Internships in Arusha, Tanzania

Overall, the program was an incredible experience—well run and excellently executed. Mentors were consistently available for questions or concerns and were always very helpful. The security staff, along with the mentors, kept a close eye on our safety, and I never felt concerned. The accommodations were clean and much nicer than expected. The housekeeping and kitchen staff were incredible—kind, attentive, and accommodating. The program changed my outlook on medical care and patient interaction. It also reshaped my view of philanthropy and reinforced how important it will be to give back to the community once I am a physician. Additionally, I gained invaluable clinical experience and saw many cases I would never have had the opportunity to witness otherwise. The community outreach was one of my favorite parts of the program. I learned so much about the local community and the challenges it faces, and I felt fulfilled contributing—even in small ways. After returning from this trip, I hope to stay involved with IMA and support these outreach events from afar through donations. From an early age, I was surrounded by role models in medicine. While I didn’t know until high school that I wanted to pursue this career, helping people through science has always felt ingrained in me. Three of my grandparents were physicians, and my Grandma Jean would take my brother and me to medical conferences at the school of medicine she attended. These are some of my earliest memories of medicine—an exciting, innovative, fulfilling, and collaborative field. While the human body and science fascinate me, the answer to why I want to pursue medicine is simple: I strive to help and care for people. While in high school, I was fortunate to go on two volunteer trips to the Dominican Republic to teach English, but nothing could have prepared me for my first time walking into Coast General Teaching and Referral Hospital (CGTRH). I saw hallways crowded with people of all ages waiting to be seen, departments with worn facilities, and large, hot wards where patients rested without monitors. This was unlike anything I had seen before and made me eager to understand why conditions were the way they were—and what I could possibly do to help. Experiences from My Time in Kenya During my first week at CGTRH, I was placed in the Pediatrics Department. On my first day, I was assigned to Dr. Ken in the outpatient pediatric clinic. I had shadowed at an outpatient allergy clinic at my university, so I was interested to see how this outpatient clinic would compare. One striking difference was the absence of scheduled follow-up visits or well-child checks—there was a triage desk and a crowded waiting room of parents and children waiting to be seen. I learned that CGTRH is a referral hospital, with care focused less on preventive services and more on specialized treatment. Another barrier I observed was that, unlike in the U.S., only a small portion of patients have health insurance due to cost. This discourages preventive care and often delays seeking help until an issue has significantly progressed. Many cases with Dr. Ken were typical of pediatrics—coughs, runny noses, and fevers—but visits were necessarily brief given the volume of patients. I noticed that many children had been sick for an extended period before coming in. For example, a mother brought in a young boy with a cough who was rapidly losing weight, and Dr. Ken was concerned about tuberculosis (TB). TB isn’t something I had encountered often in the U.S., where incidence is relatively low. When I asked Dr. Ken more about the condition, he took me to the TB clinic where he also works. I observed Directly Observed Therapy (DOT), in which a clinician or trusted supporter observes a patient taking their medication. One patient had drug-resistant TB requiring multiple medications over many months. My astonishment at the differences in care continued in the inpatient Pediatric Ward. While rounding with an intern, I noticed children in metal beds with limited entertainment and minimal monitoring—more a reflection of staffing shortages than a lack of compassion. Many cases involved malnutrition and complications from limited preventive care. I’ll never forget bonding with a young, nonverbal boy with special needs whose face lit up when he grabbed my hand to stand on his bed and curiously touched my watch. That small moment made me feel I had brightened a patient’s day. The next week in the Accident & Emergency (A&E) Department was the hardest. On my first day in Pediatric A&E, I worked with Dr. Aisha, who ran the unit with urgency and decisiveness. A case that stood out involved a one-year-old likely in advanced stages of pediatric HIV. I learned how transmission can occur during pregnancy, birth, or through breast milk—and how prevention and treatment are possible with appropriate steps. It was heartbreaking to see how stigma can impede care, even when treatment is available. In adult A&E, I saw conditions starkly different from the U.S. Patients often waited hours for transfer or treatment, and pain medications were used far less. One night, a fourteen-year-old with a radius and ulna fracture awaited a closed reduction and would remain fully awake with minimal analgesia. He had declined additional pain control, likely due to cost. Hearing his screams during the procedure was devastating. I couldn’t help but compare it to my own childhood fracture, when I received sedation and went home with pain medication. The experience highlighted how resource constraints and poverty deeply affect care and patient experience. My next week was in Maternity. I had never seen a childbirth and was eager to learn. I’d heard that maternal health services are offered free of charge in Kenya, which affects resource allocation and staffing. I noticed staff were often unable to check on patients frequently, and communication sometimes happened over the patient rather than to the patient. The most striking difference from the U.S. was the limited availability of pain management for vaginal births—no epidurals, and often no fluids—though oxytocin was given after delivery and lidocaine used for suturing if needed. Family members were not allowed in the delivery room, which made me especially determined to provide kindness and support to laboring mothers. I also observed cesarean sections and other procedures in the OR. I was surprised by the speed and efficiency of C-sections, and relieved that mothers appeared comfortable. In addition, I saw a cervical tear repair and a hysterectomy. I left the week in awe of birth and with a deep appreciation for the strength of women’s bodies. During my last week, I rotated through Surgery. In the outpatient neurosurgery clinic, I saw many conditions more prevalent in Kenya than in the U.S.—including multiple cases of hydrocephalus. In the OR, I observed a shunt placement for a child I had seen the previous day, which was meaningful because I could follow the patient’s course of care. I also witnessed an open-heart tetralogy of Fallot (TOF) repair performed by a visiting cardiovascular surgeon from Rome, Dr. Roberts, who spent three weeks at CGTRH teaching local surgeons to perform the procedure. Beyond the awe of standing inches from a beating heart, I was inspired by his commitment to pay knowledge forward so more patients can be helped. My favorite and most impactful experiences were the public-health lessons in schools and the community outreach clinics. From my time in the hospital, I saw how essential it is to educate young women about reproductive health and children about hygiene. As a Public Health minor, I know many prominent diseases and much morbidity can be reduced through education. Especially where preventive care is less common, it’s vital to know what is normal or concerning, when to seek care, and how to stay healthy. Providing resources like pads and toothbrushes alongside education felt tangible and empowering for the community. I also loved engaging with local students. A visit to a school for students with special needs had a profound impact on me. I’ve worked with individuals with special needs before and find it deeply rewarding. Breaking through communication barriers and seeing smiles in response brought me joy. Although the school’s conditions were run-down, it felt meaningful to help IMA donate supplies—and to dance and spend time with the students—knowing we’d brightened their day and supported an under-resourced school. The IMA community clinic was another highlight. When our bus arrived, hundreds of people were waiting to be seen. It was difficult to see how many lacked access to affordable care. Working with an A&E doctor, I learned that many patients came primarily for needed medications to manage chronic conditions. As I’d witnessed in the hospital, gaps in steady treatment can lead to serious complications. I also observed how environment and living conditions shape health: many children had fungal infections, which, though treatable, can become serious without hygiene resources. I learned that children under fourteen receive periodic deworming because of risks from soil exposure and water quality; worms can cause malnutrition, diarrhea, anemia, and even death. Seeing these patterns through a public-health lens was eye-opening. One especially impactful case involved a woman with chronic back pain who needed an X-ray that cost 500 shillings—around three U.S. dollars. She couldn’t afford it. The doctor suggested setting aside 50 shillings each week until she could. It was hard to watch her leave without a diagnosis over such a small sum by U.S. standards, yet I admired the doctor’s practical, respectful solution. It reinforced my commitment to help people find paths forward and to be philanthropic wherever possible. My Future as a Physician I feel incredibly lucky to have learned so much from the staff at CGTRH and to have seen such a range of cases. Above all, I will carry forward the importance of patient interaction, kindness, and empathy. I saw firsthand that not everyone can access care, and that care is sometimes constrained by finances, patient volume, and staffing. Even so, I watched many clinicians do everything within their power to help—explaining carefully, thinking creatively, and treating patients as they would their own family. From my time in Kenya, I learned that every patient has a story—a life, a family, a job—beyond the chart. As a future physician, I hope to hold onto that perspective. It will help me treat patients with empathy and keep my passion for medicine alive by reminding me of the impact I can have. Connecting with the people and culture of a beautiful, drastically different country has had a profound impact not only on my life but also on my passion and ambition to help others through medicine.

I had an absolutely amazing experience during my time in East Africa through the International Medical Aid program. The staff and mentors were phenomenal. They were available 24/7 and truly listened to our feedback and requests whenever we had questions or concerns. I felt extremely safe the entire time and would absolutely recommend this experience to everyone. I left Kenya with an abundance of new knowledge regarding medicine, culture, language, and much more. I came back to the States with a completely new outlook on medicine and life, and I can’t wait to see how this experience will serve me in the near future! It was 5:45 a.m., just after my final flight landed, and I was greeted by the Mombasa city skyline glowing beneath a magnificent sunrise. The most beautiful shades of pink and orange blended effortlessly, as if they were hand-painted. As I gazed into the enchanting East African sunrise, it felt like home. But with every mile we drove, I felt farther and farther away. In the city, hundreds of people crowded the streets, many walking without shoes. Local shop owners were opening for the day—displaying goods unfamiliar to me. Traffic was chaotic. Buses, tuk-tuks, cars, and mopeds moved as if in a video game—obeying no rules or right of way. Dizzying thoughts came to me: Where am I? This doesn’t feel like real life. Did I make the right choice by coming here? A few days later, I approached the faded “Coast General Teaching and Referral Hospital” sign for the first time, and those same thoughts returned. The hospital was wildly different from anything I had seen before. Beds lined the walls of the “casualty” department, many occupied by people with oozing infections or stab wounds. The aroma of bleach mixed with blood filled the air. We seemed to follow a dotted trail of blood on the floor, passing a room that looked like it belonged in an old mental asylum. The hospital operated like a human body—many intricate systems working together to keep the whole functioning. Providers in the emergency department worked efficiently and tirelessly to treat incoming trauma patients. We passed by maternity, where nurses held newborns as they took their first breaths, and observed the ICU, where some people took their last. It was a lot to take in all at once. As my first rotation approached, I was nervous. At the Ear, Nose, and Throat (ENT) department, I was warmly greeted by the medical students rotating that week. They immediately struck up a conversation, asking more personal questions than I expected: “What is America like?” “What struggles do you have in America?” “Are you a Christian?” “Who are you voting for in the upcoming election?” I chuckled, knowing Americans ask much lamer questions on a first date. I felt guilty describing what America was like. It seemed unfair to look into their lives for a few weeks and then go home to a place where many of their problems didn’t exist. To my surprise, they were more curious than envious and spoke about Kenya with immense pride, showing me bracelets beaded with the Kenyan flag colors. My first takeaway came from this encounter: I live in a great country, yet I don’t have nearly enough pride in where I come from. The medical students led me into the exam room, where a physician’s kind smile lit up the space. Dr. Juma looked younger than most doctors I had shadowed in the U.S. but had an immense amount of knowledge about his specialty. I had purchased a 100-page, pocket-sized notebook for my notes over three weeks, but by my third day shadowing Dr. Juma, it was full. I learned more than I thought possible about different types of ear infections, tonsillitis, thyroid conditions, and much more. Every night after leaving my ENT rotation, I researched the cases I had seen that day, and my excitement for medicine grew. I even witnessed my first surgery—a tonsillectomy—one of the most common pediatric surgical procedures in Kenya (Oburra, 2001). By Friday, I had a newfound interest in ENT and took time to collect my thoughts about what I had seen. Two cases in particular stood out to me—one that still makes me smile and another that broke my heart. Midweek, a boy who appeared to be around five came in with a large facial tumor invading his face and most of his neck. It was impossible not to notice. His eyes seemed dull, as if the weight of the tumor burdened him physically and emotionally. I couldn’t imagine entering kindergarten not looking like the other kids. Dr. Juma examined him and quickly determined the growth was a cyst—fluid-filled and easily excisable via surgery. He reassured the father that the procedure would be straightforward and require little recovery time. For the first time since meeting him, I saw a sparkle in the boy’s eyes and the beginnings of a smile. Almost every job helps others in some way, but physicians have the unique privilege of changing lives and restoring a sense of normalcy, whether physical or emotional. They’re also in a vulnerable position—hearing people’s biggest insecurities, sharing their most painful moments, and sometimes being part of the best day of their lives. For this boy, Dr. Juma had the opportunity to give back the most important feature he had—his smile. The second case involved a girl with special needs who came for a hearing consult. The room quickly filled with her family—mom, dad, grandma, grandpa, aunts, uncles, and siblings—an army of support. The grandfather, clearly struggling, pushed her wheelchair toward Dr. Juma’s desk. The chair was falling apart: bent wheels, missing handles, and an eroded pleather seat. It broke my heart to see what a burden this old chair was for the family. It was obvious even this appointment would strain them financially. After the consult, I asked the nurse how much a new wheelchair would cost. “About 10,000 shillings, which is $77 USD,” she said. I understood why it was such an expense; I’d learned many families lived under a poverty line equating to about three U.S. dollars per day (Odhiambo & Njeru, 2019). Something as simple as a working wheelchair could change this family’s life, yet it stood in the way of getting her to appointments—or even outside. It was frustrating, especially seeing how loving and willing her family was to help. Physicians get to see people’s greatest needs and give from their excess. It may be impossible to erase poverty, but we can change one family’s life at a time by having eyes to see what they need. My next two weeks were in the surgical and maternity departments, where my spirit felt heavier. It was constantly up and down—happy and devastating, life and death. In one operating theater, surgeons miraculously returned organs to a newborn’s chest; in the next, a man screamed in pain after mistakenly waking during brain surgery. The highs and lows weighed on me, and I think my body responded by shutting down my empathy. On my first day, I couldn’t fathom how doctors could seem so uninterested when things went wrong or people died. They would pull the sheet over a patient and move on to the next. As I moved through more intensive rotations, I started to understand. Doctors and nurses are understaffed and overworked—there are approximately 16.5 healthcare workers per 10,000 people in Kenya (Odhiambo & Njeru, 2019). They’re under-resourced and tired of seeing problems they can’t fix. They treat septic, HIV, and TB infections all day, witness constant loss, and have little power to address root causes. Despite my frustration, I didn’t like feeling as if patients were just another helpless problem or time of death. It sickened me that I felt minimal emotion when a mother and baby died during childbirth. Although we’re taught to “turn off” our emotions when treating patients, I saw the harm it can do. Many laboring moms cried out in tremendous pain while being left in the dark about what was happening to them. A simple “We’ve got you, mama,” or “We’re going to help you through this,” can make all the difference to someone alone and in pain. Patients are human, just like us, and we should be allowed to laugh with them, cry with them, and pray with them—all of which, I believe, separates competent physicians from extraordinary physicians. My time interning in Kenya with International Medical Aid was truly an experience like no other—one that not only reinforced my love for health care but also softened my heart toward the communities around me. Although I’ve mostly discussed hospital experiences, I learned from every interaction I had. I met people with unwavering joy despite circumstances, a work ethic like none other, and a welcoming presence toward everyone. Many of the people and patients I met in Kenya are now who I strive to be more like back home. As for my journey to becoming a doctor, I realize the pressure I feel—getting good grades or scoring well on the MCAT—is an immense privilege. Having the opportunity to become a physician is one of the greatest gifts I’ve been given, and I intend to steward it well. This experience taught me what kind of physician I want to be: a smart, kind, empathetic doctor who always feels for her patients and provides the best care possible.