Medicine Internships in Caribbean

This program allowed me to grow as an ethical leader in my community, a leader who leads by example. My experiences at Coast General will forever shape my perspective on health care and scarce resources in healthcare settings. While in Kenya, I received constant support from the IMA staff. One specific example that stands out to me was when I was left in the lab by one of the CCC doctors. I called Hilda for support, and even though she was not working that day, she immediately sent Dr. Shaziim to support me. In the residences, the mentors would always be looking out for me, making sure I was healthy and happy as I completed the program. One specific moment in Internal Medicine that stood out to me was when I did rounds in the women's ward with Dr. Shaziim and the gastroenterologist. Dr. Shaziim incorporated my previous knowledge of HIV from the CCC into explanations to help me learn and build upon my knowledge. Thanks to their efforts to involve me in their diagnosis process, I now want to pursue gastroenterology.

This internship was an amazing once-in-a-lifetime experience that I am very grateful for. I have met so many wonderful people, including all of the program staff, interns, and hospital staff. Safety was a major concern for my family and me before my internship, but the program mentors and staff were very informative and cautious, so I felt very safe throughout my stay. The accommodations and food were also beyond what I expected. I have learned so much not only clinically, but culturally as well, and I would love to go back once more in the future. My internship this past winter with International Medical Aid in Mombasa, Kenya has opened my eyes to different perspectives and has given me a glimpse of what life is like in a place that is more than 10,000 miles away from my home. I have learned so much in not only medicine but in culture as well. Through the cultural treks and language classes provided by this program, I was able to learn about the history of the Swahili people, how the Kiswahili language came about, along with the traditions and practices of the culture of the people of Kenya. This opportunity has allowed me to gain meaningful experiences and relationships that I will forever cherish. I spent my internship at Coast General Teaching & Referral Hospital, where I had the opportunity to shadow both medical and clinical officers who play a large role in healthcare in three major departments: Emergency Medicine, Pediatrics, and General Surgery. Alongside these healthcare providers were nurses who play a critical role in patient-centered care and whom I came to befriend. Every day of my three weeks of this internship contained precious moments and learning points that have only furthered my passion for the medical field. Even through a slight language barrier, sincerity shines through, which is something that I will always carry into my practice as a future healthcare provider in the United States. If there is anything that has had a profound impact on my view of life, it is the realization that there is a limit to what I am able to control. From my experiences so far, whether in a medical setting or daily life, there is only so much I am capable of doing for people. This realization crossed my mind countless times as I thought about ways in which I could do more because in my current position, I have no say or control in a life-or-death situation, regardless of how dear someone may be to me. Especially as an intern and student, I was limited to speaking words of encouragement as I watched patients suffer, or simply waiting and hoping for good news. The desire to be able to do more than that has sparked my passion to pursue a career as a medical professional. The healthcare system I experienced in Kenya is notably different from the United States in terms of access to care, disease burden, and health coverage for patients. From the medical officers, clinical officers, nurses, and patients that I spoke to, I found that many patients do not seek care due to long distances and lack of transportation. Although hospitals are scattered throughout the country, they may not be evenly distributed throughout each region or neighborhood. Furthermore, some patients live closer to private hospitals but cannot afford them because they charge much more than public hospitals, which many patients are also unable to afford. This relates to Kenya’s poverty rates, with about one-third of the population living below the national poverty line in 2019 (World Bank, 2023). Additionally, the disease burden in Kenya is very high, with human immunodeficiency virus (HIV), which can develop into acquired immunodeficiency syndrome (AIDS), being one of the major communicable diseases. As for non-communicable diseases, major ones include cardiovascular disease (CVD) and metabolic diseases such as chronic kidney disease, diabetes, and hypertension, all of which contribute to the high disease burden in Kenya. The need for non-communicable disease services to be expanded has been recognized, with guidelines supporting these provisions in patients with HIV, but coverage still remains low (Smit et al., 2019). Additionally, during the Global Health Lecture Series presented by Dr. Shazim during our internship, we learned that the high burden of HIV and AIDS in Kenya accounts for about 29% of annual adult mortality, 20% maternal mortality, and 15% mortality in children under the age of five, which are much higher than mortality rates in the United States. Similarly, non-communicable diseases contribute to more than 50% of inpatient admissions and 40% of hospital mortality, which is also linked to a financial burden for these patients that is further connected to nationwide poverty. With a high disease burden in Kenya also comes a high financial burden, with a major issue being health coverage. Informal sector workers, a population that drives a significant portion of employment in Kenya, have a low rate of national healthcare insurance (NHI) enrollment. This may be due to existing socioeconomic inequalities and barriers they face, including limited access and having to pay NHI premiums out-of-pocket (Wamalwa et al., 2025). This contributes to increased morbidity and mortality due to inequitable access to care, as high out-of-pocket costs prevent patients in this population from seeking care. Studies suggest strategies such as using a tax-based system or expanding subsidies to support NHI enrollment among populations like this, though more research may be needed. Diving deeper into the healthcare system in Kenya showed me the existing gaps that prevent patients from receiving the care they need and ultimately contribute to mortality. My first thought when I learned about the healthcare system in Kenya was that these gaps seemed almost impossible to close. However, it made me think about how these gaps could be reduced, even slightly—whether by addressing health disparities through a health equity lens, focusing on advocacy, or working as a healthcare provider in a hospital setting. This led me to ask further questions, which eventually instilled in me a desire to contribute to making a difference. Although my role as an intern may have seemed insignificant in terms of what I was able to practice, I built many meaningful relationships with various people there and I would like to believe that I made a difference in at least one person’s life. Even though I cannot change the world, brightening one person’s day may feel to them as if something meaningful has changed. This could be the drop that turns into a ripple and has a lasting effect. If one drop can turn into a ripple, I can only imagine what numerous drops can do. I believe International Medical Aid is a wonderful example of how gaps in Kenya’s healthcare system can begin to close. Each intern interacts with numerous patients and healthcare providers and brings back a piece of their journey home to share their stories. Each intern may have also offered words of consolation, encouragement, and hope to the patients they encountered, giving them strength during what may have been the lowest points of their lives. I learned that the smallest acts can accumulate and become something deeply meaningful that touches people’s lives. Each person’s life holds immense value, and I want to be part of something that gives people the opportunity to value their own lives—whether by providing treatment options or simply being there to reassure and brighten their days. I want to be someone who brings joy into people’s lives, a shoulder to cry on when they are hurt, and a source of peace for those in their final moments of life, because that is what I would want if I were in such a position. I want to bring good news to families of patients who have recovered, console them when unexpected things occur, reassure them when they express concerns, and be someone not only patients can trust and rely on, but someone their families can rely on as well. My perspective on life has changed, and for that I am eternally grateful.