Global Health & Pre-Medicine Internships Abroad | IMA

I knew coming into this internship that I would have an opportunity to see healthcare in a setting that many never have or will see. However, I did not expect to emerge from this internship with so many new friends found in the hospital, community, and the IMA program itself. From the moment I drove through the IMA residence gates, I was greeted by a community of staff and interns who welcomed me like one of their own. The hospitality and generosity continued as I began to engage with the Coast General Staff. Even through chaos and exhaustion, the medical professionals I worked with were willing and eager to teach me about procedures and illnesses they encountered, local healthcare struggles, and even inform me about Kenyan life outside of the hospital setting. The IMA staff worked extensively to ensure that the interns were exposed to all of the things that Kenya has to offer. I especially cherish the kitchen staff for introducing me to traditional African dishes and even their takes on American classics, all of which were phenomenal. I enjoyed the cultural treks and classes that further helped me to immerse myself in this new culture. My favorite activities outside of the hospital setting were the community outreach events, or more specifically, getting to visit the Tumaini Children's Home. Being able to connect with the youth of Mombasa is something that I will never forget, and it is something I wish for everyone to get to experience. Following the end of my internship, I wish I could stay for many more weeks, and I am eager to find more opportunities like this in the future. From my two weeks in Mombasa, Kenya, I vividly remember three words from the Swahili Language: “jambo”, “pole pole”, and “rafiki”. Even if they are few in number, the sentiment behind these words is a true testament to the hospitality, serenity, and amiability of this country and the people who inhabit it. My time with International Medical Aid has been an experience that has taught me amounts of medical knowledge beyond measure, but it is these three specific attributes that I will carry with me through my future medical journey and beyond. “Jambo”, meaning “hello”, perfectly encapsulates the welcoming nature of the people I met in Keyna. At the IMA residence, the staff’s openness was remarkable. I was greeted by a team of individuals who were eager to provide me with abundant opportunities to explore Kenya, even beyond the medical scene. My favorite trek included visiting the spice markets, Fort Jesus, and, most notably, the Pembe Za Ndovu. “One has not truly been in Mombasa without seeing the giant tusks,” our guide said. Known by many as the Mombasa Tusks, this attraction site historically commemorates Queen Elizabeth's visit during the time of British colonization and was later refurbished before Princess Margaret’s visit in 1956 (Gacherl, 2022). This large structure symbolizes the culture's hospitality as it welcomes thousands of individuals a year, from royalty to travelers like myself. Similarly, the Coast General Teaching and Referral Hospital staff welcomed me with open arms. The medical professionals enthusiastically participated in discussions regarding typical cases and their management, the influence of local culture on medical procedures, and their creative use of resources to assist patients. Several Medical Officers, in particular, were especially skilled at informing interns about specific cases, explaining them in precise but easily understood detail. For instance, Dr. Sarat extensively explained meningitis, a condition where the meninges become infected, causing fever, a stiff neck, and potentially seizures or death. While this disease annually affects around 3,000 individuals in the United States, it ranks among the top five pediatric cases at Coast General Teaching and Referral Hospital (Boston Children’s Hospital). Cerebrospinal fluid retrieved from lumbar puncture procedures is commonly used to diagnose meningitis. I had the opportunity to witness two lumbar punctures during my pediatric rotation in addition to a variety of other minimally invasive, palliative, and diagnostic procedures. The willingness of the busy staff to share their knowledge and genuine interest in my learning made my experience invaluable. Mombasa’s medical community, much like its general population, has characteristics of generosity and openness, making it a truly welcoming place for anyone fortunate enough to visit. “Pole Pole”, meaning “slowly” or “little by little”, captures the laid-back and contented attitude prevalent in many aspects of Kenyan life. This philosophy promotes slowing down to appreciate the hear and now and life’s journey, as opposed to rushing toward the future. Based on my experiences, the most significant difference between American and Kenyan communities is the level of urgency and perception of time. In the United States, a fast-paced, career-driven lifestyle is the norm. Although Kenyans place a high value on their work, they also tend to live considerably slower and more deliberately. The emphasis on connections and experiences over strict adherence to time is evident in the fact that it is culturally acceptable to arrive thirty minutes later than planned (Healthcare Internship Orientation: Cross-Cultural Considerations). They are efficient, yet they savor and appreciate the journey that leads to their final destination. During the hospital orientation, Dr.Shazim stated that each ward floor has a patient capacity of 75, yet there is usually only one Medical Officer on each floor. This information shocked our entire group, as such a disproportionate ratio is relatively uncommon in the United States. I anticipated my first day shadowing in these wards to be chaotic, with little opportunity to build rapport with and inquire information from the Medical Officers. To my surprise, this was not the case. Despite being severely outnumbered, the Medical Officers took their time assessing and explaining each patient and their treatment plan, often engaging in lighthearted interactions with both patients and fellow staff members. The surgery department shared a similar sense of serenity. During my night rotation in this department, there were multiple gunshot casualties, creating a serious, urgent atmosphere. However, amidst all the x-rays and sutures, the anesthesiologist was singing along to “Tennessee Whiskey” by Chris Stapleton. The ability of the medical staff to stay composed through daily tasks and challenges highlights the common sense of calmness and relaxation towards life shared by Medical Officers, other medical staff, and Kenyan citizens in general. “Rafiki”, meaning “friend”, indicates the importance of friendship and teamwork that I observed through my experience. Aligning with their welcoming charisma, the African people are thoughtful, supporting the community and individuals alike. During my second week at this internship, I got to visit the Tumaini Children’s Home. From the moment we walked through the gate, the children asked us to talk, laugh, dance, and play. Their eagerness to befriend every one of the interns models that, even in this culture's youth, they are committed to serving and supporting everyone. This sense of friendship and care extends far beyond the youth of Kenya, as exemplified in their Vision 2030 political agenda. In 2008, the president at the time, Mwai Kibaki, initiated a campaign that planned to create a more industrialized society by 2030. One of the three pillars of this plan was to increase the social prosperity of the Kenyan people. From recruiting more teachers and building more educational centers to supplying additional tuition funding to lower-income families, this pillar strives to facilitate educational opportunities for citizens to become more involved in society through jobs, vocation, and recreation (Kenya Vision 2030). The Kenya government replicates its cultural values of promoting the well-being and happiness of others by continuously focusing on providing opportunities for growth and support to all of its citizens. In the hospital, the camaraderie among the staff was palpable. Whether professional or personal, the medical staff at Coast General were always communicating with each other. During a thoracic gunshot wound procedure, I witnessed their remarkable teamwork firsthand. Nearly 15 medical professionals were coming in and out of the operating room, retrieving supplies, providing the newest MRI scans, offering their expertise, etc. The bullet ended up being more difficult to retrieve than expected, and they were unsure if they would actually be able to do so without causing too much trauma. I specifically remember a group of Medical Officers huddled together going back and forward discussing this matter. They ultimately came to the general consensus that they would send the stable patient to the ICU, allowing a more specialized professional to assess the patient and provide his medical advice. Much like healthcare within the United States, it is essential that the medical staff discover and communicate patient care plans with one another. The staff at Coast General surpassed my expectations of what communication in the hospital setting should be, as they effectively communicated through difficult cases and maintained a positive, friendly relationship. My time in this internship exposed me to an abundance of medical diagnoses and procedures, some of which I had never even heard of. I enjoyed the ability to feel so involved in each case, affirming my ambition to go into this field, particularly in the high-pressure environment of the operating room. While I gained significant medical knowledge and techniques, the most valuable lessons I learned were those that medical school might not necessarily teach, such as the concepts of “jambo”, “pole pole”, and “rafiki”. Experiencing the warm and welcoming nature of the Kenyan culture has made me realize how essential this trait is in the healthcare setting. Having these welcoming characteristics helps foster trust, comfort, and honest communication between the medical staff and patients. In the role of a healthcare professional, I have found the importance of replicating the Kenyan's relationship with time. Moving forward, I understand the necessity of slowing down and invoking professional and personal life balance. Doing so ensures that I can provide a calm and supportive environment for patients. Along with this, having supportive friendships and collaborative teams is an important aspect of my career and life in general. Being able to effectively communicate with staff members is important, but obtaining supportive relationships is equally as important in this high-stress career. This experience has prepared me to embrace these three values as I pursue my future in healthcare. After completing this internship, I am extremely grateful for the chance to travel to Mombasa, Kenya, for two weeks and be a part of the International Medical Aid program. In addition to explaining my knowledge of medicine, this experience has taught me priceless life lessons. The warmth of the Kenyan people, their emphasis on cooperation, and their balanced outlook on life have taught me the value of building trust, upholding individual well-being, and working well with others. I am applying these traits in medical school and future career endeavors to continue to provide kind, patient-centered care.

My three-week internship with IMA was the most incredible experience I have ever had. Working in Coast General Teaching and Referral Hospital gave me a new outlook on life and such a sense of gratitude for the access that I have and a newfound drive to be the best healthcare professional I can be. The IMA staff, from the house staff to the program mentors, were the nicest and most helpful people I have ever met. I f ever there were any challenges we were facing, they worked very diligently to make us feel comfortable and supported.This trip had such an impact on me. I met the most amazing people - friends I feel like I've known forever. Working in the clinics with the kids were always my favourite. Getting to meet them, talk with them and answer their questions was such an amazing feeling. Seeing the impact we made on the communities we visited was such a monumental feeling that will last a lifetime. I have nothing but gratefulness for the opportunity to participate in such an amazing experience. Thank you, IMA, for having me! My whole life I’ve known exactly what I wanted to do with my life. I’ve spent my entire educational career working towards becoming a cardiothoracic surgeon, whether it be studying my dad’s old anatomy textbooks at 14, researching the results of my latest blood test, or doing Co-op placements at a hospital in high school. I have been building up my clinical experience in the Canadian Healthcare system for the past 4 years, and I can honestly say that nothing came remotely close to the profoundly impactful experience I had at Coast General Teaching and Referring Hospital. The sheer amount of opportunities to observe so many different arenas of the healthcare system in Kenya could not compare to what I could have gotten back in Canada. I arrived in Mombasa at 4 in the morning after 30 hours of travel and a treacherous experience in the Jomo Kenyatta International Airport. Immediately, I was greeted by Benson and Javan who packed me in my “brain-fogged” state into a van and brought me to the residence. The only thing I remember from the drive was staring out the window and seeing the giant elephant statues and Javan asking me if I knew any Swahili. I arrived at the house, to find it completely empty; I was the first person to arrive for the summer cohort. I fell fast asleep and was awoken by a knock on my door a couple hours later by Naomi, who had called me down for breakfast. I met with Joshua, Grace, and the rest of the amazing kitchen staff who had prepared me a beautiful meal. I ate and proceeded to go right back to sleep, which was interrupted by the arrival of my newest roommate. Hilda introduced me to my roommate Lily, and we then proceeded to complete our first bonding moment: sleeping the entire day. We met the rest of the mentors: Margret, Christabel, and Michelle later that day and our driver Teddy and next housemates Terry, Devi, Sarah, and Lakshanna. It may seem strange that I dedicated an entire paragraph to talking about a day that I spent mostly sleeping. However, to me, this day was when I met some of the greatest people. Every single staff member I mention had such a deep impact on my experience in Kenya. These were the nicest people I have ever met, and they went above and beyond just doing their jobs to make each and every one of us interns feel safe and welcome in that home. The experience was only enhanced by having the other interns around. The opportunity to not only learn from my experiences, but learn from their experiences as well was profound. As one of the younger and less experienced students in the house, my newfound friends offered me much advice on how to pursue my future career when I return home. This experience has given me lifelong friends who made my trip even more insightful than I could have imagined. The three weeks that I was in Kenya was an interesting time to travel in terms of healthcare politics. I arrived in Kenya during the doctor strike. Kenya doctors' strike of 2024 was a major statewide demonstration by physicians working in public hospitals that started on March 13 and went on for 56 days. The Kenya Medical Practitioners, Pharmacists, and Dentists Union (KMPDU) called for the walkout in response to unresolved concerns about low pay, unfavourable working conditions, and the failure to execute a previously agreed-upon Collective Bargaining Agreement (CBA) from 2017. The physicians requested increased pay, the immediate posting of medical interns at KSh 206,000 per month, and improved working conditions in all public institutions. Millions of patients countrywide were negatively impacted by the strike's substantial interruption of medical services, which made it difficult for many public hospitals to provide even emergency care. I spent my first week ( May 6 - May 10) in the Accident and Emergency Department, where I saw first hand the effects of this strike on patient flow. The halls of CGTRH were empty, the beds in the acute injury area were at ¼ capacity. The emergency area of the A&E was filled with patients that were picked up on the street by the police or brought in by ambulance. I walked in and was introduced to the charge nurse Antoine, who showed me around. We went to see each patient and he explained to me what was going on with them. We saw a patient with deep head lacerations from a drug induced motor incident, a woman with a blocked urethra causing her filled bladder to protrude out of her stomach, a teen boy with a fractured ulna and a blood infection, and most notably, a patient who overdosed on drugs trying kill himself. Antoine explained to me that unfortunately, cases of attempted suicide is something that is seen quite often in the emergency department. This notion was solidified during our global health lecture series where it was explained that mental health disorders are a significant cause of morbidity and contribute to the burden of non-communicable diseases in Kenya. These disorders not only affect but are also affected by other non-communicable diseases. They can serve as a precursor or consequence of a non-communicable disease or result from interactive effects between the two1. During this strike period when I was in the A&E, I saw the physical manifestation of the consequences of the strike. I had read articles that the bodies in the morgue were piling up because people were not going into the hospitals to get treated because they knew the strike was happening2. I saw this first hand based on the sheer amount of bodies brought in dead, either by family, or by police who found them on the streets. Many people were brought in alive, but it was too late to help them and they were made comfortable so that they could pass away painlessly. Although the patient influx was slower than it normally would have been, I was able to learn quite a lot during my time in the A&E. I followed around new nurses as they were trained on hospital procedure and they taught me the ins and outs of their jobs. I shadowed the doctors and asked questions about their patients to which they explained in detail their conditions and their course of treatments. I was able to observe minor procedures and assist in small ways. I saw an incredible amount of patients flow in and out of the hospital in such a small amount of time, allowing me to experience so many different avenues of healthcare. My most notable patient interaction occurred when I was in A&E, which solidified my already heightened interest in healthcare and will probably have a great impact on the way I will treat all my future patients. A woman was brought into the hospital by her daughter and granddaughter. This woman had an underlying heart condition and came in with a systemic infection. She was short of breath and frothing at the mouth. This woman was in a state of extreme discomfort. I was the only IMA intern in the A&E this week, however, there were other interns from other companies who were already in medical school from across the world and the interns and medical students from the local medical school who had joined me in the A&E that day. When the doctor rounded on this patient, we all joined her. The medical students were allowed to take vitals and speak with the patient and family about the condition. Once the doctor had left, the students remained, curious as to what this patient's conditions were. Throughout the day, the students went back and forth, playing with the equipment surrounding the patient, taking her vitals, and blatantly talking about her conditions in front of her face. This woman was working her harvest to stay alive, she was in extreme discomfort, her family was surrounding her, and these students, who were so eager to learn, had forgotten that this wasn’t a dummy they are given in school to guess what the disease is. They seemed to have forgotten that there was an actual human being laying on that bed and not a textbook for them to study. This made me quite uncomfortable watching, but I tried not to think anything of it, as they were just eager students wanting to learn more. I went to the trauma theater sometime later to observe a hip realignment, and when I returned, I was met with a code blue. This patient had coded and was brought to the resuscitation room. I stood back, blocking the view of passing spectators. That’s when a flood of students from across the hospital rushed into the already crowded room. The doctor and nurse were performing CPR on the patient, as the 25 students stood back, whispering and snickering in the corner of the room as the daughter and granddaughter cried and paced the floor behind them. The resuscitation went on for 25 minutes. Not a single person in that room was helping apart from 3. They were all talking in the background while this woman was vomiting the contents of her stomach. Unfortunately, the patient passed away. I will never forget the screams of her distraught daughter, they still ring in my ear. All I could think about for the rest of the day was this woman and her family. She spent the last remaining moments of her life treated like a lab experiment and died with no semblance of privacy. She was poked and prodded, not even for the benefit of her health, but for the education of others. Her family couldn’t enjoy their final moments with their mother and grandmother. This experience will change the course of my education. When I do my rotations in hospitals, this experience will follow me. I will do everything in my power to never make a patient feel the way this woman must have felt in her dying moments. Although the story is sad, and most other interns will probably have more inspirational stories that inspired their future careers, this is the most significant one for me. This experience will forever serve to remind me that I am treating a human being, and not a disease; It will remind me to not get too wrapped up in my love of medicine and remember the reason I wanted to go into healthcare in the first place, to help human lives. After the KMPDU and the Kenyan government reached a return-to-work deal, the strike came to an end on May 8, 2024. The government promised to comply with the physicians' requests in this agreement, but other matters remained unsolved and were postponed for future discussion, especially those pertaining to the posting of medical interns. During this time, I was in my 2nd week of my internship, working in the surgical department. This week was the transition week where the hospital was starting to return back to normal. This rotation was one that I was most excited for as this is what I wanted to do in my future. I spent time in the Surgical Outpatient Clinic Department, where I shadowed a group of neurosurgery residents and cardiothoracic surgery residents. When speaking with the neurosurgery residents I learned 2 interesting facts. 1) that there is only one active neurosurgeon in the entire Mombasa county and 2) the most common type of cases they see is pediatric head traumas. The leading causes of injury in Kenya include assault (42%), road traffic crashes (RTC) (28%), unspecified soft tissue injury (STI) (11%), cut-wounds and dog-bites, falls, burns and poisoning (each <10%)3. This was made prevalent when I was in the surgical department. Most of the procedures I encountered were performed on children ranging from ages 2 months to 14 years of age. During my time in the surgical department, my love of surgery was amplified exponentially. The procedures I observed include: jugular dialysis catheter implantation, craniotomy and hematoma removal, VP Shunt for hydrocephalus, Acute Left Thalamic Hemorrhagic CVA, 2 Fistulas, Suprapubic Catheter Implantation, Anterior Corpectomy, Umbilical Hernia Removal, 5 C-Sections, Tubal Ligation, and an Emergency Hysterectomy. I spent my last week in the Labor and Delivery Ward, where I quickly realized that maternity care was not the right fit for me. Despite observing around 25 live births and several C-sections, this experience confirmed my preference for the surgical field. Although it wasn't my favorite rotation, I still gained valuable insights and skills, which only heightened my excitement for a career in surgery. Reflecting on my time at Coast General Teaching and Referral Hospital, I can see how profoundly this experience has shaped my professional aspirations. The opportunity to observe and participate in a wide range of medical procedures and patient interactions has provided me with a holistic understanding of the healthcare system, particularly in a resource-limited setting. This exposure has taught me the importance of adaptability, empathy, and cultural sensitivity—qualities that are essential for any healthcare professional. Witnessing the impact of the doctors' strike firsthand underscored the critical need for effective healthcare policies and the challenges that medical professionals face. It reinforced my commitment to advocating for better working conditions and patient care standards in my future career. Furthermore, the relationships I built with my mentors, colleagues, and patients in Kenya have left a lasting impression. Their dedication and resilience have inspired me to strive for excellence in all aspects of my practice. I am more determined than ever to pursue a career in cardiothoracic surgery, armed with the knowledge, skills, and compassion gained from this transformative experience. This journey has not only confirmed my passion for medicine but also deepened my resolve to make a meaningful difference in the lives of my future patients. My internship experience with International Medical Aid in East Africa has been profoundly transformative, offering me invaluable insights and shaping my future career aspirations in healthcare. Throughout my time at Coast General Teaching and Referral Hospital, I have gained a comprehensive understanding of healthcare delivery in a resource-limited setting, experienced the impact of political dynamics on medical practice, and encountered cultural variations that have enriched my perspective as a future healthcare professional. One of the most significant lessons I learned is the importance of adaptability and resourcefulness in healthcare. Working in a setting with limited medical supplies and personnel, I witnessed firsthand how healthcare professionals in Kenya make the most of available resources to provide patient care. This experience has taught me to be innovative and flexible, qualities that will undoubtedly enhance my ability to respond to various challenges in my future career. The doctors' strike during my internship period highlighted the critical need for effective healthcare policies and the challenges faced by medical professionals in advocating for better working conditions. This experience has underscored my commitment to not only practicing medicine but also being an advocate for systemic improvements in healthcare delivery and professional working conditions. Understanding the intricacies of healthcare politics has made me more aware of the broader context within which healthcare is provided and the importance of being an informed and engaged healthcare professional. Culturally, working in Kenya exposed me to diverse patient populations and varying health beliefs and practices. This cultural immersion has enhanced my cultural competence, an essential skill for providing empathetic and effective care to patients from different backgrounds. The patient interactions I had, particularly with those who faced significant health challenges, reinforced my dedication to treating each patient as a unique individual, respecting their cultural context and personal experiences. Observing unique clinical cases, such as severe trauma cases and the management of non-communicable diseases in a different healthcare environment, has broadened my clinical knowledge and skills. These experiences have solidified my interest in pursuing a career in cardiothoracic surgery, as I have seen the critical need for specialized surgical care in diverse settings. In conclusion, my internship in East Africa has profoundly influenced my interest in pursuing a career in healthcare. It has equipped me with a deeper understanding of the complexities of healthcare delivery, the importance of cultural sensitivity, and the need for advocacy in healthcare. I am committed to using this newfound knowledge and perspective to make a meaningful difference in the lives of my future patients, advocating for improved healthcare systems, and providing compassionate, culturally competent care. This transformative experience has not only confirmed my passion for medicine but also strengthened my resolve to be a dedicated and empathetic healthcare professional.

Whenever I’m asked, “How was your trip?” I find it hard to form a response that does justice to the experience. Whether I say “amazing” or describe it as “eye opening and incredible,” those words never capture the overwhelming impact of the journey—a journey I’m still processing. I chose IMA because of its highly rated safety and focus on cultural immersion, but I was met with far more. From the moment I applied, the staff was responsive and helpful in providing information. When I stepped off the plane in Mombasa, I had prepared myself for a very minimalistic lifestyle. Growing up, you hear stories about poverty in Africa. I had even visited other countries like Costa Rica, where I witnessed second-world conditions firsthand, so I thought my experience might be even more austere. However, when we arrived at the residence, I was surprised by the grandness of the home. There was a pool, indoor toileting, running water, and electricity. In addition, I enjoyed 24-hour security in a safe neighborhood, reliable transportation, hot meals prepared for me, air conditioning at night, a made bed, and daily laundry. I even sent pictures of my delicious meals to my parents, who were relieved to see I was well cared for. The staff’s attentiveness made me feel at home and ensured I had everything needed to succeed. There were moments when we interns felt it was more of an educational vacation than a rigorous internship. Yet, when considering my hospital experiences, it’s easy to recount the shocking differences between a third-world country and the United States. Life in Kenya is simpler and slower—people are kinder and more tolerant, and there’s far less judgment, which makes learning and connection more enjoyable. Even back home, I found the overstimulation of American life jarring—I once sat through an entire rotation of a stoplight in my first week back. My journey extended beyond lifestyle contrasts into the realm of healthcare—a sector where I encountered challenges that reshaped my perspective. Within the often frustrating limitations of Kenyan healthcare, I discovered a new regard for human life that has reignited my passion for becoming an empathetic provider. Healthcare delivery varies greatly around the world; each system has unique challenges that are impossible to fully appreciate without firsthand experience. As an emergency department clinical technician, I’m no stranger to staffing shortages or burnout, but the term “under-resourced” hardly conveys what I witnessed at Coast General Teaching and Referral Hospital. Many of these limitations stemmed from Kenya’s transition from centralized to decentralized operations. From 1964 to 2010, primary and secondary health services were run by the national government. Since 2010, these services have shifted to county governments for operation and financing—even though large public hospitals like Coast General still rely on national support. This hybrid system has led to challenges in financial distribution, resource access, and accountability. For example, in the Newborn Unit, a Pediatric Morbidity and Mortality CME session revealed a shocking 25% mortality rate in September. The head consultant demanded answers, and two critical issues emerged: there were only three CPAP machines available for the many infants who needed them, and most of the babies who died were not born at CGTRH but had suffered delayed care after being referred from underfunded county hospitals. Resource dilemmas were evident in nearly every department. In the maternity section, nearly no patients received prenatal care, resulting in many children being born with conditions like hydrocephalus—despite the known benefits of proper folic acid intake. At the medical clinic, high blood pressure was rampant, a situation likely exacerbated by the naturally high salt content in many African foods. While such issues might be addressed easily with sufficient funding and education, both county and national budgets in Kenya prioritize infrastructure and education over healthcare. (Current State of Healthcare in Kenya, 2022, p.31) The United States spends about 16.885% of its GDP on healthcare compared to Kenya’s roughly 5.167%, a disparity that affects everything from medical supplies to the quality of patient care. In the Casualty Unit, I witnessed gloves, needles, and sutures used with extreme frugality—often reused in ways that would be unthinkable in a more resource-rich environment. This culture of conservation is passed down through every level of the system. In Minor Theatre, I observed a resident chastising an intern for not conserving sutures—a practice critical in Kenya yet less emphasized in the United States. Staffing shortages compounded the issue, forcing interns into roles with minimal supervision. In Casualty, interns hurriedly collected patient histories, wrote orders, and interpreted scans with little oversight, sometimes leading to critical oversights. Cultural factors also heavily influence care. Kenya is home to forty‐four tribes, each with its own traditions and beliefs about medicine. In one instance at the skin clinic, a patient—initially hesitant to discuss his urinary issues because the room was filled with female staff—revealed he had been self-treating recurring UTIs for a year. When the consultant recommended circumcision as a preventive measure, the patient, a member of the Luo tribe which traditionally does not practice circumcision, refused the suggestion despite the explanation. This encounter underscored how deeply entrenched cultural values and stigmas, even among healthcare professionals, affect treatment decisions. The persistent stigmatization of HIV, which in 2015 was linked to 29% of annual adult deaths (with women being more vulnerable), further complicates efforts to educate youth and prevent transmission. (Disease Burden in Kenya, 2021, p.11) I also witnessed how financial constraints ripple through the system. Patients often remain in hospitals well past their discharge dates because they cannot pay their bills, leading to overcrowded wards and an increased risk of further illness. In remote areas, limited transportation and resources force many to rely on traditional remedies—exemplified by a twelve-year-old girl in Ward 10 who succumbed to Rheumatic Heart Disease after her family’s delayed decision to seek medical aid. Through all of these challenges, I learned that at the center of healthcare is the human life we serve. Whether it’s sutures, medication, surgery, or simply an empathetic ear, every patient deserves care. My time in Africa has reshaped my understanding of medicine and reinforced my commitment to compassionate, patient-centered care. It’s a reminder that even in resource-limited settings, the human spirit can inspire profound change.