Internships in Arusha, Tanzania

My time in Kenya was one of the best experiences of my life. Interning in the hospital taught me so much about myself, nutrition, and the world. The clinical mentor Nashon in the ICU was one of the more helpful nutritionists I worked with—and while he challenged me, he also taught me so much. Each individual, from the mentors to the chefs to the interns, was so kind and made the experience so fun. The Masai Mara safari was definitely a highlight as well. The tour guide, Shadi, was so kind and really made the experience. I did feel that the program was geared a lot more toward pre-med fields, with mandatory sessions about suturing and clinical skills like that. As a nutrition intern, I sometimes felt out of place and that my time was not as well organized—but I still got so much out of the experience and would not trade it for the world! My recent nutrition internship with International Medical Aid in Mombasa, Kenya, was nothing short of transformative. Throughout my three week internship, I had the opportunity to experience hospital rotations in the pediatrics, oncology, and ICU units, participate in community health clinics about hygiene and women's health, and participate in cultural treks that gave me an expansive view of Kenya and its healthcare system. This experience opened my eyes to new aspects of healthcare delivery, nutrition practice, and political and cultural dynamics that will forever impact my career in nutrition and my approach to healthcare equity and global health overall. During my rotations at Coast Provincial General Teaching & Referral Hospital, I encountered a variety of nutrition-related conditions during my rotations in pediatrics, oncology, and the medical and surgical ICUs. The healthcare professionals I shadowed were working in an environment constrained by limited supplies and strained infrastructure despite having patients plagued by advanced malnutrition, dehydration, and complications resulting from infectious disease and poverty. However, I was most stricken by the lack of basic nutrition information from patients, especially during my rotation in the pediatric department. Formula feeding is very stigmatized in Kenya because breast milk is considered a safe feeding option for mothers battling with HIV/AIDS. Due to the stigmatization of formula feeding, mothers face excessive stress to ensure that their child is being fed properly, especially within the first six months of life. I saw many cases of children who were malnourished from the start of their life with symptoms such as muscle wasting, edema, weakened immune systems, and cognitive defects. On top of the stigmatization of breast feeding, mothers often failed to have adequate knowledge of breastfeeding despite it being the predominant form of feeding for their infants. The other nutrition interns and I performed breast feeding information sessions to large groups of mothers in the pediatrics unit to inform them on the proper way to hold their child when breastfeeding, how to get the child to suckle, and more. Being able to educate patients is the first step in making a change so being able to do this felt very impactful. Another example of limited access to nutrition education was during my rotation in the oncology department. Nutrition interns were given a pamphlet that outlined how to take care of yourself with cancer through methods like food, exercise, and sleep. While working in the oncology clinic taking the height, weight, and BMI of patients I left the pamphlet on the desk. An older man came in and shared that he had prostate cancer and had about six months left to live. He picked up the pamphlet and was immediately taken by the information inside. I told him he could keep it and he was incredibly grateful. I wondered why he was not given a care guide like this alongside his diagnosis and if he had, would his outcome have been different? Coming from America where the predominant nutrition related issues are obesity and chronic disease, I was shocked by the amount of kids facing food insecurity. According to the article Preventing and Treating Maternal, Adolescent, and Child Malnutrition written by UNICEF, “11 per cent of children are underweight, with four per cent wasted. Wasting and severe wasting are linked to increased and preventable deaths among young children,” (UNICEF). This was very prevalent in the pediatrics ward at Coast General Hospital and with just one nutritionist for the whole ward, this posed a challenge. Treatment options for these cases included vitamin supplements such as F-75, F-100, AminoGuard, and more in addition to counseling patients on how to increase their caloric intake. I found it challenging to see that even though a patient may have the proper nutrition information, a lack of monetary stability didn’t always make it possible for patients to have access to the food or supplements that they needed. This was new for me because in America, it is more common to have access and money to ensure that the changes a healthcare professional is providing can be implemented. Despite this, the problem solving techniques and resilience demonstrated by the medical professionals in these scenarios taught me that nutrition interventions can be creative and require deep contextual understanding. Kenya’s healthcare system operates under complex political dynamics. Areas such as Mombasa are historically underrepresented and underfunded. I saw firsthand how malnutrition in marginalized communities are deeply tied to such structural inequalities. For example, during my rotation in the surgical ICU, we saw a patient that needed liquid feed during his recovery from an Ileostomy because he was not able to properly break down micro and macro nutrients. These feeds were too expensive for him to purchase, however, so the nutrition team had to come up with a creative solution to this problem: Mala. Mala, fermented milk, naturally breaks itself down into glucose and galactose due to its enzymes. Therefore, Mala is very easy to digest and a cheap option for individuals who cannot afford the medication they need. This experience taught me that as a future nutritionist, it isn’t enough to focus solely on nutrient science. I must understand, and whenever possible help improve, the political, administrative, and infrastructural systems that determine supply chains, health education, and equitable program implementation. One unique experience that I had during my time in Mombasa was that I was present during a medical personnel strike. According to Daily Nation, “Doctors were promised salary adjustments and payment of arrears spread across different financial years, to be implemented in phases. However, the implementation has been plagued by delays, with healthcare workers pointing to bureaucratic inefficiencies and a lack of political will to honour the agreements,” (Daily Nation, 2025). This leads to healthcare workers' payment being delayed and them not getting the money they need in time. Many student nutritionists that I spoke with during my time at Coast General explained how even though you can be educated, it is extremely hard to get a job in Kenya. This is because it is necessary to have a connection to the place in which you are trying to get a job through family or status. This corrupt system leaves educated people working under-paying jobs and a shortage of healthcare workers overall. Political and structural issues directly impact a patient's access to care and this became evident during my time at Coast General. I found myself in a hospital lacking attending nutritionists, while hundreds of patients still needed basic care. This experience revealed the relationship between labor relations, government, and healthcare access and highlighted that effective nutrition care depends not only on clinical skills but also on policy stability and the rights of workers. My experience at IMA was more than just clinical exposure. It provided me with the opportunity to participate in community outreach. Being a part of the Women's Health Clinic and Hygiene Clinic were some of the highlights of my time in Kenya. Co-leading information sessions to educate kids about their bodies and how to take control of their health was such a unique experience. We were able to tell how genuinely interested they were about what we had to teach them and how much this information meant to them. Although it was hard to see the lack of basic knowledge when it comes to hygiene and health, we were really able to make a difference in the lives of these individuals. A particular moment when I felt really affected was during my first Women's Health Information Session. While we were handing out menstrual pads, girls were taking multiple and hiding them under their chairs or in their desks in order to get more. Although this could be seen as a practical joke done by the kids, I took it as an indicator of just how limited resources are in this area and what a need there is for help. Cultural norms, oral tradition, and location all affect access to accurate health information and resources so being able to set the facts straight with these populations can make a great impact. One thing that I was not anticipating to be such a challenge during the internship was the language barrier. While English is an official language in Kenya, many patients and community members are more comfortable speaking in Swahili. Communication required patience, empathy, and occasional translation support. I learned a greater message in this struggle, however. I learned that the basis of healthcare is always built on trust, mutual respect, and cultural humility. It is so important for nutrition professionals to be culturally competent and understand how to interact with those different from us because nutrition is such a personal topic. Things like religion, socioeconomic status, and environmental factors have a large impact on nutrition care and it is necessary to have a grasp on a patient's history before providing care. One thing that I found interesting was that on the front of each patient file was the patient's religion. Religion greatly affects how patients will respond to care in Kenya. For example, Muslim patients do not eat pork which is something that you would not want to overlook when having a conversation with a patient or creating their food regime. Even though I did not fully understand each religion or tribe in Kenya, I learned that moving forward in my career it is necessary that I stay curious and aware of the differences in patients. Before Kenya, public speaking was not one of my strengths. Although it is still not my favorite thing, my time in Kenya taught me to be a lot more confident in myself. From traveling halfway across the world on my own, to leading women's health information sessions, teaching about hygiene in schools, and having group discussions with nutrition professionals and interns my confidence improved exponentially. Teaching during health education sessions made me feel more confident in the field of nutrition as it combined nutrition science and food hygiene with community engagement. I learned to enjoy sharing health information with large groups of individuals which is something that I can definitely pursue in America especially as I get further along in my nutrition career. Healthcare environments at Coast General Hospital showed me the power of resourcefulness and problem solving. I learned new techniques and ways of looking at nutrition issues that I would never be able to find in a textbook. I learned how to listen to patients and complete urgent and challenging tasks with limited and underwhelming resources. One example of this is how all medical records are hand written. Charting took much longer than it would in America because everything was done on pen and paper. There was also a plethora of missing information on many charts because they were not available to Coast General or they were just never updated. Additionally, I saw nutrition professionals pivot when supplements ran out. In the pediatrics ward, one of the main supplements for malnourished children ran out, F-75. The nutritionist swiftly found another supplement, F-100, that could be used instead with a few modifications. This taught me how to deal with contingencies that are bound to happen in the medical field and emphasized the importance of problem solving that I will carry into my future career. My experience in Mombasa cemented my desire to become a nutritionist who also understands the social, political, and infrastructural drivers of nutrition. I envision a career that designs culturally adapted nutrition education for all individuals. It is important to recognize how factors such as funding inequities determine nutrition and healthcare access. In Kenya, there is a large difference between the public and private sectors of care. Public healthcare is government funded leading them to be understaffed, poorly equipped, and lacking supplies. Private hospitals have much better funding and facilities and they can handle more rare and serious cases of illness. According to The Center for Human Rights and Global Justice, “The wealthy may be able to access high-quality private care, for many, particularly in lower-income areas, the private sector offers low-quality services that may be inadequate or unsafe,” (The Center for Human Rights and Global Justice). It is unfair that individuals have to be wealthy in order to receive quality care. If I had to sum up my nutrition internship with two words it would be life changing. I learned that science and medicine are only powerful when paired alongside cultural empathy, political awareness, and peer collaboration. I saw that structural inequities greatly affect lives, that clinical skills must be flexible, and that meaningful change often begins with listening, adapting, and teaching. Going forward, I will build a career that incorporates both nutrition science and health equity. I am committed to respecting culture, navigating resource limitations, and advocating for policies that ensure every community has access to the nourishment they need to not only survive, but to thrive. While Kenya is very different from America, these are messages that can transcend continents, languages, and lives.

My experience with International Medical Aid in Peru was transformative, and the staff were at the heart of it. Their guidance, care, and example shaped not only my learning but also the way I now see medicine. Dr. Fabrizio was one of the most down-to-earth and knowledgeable teachers I have ever had the privilege of learning from. He led many of our lectures and constantly reminded us that health is never just physical; it is also mental. He taught us how to approach patients holistically and how to rely on our clinical skills and hands as tools when technology was limited. His way of teaching made complex concepts accessible and grounded, and his example will stay with me throughout my career. Dr. Miriam was equally impactful. She not only lectured with clarity and compassion but also worked alongside us in the community clinic in Andahuaylillas. I had the privilege of being with her when we saw a 78-year-old farmer who had not sought medical care in years. Watching her balance empathy with clinical skill as she cared for him was deeply moving, and it showed me what it means to treat a patient as a whole person, not just a list of symptoms. Our program coordinator, Manuela, created an environment where we always felt supported and welcomed. She was consistently kind, approachable, and attentive to our needs, which allowed us to feel at home even when we were far away. Surabhi and Juda also played an invaluable role in ensuring our safety and comfort throughout the program. They were present and attentive, often behind the scenes, and their commitment gave us the confidence to immerse ourselves fully in the experience without worry. What stood out most to me was that each staff member went beyond their formal roles. The physicians modeled the kind of care that sees patients as individuals with stories, while the program staff ensured that we had the structure and security to learn and grow. This combination made my time in Peru not only eye-opening but also profoundly fulfilling. The program has given me lessons about privilege, resilience, and holistic care that I will carry into my future in medicine, and for that I am deeply grateful to every member of the team. “Un día.” One day. This is what a nine-year-old girl said to me when I showed her pictures of my life back home. That simple phrase has stayed with me as it revealed both her dreams and my privilege. We don’t realize the opportunities we hold until we’re met with the reality of others. This was the greatest lesson I learned throughout my internship with International Medical Aid in Peru. Over several weeks in Cusco and the surrounding mountains, I saw the ways limited health education, scarce resources, and cultural barriers shape how people experience health. I listened to children who had limited education about hygiene or menstruation, to patients who had not seen a physician in years, and to elders who still relied solely on traditional remedies. I also saw resilience—in girls who proudly signed their names on pottery they sold to support themselves, in communities who welcomed us into their schools, and in physicians who made the most of every tool available. These experiences challenged me to rethink what it means to be a healthcare provider. They taught me that medicine is not just about treating disease; it is about building trust, offering education, and meeting people where they are. My time in Peru deepened my commitment to a career in healthcare, one rooted in empathy, humility, and advocacy. In every school and orphanage we visited, I realized how much of healthcare begins long before a patient steps into a clinic. Many of the children we met had never been taught how to wash their hands properly, why brushing teeth matters, or what to expect when their bodies begin to change. At the girls’ orphanage, we gave talks on dental care, handwashing, and menstruation, and their questions reminded me just how powerful basic education can be. Some of the girls believed that menstruation meant they were sick, while others were shy to even say the word. Watching their faces light up as myths were debunked was a reminder that information can be as healing as medicine. Back home, I had always taken school health classes for granted; in Peru, I saw what it meant when those lessons were missing. It struck me that the first prescription a physician can give is not always a pill—it is knowledge, dignity, and understanding. As a future physician, this lesson reminds me that I cannot assume patients come with the same baseline of health literacy I had growing up. If I want to truly serve my patients, I will need to carry this humility forward, taking the time to listen, explain, and leave them with more than a prescription—with the confidence and knowledge to care for themselves. That same lesson came into sharper focus during my rotation in Tópicos, where nearly every patient who walked in had varicose venous ulcers. We cleaned and re-dressed wound after wound, with many returning with infections and deterioration. One woman had scratched at her ulcer, not realizing the bacteria under her nails could worsen it beyond recognition. It wasn’t neglect; it was lack of guidance. The nurse explained that these ulcers were so common in Peru due to long-standing labor in agriculture and markets, high rates of obesity, and almost no access to early preventive care. She enlightened me that chronic venous disease thrives where occupational risks, delayed treatment, and poverty converge, and I could see that truth in every leg we bandaged. What I had glimpsed in orphanages—the cost of missing basic education—I now saw magnified in adults whose wounds had spiraled because no one had ever taught them how to care for themselves. In Canada, I grew up with hygiene lessons, clean water, and health literacy woven into everyday life; in Peru, those privileges were often absent, and the consequences were written directly on people’s skin. These structural inequities became even more visible during our community clinic in Andahuaylillas, where many of the patients we saw had not accessed medical care in years. One man I encountered, a 78-year-old farmer, had bilateral vision loss, severe back pain, and a chronic cough that had persisted for more than five years. Decades of agricultural labor, exposure to wood smoke from cooking fires, and his deep mistrust of physicians reflected patterns I later recognized were not unique to him, but part of a larger reality in Peru. He told us that nearly thirty years ago, doctors had advised amputating his leg due to a severe problem, but he refused and “treated it at home,” now claiming it was fine. That experience convinced him that doctors could not be trusted, reinforcing a reliance on home and traditional remedies—an approach I saw echoed in many rural patients. Chronic obstructive pulmonary disease (COPD) in Peru is often driven not by smoking, as in wealthier countries, but by biomass fuel exposure in rural areas and past tuberculosis infection in urban centers (Miranda et al., 2015). His case was a striking reminder of how structural and environmental conditions dictate disease pathways. I saw similar themes in patients who were either visibly malnourished or living with obesity—two extremes often rooted in the same absence of nutritional education and preventive care. Nearly 30% of Peruvian children suffer from anemia, with prevalence reaching 38% in rural areas, largely explained by socioeconomic and educational disparities (Al-Kassab-Córdova et al., 2022). These same inequities perpetuate adult conditions like venous ulcers, which worsen without early nutrition and wound care. At the other end of the spectrum, I also met patients struggling with obesity and hypertension, consistent with data from Lima showing that more than half of patients with type 2 diabetes live with additional chronic diseases such as obesity, hypertension, and dyslipidemia (Bernabé-Ortiz et al., 2015). My patient in Andahuaylillas was not just an individual with COPD or TB; he was the embodiment of Peru’s double burden of disease, where poverty, environment, and education converge to shape health outcomes. His story made me realize how much of my own access to clean cooking, preventive care, and trusted physicians has been a form of privilege I had never questioned before. This showed me that medicine is as much about context as it is about cure, and that healing begins with seeing the whole person along with the conditions that shape their daily lives. Another significant lesson I carried home was the manner in which Peruvian physicians approached mental health. Although I learned in lectures that Cusco has only about fifteen psychiatrists for the entire region, the doctors and nurses I observed never disregarded psychological well-being. They recognized that health cannot be separated into physical and mental dimensions, consistently seeking to make patients feel heard and understood. This was especially evident in the orphanages, where many of the girls had endured poverty, trauma, or domestic violence. Their questions to me revealed how deeply their environment shaped their sense of identity and purpose; some, not even two years younger than myself, asked whether I had a husband or children, as if a woman’s life were confined within these boundaries. At eighteen, I was struck by how different our realities were, and how limited social and educational opportunities had already narrowed their vision of what was possible for themselves. These conversations underscored that health is not only about physical well-being, but also about how people understand their worth, their opportunities, and their place in the world. I saw this perspective carried into practice at the community clinic in Andahuaylillas, where the physicians made it a priority to establish a station for a psychologist so that patients could receive mental health support after their medical evaluations. Their example reminded me that being a doctor requires seeing patients not only as clinical cases, but as whole individuals whose stories and experiences profoundly shape their health. They showed me that holistic care does not always depend on advanced technology or specialist services; it begins with empathy, attentive listening, and presence. While in Canada I have often taken for granted the growing recognition of mental health and the availability of counseling, in Peru I witnessed how deeply impactful it can be when physicians themselves integrate mental well-being into every encounter. This approach is one I intend to carry forward in my own career, ensuring that my patients feel acknowledged not only in their symptoms but also in their humanity. My time in Peru taught me what it truly means to be privileged. I had never realized how far my liberty extended or how much I had taken for granted. The ability to imagine a successful future for myself, to believe I could pursue it, and to access clean water, preventive health, and nutritional education are privileges that often pass unnoticed. In Peru, I saw the reality behind what happens when those pieces are missing: children growing up without health education, adults unable to manage preventable conditions, and elders relying on traditional remedies after losing trust in the medical system. Yet I also witnessed resilience—in young girls who inscribed their names into pottery to claim a sense of identity, in communities that welcomed us into their schools, and in physicians who, even with few resources, practiced medicine with empathy and intentional care. These experiences taught me that medicine is never only about treating disease, but about restoring dignity, sharing knowledge, and meeting people where they are. The physicians I shadowed modeled what it means to care for the whole person, listening to stories, acknowledging mental as well as physical well-being, and ensuring that every patient left feeling seen. Their example reshaped the vision I hold for myself as a future physician. I want to carry forward what Peru gave me: the discipline to look beyond symptoms, the humility to learn from every patient, and the responsibility to use my own privilege to bridge gaps in care. One day, I hope to stand fully in that role, offering my patients the same compassion and hope I once witnessed in Peru. Un día.