malaria, TB, of the respiratory system, skin diseases, and more are extremely prevalent in Kenya. Many of the patients in the Coast General hospital had these diseases and the doctors in the hospital are the ones that have to diagnose and treat these illnesses. It is important to understand how prevalent these diseases are in Kenya in order to understand how the doctors may try to manage these various illnesses. Of course, these are not the only illnesses of the disease burden in Kenya, but they are some of the ones I most frequently saw patients within the hospital. The lecture on Disease Burden in Kenya allowed me to understand the challenges that healthcare providers in Kenya often face and how they may manage the spread of these diseases. The last lecture I was able to attend was on the current state of healthcare in Kenya. This lecture was particularly insightful because I was able to grasp a better knowledge on the working of Kenya’s healthcare system. In Kenya there are three different categories of healthcare which when comparing to America is similar. Where I found more differences between America and Kenya is with the funding, accessibility, and outcomes. American spend much more on healthcare than the citizens of Kenya, but in Kenya many more citizens are paying out of pocket which can become difficult for the patients who cannot afford their needed healthcare services. In the Coast General hospital, this issue of being unable to pay medical bills was prevalent as many of these patients were not allowed to leave the hospital or did not get the service they needed until the bill was paid. It is important to consider the challenges that many healthcare providers must face when working in a hospital such as Coast General where they may be unable to care for a patient due to their economic status. Through this lecture I was able to understand more of the differences between Kenya’s healthcare system and America’s. My experience with International Medical Aid was one that I will never forget or take for granted. To be able to have the opportunity to immerse myself in a new culture is one that has allowed me to grow as a person. Being in the Coast General hospital for the three weeks I had there taught me to be more grateful for the life I have been gifted with. In addition, it has pushed me to want to give back to communities as well as be open minded to new experiences. The list of lessons I have learned during the internship could be endless, but mostly it has taught me what it means to be a physical therapist. The Therapists I worked with were kind, generous, and careful to be sure they gave the patients all the help and support they needed. There is not enough gratitude I can express to be given this opportunity to learn and grow during my time with Internation Medical Aid.

This experience was completely different than anything I've done in my life, but I am so happy that I leaped out of my comfort zone and came to Kenya! Everyone at IMA was very welcoming. They made sure we were safe in and out of the residence and were always available to address concerns. Before coming to Mombasa, I had never shadowed in a hospital before. Seeing the passion of the doctors and medical interns at Coast General taught me a lot about the hard work, dedication, and kindness it took to be a physician. It was interesting to see the differences in healthcare delivery, sanitation, and treatments offered in Kenya compared to the United States. One of the best parts of the trip was getting to interact with the locals. The weekly hygiene and menstrual health education sessions gave me a deeper look into the community of Mombasa. It was so cool to experience a new culture!