International Medical Aid (IMA)

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

When I boarded the plane to Kenya to begin my internship with International Medical Aid, I was filled with excitement, curiosity, and a desire to serve. I have long aspired to become a physician assistant, but I also wanted to ensure that this goal was driven by genuine passion rather than simple interest. I had always hoped to participate in global health efforts and provide care to populations with limited access to healthcare. I wanted to understand patient care outside the modern diagnostic tools, fast-paced hospital systems, and technological resources that shape much of medicine in the United States. During my time at Coast General Teaching and Referral Hospital in Mombasa, I discovered far more than I anticipated: a deeper understanding of healthcare disparities, a profound respect for resilience and community, and a renewed commitment to pursue my career with purpose. When I landed in Mombasa, I felt a mix of familiarity and astonishment. Palm trees swayed over busy streets, and the air carried a warmth that extended beyond the weather. Cars moved in a chaotic harmony, with drivers honking and weaving through traffic while somehow avoiding collisions. Tuk-tuks sped between cars and motorcycles, while pedestrians crossed roads amid the flow of traffic. Vendors lined the roadside selling everything from fresh fruit to clothing, their voices full of energy and persistence. As a Somali born and raised in the United States, these sights felt both foreign and strangely comforting. They reminded me of the stories my family shared about home, full of movement, community, and constant hustle. For the first time, I felt connected to a place I had never lived, yet somehow carried within me. The warmth I received from the IMA staff, doctors, nurses, and local community helped me transition from feeling like an outsider to feeling accepted. Coming from the United States, I have grown up in a healthcare system that, despite its high cost, is equipped with advanced technology and support systems for many patients through insurance programs and government assistance. In the United States, individuals facing financial barriers often still have access to emergency care, routine screenings, and early diagnosis. In Kenya, I learned that healthcare accessibility is shaped not only by cost, but also by location, transportation, and the uneven distribution of medical resources. Many patients travel long distances to reach facilities like Coast General Teaching and Referral Hospital, a public hospital that serves a large population with limited supplies and staffing. Unlike private hospitals, public hospitals operate with restricted funding, yet they remain the primary option for most families. Witnessing doctors and nurses provide care despite shortages in equipment, staff, and funding reshaped my understanding of healthcare. I realized that medical systems are defined not only by their resources, but also by the resilience of the people working within them and the accessibility they provide to those who need care most. My first week was spent shadowing in the pediatric ward at Coast General. There, I learned that caring for a child involves far more than treatment and diagnosis. A child’s well-being is also deeply influenced by the social, political, and economic circumstances surrounding them. The ward was filled with young patients, each with conditions shaped by a different combination of medical and social determinants. Many children were battling illnesses such as malaria, pneumonia, and tuberculosis, conditions that are often preventable or treatable when identified early. However, because of delayed diagnosis and limited access to healthcare, relatively manageable illnesses often developed into serious complications. It became clear that a child’s health in Kenya is influenced not only by biology, but also by access, opportunity, and affordability. One of the most valuable lessons I took away was observing how healthcare providers approached diagnosis through close observation, critical thinking, and thorough physical examination. Dr. Ken, whom I shadowed throughout the week, emphasized that medicine begins with asking the right questions, listening carefully to caregivers, and using physical examination as a primary diagnostic tool rather than relying immediately on testing. For example, a nine-month-old baby who was struggling to breathe needed to be evaluated for either pneumonia or asthma. The physician assistant used chest auscultation, history-taking, and observation to guide treatment. This demonstrated a high level of clinical judgment and confidence. It showed me that good medicine does not always require advanced technology, but it always requires close attention. Another case that deepened my understanding of pediatric care involved a twelve-year-old child suspected of having leukemia with a critically low platelet count of 7. A normal platelet count ranges from 150,000 to 450,000 per microliter. The providers were not yet certain whether the child had cancer, and additional testing was needed before a definitive treatment plan could be made. In the meantime, the child was closely monitored and treated as necessary, highlighting how medical teams must make critical decisions even when full information is not immediately available. Witnessing this balance of caution, urgency, and hope was both shocking and eye-opening. I realized how fragile a child’s health can be, and how every clinical decision carries immense weight. The patient who affected me most was a child admitted with aspiration pneumonia, a bacterial lung infection caused by inhaling substances other than air, such as vomit, saliva, or liquids. His bones were fragile, his legs were extremely thin, and swallowing placed him at constant risk of aspiration. The recommended treatment was a PEG tube to provide nutrition, but the procedure had been delayed because of his mother’s financial hardship. It was heartbreaking to watch her sit beside him each day waiting for a solution. Another intern and I spoke with her, and with her permission, we organized a GoFundMe fundraiser. Within a few days, we raised enough money to cover the PEG tube and his hospital bills. For the first time, I truly understood the role of advocacy in patient care. This experience taught me that healing can depend not only on medical expertise, but also on community action and compassion. By the end of the week, I saw pediatrics differently. It was not just a place where children received treatment, but a setting that reflected larger public health challenges such as malnutrition, sanitation, infectious disease, and socioeconomic inequality. I learned that healthcare professionals in Kenya practice medicine with deep dedication, knowledge, and resourcefulness. Their work reinforced my belief that becoming a physician assistant means not only treating illness, but also understanding the realities that shape health. Pediatric care reminded me that every child is more than a diagnosis; each is a life shaped by family, environment, and access to opportunity. My second week was spent in the maternity ward, where I witnessed joy, strength, and hardship. Unlike pediatrics, where children often arrived after days or weeks of illness, maternity care centered on the very beginning of life. Most of the births I observed were cesarean sections, and seeing the surgery in person was very different from reading about it in a textbook. I was struck by how quickly and confidently the surgical team delivered each baby. What impressed me even more was the precision required afterward. While the actual delivery took only a few minutes, closing the uterus and carefully suturing the abdominal wall required patience, skill, and focus. Observing a C-section up close felt surreal. Witnessing a stillbirth was one of the most emotionally difficult experiences I had during my time at Coast General. I had read about fetal mortality rates and the impact of inadequate prenatal care and delayed access to hospitals, but no statistic could capture the silence in the room or the quiet empathy of the nurses, who understood exactly how to offer comfort without words. In that moment, I realized that healthcare providers must possess not only medical knowledge, but also emotional strength. The ability to support patients and families in their worst moments is just as important as providing skilled care during successful ones. As a future physician assistant, I will need to approach moments of loss with the same clarity, compassion, and devotion I bring to moments of healing. This experience taught me that clinical success does not always mean a positive outcome, but compassion is always part of the responsibility. My time in maternity showed me that medicine is not only about welcoming new life, but also about honoring lives that do not begin as hoped. One of the clearest takeaways from my internship was the contrast between healthcare delivery in Kenya and in the United States. In Kenya, medical care is often provided with limited resources and equipment that would be considered standard elsewhere. Yet the system compensates for these limitations through resilience, teamwork, and creativity. Doctors and nurses consistently made the most of what they had. For example, I observed nurses using part of a surgical glove as a tourniquet when drawing blood. These realities reflect a broader systemic difference in healthcare spending and infrastructure. Recognizing that disparity helped me understand why the two systems function under such different conditions. My internship with International Medical Aid changed how I see healthcare, the world, and myself. I learned that medicine involves far more than treatment plans and clinical skills. It also requires advocacy, cultural humility, emotional intelligence, and adaptability. I encountered illnesses that are uncommon in the United States but prevalent in Kenya. More importantly, Kenya will remain part of my story, not simply as a place I visited, but as the place that reshaped my understanding of medicine, taught me the power of empathy and resilience, and showed me what it truly means to care for others.

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