International Medical Aid (IMA)

This trip was truly life-changing and inspiring, and I am very thankful for all of the staff for their amazing support through the process. I loved everything—the food and culture were beyond amazing. I want to give a shout out to my bestie Janet; she accompanied me through my weekend treks. I had a blast with her, and I’m so glad she’s the one that went with me. I never felt unsafe during my time in Kenya, and for that I am so appreciative. I think one of the most positive experiences I made on this trip were the friendships I made, but also the community outreach events we had. There was nothing more eye-opening than going to underprivileged communities and providing the extra support that they desperately needed, which is proper healthcare. I am so blessed to have been able to experience something like this with such a well rounded program. Thank you!! The first time I heard about IMA, I was immediately intrigued. I remember seeing the program, and it fueled my curiosity that had been growing ever since I thought about doing an internship. The idea of actually getting accepted into such a program felt almost far-fetched. I have never taken the time to apply to anything like this before, so the idea of stepping into this opportunity was so thrilling yet nerve wracking. I was lucky enough to have a supportive circle around me—people that encouraged and reminded me that I was capable of doing anything I set my mind to. With enough convincing, I applied. In my mind, I thought, “What’s the worst that could happen? I don’t get accepted—or I could end up having the craziest experience in Kenya.” Fast forward a couple months, and I find myself at the Royal Suites residence, staring in awe at what the next three weeks of my life would hold. I was greeted by a wonderful group of peers and staff, and from that moment, I knew I would be in good hands. Walking into this program, I had some experience as a medical assistant in a neurology office. However, that was completely different from what I encountered at Coast General Teaching and Referral Hospital. I vividly recollect the first day I arrived at the hospital, knowing I would encounter far more striking cases than those back home. During my time there, I rotated through the Emergency, Pediatrics, and Surgery departments, and I also participated in night rotations at least once a week in other departments. Before beginning, I received an orientation that included discussions on what to expect in terms of medical cases, as well as the local culture and customs. I was told that healthcare in Kenya was severely understaffed and poorly supplied due to location and financial reasons (Cultural Approaches to Pediatric Palliative Care in Central Massachusetts: Kenyan, n.d.). I was also informed that many patients present with advanced stages of illness, often as a result of financial constraints or religious beliefs. During my time in the Emergency Room, I saw many patients that would arrive with advanced cancers, severe infections, and untreated wounds. When asked about the situation, the most common response was that they simply did not have the money for treatment. Others would say the nearest medical facility was too far from their homes, requiring them to strategically plan when they could make the trip. One response in particular really struck me: a patient’s family explained that they were relying on prayer to heal their loved one, believing it was best to let God provide the cure. As a believer myself, I was impacted and inspired by that statement. However, it was hard to reconcile because many of the situations I saw needed urgent attention. In those moments, it felt challenging to accept that faith alone was being relied upon in circumstances where timely medical care was critical. There are many traditions of healing and medicine that Kenyans use. Various natural remedies are commonly used such as African potatoes, rooibos, and the hoodia cactus. Additionally, there are rituals that are performed for spiritual healing. For example, shells, bones, and stones are used to communicate with ancestors or spirits to learn more about the patient’s health condition (Brooke, 2023). When I was in the hospital I never encountered someone that firmly believed in these practices, but I heard from the nurses around that it was used by many patients. In terms of patient care, I witnessed a wide range of cases. Being in a public hospital, I observed severe understaffing as well as lack of essential tools equipment. There were many moments when I would instinctively look for an instrument we would normally have back home, only to find it unavailable. In those situations, we often had to improvise and make do with what was already on hand. I vividly recall one night during a shift a patient began coding. One of the nurses was desperately searching for a BVM (bag valve mask), going drawer by drawer in an attempt to find one. The search took four or five minutes, and by the time the mask was finally located, the patient had already been declared deceased. I don’t know if the patient would have survived had the mask been found and used sooner; regardless, the situation highlighted the critical lack of necessary resources. Another example of improvisation was when gloves were used as tourniquets, which led to supplies running out more quickly. I remember one shift in the PICU, I was reminded that one of the mothers that gave birth to two beautiful boys was in intensive care due to birthing complications. One of the nurses approached me and one of my peers, asking if we were interested in feeding the babies. Without hesitation, we both agreed. I have never fed a premature baby before, so I was incredibly nervous and assumed there would be a machine of some sort. I was wrong. We had to use a syringe, carefully letting the milk independently go through the tube. This process was time-consuming, as we had to hold the syringe up in the air to allow the milk to flow, which took roughly ten to fifteen minutes. At times, the milk would get stuck in the tubes or even harden, creating additional challenges. I remember hearing that these methods were used back in the day, so it wasn’t uncommon—just time-consuming and requiring extra attention. Typically, Nairobi and the Central Province are considered to offer the best public healthcare, while the North Eastern Provinces are generally more underdeveloped in terms of medical infrastructure and resources. There are private hospitals in Nairobi that are very respected and known to be top tier (Healthcare in Kenya, n.d.). After all that I have learned during this trip, I returned home with a deep sense of appreciation for the healthcare providers I had worked alongside, as well as a strong desire to continue learning more about global healthcare practices and the challenges faced in resource-limited settings. Witnessing the dedication of the healthcare providers who worked tirelessly despite limited supplies and overwhelming patient needs gave me a deep sense of respect and admiration for their commitment to their patients. I recall all of the conversations I had with the providers and students—one thing was clear: they all shared a deep love for the field. They acknowledged that their work could be challenging and frustrating at times, yet none could imagine doing anything else. There was genuine passion and grit behind every single provider, evident in the care they provided and the dedication they showed to their patients. I witnessed what it was like to think quickly on my feet and rely on the limited skills I had. These experiences taught me that healthcare isn’t just about medicine—it’s about human connection, understanding, and trust. I will be sure to bring these lessons into my career by prioritizing empathy, effective communication, and cultural sensitivity. I’ve always had a deep passion for healthcare, shaped both by my childhood interests and personal experiences. This trip has only intensified my passion, leaving me with a strong desire to learn and do even more in the field. I fully plan to return to Kenya and work at Coast General once I am a certified Physician Assistant, so that I can gain more practical experience while contributing to the healthcare system and properly helping patients in need. My time in Kenya was transformative. It exposed me to the realities of healthcare in resource limiting settings, challenged me to develop critical thinking skills and adaptability, reignited my passion for healthcare, and strengthened my commitment to pursuing a career as a Physician Assistant. I am determined to apply all that I have learned in every aspect of my future practice—fully dedicated to serving patients with compassion and cultural competency while continuing to seek opportunities to learn and grow as a healthcare professional. Beyond the clinical skills, this experience taught me the importance of patience and resiliency. This applies to myself and the patients. I learned how small gestures like listening, showing empathy, and providing reassurance can have a profound impact on the patient’s wellbeing and steps to recovery. Allowing myself to see how other providers navigate such a challenging system inspired me to think of more solutions and think proactively about improving healthcare, even in similar situations where resources are limited. I have gained an appreciation for proper teamwork and collaboration. It was refreshing to see how providers rely on one another to manage heavy workloads and ensure the patients’ comfortability—some demonstrated it better than others. This experience has diligently motivated me to approach my future career with a humbled mindset of service, humility, and continuous growth. Every patient encounter is an opportunity to make a meaningful difference. I am now more committed than ever to properly advocating for patients, embracing diverse perspectives, and integrating proper cultural competency in all aspects of my future practice.

My experience in Kenya with International Medical Aid was incredible. The in-country support was excellent, and I always felt safe thanks to clear guidance and protocols. Accommodations were comfortable, and the food was a wonderful introduction to Kenyan cuisine. The clinical experience was invaluable. I got to shadow PAs and physicians, learning how they provide compassionate care even with limited resources. My mentors Mitchel, Margaret, Benson, and Hilda were especially amazing; they guided me, answered questions, and made the experience meaningful and inspiring. Overall, this program deepened my understanding of healthcare, strengthened my communication and cultural awareness, and reinforced my commitment to becoming a healthcare provider. It was a truly memorable and transformative experience. I came to Mombasa, Kenya, with a curiosity about global healthcare. What I left with was far more than observation—I left with a deeper understanding of resilience, compassion, and the creativity required of healthcare providers in resource-limited settings. My two weeks at Coast General Teaching and Referral Hospital through International Medical Aid shaped not only my perspective on medicine, but also the kind of provider I aspire to become. The resource-limited setting of a Kenyan referral hospital highlighted the importance of adaptability, clinical judgment, and teamwork in medicine. It also deepened my appreciation for cultural competence and reinforced my desire to pursue a career that bridges patient care with compassion, equity, and access. I reflected throughout my internship on how these lessons shaped my personal and professional goals, and how I plan to apply this knowledge to my future career in healthcare. My first week at the hospital was spent in pediatrics, including the High Dependency Unit, the inpatient ward, and the outpatient clinic. Each area exposed me to different aspects of pediatric medicine and highlighted the challenges of providing care in a resource-limited setting. In the High Dependency Unit, I saw children critically ill with conditions such as malaria, pneumonia, and severe dehydration. With limited monitoring equipment, providers relied heavily on careful physical exams and clinical judgment. Watching physicians and nurses act with such precision reminded me that medicine depends as much on knowledge and presence as it does on technology. I also noticed how central families were to care—mothers and caregivers often stayed at the bedside, feeding and comforting their children. It underscored for me that treating a child means supporting the entire family. The inpatient ward was crowded but full of resilience. Children admitted for longer-term care still found ways to laugh, play, and smile, even while battling illness. This reminded me that pediatrics requires not only medical skill but also creativity, optimism, and patience. The outpatient clinic emphasized communication and trust. I shadowed physicians and medical students as they diagnosed fevers and infections, counseled parents, and provided follow-up care. One memorable encounter was a mother worried about her child’s persistent cough. The physician took time not only to examine the child but to reassure her and explain how to monitor symptoms. That interaction showed me how powerful reassurance and education can be. That week in pediatrics taught me that medicine is not only about addressing immediate illness but also about building trust, supporting families, and adapting to circumstances. The lack of abundant resources revealed how powerful strong clinical reasoning, communication, and compassion can be. As an aspiring PA, I want to carry these lessons forward by becoming a provider who combines medical expertise with cultural sensitivity and emotional intelligence. In the United States, I may not always encounter the same level of resource scarcity, but disparities still exist. This experience showed me that effective providers don’t just treat patients; they meet them where they are, partner with their families, and offer care that is both competent and compassionate. During the second week of my internship, I rotated through the emergency department, including both adult and pediatric units. The emergency department was fast-paced, unpredictable, and often chaotic—a contrast to the structured environment of the outpatient clinic. I witnessed cases ranging from acute infections to trauma. One case that stayed with me was a toddler with severe malaria whose rapid deterioration required immediate intervention. Observing how the team coordinated care under pressure highlighted the importance of quick decision-making and clear communication. Another case involved a man who was involved in a street traffic accident and sustained a significant injury to his face, including a compound fracture and mandible dislocation. The attending physician quickly assessed the situation, coordinated imaging, and explained the care plan to the anxious patient. Observing this interaction, I realized how crucial clear communication is—not just with the patient but also with the family. Every word mattered in building trust and helping the family feel involved in care decisions, and it made me feel content with how everything was handled. The adult ED presented different challenges. Patients often arrived with complex conditions, and resources were limited compared to what I have seen in U.S. hospitals. I saw providers rely on careful observation, prioritization, and creative problem-solving to stabilize patients efficiently. Overcrowding was common, and staff had to make rapid decisions about who required immediate intervention versus who could wait. I had the opportunity to observe the triage process firsthand, watching nurses and physicians quickly assess vital signs, symptoms, and overall condition to determine urgency. This experience emphasized the importance of staying calm under pressure, making swift decisions, and trusting one’s clinical judgment—skills I hope to carry forward as a future physician assistant. Beyond clinical skills, the ED also highlighted the human side of medicine. Many patients were in distress not only from illness or injury but also from fear, uncertainty, or socioeconomic stressors. I observed how providers offered reassurance, listened attentively, and made patients feel heard even in brief interactions. This reinforced a lesson I had learned in pediatrics: effective care is not just about diagnosis and treatment, but about empathy, communication, and emotional support. Experiencing this firsthand strengthened my desire to pursue a career where I can provide competent and compassionate care, especially in moments when patients are most vulnerable. During my overnight shift in the Labor and Delivery ward, I witnessed the intensity, urgency, and profound humanity of bringing new life into the world. Even though my time there was brief, I observed the critical teamwork between medical officers, nurses, and midwives, and how every decision carried weight for both mother and child. I was shocked to learn that epidurals were generally not offered unless the mother was undergoing a C-section, and I felt for the women laboring without this form of pain relief. Seeing their strength and resilience firsthand was both humbling and inspiring. I also had the opportunity to view a C-section, which was an eye-opening experience. Observing the surgical team’s coordination and focus, as well as the immediate transition of the newborn to care, highlighted the precision and teamwork required in critical situations. This experience reinforced lessons I had already begun to understand in pediatrics and the emergency department: medicine is not just about technical skill, but also about empathy, communication, and presence. Providers balanced clinical urgency with compassion, comforting patients and offering reassurance even in high-stress moments. Being in the ward overnight gave me a deep appreciation for the emotional and human side of healthcare and reminded me that being a provider is as much about supporting people through life’s most vulnerable moments as it is about treating disease. These lessons strengthened my aspiration to become a physician assistant who can deliver competent care while also connecting with patients on a human level. Mombasa County has a higher HIV prevalence than the national average, and that statistic became profoundly real during my time at the hospital. I encountered numerous patients—both adults and children—whose lives were directly affected by HIV. The emotional weight of these encounters was palpable, especially when discussing treatment plans and the challenges of medication adherence. One particularly memorable interaction involved a mother in the pediatric ward, deeply concerned about her child’s health. The physician took extra time to explain the child’s condition, the importance of antiretroviral therapy, and the need for consistent follow-up care. Witnessing this compassionate communication underscored the significance of not only medical treatment but also emotional support and education in managing chronic conditions like HIV. My two weeks in Mombasa were transformative, offering lessons that extended far beyond clinical knowledge. From pediatrics, I learned the power of observation, clinical reasoning, and compassion. The emergency department taught me adaptability, rapid decision-making, and the importance of clear communication under pressure. Labor and Delivery showed me the courage and resilience of patients and the teamwork required in critical moments. Encountering patients affected by HIV deepened my appreciation for the intersection of medical care, patient education, and emotional support. I realized that effective healthcare requires not only knowledge and skill but also cultural sensitivity and the ability to support patients through their most vulnerable moments. Together, these rotations solidified my desire to become a physician assistant who can provide competent, compassionate care in a variety of settings. I am inspired to carry forward the lessons I learned in Kenya—the importance of empathy, communication, adaptability, and partnership with patients and families. This internship has not only reinforced my commitment to healthcare but has also shaped my vision for the kind of PA I aspire to be.

I felt safe and supported in all areas during the program. Staff and fellow interns made me feel welcome and comfortable during my stay. The whole experience has helped me to realize that I am pursuing what I would like to do as a career - clinical psychology. The staff in the psychology department at Coast General were open, friendly, and knowledgable. I had the opportunity to see diverse mental health cases and learn how different cultures address mental health issues. The most influential part of the program was the outreach we participated in at schools and community clinics. Speaking with the kids and community members was moving because I encountered both kindness and resilience. “Although the world is full of suffering, it is also full of the overcoming of it,” Helen Keller. My time with IMA and at Coast General Teaching and Referral Hospital in Kenya was utterly life-changing and exemplified that quote. The role of psychologists at Coast General Teaching and Referral Hospital is multifaceted. They are counselors for patients, their families, and doctors; they are the support system for those patients without family or friends; they are educators, explaining the health implications to patients for their individual physical ailments; and they are called in to convince patients to get crucial surgeries. Every day there are cases of schizophrenia, bipolar disorder, major depressive disorder, anxiety, postpartum depression, postpartum psychosis, post-traumatic stress disorder (PTSD), autism, cerebral palsy, and learning disabilities. Cases of deteriorating mental health continue to increase, particularly anxiety and depression, as a large portion of the population deals with poverty and fear from political instability. According to the IMA lecture on the disease burden in Kenya, “one in four Kenyans is likely to suffer from a mental disorder at some point in their lives” (IMA, 2025). The psychologists have an added barrier to their work because of widespread stigma against mental health care. Mental health professionals have a battle to fight against stigma in every country and society, but people’s preconceptions differ from culture to culture. I arrived in Kenya with an understanding that there was pervasive skepticism and distrust towards mental health, but I did not expect to encounter a widespread belief in witchcraft. Almost every day, at least one patient would blame witchcraft or karma as the reason for their suffering or the suffering of a loved one. Someone experiencing psychosis, addiction, depression, or the loss of a child in childbirth might explain it away as the result of being cursed by a witch, or a consequence of wrongdoing by them or a relative. Thus, patients refused psychological care, disbelieving that anything other than praying to God or seeing a traditional healer could free them from their suffering. When the psychology department was called to the wards for specific patients, many of them would ask, “Are you talking to me because you think I’m crazy?” They feared this label and made it clear that we could talk to them if we wanted, but they were nothing like the “crazy people” we usually speak to. Mental health stigmas come from more than fear of the supernatural. In the United States, people also fear seeking treatment because of potential discrimination. This discrimination is a product of centuries of misunderstanding the brain and mental illness, and viewing negative representations of those with mental health disorders in the media. According to the American Psychiatric Association, even when people understand the medical and biological aspects, mental disorders still have a bad connotation and people will go out of their way to avoid those who suffer from these conditions (Singhal, 2024). The better my understanding of these social and cultural stigmas, the better clinician I will be in the future. Treatment of patients who believe their disease is a spiritual or metaphysical problem will be different from treatment of those who see it as biological or emotional. It is not helpful to deny the patient’s belief and attempt to psychoeducate them because such beliefs are often deep-rooted. The delivery of mental health care at Coast General is largely the same as treatment in the West, though provider strategies differ slightly. A combination of counseling and prescription medications are used for psychological disorders, but care at Coast General goes far beyond mental disorders. As the medical doctors have limited time to spend with their patients, psychologists fill in the gaps and take on the responsibility of explaining patient conditions and treatments. Low levels of health literacy among patients complicate communication between the patient and health care provider. I witnessed multiple difficult moments with patients’ family members and real moral dilemmas in terms of approaches used to communicate the need for certain treatments. At least once a week we visited the mother of a three-year-old boy who was being cared for in the ICU. I sat with her for the first time as the psychologist explained that her son was initially misdiagnosed. The doctor understated the severity of the boy’s heart condition and missed the gangrene consuming his left foot, up to his ankle. We informed her that her son needed heart surgery as soon as possible, required his leg amputated, and still only had a 50% chance of surviving. The mother held an immense sadness behind her eyes but sat stone-faced and strong as she expressed gratitude for the psychologist’s honesty. The doctors avoided her and she was in the dark before we saw her. She said she understood the limited resources of the hospital and would be satisfied with the doctors’ best efforts. We visited her multiple times to update her on her son’s condition, finally giving her the date of his upcoming surgery after three weeks of waiting. She was grateful and I was hopeful for the boy until my final day at Coast General, when the psychologist informed me she had to tell his mother her son could no longer get surgery. He was too malnourished and his vitals were too low to survive the procedure. He would die in a few days. Patients often expressed distrust of the medical providers at Coast General. Some, such as the three-year-old boy’s mother, understood that few other choices exist, despite a lack of resources at this hospital. However, others preferred to take their chances without treatment. In these cases, the psychologists applied any strategy they could to change the patient’s mind, even if it required strong persuasion. One mother refused to let her five-year-old son receive heart surgery that would increase his chance of living by 20% because she did not trust the capabilities of the doctors. The psychologist sent to speak with the mother told her that she was in luck: a specialist from Nairobi was coming to the hospital. He visited only once a year and received a limited list of patients to perform surgery on, and her boy made it onto the list. At this news, the mother agreed for her son to receive the surgery. However, this specialist from Nairobi did not exist and the surgery would be performed by a Coast General surgeon. The psychologist explained her choice as the only option because the mother was risking her son’s life based on fear and this was unfair to the child. Another patient, a sixteen-year-old girl who had just given birth, had a tear from her vagina to her anus and needed to get stitches, but refused. She was afraid of experiencing more pain after the agony of childbirth. The psychologist began the conversation explaining the risk of infection and other health problems that could result without suturing the tear. However, as the girl did not seem convinced, the psychologist switched tactics and told her that without stitches, her husband would leave her because she would no longer have a tight vagina. This, the psychologist explained, was a greater fear than the risk of infection and death. I continue to wrestle with whether these decisions to scare patients outweigh the problems that might result from declined procedures. A population of people the psychologists treat with regularity are those who have experienced gender-based violence (GBV). GBV has been a long-time problem in Kenya, and similar to mental illness, it is a taboo topic. The GBV patients I encountered were often soft-spoken and reluctant to talk about their specific experiences with violence, while able to converse on other topics. This is particularly the case for male victims. The GBV clinic psychologists explained that male victims do not often come forward because of shame and the feeling of weakness. However, the psychologists also said that any victim who does not speak about their experiences has a higher likelihood of becoming a perpetrator to others. It is also common for families to try and handle the situation among themselves, making it difficult to pursue justice. The fear of stigmatization by others outweighs the desire to report the incident to police. The GBV clinic at Coast General is one of very few in the country and was partly funded by the United States Agency for International Development (USAID) before it was disbanded by the Trump administration. USAID targeted GBV in Kenya by funding “shelters, medical care, counseling, legal aid, and educational initiatives” (Burkybil, 2025). A plaque in the psychology office read, “The Medically Assisted Therapy (MAT) Clinic at Coast General Hospital was officially handed over to the Governor of Mombasa County H.E. Ali Hassan Joho on the 11th September 2015. The facility was refurbished and equipped by UNODC [United Nations Office on Drugs and Crime] with financial support from USAID”. I saw similar signs and brandings of USAID around the hospital, on trash cans and equipment, with the words “From the American People”. My breath caught in my throat the first time I saw this as I had never seen firsthand evidence of the work done by USAID abroad. It made me reflect on how much these programs matter, and how real their impact is on everyday care. Based on these experiences, I feel inspired to write my college senior thesis on gender-based violence and the effects that ending USAID has internationally. My time with IMA in Kenya confirmed my desire to pursue clinical psychology and work for a humanitarian organization, like Doctors Without Borders. Trauma psychology, advocating for better mental health care, and education on mental health are my primary interests. Since returning to my home in the United States and sharing my stories with others, I realize that simply sharing makes an impact on those around me. Describing my experiences and recounting interactions with patients and children, and the examples of USAID’s impact in the country, are transformative to others I’m told. My participation in the East Africa IMA program is a lifetime gift resulting in an increased understanding of cultural differences, helping me be a better global citizen, and impacting my future career.