International Medical Aid (IMA)

During my time in Mombasa, Kenya with International Medical Aid, I was welcomed into a world that far exceeded my expectations. The hospitality at the residence was nothing short of remarkable. Every member of the International Medical Aid team in Kenya—from Margaret, Benson, and Hilda to Mitchel—was genuinely kind, attentive, and incredibly knowledgeable. They didn’t just answer my questions; they provided insights that reflected a profound understanding of both the medical field and the local culture. Their support made me feel truly at home in an environment that was entirely new to me. At Coast General Teaching and Referral Hospital, my astonishment grew. The doctors there were not only exceptionally knowledgeable but also passionate about teaching. They welcomed us into their world, sharing complex medical cases with enthusiasm and clarity. I witnessed conditions and procedures that I would rarely, if ever, see in the United States—multiple cases of hydrocephalus, open-heart surgeries, and complete knee replacements and removals. The diversity and complexity of the cases were eye-opening, and the relationships I built with the doctors extended beyond the professional. We talked about life, culture, faith, and much more, forming bonds that I will cherish forever. Even beyond the hospital, the experience was extraordinary. The kitchen staff at the residence exemplified kindness and attentiveness, going out of their way to ensure we were well-fed and comfortable. A small gesture—happily preparing more eggs when they ran out—spoke volumes about the care and attention we received. One of the most memorable aspects of my time in Mombasa was visiting local schools. The joy and excitement of the children and staff were palpable; their smiles and enthusiasm made us feel like celebrities. These interactions were not just heartwarming; they were a profound reminder of the impact we can have on communities and the importance of human connection. This entire experience deepened my passion for medicine. It reaffirmed my desire to become a physician and grounded that aspiration in a broader understanding of global healthcare and human dignity. When I returned home, I couldn’t stop sharing my experiences—each story more vivid and inspiring than the last. My time in Mombasa was not just a chapter in my journey; it was a defining period that I will carry with me throughout my career and life. I have always had the desire to step out of my comfort zone and face challenges on my own, which is somewhat unusual given that I have a twin with whom I share much of my life. Despite our closeness, I’ve always felt the need to explore the world independently, pushing myself to grow in personal ways. When I was sixteen, I took my first step in this direction by traveling alone to Quito, Ecuador, where I worked in daycares supporting children in under-resourced communities. Looking back, I learned a great deal about myself and my drive to serve others. Now, at twenty-two, I was preparing for something even more profound: a journey to Mombasa, Kenya. Africa—a continent I had only seen in pictures and heard about in stories, often tied in my mind to the phrase “Hakuna Matata” from The Lion King—felt entirely foreign to me. It was an unfamiliar world I had yet to experience firsthand. This trip felt vast, mysterious, and full of endless possibilities. It was the realization of a lifelong dream: an opportunity to completely immerse myself in a new culture and understand how others live, all while pursuing my dream of becoming a doctor. This time, it wasn’t just about leaving home; it was about entering a world I had imagined but never truly comprehended. The moment I landed at Moi International Airport and began the drive to my residence, I knew these memories would stay with me forever. Stepping foot in Africa, I was embraced by a warm, humid breeze that made me feel genuinely welcome—much like the people themselves. The landscape was breathtaking: lush green trees, clear blue skies, and glistening patches of water. From the plane, the clusters of cement homes scattered across the greenery hinted at the lives and stories rooted there. As we drove on the left side of the road, dodging oncoming vehicles sharing the same narrow lanes, I absorbed every detail—the lively chatter in the streets, the hum of daily life, and the distinct clatter of local transportation. Tuk-tuks—small three-wheeled vehicles—zipped by in a burst of colors, while matatus—shared minivans packed with passengers and adorned with bold slogans—wove through traffic. These were more than just modes of transit; they embodied community, connection, and movement. As we crossed the main bridge into Mombasa, I began to see homes belonging to the impoverished: brick and cement structures topped with corrugated metal sheets. The juxtaposition of natural beauty and visible hardship heightened my sense of wonder and responsibility, igniting a fire within me to understand this new world more deeply. It felt surreal stepping into a reality where everything was both beautiful and unknown, and I was ready to embrace every challenge ahead. Throughout my month in Mombasa, I was eager to understand the systemic factors contributing to gaps in healthcare and persistent inequities. I asked myself difficult questions: Why are HIV and AIDS so prevalent in this region? Why does malaria affect people here so differently than in other places? Why do so many lack basic needs in a globalized world? How can healthcare systems function when wealth per capita is so limited? Why is quality care so often reserved for those who can afford it (Bhattar, 2023)? To begin answering these questions, I knew I had to see the realities firsthand. During my first overnight shift at Coast General, I walked through dimly lit corridors toward the Accident and Emergency (ANE) department. The air felt heavy with urgency. The room was filled with patients and families, each carrying visible fear, pain, and hope. The soft murmur of Swahili, the beeping monitors, and the muted cries of those in distress created an atmosphere I will never forget. In the distance, the call to prayer from a nearby mosque echoed through the night—a calm, spiritual counterpoint to the intensity inside. That juxtaposition between serenity and crisis crystallized my purpose: I was there not only to learn medicine, but to witness the intersection of suffering, resilience, and care. Mombasa was far more than a mission trip or internship; it reshaped my understanding of healthcare on a global scale. Compared to my previous experiences in the United States, the most striking difference was the scarcity of essential resources. In even the most basic American hospitals, many tools and medications are taken for granted. In Kenya, I witnessed a system where shortages of pain medication, diagnostic equipment, and basic supplies were a daily reality. Hospitals like Coast General Teaching and Referral operate under immense strain, with staff doing everything possible despite chronic resource limitations. Doctors and nurses are stretched too thin, with only about 21 doctors and 100 nurses per 100,000 people. Their work demanded creativity, resilience, and constant improvisation. One day in ANE, chaos erupted when a tuk-tuk screeched to a stop and a young man was rushed in. His ankle and foot were hanging by a strip of skin, with his tibia fully exposed. It was one of the most horrific injuries I had ever seen. There was no doctor immediately available—only a single nurse. She called for a “saline toilet,” a term I had never heard before. Everything happened quickly. I found myself holding the patient’s leg steady as the nurse pulled out a red bucket, poured saline over the open wound to wash away dirt and debris, wrapped it tightly, and stabilized it with a wooden splint. With minimal equipment and limited pain management, she stabilized him and moved him into a long queue to see the trauma surgeon. Her composure, resourcefulness, and speed were incredible—and haunting. It was a powerful example of both the strength and the constraints of the system. The hospital’s limitations were evident elsewhere. In the surgical ward, I noticed an operating table missing a leg, propped up to keep it functional. It felt like a metaphor for the healthcare system itself: standing, but precariously. Yet amid such challenges, the dedication of the medical staff was unwavering. They were deeply committed to teaching and to caring for their patients. I cherish the conversations we shared—not just about medicine, but about their lives, beliefs, and hopes. Hearing how Islam informs daily life, learning about halal practices, and exploring Kenya’s rich diversity—with over forty tribes, each with its own traditions—gave me a deeper appreciation for the context in which they practice medicine. The resilience I saw in Mombasa profoundly affected me. It showed me how medicine can transcend limitations when driven by compassion and ingenuity. It deepened my understanding of global health and highlighted the urgent need to address healthcare disparities. I hope to carry these lessons into my medical career as a constant reminder of the importance of empathy, adaptability, and a commitment to improving care for all people, regardless of who they are or where they live. Many of the answers to my early questions lay not only in hospitals but also in schools and systems. After our daily rotations at Coast General, International Medical Aid often took us to other facilities and communities in the coastal region. One day, we visited a private hospital and observed stark differences in access based solely on socioeconomic status. Compared to Coast General, this hospital had advanced technology, ample staff, and visibly satisfied patients. But the cost to walk through the door was nearly ten times higher. Many patients at public hospitals simply could not afford consistent medication, leading to severe hypertension and preventable complications. The inequality between the two hospitals made it painfully clear why public facilities have higher rates of hospital-acquired infections and worse outcomes. On a more hopeful note, our weekly school clinics on hygiene, mental health, and reproductive health were among the most meaningful parts of my experience. These schools lacked technology, supplies, and structure, yet were full of life. The children greeted us with endless high-fives, hugs, and laughter. Their joy was a refreshing contrast to the heaviness of the hospital. Teaching them how to brush their teeth and providing toothbrushes and toothpaste felt like a small but significant act of care. The mental health clinics were especially impactful. Many students faced serious social and financial challenges, including the burden of school fees. While mental health is increasingly recognized and supported in the U.S., in Kenya it is still often stigmatized as weakness rather than understood as a legitimate health concern. With only a small number of psychiatrists and psychiatric nurses serving millions—most based in Nairobi—the gap is immense. Hearing students’ stories was a powerful reminder of how cultural perception, access, and stigma intersect. In the clinical setting, I became acutely aware of details I once took for granted. I watched IVs placed in more fragile veins on the hands and forearms, saw surgeons operating without full protective face shields in settings with high HIV prevalence, and observed how infection-control limitations put both patients and providers at risk. The pediatric ward, tucked away and crowded with infants suffering from infectious diseases like gastroenteritis, highlighted the vulnerability of the youngest patients. Learning that babies with suspected sepsis might wait weeks for PCT test results was deeply frustrating; it underscored how delays in diagnostics can jeopardize lives. At the same time, I gained invaluable hands-on learning experiences—such as assessing infants for nutritional deficiencies and palpating a pyloric mass—bringing textbook concepts into real, human focus. I was struck by the prevalence of hydrocephalus, often linked to inadequate prenatal care, and learned that some mothers, influenced by cultural beliefs, avoid essential vitamins like folic acid during pregnancy, unknowingly increasing risks for their children. Each of these moments revealed how cultural, economic, and systemic factors intertwine to shape health outcomes. Witnessing these realities strengthened my resolve to pursue a career in medicine, specifically surgery. As I apply to medical school with the goal of becoming a surgeon, I carry with me a clearer understanding of global inequities in care and a deep commitment to addressing them. My experiences in Kenya have shaped my aspirations and reaffirmed my dedication to serving patients who, like those I met in Mombasa, navigate the fragile boundaries of hope and healing. There is one thing I know for certain: when I am an established physician, I want to return to this incredible place and community to give back in the most meaningful ways possible. During my time in Kenya, a group of Italian surgeons was performing cardiac procedures previously unavailable in the coastal region. I could not imagine a more powerful way to give back than to follow a similar path—returning with colleagues to share skills, expand services, and show others what a remarkable place Mombasa truly is. International Medical Aid allowed me to experience all of these complex, inspiring emotions. They have come remarkably close to perfecting this program, and I would recommend it not only to medical students but to anyone serious about understanding global health. Mombasa could not have been a more transformative experience as I take the next steps toward the physician—and person—I hope to become.

Prior to arriving in Kenya, I purposely avoided watching vlogs or videos about the accommodation, activities, or hospital—even though I had been following IMA’s account for almost nine months. There were two reasons for this: I wanted to preserve an element of surprise, and I had so much trust in the program that I didn’t feel the need to examine every detail. I remember constantly reassuring my mother, telling her, “I know they will definitely take care of us and make sure we have the best experience possible. I just know it.” Fast forward to after completing the program, I can confidently say that not only was my trust validated, but my expectations were exceeded. This feeling started the moment I left the airport and was welcomed with an IMA banner, helped with my luggage, engaged in a warm conversation in the car, and then arrived at the Woolsack Suites, where I was kindly welcomed. Within that first hour, I had tears in my eyes and felt a genuine sense of being “home away from home.” During the three incredible weeks I spent in Mombasa, I always felt safe, supported, and heard. Whenever I had a question or concern, I could approach any staff member and they were always kind, patient, and helpful. I built strong connections with many members of the IMA team—connections I will never forget and will always mention among the highlights of my experience. The food was consistently well-balanced and nutritious. I deeply appreciated the hard work and care the kitchen staff put into preparing each meal, as well as their effort to provide alternatives for anyone with allergies or dietary requests. On a funny note, my mother had spent twenty years trying to get me to eat eggs in the morning without success—until Kenya. Somehow, I started eating eggs there, and now my mom couldn’t be happier. It is one of many small but memorable ways this experience changed me. I am beyond grateful for each and every person within the IMA community. On a more personal level, this experience opened my eyes to a wider range of health issues and strengthened my desire to continue the volunteering journey I began at fourteen. Witnessing children dancing, smiling, and learning during community outreach events warmed my heart. Being in Kenya reminded me how important it is to have a close-knit community where people support one another and work together to face challenges. I will always be grateful for contributing, even in small ways, to the smiles on the faces of those we met—and for the lessons they taught me, often without realizing it. It was on a warm, sunny Saturday in 2013 that this journey truly began. I walked to my elementary school after hearing about a UNICEF fundraising campaign and was excited to donate the pocket money I had been saving in my piggy bank. I remember proudly carrying the blue and white UNICEF T-shirt on my way home, looking up at the sky and hoping my small contribution might help someone in the world. From that day on, I started learning about humanitarian organizations, watching videos, reading articles, and discovering different parts of the world, their cultures, and their struggles. I promised myself that when I grew up, I would strive to do the kind of work that helps others and makes people smile. Fast forward ten years to another sunny Saturday in 2023. I stumbled upon an ad with a group of students in blue scrubs holding a banner that read “International Medical Aid.” For once, I didn’t skip it. I clicked the link, read about the program, and applied—without telling my parents. That stayed secret until the day I received my acceptance email. From that simple moment of choosing not to scroll past an ad, the summer of 2024 became a solo trip for me—not just a trip, but an opportunity to align my academic path with my volunteer work and to continue fulfilling the promise I made as a child. Although I traveled from Tunisia, the northernmost country in Africa, my twenty-one-hour journey made it feel as though I had crossed continents. On my second flight to Mombasa, I began to wonder how the healthcare system I grew up around in North Africa would compare to that of Kenya, another African country with a very different context. I landed on a Sunday afternoon while others were already on a guided hospital tour, so the next day, on our way to Coast General Teaching and Referral Hospital (CGTRH), I was the only one who had no idea what to expect. From the parking lot, the hospital appeared spacious and surrounded by greenery, which made me feel more at ease. My first rotation was in Radiology. As we walked toward the CT scan area, the calm gave way to reality: a crowded waiting area and a small, busy scan room operating at a rapid pace. We were greeted by Dr. Lisa, who welcomed us warmly and, within my first hour there, took the time to explain core concepts in radiology while simultaneously managing patients and results. I was impressed by both the efficiency of the team and the quality of the imaging. That same day, we moved to MRI, where it quickly became clear that staffing was limited—Dr. Lisa moved between CT and MRI, balancing both responsibilities. Despite the workload, she taught us about radiation protection, MRI safety protocols, differences between CT and MRI, and how collaboration with the laboratory is essential, especially when using contrast agents that require checking kidney function. Throughout the week, I learned patient positioning, safety steps, and the realities of working in a high-demand, resource-limited environment. During longer scans, we would watch educational videos together or I would use her extra computer to research more advanced imaging techniques. At the end of my first week, during the Friday debrief and a global health lecture on the burden of disease in Kenya, I realized how much more there was to understand. We learned that HIV/AIDS, malaria, and tuberculosis are among the leading communicable diseases in Kenya—very different from the patterns in Tunisia, where HIV prevalence is low, malaria is not endemic, and TB is of intermediate concern. This lecture took me back to my International Baccalaureate extended essay on antibiotic resistance and Mycobacterium tuberculosis. I had studied MDR-TB and XDR-TB in theory; hearing about their relevance in Kenya made the issue feel far more immediate. We also discussed non-communicable diseases such as cardiovascular conditions, diabetes, and cancers, which account for a significant proportion of morbidity and mortality in both Kenya and Tunisia, though in different proportions. These comparisons helped me see how context shapes health outcomes and access to care. We also heard about challenges in laboratory systems, including a case where a patient was placed in a TB ward due to a test mix-up and later actually contracted TB. Having interned in a medical analysis laboratory myself, I knew how easily samples could be mislabeled—but also how crucial it is to prevent such errors. Hearing that story made me reflect on the importance of quality control and patient safety. My second week was spent in Surgery. As a biomedical student who had taken an anatomy module involving regular cadaver dissections, I was curious to see how much of that knowledge would transfer into the operating room. The answer was: in structure, a lot; in feeling, everything was different. In the lab, mistakes are part of learning. In the OR, a single mistake can change or end a life. The environment was intense and precise, and we had to be constantly aware of sterility and our surroundings. One of the most memorable cases was a subdural hematoma surgery. Part of the patient’s skull bone was removed and, due to a lack of appropriate storage equipment, placed in the subcutaneous tissue of his abdomen until it could be replaced. The surgeon explained how the bone would be preserved and how this was the safest available option given the constraints. He also questioned us about abdominal anatomy, pushing me to connect what I had studied to what I was seeing in real time. Another striking case involved a woman in her early thirties undergoing an above-knee amputation. At first, I did not expect the extent of the condition, but when I entered the operating room, I saw maggots that had fallen from her infected leg. What began as diabetic foot ulcers had progressed into severe infection and myiasis despite a prior toe amputation. It was one of the most difficult but impactful cases I witnessed. The surgery rotation also included time in clinics, where I could observe how physicians assess patients and apply my musculoskeletal knowledge in real-life scenarios. I saw a patient with polio for the first time, whose surgery carried a very uncertain outcome, and many patients with fractures and dislocations complicated by diabetes and hypertension. I learned that sciatica is one of the most common pain complaints after headaches in Kenya—an interesting connection with topics I had recently presented on academically. My third and final week was in the Emergency Department, and it was the most emotionally challenging part of the internship. The environment there was much less organized and hygienic than in radiology or surgery. Sheets were not always changed between patients, even when stained, despite the high risk of infectious diseases, including HIV. One day, a patient’s family member approached me to ask for clean sheets, and from that moment forward, I paid closer attention and tried to help advocate for basic cleanliness when I could. On our first day, the head nurse explained the triage checklist and assigned tasks due to a potential protest. Despite the efforts of several dedicated staff members, I often sensed a lack of urgency in Adult A&E, likely driven by extreme workload, burnout, and resource limitations. One case that marked me deeply involved a man with a piece of glass embedded in his head. He needed a CT scan, but when we reached the radiology department, the doors were locked. Alongside other interns, I ran back and forth trying to find a solution. Eventually, he received the scan, and we learned that the glass had not damaged any vital structures. His mother hugged us in relief; it was one of the warmest, most human moments I experienced in the hospital. Unfortunately, many other moments were heartbreaking: witnessing the deaths of a young man and a two-year-old girl, seeing a woman with 90% burns whom doctors knew had almost no chance of survival but still admitted to ICU out of hope, observing a patient with polymyositis in severe condition for whom establishing IV access took over an hour, and a man harming himself after being accused of killing his wife. The most shocking image of all was seeing two deceased patients placed together in the same coffin. In between ER shifts, I also spent time in Maternity, where I helped support mothers in labor, observed C-sections, and witnessed the first breaths of newborns. When the ward was less busy, I read through the educational posters on the walls about obstetric and neonatal emergencies. These resources were simple but powerful reminders of how essential knowledge and protocols are in saving lives. Beyond the hospital, the Wednesday and Saturday outreach clinics were among my favorite experiences of the entire program. At schools and community sites, including a school for children with special needs, I felt as though my younger self—the girl in the UNICEF T-shirt, the teenager in Interact Club, the volunteer during COVID-19 vaccination days—had finally stepped fully into the world she had dreamed of. Through IMA, I was no longer just reading or watching videos about humanitarian work; I was living it. We helped organize clinics where around 450 people could receive diagnosis and medications free of charge. We taught children about hygiene, health, and self-care, distributed essential supplies, and spent time dancing, learning, and laughing together. I saw how outreach, education, and access to medication could change someone’s day—and potentially their future. It made me proud of how far I had come in honoring the promise I made to my younger self: to help others in meaningful, tangible ways. Overall, my experience at Coast General Teaching and Referral Hospital and with IMA was intense, eye-opening, and transformative. It allowed me to apply what I have studied in pharmacology, immunology, and biomedical sciences to real-world settings, while also challenging me emotionally and ethically. Being physically present—seeing, listening, helping, and learning—shifted my perspective far beyond what videos or articles alone could ever do. Most importantly, my time in Kenya reminded me why I want to pursue a career in healthcare and research that remains deeply connected to service, global health, and humanitarian work. It strengthened my determination to volunteer abroad, advocate for better systems, and contribute to making care more accessible and compassionate. For all of this, I am profoundly grateful to IMA, the staff, my fellow interns, and every person I met along the way who helped shape my journey and reaffirmed my commitment to making the world a better place for everyone.

My experience in Kenya was better than I could have ever imagined. I truly think it was the best experience I have ever had. From the day I arrived, the IMA staff was always friendly and immediately made me feel at home. The residence was always well kept, with staff cleaning our rooms. Additionally, the food was amazing, and the kitchen staff always welcomed our meal requests and would get them to us right away. Our program mentors were amazing and would always happily talk to us. They gave excellent advice and were always willing to help. The program staff was the main reason that my experience was so amazing. We also received a lot of knowledge about the culture of Kenya from them, which helped me to understand the situations of patients I saw at the hospital. I learned so much about different types of health conditions, especially from Dr. Ken in pediatrics, who would give mini-lectures to us between patients so that we gained the most amount of knowledge that we could. Along with shadowing at the hospital, all the community outreach clinics taught me so much about the community in Kenya. The clinics were my favourite part of the internship, as the kids were always so happy to see us, and I felt like I was making a difference to them. Overall, my experience was amazing, and I felt it went so quickly. I never once had any worry about feeling unsafe or alone, as I was surrounded by amazing staff. I will definitely be coming back. Five years ago, I would have never imagined that I would be spending 3 weeks interning as a pre-physician assistant student at the second-largest public hospital in Kenya. From a very young age, the idea of attending medical school was implanted into my head by grandparents, teachers, and even friends’ parents. However, healthcare workers were plenty in my family, and I did not want to do what everybody else wanted of me. It was not until the end of my high school career during the COVID-19 pandemic that I found a real love for the medical field. Throughout the past 3 years of university, I started working towards the goal of attending medical school and working in the healthcare field, yet I was still confused about whether becoming a physician was my calling or whether there was another healthcare profession that I would be interested in. When I learned about physician assistants, it seemed to be a perfect match for what I wanted, yet it also added to my confusion about what healthcare career I should pursue. Coming to Kenya, I had plenty of questions and was unsure of where I stood in my career but came with an open mind. Before my internship in Kenya, the only clinical experience I had was volunteering at the Grace Hospital emergency department in Manitoba, Canada. I had expected that the Kenyan hospital would look much different from the Canadian hospitals and would be severely under-resourced. Additionally, being born in a third-world country myself and having visited back home to Sri Lanka on multiple occasions, I have seen what an underfunded public hospital can look like and thought I had a decent idea of what the Coast General Hospital would look like. However, from the first orientation day in the hospital, I realized how much I truly had to learn about the state of healthcare in Kenya. Much like I imagined, there were outdoor portions of the hospital and cracks were present in the walls and ceilings; what I had not thought about previously was the lack of sanitation at the hospital. I was shocked to see doctors treating patients without gloves and sometimes without masks as well. Blood spills in the emergency department were wiped with a dirty, wet mop that was then used to wipe another spill in a different room. The only time I saw a counter being wiped was in the pediatrics department, but I was saddened to see that there were no actual cleaning products used, and it was only hand sanitizer being wiped down. In Canada, I would have never thought of cleaning products as a privilege, but from that first day, I realized just how much I have taken for granted. My first week was spent in the pediatrics department, where I switched between the outpatient clinic and the in-patient ward. There were two medical students at the in-patient ward who explained to me what the morning would look like, which included changing patient bed sheets, taking vitals of all patients, and then doing rounds with the doctor once she arrived. Right away, I noticed how involved mothers were in the care of their children in the ward. In Canada, it is normal for the nurses and healthcare aides to change bed sheets and clean the baby, yet in this ward it was the mothers changing the bed sheets and getting the baby ready for when the doctor came around. The sense of community between the mothers in the ward was evident, as everyone was helping each other. Even though many things from Western healthcare may be an improvement compared to the healthcare found in Kenya, I think having the mother involved more in their babies’ care is something that Western healthcare should adopt as well. The mothers all seemed so happy to aid in their babies’ care, which is not something you see in Canada, as nurses and healthcare aides do most of the caring. Furthermore, during rounds, I was able to learn about rickets disease and feel a baby’s abdomen for a common swelling symptom of rickets. The doctor explained that vitamin D deficiency is very common in babies who take formula because the formula in Kenya lacks vitamin D, leading to plenty of deficient children. Additionally, a natural source of vitamin D is sunlight; however, it is “imperative for mothers to seek employment very early in the postnatal period [meaning] that infants are often looked after in indoor informal daycare facilities” (Jones, 2017). As much as I would like to think that if we get formula with vitamin D into Kenya the cases of deficiency would decrease, I could see that the problem was much bigger, and therefore the solution would also take years of change. This first case of rickets opened my mind a lot, as I would have never thought that something as simple as access to enough sunlight would be an issue for these children; but with families facing poverty and mothers having to work right away, most of the children are not raised the way we are in North America. Finally, in the outpatient clinic, I learned a lot from Dr. Ken. With every patient that came in, he explained all the symptoms and possible treatments for the child. Between patients, he would also take the extra time to teach us about pneumonia, tuberculosis, and different blood disorders. I will forever be grateful for all the knowledge I received from Dr. Ken and will make sure to keep the notes with me for when I continue into physician assistant school. The biggest lesson that I learned from Coast General that I will be keeping with me throughout my career is how important patient bedside manner is. I was heartbroken to see how some of the nurses and doctors treated the patients. One case in particular that struck me was a boy in his 20s who came in after an accident in a tuk-tuk that resulted in him rolling on the pavement and having multiple large wounds all over his body, as well as a shattered wrist and broken ribs. When taking him for an X-ray, the medical students were pulling his body left and right to get him into position and trying to force the board under him while berating him for screaming in pain. The sounds of his screams were very difficult for me and the other intern to hear and are something I still remember. I could see how much pain he was in when he arrived, and to see him treated so rough at a place that should be caring for him was very difficult to watch and understand. I saw situations similar to this multiple times during my internship where just a little bit of compassion may have helped these patients tremendously. At the labour ward, I saw doctors telling the mothers to stop screaming during labour and saw them get annoyed when mothers tried to hold their hands. I could see that most of the healthcare workers at Coast General were very overworked and exhausted with the conditions they had to work in, causing them to show less compassion. In addition to a lack of resources, the hospital was severely understaffed, with an average of 21 doctors and 100 nurses per 100,000 people compared with the WHO-recommended minimum staffing levels of 36 doctors and 356 nurses per 100,000 people (IMA, 2024). This was especially evident to me in the newborn unit, where I spent one night shift. There was one premature baby whose oxygen saturation level had dropped to 40% because his oxygen tube was not in his nose properly; however, even though the monitor was beeping, no nurses were rushing to fix this. I notified the nurse, who then came to fix it, but when I came back half an hour later, I could see the oxygen saturation at a dangerously low level once again. This time, when I notified the nurses, they did not come to fix it, and I had to tell three nurses before one finally came to help the baby. Even then, this nurse showed no sense of urgency and came only after a few minutes. This was extremely frustrating for me, as all I could do was notify them, but I could not force them to have more urgency. I realized quickly that in the newborn unit, some nurses had the mindset that the premature babies would probably die anyway, which may be the reason for their lack of urgency, as at least 5 babies passed away there every day. An article from the UCLA School of Medicine says that “how physicians, [and] nurses… approach patients and their families can directly affect the overall experience for patients and their willingness to learn… good bedside manner ultimately improves communications and reduces errors” (Geffen, 2016). If there were more staff present, I am sure bedside manner would be much better and would no doubt lead to a decrease in patients’ distress and hopefully even a decrease in this mortality rate. Apart from all I learned at Coast General, I learned a lot from the culture and people of Kenya. I was amazed at how welcoming everyone was and was especially touched by how happy the kids were at the schools we visited. I have truly never felt as happy as I was when I walked into a classroom and had all the young kids come up to hug me and touch my hair, and it only confirmed for me how much I want to work with children during my career. One school we visited for a mental health clinic especially touched me because I got an insight into how hard their lives must be. The classroom was filled with teenagers, and when we asked them to write down their feelings and any questions on paper, I received multiple comments talking about friends who had committed suicide. Within that classroom of about 30 to 40 students, there were six stories of friends who had committed suicide because of physical and/or sexual abuse from family members. It was heartbreaking to hear these stories but was also heartwarming to see how much joy these teenagers portrayed throughout all their struggles. After we had a good conversation on journaling and how to express our feelings, we had a small dance party outside on the field, and it was truly amazing to see how much fun they were all having. They were so welcoming to us and even brought me into the dance circle with them. I will never forget that moment, as they brought me so much joy, and I only hope that we brought them as much joy as well. Every day that I experienced more of the culture, I became more aware that I was extremely lucky to be there. I went to Kenya with an open mind, ready for new experiences and to learn as much as I could. I got so much more out of this internship than I could have ever imagined. My boyfriend has always said he has wanted to come to Africa to live in a village and help the people as much as he can, and this trip led me to start planning this trip for our future, as I honestly fell in love with the culture and people. I also believe that my experience at Coast General helped me to fall in love with medicine just as I had at the beginning of my university career. I no longer have any doubts about what I want to pursue as my career and have decided to apply to a physician assistant program. None of these plans and excitements for myself were present before my experience in Kenya. I will forever be grateful for my life-changing experience and promise to come back to Coast General once I have started my career to help as much as I can.