Internships in Kabale, Uganda


2 Internships in Kabale, Uganda
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International Medical Aid (IMA)
Global Perspectives in Nutrition Placement/Dietetic with IMA
International Medical Aid (IMA) is a not-for-profit organization ...
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Child Family Health International
Global Health in Kabale, Uganda
Become a part of the community in Kabale, a town located in south...
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Unearthing Abundance at Home
by: Emmanuel Phiri - ZambiaProgram: Global Health in Kabale, UgandaAs African students, we often overlook the incredible wealth of opportunities for growth and adventure right within our own continent. While we’re quick to associate study abroad experiences with Western nations, Africa is bursting with rich cultures and diverse communities just waiting to be explored! How often do we dare to venture beyond our national borders and immerse ourselves in the vibrant social, economic, and cultural tapestry of our neighboring countries? As a fifth-year medical student at the Copperbelt University School of Medicine in Zambia, I felt a profound drive to grasp global health through the lens of Africa. Despite living on this magnificent continent, I realized I knew very little about the intricate cultural nuances and healthcare systems that flourished in other African nations. This gap in knowledge ignited my passion for exploration, and that’s where Child Family Health International (CFHI) came into play, serving as the perfect launching pad for my journey. "The world is a book, and those who do not travel read only one page." This quote by Saint Augustine echoed in my mind throughout my eye-opening experience with CFHI in Kabale, Uganda. It was a powerful reminder of the importance of immersing ourselves in different cultures and embracing unique healthcare systems. The program thrust me into a new culture, gifting me invaluable insights into the significance of intercultural communication and ethics in healthcare. My time at the Kigezi Healthcare Foundation (KIHEFO) clinics was particularly illuminating. Thanks to CFHI's thorough pre-departure courses, I gained essential knowledge that shaped my experience. As I reflect on my journey, the Africa CDC Public Health order comes to mind, emphasizing the need for unity in addressing our continent's health challenges. My interactions with CFHI reiterated the notion that understanding our individual and collective roots is vital to realizing the dream of a united Africa. The adventure began with a twist when I hilariously missed my flight with RwandaAir on Saturday, November 2nd, 2024, at 5 PM GMT+2. My plans to land in Kigali, Rwanda, to meet my local coordinators and head to Kabale, Uganda—a mere two-hour drive across the Gatuna border—had quickly turned chaotic due to unforeseen traffic jams. Anxious and late, I managed to rebook my flight (at a bit of a cost) and decided to spend the night at the airport, rather than face the pricey trip home. Fortunately, I embarked on my journey the next day, Sunday, at 4 PM GMT+2. Despite stormy weather causing some delays, we touched down in Kigali by 9:30 PM. Upon my arrival, I was warmly welcomed by my preceptors, Prosper Ainemukama and Praise, who, despite their tiredness, radiated kindness. By 1 AM, I found myself in Kabale, just minutes from the border, thanks to our skilled driver, Mr. Tony, who expertly navigated the thick fog. Morning broke, and I was greeted with a breakfast of bread and scrambled eggs that tasted like home. Everything around me felt foreign yet inviting, and the genuine warmth of the local people quickly enveloped me. I formed a special bond with my new neighbors in the apartments, particularly with the lovely Madam Bibiana who managed the kitchen and her husband Mr. Fred, alongside the cheerful Doreen, who took care of cleaning. They welcomed me like family. At 9 AM, I set off on a guided stroll around town with my preceptor Prosper, my heart brimming with enthusiasm and curiosity. Together, we explored the bustling KIHEFO clinic, engaged with the dedicated staff, and roamed through local markets filled with vibrant life. Every moment allowed me to soak in the lively spirit of Kabale—a small yet dynamic town where the “boda boda” motorcycles, a novel sight for me coming from Zambia, whizzed by as the primary mode of transport. For longer journeys, larger buses were ready to take travelers to the capital, Kampala, an eight-hour drive away. I fell head over heels for Kabale, captivated by its lush mountainous scenery and cool, refreshing climate. Truly, as the books say, it is the pearl of Africa—a shining gem that embodies the essence of Uganda. My regular visits to the clinic became a canvas for my skills, allowing me to engage in Diabetic Week, where I screened, counseled, and raised awareness about diabetes among community members while honing my communication skills, cultural humility, and competence. My first week was a whirlwind of introductions to the local environment and KIHEFO’s invaluable activities. One standout moment was a 32-kilometer drive along the Mbarara road to participate in a mobile HIV/AIDS clinic. This hands-on outreach experience grounded me in the power of community engagement, as I witnessed locals come together for essential care. Distributing ART drugs and providing necessary counseling alongside the team, particularly Dr. Brighton—the sole licensed physician—filled my heart with fulfillment. His impactful insights during our brief conversations sparked an even greater passion for global health and our collective ability to effect change. Engaging with the local community through mobile clinic outreach was undoubtedly one of the most rewarding highlights of my journey. Traveling beyond the town to meet patients on antiretroviral therapy (ART) offered me a new lens to view how we could enhance follow-up care and amplify peer support. One particularly heartwarming moment was when community members rallied around a colleague who had stopped taking their medication, beautifully illustrating the profound impact of peer encouragement. I also dove into learning about the local language and culture, which allowed me to forge genuine connections with community members through shared laughter and meaningful interactions. Conversations with Dr. Geoffrey Anguyo, KIHEFO’S founder and Executive Director, expanded my understanding of Uganda's health system, delving into maternal and child health and the challenges of malnutrition. I was particularly captivated by the 'Rabbit Project,' a visionary initiative aimed at combating malnutrition by providing both a source of food and an avenue for income. Visiting the rabbit-rearing sites was a true eye-opener, showcasing their innovative approach to sustainable living. My final week in Kabale took me to the indigenous Batwa community, whose story of displacement, marginalization, and immense resilience left a lasting impression on me. Forcibly moved from their ancestral lands to make way for national parks, the Batwa faced daunting challenges, grappling with the loss of their skills and resources to navigate this new reality. Witnessing their strength and determination was a profoundly moving experience. Of course, living and working in a foreign environment came with its share of hurdles. I encountered language barriers, embraced cultural differences, and faced moments of uncertainty. Yet, it was precisely in these challenges that I unearthed invaluable lessons in humility, adaptability, and personal resilience. Initially, I was enthusiastic about the prospect of sharing this experience with fellow students, but when I learned I’d be embarking on this journey alone, I felt a wave of apprehension. My expectations of fun and camaraderie dimmed momentarily, but I soon realized that this individual experience would be rich in its own right. I also anticipated that the lifestyle and healthcare system in Uganda would mirror those of Zambia, given our shared African heritage. To my delight, I discovered distinct cultural nuances and approaches that left me pleasantly astonished and forever changed. Reflecting on my time in Kabale, I can’t help but appreciate the power of immersion and experiential learning. This journey transcended the acquisition of new skills or knowledge; it was a voyage of self-discovery, revealing my strengths, weaknesses, and passions. Kabale has imprinted itself on my heart, and I will carry the lessons and memories from this incredible experience for a lifetime. For anyone considering a global health experience, I wholeheartedly recommend Kabale as your top choice. Immerse yourself in the remarkable work being done by the team at KIHEFO, and embrace the adventure with an open mind, flexibility, and a willingness to take risks. Don't shy away from the unknown or fear making mistakes. Kabale is a treasure trove of beauty, warmth, and resilience—prepare to fall in love with this enchanting town and its extraordinary people!
Without question the most extraordinary experience of my life
by: Alexandra Battaglia - United StatesProgram: Global Perspectives in Nutrition Placement/Dietetic with IMAThis was, without question the most extraordinary experience of my life, and I would recommend this program in the utmost. I cannot speak highly enough of the IMA staff - the program mentors, residence staff, and drivers each went far above and beyond to make this experience as enriching as possible. I cannot adequately express the depth of my gratitude to each of these extraordinary people, all of whom welcomed and supported me every step along the way, despite the unexpected obstacles that were faced. The IMA team afforded me plenty of independence to take the initiative to make this experience my own while invariably grounding me in a strong network of support. The accommodations were fantastic; I felt incredibly safe, both from a security and from a hygiene perspective. The food was phenomenal; the talented cooks were incredibly accommodating of my particular dietary needs while still ensuring I was able to enjoy Kenyan cuisine. The degree to which IMA is embedded into the community through local outreach initiatives is one of the highlights of this program. It’s beyond question that the organization devotes as much of its resources to the community as possible. As I consider my experience as an IMA intern, I would be remiss if I did not begin with a reflection on my ignorance and privilege. Before my venture to Kenya, I was well aware that I am an ignorant and privileged Mmarekani who’s seen so little of the world, but I did not fully grasp the impact of ignorance or appreciate the degree to which one person’s social privilege can affect others. I recall a conversation that I overheard on the flight to Mombasa. Two individuals in the row opposite my own were discussing how the United States uses propaganda to misrepresent African culture. One passenger noted that American media is apt to report on violence and famine but quick to ignore the progress and contributions of African nations. The other replied that Americans also fail to recognize the diversity that exists within Africa. Indeed, in Kenya alone, there are over forty tribes and more than as many languages spoken—and this represents but one of Africa’s 54 countries (American University, n.d.; Balaton-Chrimes, 2020; United Nations, 2021). I was later engaged in dialogue with a local who echoed the sentiment of my fellow passengers, remarking that many Americans think of Africa as a country rather than a continent. I was disheartened to realize, upon reflection, that I agree with him—perhaps not in a literal sense, but I’d wager that the designation as a continent is the extent of most Americans’ expertise on the subject. I’d go so far as to postulate that most—admittedly including myself before this experience—couldn’t name more than a few African countries and, even of those they could name, could hardly tell you a single thing about their history, government, or culture. After all, we Wamarekani seem to be, by and large, ignorant of every part of the world that lies outside our country’s borders. As I contemplated these comments and the perception of America that they reflect, I began to wonder why we are not more alarmed that this is the state of our country. Why do we demonstrate such self-absorption? Particularly considering the vast privilege so many of us carry, should we not endeavor to become deeply embedded within our global community so that we may use our resources to assist others in raising themselves from disadvantaged circumstances? This is certainly not a novel concept, but I suspect one of the obstacles it faces is what I’ve observed to be a natural aversion to accepting that one is privileged; people prefer to maintain that they’ve “earned” everything they have. But we need not be afraid of acknowledging privilege. I’ve come to believe that privilege itself is not the “problem”—it’s what we choose to do with it that matters. I don’t think anyone embodies this quite as poignantly as one of my peers, a medical student whom I had the great honor of befriending through this experience. Much could be said about her—about her passion, medical brilliance, and worldliness. From her, I was fortunate enough to witness the wielding of privilege in a manner that resulted in a resounding positive impact. She engaged her social media presence, connections, and medical knowledge to raise funds for the procurement of supplies for the hospital, two local orphanages, and a home for the elderly. Her courage, industriousness, and dedication in pursuing her own avenue of service cannot be overstated. From her, I learned that within the realm of humanitarian work, one must not be solely occupied with their “program” so to speak—one must go beyond the tasks assigned to them and reflect critically to identify how they, as an individual with unique skills and assets, might leverage the resources their privilege has afforded them to best contribute to the community they serve. We all have attributes and tools that, when fully engaged, allow us to bring something more to what we do. I am deeply grateful for the community work in which I was able to participate as an IMA intern. Assisting at the free, community medical clinic was among the most memorable experiences of my life. Initially, the planning did not include a nutrition station at the clinic; however, a fellow IMA nutrition intern advocated for its addition, having found a Coast General nutritionist willing to attend with us. In the days prior to the event, the two of us worked closely with the nutritionist to prepare materials and coordinate our roles. At the clinic, I was responsible for conducting anthropometric assessments and determining whether to refer patients to the nutritionist for counseling. We assessed hundreds of patients, representing a wide range of health statuses. Considering 60% of Kenya’s population is moderately or severely food insecure, I expected to see predominantly an underweight presentation of malnutrition (World Bank, 2019b). However, I encountered both under- and overweight patients. Indeed, in recent years, Kenya has seen a trending increase in mortality from noncommunicable diseases, many of which are associated with obesity and its contributing lifestyle factors (World Bank, 2019a; WHO, n.d.). This comes as U.S. dietary patterns exert increasing influence and corrupt a diet traditionally bountiful in fruits, vegetables, legumes, and other nutritious staples. I often discussed such topics with the aforementioned nutrition intern, an accomplished dietitian with a strong dedication to charitable works and someone from whom I learned a great deal. Beginning my first days there, he quizzed me with the occasional scientific question of a nutritional nature, on subjects ranging from medium-chain fatty acids to sports drinks. Anytime I did not know the answer, I asked him to tell me, as is my curious nature. He would respectfully reply that I should look it up and tell him the answer. This was initially quite confusing to me; I expected him to provide a response, seeing as he was the one testing me and presumably knew the answer already. However, I came to recognize and appreciate the value of the lesson he was teaching me: that one must have their own mind—that one must review the science to inform their own conclusions rather than blindly accept knowledge imparted to them by others, qualified as those others may be. Nutritional science is a complicated and rapidly-evolving field; on any given subject, there are numerous interpretations of the literature. I realized from my time with him that to become a competent dietitian, it is necessary to traverse these murky waters in order to develop an informed knowledge base, one that can be used to justify every piece of nutritional advice one sets forth. This lesson could not have come at a better time, as it was with this mindset that I entered the pediatric department at Coast General Teaching and Referral Hospital. Having never worked with watoto before, I was keen to gather every ounce of knowledge that I could, as the many pages of notes in my journal can attest. During my week in the department, I learned, for example, about taking MUAC measurements, differences between the presentation of chronic and acute malnutrition, formulas appropriate for the treatment of harisha, and nutritional implications of pediatric hepatitis. I recall a particular child—he was on a restrictive protein regimen of 0.5 g/kg due to his hepatitis. We started him on a formula low in protein but with a higher-than-typical ratio of branched-chain amino acids in an attempt to optimize utilization of what little protein his liver could tolerate. I assisted the nutritionist in designing a menu that would accommodate his nutrition prescription. What I’ll never forget, though, was his smile—it was bright enough to light the city, and I couldn’t help but smile too when he’d laugh and point at the monkeys that scurried along the window sill. The clinical knowledge is important to remember, but so too are these moments. I have suspected for some time that this environment of work would be one in which I would find my calling. However, having never been to a low-resource region of the world, I could not know for certain. My time in the hospital was far too short, but even so, I can report in earnest that I did, indeed, find the sense of purpose that I’d hoped. Coast General can certainly be a challenging environment to say the least, but one must be sensitive to the numerous obstacles that public hospitals face. Lack of staff, lack of resources, and corruption each take their toll. I don’t really know how I’d begin to describe the emotions I experienced on a daily basis, but I can say that there is a complicated pain that accompanies this work. However, I’ve grown to realize that this pain is, in part, what drives me to be in this environment—to be part of a collective committed to serving its most vulnerable, no matter the conditions. I would love to be able to describe, clearly and succinctly, why exactly I feel, despite its challenges, such an intense connection to this particular professional endeavor. Perhaps all I need say is that during my internship, I awoke very early each morning simply because I couldn’t keep myself in bed any longer, as every part of me wished so fervently to do the work before me. As a mere mwanafunzi, I was not, in many situations, able to contribute to the degree that I wished while at the hospital; in my lack of knowledge and experience, I often relied on others to teach me what to do. Of course, there were tasks I could undertake independently—assessments I could conduct, calculations I could perform—but I yearned for the day when I might return, finally able to give time and knowledge rather than take it from others. The nutritionists at Coast General so graciously mentored me, and I vehemently look forward to the opportunity to honor that generosity by returning to use that knowledge in service of communities in need. Alas, until then, I shall wear my bangili, decorated with the Kenyan flag, as a reminder of this most transformative experience and as a tribute to the singular people that I had the exceptional honor of coming to know—people of boundless kindness, profound wisdom, and admirable resilience, people whom I hold dear to my heart and to whose contributions of time and tutelage I hope to do justice as a member of our global community.
Unearthing Abundance at Home
by: Emmanuel Phiri - ZambiaProgram: Global Health in Kabale, UgandaAs African students, we often overlook the incredible wealth of opportunities for growth and adventure right within our own continent. While we’re quick to associate study abroad experiences with Western nations, Africa is bursting with rich cultures and diverse communities just waiting to be explored! How often do we dare to venture beyond our national borders and immerse ourselves in the vibrant social, economic, and cultural tapestry of our neighboring countries? As a fifth-year medical student at the Copperbelt University School of Medicine in Zambia, I felt a profound drive to grasp global health through the lens of Africa. Despite living on this magnificent continent, I realized I knew very little about the intricate cultural nuances and healthcare systems that flourished in other African nations. This gap in knowledge ignited my passion for exploration, and that’s where Child Family Health International (CFHI) came into play, serving as the perfect launching pad for my journey. "The world is a book, and those who do not travel read only one page." This quote by Saint Augustine echoed in my mind throughout my eye-opening experience with CFHI in Kabale, Uganda. It was a powerful reminder of the importance of immersing ourselves in different cultures and embracing unique healthcare systems. The program thrust me into a new culture, gifting me invaluable insights into the significance of intercultural communication and ethics in healthcare. My time at the Kigezi Healthcare Foundation (KIHEFO) clinics was particularly illuminating. Thanks to CFHI's thorough pre-departure courses, I gained essential knowledge that shaped my experience. As I reflect on my journey, the Africa CDC Public Health order comes to mind, emphasizing the need for unity in addressing our continent's health challenges. My interactions with CFHI reiterated the notion that understanding our individual and collective roots is vital to realizing the dream of a united Africa. The adventure began with a twist when I hilariously missed my flight with RwandaAir on Saturday, November 2nd, 2024, at 5 PM GMT+2. My plans to land in Kigali, Rwanda, to meet my local coordinators and head to Kabale, Uganda—a mere two-hour drive across the Gatuna border—had quickly turned chaotic due to unforeseen traffic jams. Anxious and late, I managed to rebook my flight (at a bit of a cost) and decided to spend the night at the airport, rather than face the pricey trip home. Fortunately, I embarked on my journey the next day, Sunday, at 4 PM GMT+2. Despite stormy weather causing some delays, we touched down in Kigali by 9:30 PM. Upon my arrival, I was warmly welcomed by my preceptors, Prosper Ainemukama and Praise, who, despite their tiredness, radiated kindness. By 1 AM, I found myself in Kabale, just minutes from the border, thanks to our skilled driver, Mr. Tony, who expertly navigated the thick fog. Morning broke, and I was greeted with a breakfast of bread and scrambled eggs that tasted like home. Everything around me felt foreign yet inviting, and the genuine warmth of the local people quickly enveloped me. I formed a special bond with my new neighbors in the apartments, particularly with the lovely Madam Bibiana who managed the kitchen and her husband Mr. Fred, alongside the cheerful Doreen, who took care of cleaning. They welcomed me like family. At 9 AM, I set off on a guided stroll around town with my preceptor Prosper, my heart brimming with enthusiasm and curiosity. Together, we explored the bustling KIHEFO clinic, engaged with the dedicated staff, and roamed through local markets filled with vibrant life. Every moment allowed me to soak in the lively spirit of Kabale—a small yet dynamic town where the “boda boda” motorcycles, a novel sight for me coming from Zambia, whizzed by as the primary mode of transport. For longer journeys, larger buses were ready to take travelers to the capital, Kampala, an eight-hour drive away. I fell head over heels for Kabale, captivated by its lush mountainous scenery and cool, refreshing climate. Truly, as the books say, it is the pearl of Africa—a shining gem that embodies the essence of Uganda. My regular visits to the clinic became a canvas for my skills, allowing me to engage in Diabetic Week, where I screened, counseled, and raised awareness about diabetes among community members while honing my communication skills, cultural humility, and competence. My first week was a whirlwind of introductions to the local environment and KIHEFO’s invaluable activities. One standout moment was a 32-kilometer drive along the Mbarara road to participate in a mobile HIV/AIDS clinic. This hands-on outreach experience grounded me in the power of community engagement, as I witnessed locals come together for essential care. Distributing ART drugs and providing necessary counseling alongside the team, particularly Dr. Brighton—the sole licensed physician—filled my heart with fulfillment. His impactful insights during our brief conversations sparked an even greater passion for global health and our collective ability to effect change. Engaging with the local community through mobile clinic outreach was undoubtedly one of the most rewarding highlights of my journey. Traveling beyond the town to meet patients on antiretroviral therapy (ART) offered me a new lens to view how we could enhance follow-up care and amplify peer support. One particularly heartwarming moment was when community members rallied around a colleague who had stopped taking their medication, beautifully illustrating the profound impact of peer encouragement. I also dove into learning about the local language and culture, which allowed me to forge genuine connections with community members through shared laughter and meaningful interactions. Conversations with Dr. Geoffrey Anguyo, KIHEFO’S founder and Executive Director, expanded my understanding of Uganda's health system, delving into maternal and child health and the challenges of malnutrition. I was particularly captivated by the 'Rabbit Project,' a visionary initiative aimed at combating malnutrition by providing both a source of food and an avenue for income. Visiting the rabbit-rearing sites was a true eye-opener, showcasing their innovative approach to sustainable living. My final week in Kabale took me to the indigenous Batwa community, whose story of displacement, marginalization, and immense resilience left a lasting impression on me. Forcibly moved from their ancestral lands to make way for national parks, the Batwa faced daunting challenges, grappling with the loss of their skills and resources to navigate this new reality. Witnessing their strength and determination was a profoundly moving experience. Of course, living and working in a foreign environment came with its share of hurdles. I encountered language barriers, embraced cultural differences, and faced moments of uncertainty. Yet, it was precisely in these challenges that I unearthed invaluable lessons in humility, adaptability, and personal resilience. Initially, I was enthusiastic about the prospect of sharing this experience with fellow students, but when I learned I’d be embarking on this journey alone, I felt a wave of apprehension. My expectations of fun and camaraderie dimmed momentarily, but I soon realized that this individual experience would be rich in its own right. I also anticipated that the lifestyle and healthcare system in Uganda would mirror those of Zambia, given our shared African heritage. To my delight, I discovered distinct cultural nuances and approaches that left me pleasantly astonished and forever changed. Reflecting on my time in Kabale, I can’t help but appreciate the power of immersion and experiential learning. This journey transcended the acquisition of new skills or knowledge; it was a voyage of self-discovery, revealing my strengths, weaknesses, and passions. Kabale has imprinted itself on my heart, and I will carry the lessons and memories from this incredible experience for a lifetime. For anyone considering a global health experience, I wholeheartedly recommend Kabale as your top choice. Immerse yourself in the remarkable work being done by the team at KIHEFO, and embrace the adventure with an open mind, flexibility, and a willingness to take risks. Don't shy away from the unknown or fear making mistakes. Kabale is a treasure trove of beauty, warmth, and resilience—prepare to fall in love with this enchanting town and its extraordinary people!
Without question the most extraordinary experience of my life
by: Alexandra Battaglia - United StatesProgram: Global Perspectives in Nutrition Placement/Dietetic with IMAThis was, without question the most extraordinary experience of my life, and I would recommend this program in the utmost. I cannot speak highly enough of the IMA staff - the program mentors, residence staff, and drivers each went far above and beyond to make this experience as enriching as possible. I cannot adequately express the depth of my gratitude to each of these extraordinary people, all of whom welcomed and supported me every step along the way, despite the unexpected obstacles that were faced. The IMA team afforded me plenty of independence to take the initiative to make this experience my own while invariably grounding me in a strong network of support. The accommodations were fantastic; I felt incredibly safe, both from a security and from a hygiene perspective. The food was phenomenal; the talented cooks were incredibly accommodating of my particular dietary needs while still ensuring I was able to enjoy Kenyan cuisine. The degree to which IMA is embedded into the community through local outreach initiatives is one of the highlights of this program. It’s beyond question that the organization devotes as much of its resources to the community as possible. As I consider my experience as an IMA intern, I would be remiss if I did not begin with a reflection on my ignorance and privilege. Before my venture to Kenya, I was well aware that I am an ignorant and privileged Mmarekani who’s seen so little of the world, but I did not fully grasp the impact of ignorance or appreciate the degree to which one person’s social privilege can affect others. I recall a conversation that I overheard on the flight to Mombasa. Two individuals in the row opposite my own were discussing how the United States uses propaganda to misrepresent African culture. One passenger noted that American media is apt to report on violence and famine but quick to ignore the progress and contributions of African nations. The other replied that Americans also fail to recognize the diversity that exists within Africa. Indeed, in Kenya alone, there are over forty tribes and more than as many languages spoken—and this represents but one of Africa’s 54 countries (American University, n.d.; Balaton-Chrimes, 2020; United Nations, 2021). I was later engaged in dialogue with a local who echoed the sentiment of my fellow passengers, remarking that many Americans think of Africa as a country rather than a continent. I was disheartened to realize, upon reflection, that I agree with him—perhaps not in a literal sense, but I’d wager that the designation as a continent is the extent of most Americans’ expertise on the subject. I’d go so far as to postulate that most—admittedly including myself before this experience—couldn’t name more than a few African countries and, even of those they could name, could hardly tell you a single thing about their history, government, or culture. After all, we Wamarekani seem to be, by and large, ignorant of every part of the world that lies outside our country’s borders. As I contemplated these comments and the perception of America that they reflect, I began to wonder why we are not more alarmed that this is the state of our country. Why do we demonstrate such self-absorption? Particularly considering the vast privilege so many of us carry, should we not endeavor to become deeply embedded within our global community so that we may use our resources to assist others in raising themselves from disadvantaged circumstances? This is certainly not a novel concept, but I suspect one of the obstacles it faces is what I’ve observed to be a natural aversion to accepting that one is privileged; people prefer to maintain that they’ve “earned” everything they have. But we need not be afraid of acknowledging privilege. I’ve come to believe that privilege itself is not the “problem”—it’s what we choose to do with it that matters. I don’t think anyone embodies this quite as poignantly as one of my peers, a medical student whom I had the great honor of befriending through this experience. Much could be said about her—about her passion, medical brilliance, and worldliness. From her, I was fortunate enough to witness the wielding of privilege in a manner that resulted in a resounding positive impact. She engaged her social media presence, connections, and medical knowledge to raise funds for the procurement of supplies for the hospital, two local orphanages, and a home for the elderly. Her courage, industriousness, and dedication in pursuing her own avenue of service cannot be overstated. From her, I learned that within the realm of humanitarian work, one must not be solely occupied with their “program” so to speak—one must go beyond the tasks assigned to them and reflect critically to identify how they, as an individual with unique skills and assets, might leverage the resources their privilege has afforded them to best contribute to the community they serve. We all have attributes and tools that, when fully engaged, allow us to bring something more to what we do. I am deeply grateful for the community work in which I was able to participate as an IMA intern. Assisting at the free, community medical clinic was among the most memorable experiences of my life. Initially, the planning did not include a nutrition station at the clinic; however, a fellow IMA nutrition intern advocated for its addition, having found a Coast General nutritionist willing to attend with us. In the days prior to the event, the two of us worked closely with the nutritionist to prepare materials and coordinate our roles. At the clinic, I was responsible for conducting anthropometric assessments and determining whether to refer patients to the nutritionist for counseling. We assessed hundreds of patients, representing a wide range of health statuses. Considering 60% of Kenya’s population is moderately or severely food insecure, I expected to see predominantly an underweight presentation of malnutrition (World Bank, 2019b). However, I encountered both under- and overweight patients. Indeed, in recent years, Kenya has seen a trending increase in mortality from noncommunicable diseases, many of which are associated with obesity and its contributing lifestyle factors (World Bank, 2019a; WHO, n.d.). This comes as U.S. dietary patterns exert increasing influence and corrupt a diet traditionally bountiful in fruits, vegetables, legumes, and other nutritious staples. I often discussed such topics with the aforementioned nutrition intern, an accomplished dietitian with a strong dedication to charitable works and someone from whom I learned a great deal. Beginning my first days there, he quizzed me with the occasional scientific question of a nutritional nature, on subjects ranging from medium-chain fatty acids to sports drinks. Anytime I did not know the answer, I asked him to tell me, as is my curious nature. He would respectfully reply that I should look it up and tell him the answer. This was initially quite confusing to me; I expected him to provide a response, seeing as he was the one testing me and presumably knew the answer already. However, I came to recognize and appreciate the value of the lesson he was teaching me: that one must have their own mind—that one must review the science to inform their own conclusions rather than blindly accept knowledge imparted to them by others, qualified as those others may be. Nutritional science is a complicated and rapidly-evolving field; on any given subject, there are numerous interpretations of the literature. I realized from my time with him that to become a competent dietitian, it is necessary to traverse these murky waters in order to develop an informed knowledge base, one that can be used to justify every piece of nutritional advice one sets forth. This lesson could not have come at a better time, as it was with this mindset that I entered the pediatric department at Coast General Teaching and Referral Hospital. Having never worked with watoto before, I was keen to gather every ounce of knowledge that I could, as the many pages of notes in my journal can attest. During my week in the department, I learned, for example, about taking MUAC measurements, differences between the presentation of chronic and acute malnutrition, formulas appropriate for the treatment of harisha, and nutritional implications of pediatric hepatitis. I recall a particular child—he was on a restrictive protein regimen of 0.5 g/kg due to his hepatitis. We started him on a formula low in protein but with a higher-than-typical ratio of branched-chain amino acids in an attempt to optimize utilization of what little protein his liver could tolerate. I assisted the nutritionist in designing a menu that would accommodate his nutrition prescription. What I’ll never forget, though, was his smile—it was bright enough to light the city, and I couldn’t help but smile too when he’d laugh and point at the monkeys that scurried along the window sill. The clinical knowledge is important to remember, but so too are these moments. I have suspected for some time that this environment of work would be one in which I would find my calling. However, having never been to a low-resource region of the world, I could not know for certain. My time in the hospital was far too short, but even so, I can report in earnest that I did, indeed, find the sense of purpose that I’d hoped. Coast General can certainly be a challenging environment to say the least, but one must be sensitive to the numerous obstacles that public hospitals face. Lack of staff, lack of resources, and corruption each take their toll. I don’t really know how I’d begin to describe the emotions I experienced on a daily basis, but I can say that there is a complicated pain that accompanies this work. However, I’ve grown to realize that this pain is, in part, what drives me to be in this environment—to be part of a collective committed to serving its most vulnerable, no matter the conditions. I would love to be able to describe, clearly and succinctly, why exactly I feel, despite its challenges, such an intense connection to this particular professional endeavor. Perhaps all I need say is that during my internship, I awoke very early each morning simply because I couldn’t keep myself in bed any longer, as every part of me wished so fervently to do the work before me. As a mere mwanafunzi, I was not, in many situations, able to contribute to the degree that I wished while at the hospital; in my lack of knowledge and experience, I often relied on others to teach me what to do. Of course, there were tasks I could undertake independently—assessments I could conduct, calculations I could perform—but I yearned for the day when I might return, finally able to give time and knowledge rather than take it from others. The nutritionists at Coast General so graciously mentored me, and I vehemently look forward to the opportunity to honor that generosity by returning to use that knowledge in service of communities in need. Alas, until then, I shall wear my bangili, decorated with the Kenyan flag, as a reminder of this most transformative experience and as a tribute to the singular people that I had the exceptional honor of coming to know—people of boundless kindness, profound wisdom, and admirable resilience, people whom I hold dear to my heart and to whose contributions of time and tutelage I hope to do justice as a member of our global community.
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