Study Abroad Programs in Kampala, Uganda

My experience with International Medical Aid in Kenya was transformative, not only because of the extensive clinical exposure but also due to the rich cultural immersion. From the moment I arrived, the program mentor ensured that I felt safe and welcomed. Accommodations were comfortable and secure, and cultural treks and team-bonding activities fostered a strong sense of community with fellow interns and mentors while deepening my appreciation of Kenyan culture. By engaging with patients in the hospital, participating in clinic outreach to underserved communities, and interacting with young students during educational sessions, I witnessed the generosity and compassion of the community despite the significant hardships they faced. Shadowing in the hospital was invaluable, as doctors guided me through clinical presentations, diagnoses, and treatments while linking them to underlying pathophysiology, allowing me to bridge my academic knowledge with the real-world challenges of healthcare delivery in Kenya. One of the most striking cases I witnessed involved a pregnant woman with severe mitral stenosis who required an emergency cesarean section—the first surgery ever performed inside the ICU at Coast General Teaching and Referral Hospital. Systemic challenges common in resource-limited settings, including non-functional equipment and a shortage of trained staff, had delayed intubation overnight, leaving the baby without a heartbeat and placing the mother at risk of hypoxic brain injury by the time I arrived. These limitations ultimately forced clinicians to perform the c-section within the ICU, a decision that highlighted both the difficult trade-offs in patient safety and the resilience and ingenuity of providers working under immense pressure. During community outreach to rural areas, I met a teenage boy with osteosarcoma who presented with a large knee mass he initially believed was from a soccer injury. The doctors explained that amputation was the only available option, as both the financial burden and the lack of chemotherapy resources and training made limb-salvage treatment impossible in Kenya. Watching his tears and the worried faces of his family was deeply difficult, yet it became a profound lesson in empathy and the realities of delivering care in resource-limited settings. I also had the opportunity to observe the neurosurgery camp, where neurosurgeons from Germany traveled to Kenya to perform procedures and follow up on patients from previous years. During outpatient clinics, a neurosurgeon explained that their work has two sides: the heartbreak when patients arrive too late for treatment, and the hope and fulfillment of witnessing patients improve from the condition they initially presented with. The gratitude of families who previously had no access to specialized care is what motivates them to continue returning. Their work highlighted the power of global collaboration in medicine and showed me how compassion and cultural humility truly transcend borders. Overall, the strong support I received from mentors, the meaningful clinical immersion, and the kindness of the local community made this program an experience I will carry with me into my medical career. It not only strengthened my commitment to global health but also underscored the importance of adaptability and empathy in delivering care across diverse cultural and resource settings. but show the full text Thought for 1m 8s My experience with International Medical Aid in Kenya was transformative, not only because of the extensive clinical exposure but also due to the rich cultural immersion. From the moment I arrived, the program mentor ensured that I felt safe and welcomed. Accommodations were comfortable and secure, and cultural treks and team-bonding activities fostered a strong sense of community with fellow interns and mentors while deepening my appreciation of Kenyan culture. By engaging with patients in the hospital, participating in clinic outreach to underserved communities, and interacting with young students during educational sessions, I witnessed the generosity and compassion of the community despite the significant hardships they faced. Shadowing in the hospital was invaluable, as doctors guided me through clinical presentations, diagnoses, and treatments while linking them to underlying pathophysiology, allowing me to bridge my academic knowledge with the real-world challenges of healthcare delivery in Kenya. One of the most striking cases I witnessed involved a pregnant woman with severe mitral stenosis who required an emergency cesarean section—the first surgery ever performed inside the ICU at Coast General Teaching and Referral Hospital. Systemic challenges common in resource-limited settings, including non-functional equipment and a shortage of trained staff, had delayed intubation overnight, leaving the baby without a heartbeat and placing the mother at risk of hypoxic brain injury by the time I arrived. These limitations ultimately forced clinicians to perform the c-section within the ICU, a decision that highlighted both the difficult trade-offs in patient safety and the resilience and ingenuity of providers working under immense pressure. During community outreach to rural areas, I met a teenage boy with osteosarcoma who presented with a large knee mass he initially believed was from a soccer injury. The doctors explained that amputation was the only available option, as both the financial burden and the lack of chemotherapy resources and training made limb-salvage treatment impossible in Kenya. Watching his tears and the worried faces of his family was deeply difficult, yet it became a profound lesson in empathy and the realities of delivering care in resource-limited settings. I also had the opportunity to observe the neurosurgery camp, where neurosurgeons from Germany traveled to Kenya to perform procedures and follow up on patients from previous years. During outpatient clinics, a neurosurgeon explained that their work has two sides: the heartbreak when patients arrive too late for treatment, and the hope and fulfillment of witnessing patients improve from the condition they initially presented with. The gratitude of families who previously had no access to specialized care is what motivates them to continue returning. Their work highlighted the power of global collaboration in medicine and showed me how compassion and cultural humility truly transcend borders. Overall, the strong support I received from mentors, the meaningful clinical immersion, and the kindness of the local community made this program an experience I will carry with me into my medical career. It not only strengthened my commitment to global health but also underscored the importance of adaptability and empathy in delivering care across diverse cultural and resource settings. To provide additional context for why this Pre-Medicine Internship meant so much to me, I want to share the personal experiences and reflections that shaped how I approached this opportunity and what I learned through it. From a young age, I became acutely aware of the challenges of living with illness. As a child, I struggled with severe atopic eczema, which affected me physically and also introduced me to the emotional weight of managing a chronic condition. At sixteen, I was diagnosed with keratoconus—a progressive eye condition where the cornea thins and changes shape, leading to blurred vision. The exact cause of keratoconus remains uncertain, with both genetic and environmental factors implicated; in my case, it was suspected that repetitive eye rubbing due to chronic eczema contributed to the disease. Undergoing treatment to halt its progression was a formative experience and one of the first moments that truly drew my curiosity toward medicine. I became deeply interested in how diseases can arise from different etiologies yet converge in their pathophysiology, and I wanted to understand the mechanisms behind those connections. During middle and high school, I dedicated much of my energy to lifesaving sport. The hours of training instilled discipline, initiative, and a readiness to step into leadership roles—especially when preparing for basic life support scenarios. These experiences taught me teamwork, responsibility, and the ability to stay calm in moments of urgency. Together, my medical history and my training offered a glimpse into what a career in healthcare might involve. Still, at that time, those influences felt more like inspiration than conviction; while they sparked my admiration for medicine, I had not yet fully envisioned myself carrying the immense responsibility of caring for patients in a clinical setting. That perspective changed profoundly through my Pre-Medicine internship experience with International Medical Aid (IMA) in East Africa—one of the most transformative opportunities of my life. Immersing myself in a healthcare system so different from the one I knew in Canada not only deepened my understanding of medicine, but also reshaped how I think about what it means to serve as a healthcare provider. I witnessed the resilience of patients facing significant barriers to care, the ingenuity of clinicians working resourcefully with limited supplies, and the strength of community that was woven into daily life. These experiences challenged me to think critically about global health disparities, the importance of cultural humility, and the role of empathy and gratitude in clinical practice. More importantly, they gave me a clear and undeniable sense of direction: I want to dedicate myself to medicine—not only to treat patients, but also to contribute to bridging systemic inequities in healthcare. I invite you to follow along with my journey as I reflect on the knowledge and perspective I gained through this internship, and how these lessons will guide my path toward a career in healthcare. During my first week, I rotated through the intensive care unit (ICU), a critical care environment dedicated to managing patients with acute, life-threatening organ dysfunction. In Canada, where I am from, the closed model of care—intensivist-led management—is the standard. At Coast General Teaching and Referral Hospital (CGTRH), however, I experienced a more open model. Although medical officers were designated in ICU, patient management was largely directed by surgeons and primary physicians in the absence of intensivists. In conversations with staff, I was struck to learn that only one nurse in the unit had specialized in critical care. Beyond human resource challenges, equipment limitations also played a major role. For example, the blood gas analyzer—essential for monitoring critical respiratory conditions—was non-functional, and these systemic constraints were not abstract; they had direct and visible consequences for patients. One case left a lasting impression on me because it had never happened in the hospital before. A 31-week pregnant woman with severe mitral stenosis, complicated by heart failure and pulmonary edema, was admitted to the medical ICU following cardiology consultation. On the night prior to my observation, her oxygen saturation had dropped below 65%, and fetal distress was documented. At that time, the medical ICU lacked access to non-invasive oxygen delivery devices, and the blood gas analyzer was non-functional. Despite multiple indications for airway intervention, limited equipment and a shortage of trained personnel led to intubation being deferred overnight. When I arrived the following morning, the unit was in a state of urgency, with ongoing debate about whether to transfer the patient to the operating theatre. Given her critical status, disconnecting her from mechanical support for transfer was not feasible. She had already endured prolonged hypoxemia overnight, raising grave concern for hypoxic brain injury. As a result, an emergency cesarean section was performed in the ICU—the first surgical operation in the hospital’s history to be conducted in that setting, without standard infection-control infrastructure. That morning, no heart rate was detected on fetal assessment. Neonatal resuscitation with CPR was attempted but unsuccessful. After delivery, the mother experienced a period of profound hypotension, with persistently low perfusion pressures despite intensive resuscitative measures, before eventually stabilizing and surviving. This case illustrated both the complexity of critical care in resource-limited settings and the devastating consequences of systemic constraints. Beyond observing these systemic challenges, I also gained direct exposure to critical care procedures, including placement of a central line. A patient presented with hepatic encephalopathy in the setting of hepatic, hypovolemic, and septic shock—likely secondary to chronic alcohol use and underlying liver cirrhosis. The patient suffered cardiac arrest but was successfully resuscitated with CPR. A central venous catheter (CVC) was then inserted to provide rapid access to a major central vein for administration of medications and fluids. Vasopressors such as adrenaline (epinephrine), dopamine, or norepinephrine were administered to restore adequate blood pressure and perfusion to vital organs by constricting blood vessels, as the patient remained in a state of shock. Inotropes were also considered when low cardiac output was present. The catheter was primed with heparinized saline to prevent clot formation. I learned that a triple lumen central line has three ports, and that the distal (blue) port provides the closest access to the right atrium—one reason it is used for vasoactive medication and central venous pressure monitoring. In this patient, the CVC was inserted via the subclavian vein for palliative care, as this site offers longer-term access due to thicker surrounding soft tissue and carries a lower infection risk compared to femoral and internal jugular sites. Aside from clinical learning, I also witnessed a case involving mob justice—where community members collectively punish a suspected offender outside the formal legal system. The patient I encountered in the ICU had sustained extensive burns as a result. Cases like this underscore deep societal distrust in law enforcement and the judiciary, often fueled by perceptions of corruption and impunity. Immersed in the intensity of the ICU, I came to appreciate that empathizing—rather than simply sympathizing—with patients’ families is crucial for effective care. Sympathy can cloud clinical judgment and decision-making, especially in sensitive discussions like signing a do-not-resuscitate (DNR) order or explaining a poor prognosis. I observed this challenge in cases ranging from a patient dying of a pulmonary embolism to a cerebral malaria patient in a coma for several days. These experiences showed me how empathy allows physicians to acknowledge emotions while maintaining clarity, objectivity, and professionalism. Similarly, during a community medical outreach clinic to underserved populations, I witnessed the importance of strong collaboration with local communities in providing accessible and compassionate care. One patient remains vivid in my memory: a teenage boy who presented with a progressively enlarging, painful lump around his knee. He initially thought the swelling was from a minor soccer injury, but Dr. Katana, whom I shadowed, had to explain that it was osteosarcoma. While limb-salvage surgery has become the standard of care worldwide, amputation remains the predominant surgical practice in much of Africa. Watching tears well up in this young boy’s eyes as he processed the reality of amputation was heartbreaking. The moment brought to mind my visit to Bombolulu Workshop, where I learned how cultural stigma around disability can intensify psychosocial burden. This experience underscored the importance of building emotional resilience while staying grounded in empathy. During my second week in the surgery department, I learned extensively about medical terminology and surgical procedures. This week coincided with a neurosurgery camp, where neurosurgeons from the SAWUBONA Foundation (Germany) visited to perform procedures and follow up on patients from previous years. With less than 1% of the world’s neurosurgeons serving the African continent, neurosurgical cases are an emerging public health concern. I was struck by how critical it is to exchange knowledge globally and build local capacity to advance neurosurgical care across Africa. My week in surgery began in the outpatient clinic, where I engaged directly with patients, observed clinical assessments in practice, and listened to patients describe their experiences confronting disease. I observed a patient with cervical myelopathy undergoing reflex testing, where hyperreflexia (an exaggerated knee-jerk response) served as a key clinical sign. In contrast, I was taught about the relevance of myelomalacia—an MRI finding reflecting spinal cord softening due to compression. Importantly, patients can present clinically with cervical myelopathy even without visible myelomalacia on MRI, and conversely, myelomalacia can appear when clinical signs are subtle or absent. This reinforced that understanding disease requires actively capturing the clinical picture and integrating—rather than confusing—signs and imaging findings. While shadowing Dr. Degiannis from Germany, I encountered a patient who had undergone resection of a pilocytic astrocytoma a year prior and now presented with a new lesion at the original tumor site. The patient remained seizure-free post-surgery, and histological analysis again showed no atypia or mitotic activity—consistent with a low-grade pilocytic astrocytoma—suggesting residual or recurrent disease rather than a new glioma. Unlike diffuse low-grade gliomas that can transform aggressively, pilocytic astrocytomas rarely progress to higher grades. Even with this relatively reassuring pathology, I observed the difficult decisions the surgeon had to make, especially in a setting where chemotherapy and radiotherapy are nonexistent and remain financially out of reach for many patients despite the oncology department at CGTRH. As Dr. Degiannis explained, outcomes often fall at two extremes: some patients arrive too late for treatment and face a poor prognosis, while others experience remarkable recoveries after surgery. I witnessed this spectrum firsthand—from an elderly patient who underwent lumbar decompression and fusion and later regained the ability to stand independently, to a child with an encephalocele who overcame ataxia and was able to walk with stability. Dr. Degiannis described these moments as joyful and fulfilling, and emphasized that they are why he continues providing care in settings where neurosurgeons are scarce. In the operating theatre, I observed craniotomy and tumor resection for various intracranial tumors. One particularly challenging case involved a giant pituitary macroadenoma with suprasellar extension. Unlike typical pituitary adenomas that are removed via a transsphenoidal approach, this surgery required a craniotomy and entry into the ventricle for safe aspiration. The tumor was soft and easily aspiratable, consistent with a benign adenoma, but its superior boundary was unclear. The surgeons encountered a thin layer over the tumor and could not immediately determine whether it was the tumor’s pseudocapsule or the diaphragma sellae—the dural layer forming the roof of the sella. Removing the diaphragma forcefully could cause a cerebrospinal fluid (CSF) leak or damage critical structures such as the optic apparatus or hypothalamus. Although intraoperative assessment (visual inspection, tactile evaluation, gentle suction, and observation of CSF pulsations) was used to distinguish capsule from diaphragm, it was unlikely that the entire tumor was resected. This case highlighted the importance of meticulous surgical technique and real-time intraoperative judgment, and it inspired me to deepen my understanding of neuroanatomy. I also cannot conclude my surgery week without emphasizing pediatric hydrocephalus. Hydrocephalus is highly prevalent in Kenya, partly due to limited prenatal screening and folic acid supplementation, which increases the risk of neural tube defects. Children often present with complications such as meningitis, and because Kenya is a high TB-burden country, infectious diseases must also be considered as contributing factors. To manage these cases, an external ventricular drain (EVD) was placed to temporarily drain CSF, relieve intracranial pressure, and obtain CSF for diagnostic infection testing. The procedure involved creating a small burr hole, opening the dura, and advancing a catheter 1–2 cm into the lateral ventricle. CSF can appear clear if normal or cloudy if infection is present. This step stabilizes the patient before a definitive procedure, such as ventriculoperitoneal (VP) shunt placement. EVD also allows CSF sampling for culture or PCR to ensure no acute infection is present before proceeding with a VP shunt. During VP shunt placement, CSF is diverted from the ventricle to the peritoneal cavity, where it can be safely absorbed. One case stood out in particular: isolated dilation of the left temporal horn, which required two shunts. Hydrocephalus can be classified as noncommunicating (obstruction within the ventricular system) or communicating (impaired CSF absorption). The case I observed represented an extreme localized form of noncommunicating hydrocephalus, where the affected ventricular compartment becomes sealed off from the rest of the CSF system. This rare presentation often occurs due to post-infectious scarring or post-hemorrhagic fibrosis. By the end of this extensive neurosurgery exposure, my curiosity about neuroanatomy had grown more than ever—along with an even deeper understanding of why global collaboration matters. During the third week, I rotated in internal medicine after requesting a change from pediatrics. I had met Dr. Faruk during a clinical outreach, and his passion for teaching and thorough explanations inspired me to learn from him. In internal medicine, morning rounds were conducted with Dr. Faruk, where a group of interns followed him while medical officers presented their patients. Although crowded rounds are not common in North America, in Kenya this approach was necessary given the level of medical training. I appreciated being part of the intense atmosphere as Dr. Faruk rigorously tested medical officers on diagnosis, management plans, and broader medical knowledge. His questions spanned multiple specialties and consistently emphasized pathophysiology and how drugs act to alleviate disease. He often reminded us that as doctors we are constantly reading, forgetting, and relearning—and that even brief daily study is essential to keep clinical knowledge alive, a habit I intend to maintain. Possibly influenced by neurosurgery camp, I will share one in-depth diagnostic challenge discussed repeatedly by Dr. Faruk that week: a suspected tuberculoma. The patient was admitted with neurological symptoms including progressive leg weakness, episodes of unconsciousness, recurrent vomiting, and convulsions. MRI revealed extensive vasogenic cerebral edema, obliteration of the ventricular system, and a significant midline shift—raising concern that untreated intracranial pressure could progress to brainstem herniation. The initial suspicion was tuberculoma, a granulomatous CNS lesion due to an immune response to Mycobacterium tuberculosis, based on two ring-enhancing lesions on MRI and the patient’s TB history. From there, I was drawn into the essence of internal medicine: evidence-based evaluation and differential diagnosis, acknowledging multiple possible diseases with similar presentations and working to distinguish them by underlying pathology. PCR for TB was inconclusive, HIV serology was negative (despite HIV being a major risk factor for TB), and the white blood cell pattern—elevated neutrophils and reduced lymphocytes—did not strongly support tuberculoma. With limited evidence, attention turned to distinguishing the lesion from metastases and primary brain tumors. Metastasis was considered given the patient’s age, though there was no known malignancy history. A primary brain tumor such as glioblastoma was also considered, though two separate lesions would be unusual. Dr. Faruk suggested a brain biopsy, but it was not recommended due to high intracranial pressure and the risk of spreading infection if the lesion were an abscess. Later that week, a colonoscopy revealed something suspicious, but before confirmation could be reached, the patient passed away—leaving the underlying cause unknown. Kenya is undergoing an epidemiological transition, where infectious diseases remain prominent while non-communicable conditions continue to rise. At the bedside, this reality is complex. The patient above had battled TB yet also carried epilepsy and what may have been an untreated malignancy. This double burden places families under major financial strain and stretches an already overburdened healthcare system, where layered illness complicates both diagnosis and management. In the internal medicine ward, this shift was reflected in the range of commonly encountered cases: acute decompensated heart failure, hypertensive emergencies, acute decompensated liver disease, and multiple myeloma. This trend became even more evident during my final-week rotation in the emergency department. While pediatric emergencies were dominated by communicable conditions such as pneumonia, sepsis, meningitis, and gastroenteritis with dehydration, I was surprised by how often adult emergencies were driven by non-communicable disease—more frequently than trauma, which I initially expected to predominate. One emergency department case remains with me. CPR was attempted on a patient for over ten minutes. As resuscitation continued and no circulation was detected in his foot, I realized he had passed away. His wife collapsed beside him in grief. He had a long history of uncontrolled hypertension, which damaged renal vasculature over time, leading to chronic kidney disease and eventually end-stage renal disease. He required hemodialysis, but financial constraints prevented consistent treatment. Severe electrolyte disturbances, including hyperkalemia and metabolic acidosis, likely triggered arrhythmias that progressed from ventricular tachycardia to ventricular fibrillation, prompting resuscitation. This case highlighted the consequences of limited health literacy around non-communicable disease, poor medication adherence, and the financial barriers that prevent access to essential therapies and follow-up care. Finally, seeing an unconscious patient brought into emergency following a suicide attempt with paracetamol poisoning reinforced that mental health cannot be ignored. Being involved in mental health education for secondary school students reinforced for me how important education is for improving community health literacy. It also reminded me of the value of offering support, sharing perspective, and being someone who listens—qualities I intend to carry forward as I take on greater leadership roles in my community. Experiencing international healthcare collaboration in Kenya was deeply inspiring. From the neurosurgery camp organized by the SAWUBONA Foundation in Germany to the establishment of the medical ICU at CGTRH through support from JICA, I witnessed dedication and expertise that truly transcend borders. Every time I introduced myself, doctors noticed my Japanese background and eagerly shared their experiences, expressing appreciation for doctors from Japan who worked with them during the challenging COVID-19 period. It made me proud of my background and inspired me to one day serve underserved communities similarly—collaborating with cultural sensitivity, sharing expertise that is valued and empowering, and contributing to lasting development of local healthcare systems. Beyond shaping my ambitions, my time in Kenya profoundly reshaped me as a person. One of the most powerful lessons I gained was a deeper recognition of gratitude. Being in a setting where resources were scarce yet generosity flowed freely gave me perspective on privileges I often take for granted. Whether it was patients sharing their stories or students welcoming me openly, I was struck by compassion and kindness that persisted despite hardship. Their resilience redefined what I believe is most essential in life: meaningful human connections, bonds of community, and the ability to appreciate what we already have. Reflecting on these experiences, I see how closely they connect to the personal health challenges and curiosity about medicine that first shaped my journey. Just as navigating my own illnesses ignited a desire to understand disease and provide meaningful care, my time in Kenya deepened my appreciation for empathy, cultural insight, and the responsibility of serving others with humility. These lessons strengthened my resolve to pursue medicine not merely as a profession, but as a lifelong commitment to addressing healthcare disparities, supporting communities, and continually learning from diverse perspectives. I am deeply grateful to the friends and colleagues I met from around the world through this program, as well as the doctors, medical officers, nurses at Coast General Teaching and Referral Hospital, and the program mentors who taught me and offered new perspectives. The medical knowledge I gained, along with the opportunity to immerse myself in healthcare in Kenya, is an experience I will carry with me throughout my continued studies in medicine.

“Pole! Pangusa,” I said gently as I poked a woman’s finger to check her blood sugar at a remote community clinic. Her daughter clung tightly to her leg, scared. The woman paused for a moment—then her face lit up. “You know Swahili!” she said, smiling. My Swahili is far from fluent, but I never expected a simple phrase to bring someone that much joy. As patients continued rotating through the vitals station, I realized how easily a small gesture can build connection. It also felt like a meaningful way to give back, even in a small way, for the immense hospitality I had already received in Kenya. That hospitality began the moment I stepped out of Mombasa International Airport. I was greeted with warmth and kindness that exceeded my expectations. The mentors and staff at International Medical Aid made me feel instantly at home, and even small moments early on reassured me that I had made the right decision. Before I had even set foot in the hospital, I met Kate—an intern from a previous cohort who was packing to leave after two months. As she tearfully described how moving and powerful the experience had been, something in me settled. I had arrived worried about travel complications, communication barriers, and whether I’d feel supported. That conversation affirmed that I was exactly where I was meant to be. My relationship with medicine started long before I arrived in Mombasa. In third grade, my dad experienced pituitary apoplexy—a rare hemorrhaging brain tumor. I still remember paramedics rushing into my parents’ room, asking rapid-fire questions, attaching electrodes, and moving with urgency. My mom’s advocacy ultimately helped get him transferred to a facility with the specialized resources he needed. After two brain surgeries, he made a near-full recovery, but as a kid I was confused and scared, desperate to understand what was happening. For years I followed his journey through appointments and specialists, and those early experiences planted the questions that eventually became my motivation. A few years later, I found myself in that same ambulance again—this time as an EMT. Serving predominantly low-income communities taught me how deeply social determinants of health shape outcomes. I learned to meet people with the same empathy and patience I would want for my own family: an elderly patient nearing the end of life, a scared immigrant mother relying on her child to translate, a veteran coping with PTSD. Over time, I stopped seeing “patients” as categories and started seeing whole individuals with layered histories—and loved ones waiting anxiously nearby. That work strengthened my commitment to medicine and to the idea that equitable healthcare must extend beyond treating symptoms: it must restore dignity and hope, especially for people society often overlooks. Kenya expanded that understanding further. During my weeks at Coast General Teaching and Referral Hospital (CGTRH), my view of medicine and humanity deepened in ways no textbook could teach. In Adult and Children’s Accident & Emergency, the pace and volume were unrelenting. Sometimes it truly felt like trying to steady a sinking ship. On my first day, I hated the helplessness of watching people suffer—patients pleading for relief while staff balanced constant urgency with limited resources. But as the days passed, I began to find my role. Some days that meant small, practical acts: comforting families, collecting supplies, helping with vitals and charting, and doing whatever I could to keep the workflow moving. Other days required stepping into high-stakes moments—joining resuscitation efforts, doing CPR, assisting with ventilations, and witnessing how teams function under extreme pressure. Those experiences reminded me why emergency medicine draws me in: the demand for critical thinking, adaptability, and calm decision-making when you don’t know what you’re walking into. In A&E, I saw clinicians and trainees constantly adjusting—using skill, teamwork, and creativity to provide care despite resource gaps. It challenged my assumptions about what “good medicine” looks like. I realized that great care isn’t defined only by pristine facilities or the newest equipment. It is defined by empathy, clinical judgment, creativity, and cultural understanding—especially when the margin for error is small. In the New Born Unit (NBU), I found a different kind of purpose. Caring for fragile new lives brought both joy and heartbreak, sometimes in the same shift. My rotations in NBU and Labor & Delivery exposed me to the raw intensity of birth, loss, and resilience. I was struck by the way staff leaned on each other, on faith, and on community to keep moving forward through grief and exhaustion. Their approach to death and dying also differed from what I had been used to at home. Rather than framing every loss as a “medical failure,” there was often a sense of acceptance grounded in spirituality and shared strength—without diminishing the seriousness of what had happened. Over and over, I witnessed life-saving adaptations in resource-limited settings—workarounds that were clever, effective, and grounded in experience. It made me rethink the “extras” I took for granted in the U.S. I saw how much can be accomplished when teams are resourceful and determined, and how survival does not always depend on the most advanced technology. That discomfort I initially felt—like the absence of certain monitoring or supplies—became a lesson in humility and perspective. I also gained deep respect for healthcare professionals who carry extraordinary responsibility while navigating systemic strain. Conversations with clinicians revealed challenges that extended beyond the bedside—financial uncertainty, heavy workloads, and the ongoing pressure to meet unrealistic standards. Those reflections naturally connected back to what I have witnessed in the U.S. as well: barriers created by insurance, delayed care until problems become critical, and the ways cost and access shape outcomes for marginalized communities. In both contexts, I saw how often the root causes of suffering exist outside hospital walls—embedded in systems that fail to provide consistent, accessible, and equitable care. That theme came into sharper focus as I reflected on rural health and “medical deserts,” where geography, poverty, transportation, and historical injustice can fuel mistrust and limit access. In Kenya, I noticed similar patterns—gaps in health literacy, financial burden, infectious disease concerns, and barriers that weaken trust between patients and the healthcare system. After speaking with people working in emergency settings, I also recognized how different infrastructure can be: when formal EMS systems are limited, communities often rely on family networks, friends, and local support systems to respond. In many places, community becomes both the first line of care and the long-term safety net. One of the greatest takeaways from my time in Mombasa is that kindness and optimism are not byproducts of circumstance—they are conscious choices people make every day. Despite limited resources and immense need, I witnessed gratitude, humor, generosity, and perseverance. The kindness I received—from program mentors to hospital staff to strangers on the streets—left a lasting imprint on me and reinforced a truth I want to carry forward: compassion doesn’t require abundance; it requires intention. I returned home with more than clinical exposure. I returned with a deeper commitment to advocacy—the kind my mother showed for my father—along with a renewed dedication to listening closely, seeing patients as whole people, and challenging the systems that repeatedly fail them. Kenya opened my eyes to a new world, a new culture, a new healthcare system, and a new reality many patients navigate daily. I am forever grateful for the experiences, lessons, and people who shaped me there, and I will carry what I learned in Mombasa into every step of my journey toward medicine.

My experience with International Medical Aid in Mombasa, Kenya, was deeply meaningful and transformative. From the moment I arrived, the in-country support team made me feel grounded and safe. Margaret, my program mentor, was incredibly supportive, always checking in on my well-being and helping me process the emotional weight of clinical work. Janet was equally encouraging, offering guidance, reassurance, and genuine care throughout my placement. Their leadership made the experience both structured and personally empowering. At Coast General Teaching and Referral Hospital, the nursing staff, physicians, and medical students were welcoming and eager to teach. They explained cases in detail, demonstrated procedures, and trusted me to participate in ways that helped me grow. I felt respected as a learner, and I appreciated how open everyone was to sharing their knowledge despite the fast-paced and resource-limited environment. The local community also showed tremendous kindness. Whether in the hospital, at outreach sites, or in everyday interactions, people were supportive, patient, and willing to help us understand cultural norms and the realities that shape healthcare access. This experience strengthened my passion for maternal and child health and further inspired my interest in child neurology, especially after witnessing how delays in early care can affect long-term outcomes. Living and working in Kenya taught me that compassion, cultural understanding, and preventative care are just as essential as clinical knowledge. Overall, this program was a powerful step in my journey toward becoming a physician who serves vulnerable populations with empathy, humility, and a global perspective.

My experience in Kenya was amazing. I loved fully embracing the culture and meeting so many new people. The people who worked at IMA and in the hospital were wonderful. From the moment Michelle picked me up from the airport, she made IMA feel like home. She was so welcoming, and we quickly became very good friends. I also grew very close with Hilda, who always went above and beyond to make me feel at home and let me know I had a friend in her. The kitchen and housekeeping staff made my time at IMA even more enjoyable. The housekeeping team once even washed my scrubs when I forgot to put them out—something I truly appreciated. I loved the food at the residence, especially the cake! It was really fun when a few of my friends and I got to help make a cake and cinnamon rolls. The residence quickly became my home, and I’m so grateful for that. I feel that I grew as a person both in the hospital and in everyday life, as I was constantly challenged to step out of my comfort zone. The special relationships I formed and every moment I spent in Kenya will stick with me forever. I truly cannot wait to return someday. Everyone comes into this world with nothing. Most people spend their whole lives working to have something—then leave this world with nothing again. So, your soul must gain more than your hands. That sentiment has come to define the way I view my daily life after my internship in Mombasa, Kenya. I've always struggled to find my passion and purpose. Yes, I have things I enjoy doing, but nothing defines who I am as an individual. It's something I’ve prayed about for as long as I can remember but never quite felt to come to fruition. That changed during my time in Mombasa. I found the importance of being a part of a community greater than myself and the impacts small actions can have on others for an eternity. I can truly say it set me on the path to becoming a better version of myself—a better future physician and a better friend. I witnessed the beginning of life, formed lifelong friendships, and saw the end of life. The full cycle. And through it all, I was challenged to value every part of my life more deeply. Birth. As Dr. Shazim would say in every debrief, “Let’s start at the beginning of life. Maternity.” Before arriving at Coast General Teaching and Referral Hospital, I was pretty determined to become a pediatrician. I have always been somewhat apprehensive about going into a specialty where death was on the line, and admittedly I had never stepped into a surgery prior to theater 2 at Coast General. Thus, I have spent most of my shadowing hours in a pediatric clinic. However, surprisingly, the maternity ward quickly became my favorite rotation. I could directly see my feelings about Kenya correspond to labor. Mothers spend months preparing to deliver their babies. They feel everything—excitement, fear, anxiety. There’s always an adrenaline rush. No one knows exactly what will happen, but the mothers, nurses, and physicians prepare for the moment a baby finally comes into this world expectantly. That’s exactly how I felt arriving in Kenya—a rush of emotions and so much uncertainty. A dream I’d held since high school was finally coming true, but I had no idea what to expect. The culture shock, the unknown, the lack of healthcare resources—it was all very real. But the maternity ward shaped me into the kind of physician I want to become. Witnessing a woman’s intense pain during labor to then peacefully hold her newborn is a moment I will carry with me. Despite the challenges of pursuing a career in medicine, like labor, being a part of some of the most shaping and important aspects of someone’s lives will make it worth it. In Mombasa I thought I’d be most influenced by the physicians, but it was the strength of the women that inspired me. They made me want to be the best physician I can be—for them. From C-sections to natural births, witnessing the beginning of life reminded me that nothing is guaranteed. I walked away with a new calling: to pursue a career in obstetrics and gynecology. I looked back on my journal entries for my rotation in the maternity ward, and I couldn't help but smile. The women I directly got to help, either by stretching with them during labor or holding their hands, I will always remember, and that empathy I learned while in Kenya will shape me into the best physician I can become. Friendship. Throughout my life, many people have influenced me. I’m a firm believer in “friends for different seasons”—some friendships fade, and some stand the test of time. Friendship is an impactful aspect of a person’s life and shapes who they are and become. In Mombasa, I saw the true value of friendship: in patients, mentors, fellow interns, and strangers. Growing up, I attended the same private school from kindergarten to senior year. I graduated with seven people, and I was not challenged to step outside my comfort zone and interact with different types of individuals. However, during my time in Kenya, I was able to reflect on different friendships I had encountered and truly what I had learned from other individuals in my daily life. There were friends who rallied together after tough shifts at the hospital. Friends like Hilda and Michelle, who made Mombasa feel like home. Patients who opened up to me—confided in me—as if we had known each other for years. Strangers asking me what I was doing in Mombasa and fully welcoming me into their city and culture. There were friends who became like family. I watched physicians rally around one another to care for a community in need. That kind of camaraderie—rooted in compassion—deepened my belief in the importance of human connection in medicine. According to Harvard Medical School, medicine has somewhat lost its human connection due to technology: “At its best, being a doctor is an extraordinary and intimate privilege. We build relationships with our patients and see them through times of both joy and suffering; our relationships with each other help us through the same. It's hard to do that in a way that's truly satisfying when we spend most of the day at the computer screen” (Harvard Health, 2016). At Coast General, resources and technology are very limited, and these physicians and nurses must communicate with the patients and peers, which depends on human connection and in turn often creates a more positive experience for the patient. I specifically saw this at the medical clinics, as physicians had limited resources but collaborated and did their best to help every individual, which is something I deeply admire. Death. I wasn’t prepared to see someone take their last breath. I expected panic, sadness, maybe fear. Whenever I have had a loved one die in the past, I usually view it in a negative way. But the death I witnessed was peaceful—like the patient was ready. In a strange way, that’s how I felt leaving Mombasa. I expected to be in tears, not ready to leave the place I had called home for the past month. But instead, I felt peace. Peace that I had experienced something life-changing. Peace that I had grown spiritually, emotionally, and personally. Peace that I had found friendships that would last a lifetime. In a way, this feeling of “death” will stick with me as I start my career to become a physician. The feeling of peace is advice I can pass onto others who are losing a loved one. Death is inevitable, but while in Kenya I learned it can also be peaceful. Death does not have to have a negative connotation, but the narrative of death can be changed for the better. “If you think about it, life is nothing but thoughts, and our thoughts come from the mind. Our thoughts are an internal path leading us somewhere. To the next thought, the next idea, the next life. Everything is created with thought—emotions, designs, and theories. Where thoughts lead us is the most important thing; it’s our inner path leading to freedom or suffering” (At Peace With Death | Bennington College, n.d.). The people in Kenya were steadfast in their faith, and this helped me realize that in some way we are all just walking each other home. I feel like this is an important lesson to take with me in my journey to become a physician, as I have to come to peace with death and help loved ones keep moving forward in their lives. Souls. Souls tie people together. A soul is what makes someone who they are—and it’s shaped by every experience, every relationship. Kenya changed my soul for the better. I poured into others. I learned patience. I experienced a completely different culture and let it shape me. In the pediatric outpatient ward, I met a young girl named Nora who became obsessed with a balloon glove I made for her. That small gesture—something so simple—brought her joy, and in turn, filled me with joy. It made me more aware of how even the smallest acts can have a big impact on someone else’s soul. Yes, Kenya was culturally different from my small town in Georgia. But what struck me most was the people—their outpouring of love and gratitude. They valued what they had. They didn’t take life for granted. In the Western world, we often measure worth by material things—by how much we have, not by how full our lives are. But in Kenya, I saw the meaning of the phrase “Make sure your soul gains more than your hands.” Even amidst poverty and corruption, people remained faithful, grounded, and fulfilled. That lesson is one I’ll carry for life. Before Kenya, I struggled to articulate my "why" for medicine. My answer was something generic—“I enjoy helping others.” But now, I understand it's deeper than that. Medicine isn’t just about helping others—it’s about having a soul-level impact. What I saw, experienced, and endured in Kenya wasn’t easy. The children begging for food outside our Ubers, the lack of basic life-saving devices in the hospital, and people dying due to lack of ICU beds. None of this was glorious, but the community of people that rallied around each other was. Despite differences in ethnic and religious backgrounds, I saw new mothers look out for each other and their newborns, which is a testament to the people in Kenya and the type of person I want to be for others in my life and when I become a physician. Following my arrival home from Kenya, I was asked to speak at church about my experience. I gave my presentation about my time in Kenya and the ways Mombasa and Coast General impacted my life. I will still struggle to put into words the impact the experience had on me. However, unbeknownst to me, the sermon directly following my speech was about souls. About how people have started to value what they materially have in this life over friendships and the impact they have on others. But whenever one dies, none of those materialistic things goes with them, but their soul does. The experiences and impacts that others have on their soul go with them to their next life. Thus, I realized that the impact Kenya had on my life will stay with my soul forever, and consequently the impact I had on others will stay with their souls. Those who connect medicine with the soul are the difference between a good physician and a great physician. The main physician I saw this connection in was Dr. Faruk. Spending the day with him in the diabetes and thyroid clinic, he taught me the importance of finding my voice and passion in medicine that subsequently has an impact on others' lives. He is starting his own nonprofit to help children with type 1 diabetes get access to insulin. This is something he is passionate about and will have an amazing impact when accomplished. Dr. Faruk is an inspiration for me, as he is the physician I want to become. A physician who is not in it for the money or for the fame but is in it for the direct impact that they have on others' souls and daily lives. As Sir William Osler said, “The good physician treats the disease; the great physician treats the patient who has the disease” (Centor, 2007) International Medical Aid has shaped me into the physician I want to become. My time in Mombasa taught me the importance of understanding each patient’s story and beliefs, and the responsibility I have now to leave a lasting impact on everyone I meet. These challenges and lessons will stick with me forever and my growth as an individual is all accredited to my experience in Mombasa, Kenya.

I had an excellent experience with IMA. The staff all went above and beyond to ensure my comfort and safety. The experience was so incredibly meaningful, and IMA’s accommodations helped me feel less overwhelmed and more prepared to take in the experience. Hilda in particular went above and beyond, especially on the Malindi adventure. She was very approachable, fun, and organized. I remember sitting in my high school biology class, flipping through a textbook when I stumbled upon a section on diseases prevalent in the developing world. It described, in vivid and unsettling detail, the symptoms of illnesses like Ebola and malaria—two diseases I had never heard of at the time. The page depicted Ebola’s internal hemorrhaging and malaria’s destruction of red blood cells as they burst and release parasites into the bloodstream. The section ended with a sobering note: Ebola and malaria might be curable, but little progress was being made due to a severe lack of research funding. The textbook also estimated the total cost to eradicate malaria. According to the Gates Foundation, the estimated cost to eliminate malaria by 2040 is between $90 and $120 billion—a sum less than the net worth of many of the world’s wealthiest individuals (Renwick). That statistic stuck in my mind and has remained with me ever since: global health inequality is a solvable problem—so why aren’t we doing more to solve it? Over the following years, my interest in global health deepened, particularly as the COVID-19 pandemic exposed glaring inequities in vaccine access. I found myself inspired by frontline healthcare workers—many of whom were my own neighbors—and by the efforts to democratize vaccine availability worldwide. I trained to become an EMT, responding to medical emergencies on my college campus, and became involved in vaccine delivery research focused on developing pulsatile-release vaccines aimed at improving vaccination rates in low-resource settings. I joined a global health club on campus and worked to raise awareness of global health issues among my peers. Still, something felt missing. I didn’t fully understand who I was helping. Who were these vaccines for? Who truly bore the brunt of these inequities? Why was it urgent to act now? I wanted to understand who was behind the numbers—the lives, the faces, the families. Landing in Mombasa marked my first time outside the developed world. I remember the drive from the airport vividly. It felt chaotic, alive, and strained all at once—tuk-tuks, motorcycles, cars, and pedestrians weaving through the streets with no apparent regard for traffic rules. At every stop, people approached our windows offering fruit, nuts, or handcrafted goods, desperate to make a sale. The struggle for daily survival was tangible. I watched silently from the backseat, feeling a complex mix of awe, guilt, and anticipation for what lay ahead in the hospital. During my first week, I was placed in the internal medicine ward, where we were introduced to Dr. Suhail, who guided us through patient rounds. One of the first patients we met was Margaret, a woman who had clearly suffered a stroke. I had been trained to recognize strokes as an EMT, but this was the first time I saw the reality firsthand: facial drooping, right-sided weakness, and expressive aphasia. Dr. Suhail explained that Margaret had been in the ward for about a week and was showing slow signs of improvement. Margaret could understand us but couldn’t speak. She lay motionless on a rusty bed, covered by a colorful blanket, with flies buzzing across her face. Her daughter, strong and vigilant, stayed at her bedside, advocating fiercely for her care—swatting flies, changing Margaret’s clothes, and reading aloud to her. When I asked Dr. Suhail how long it had taken for Margaret to reach the hospital after her stroke, he explained that many patients arrive well past the “golden hour,” when intervention might still reverse the damage. In neighboring Somalia, the average time to arrival for stroke patients is 16 hours (Sheikh Hassan). Many delay care due to lack of healthcare literacy or a belief that divine intervention will heal them (Kimani). As we continued our rounds, I began to notice the silence that filled the ward. Patients sat quietly, not using phones or engaging in conversation. It wasn’t peaceful—it was haunting. It felt like a collective understanding that not much could be done for them. Limited resources meant that Dr. Suhail had to prioritize only the most urgent conditions. Retroviral diseases, for instance, were often left untreated. Despite taking thorough histories and analyzing labs and imaging, there was often little he could offer by way of treatment. One moment that struck me deeply was meeting a 20-year-old woman with stage 4 cervical cancer. She was my age. No treatment was scheduled; she was only receiving palliative care and was expected to spend her final days on a deteriorating hospital bed under the beating sun. That image stayed with me—how unjust it felt that someone my age, with a potentially preventable and treatable disease, was forced to endure such a fate. Had the cancer been caught earlier, this woman might have a better prognosis. However, like many of the other patients we saw that day, she presented with an advanced-stage illness, and the opportunity for curative treatment had already passed. The internal medicine ward revealed a grim reality, yet within it, I also witnessed resilience and community. The patients, though suffering, created a comforting environment within the ward. They wore vibrant fabrics and their beds were covered in intricately patterned blankets. Family members looked after not only their loved ones but checked in on others in the ward as well. In the midst of helplessness, the community thrived. My second week was spent in the surgical department. I observed an array of procedures—from the placement of a ventriculoperitoneal (VP) shunt to a coronary artery bypass graft. On my first day, I watched a double valve replacement. Dr. Iqbal, a visiting surgeon, generously spent two hours walking us through the procedure. He explained that such surgeries are often the result of untreated rheumatic fever—something nearly eradicated in the U.S. due to access to antibiotics like penicillin (Cleveland Clinic). It was jarring to see complex, high-risk surgeries being performed for diseases that could have been prevented with basic, affordable interventions. This theme of treating symptoms instead of root causes recurred throughout the week. VP shunts, for example, are used to treat hydrocephalus, which can arise from neonatal infections like Streptococcus pneumoniae (Sakurai et al.). In many African countries, these infections go untreated due to limited access to antibiotics (World Health Organization). Similarly, I observed a spina bifida surgery—another condition preventable through folic acid supplementation, a standard and inexpensive part of prenatal care in high-income countries (Mayo Foundation). The reality is stark: in Africa, families face costly, high-risk surgeries for conditions that are preventable with the right public health measures. In a country where the health expenditure per capita is just $88.39 compared to over $10,000 in the U.S., bearing the cost of expensive, preventable procedures is unconscionable (International Medical Aid). It was a painful reminder that without robust public health infrastructure, expensive hospital interventions become the last resort for preventable tragedies. Even the operating rooms reflected the resource gap. During one open-heart surgery, a fly buzzed around the room. The presence of a fly during open-heart surgery wasn’t just a nuisance—it was a symbol of how drastically under-resourced the system had become. At one point, Dr. Iqbal requested an alpha blocker only to be met with silence—it wasn’t available. Instead, he instructed the anesthesiologist to improvise using a mix of saline and nitroglycerin. I later learned that Dr. Iqbal was a visiting cardiothoracic surgeon and had only been at Coast General Hospital for three days. Many doctors at the hospital split their time between public and private hospitals to make ends meet. Coast General, the largest public hospital in the region, has only one full-time cardiothoracic surgeon. As my time in Mombasa came to an end, I was left with a deepened sense of purpose, humility, and urgency. I witnessed physicians delivering care under unimaginable constraints, doing everything they could with the limited resources they had. I was struck by their willingness to teach and share knowledge despite the demands of their work. I returned home with renewed gratitude for the healthcare systems I had always taken for granted. Yet, I also returned with frustration. Why are essential resources being cut from USAID-supported programs in this region? I heard stories of emergency rooms without working defibrillators, CT machines being down, patients undergoing procedures without anesthesia, and common medications being out of stock. These are all solvable problems. Programs like PEPFAR (President’s Emergency Plan for AIDS Relief) are being significantly disrupted. PEPFAR has saved over 26 million lives since its inception and cuts to the program could put millions of additional lives at risk (UNAIDS). Additionally, PEPFAR alone employs 41,500 healthcare workers in Kenya, many of whom are now facing layoffs (Kenya News Agency). When international aid programs are cut abruptly, the burden falls on local communities who are ill-equipped to fill the gap, exacerbating health inequities and endangering the lives of many additional people. The future of healthcare in Kenya is unstable and it has me worried. The world has the tools, resources, and knowledge to fix this, but the will to help is eroding. This experience affirmed my commitment to global health—not just in theory, but in action. I now understand that to be a good healthcare professional is to care deeply about people and systems alike. It means advocating for equity, addressing root causes, and seeing the patient within their full human, social, and economic context. My hope is to one day contribute to the transformation of healthcare systems like Kenya’s—through better infrastructure, expanded access to care, and increased healthcare literacy. I am more determined than ever to be part of the solution.

My internship in Cusco, Peru, through International Medical Aid was an incredibly rewarding and transformative experience. From the moment I arrived at one in the morning, the in-country team went out of their way to ensure that we felt comfortable, safe, and welcomed. They checked in regularly, offered tips such as where we should get food or exchange money, and made sure we always had someone to turn to if we needed help. Safety was clearly a priority. Whether we were in the clinic, traveling to our placements, or exploring the city, I felt well-supported and informed about precautions. Accommodations were comfortable and clean, with a friendly and welcoming atmosphere that made it easy to connect with fellow interns. The food provided was both delicious and varied—meals reflected the local culture, which was a wonderful part of the immersion experience. Professionally, I learned so much through shadowing and observation in the local hospital and clinics. I gained a deeper understanding of how healthcare is delivered in resource-limited settings and saw firsthand the adaptability and creativity of medical professionals working with fewer resources. I especially appreciated the chance to engage with patients, practice my Spanish, and observe procedures that broadened my clinical perspective. On a personal level, this experience deepened my cultural awareness and reaffirmed my passion for medicine. I left Peru with a stronger appreciation for community-based care, a greater respect for global health work, and lasting friendships with fellow interns. The combination of meaningful clinical exposure, cultural immersion, and outstanding in-country support made this one of the most impactful experiences of my life. I am truly grateful for everyone who made it possible and would highly recommend this program to anyone considering a healthcare career. As an aspiring future healthcare worker, I believe that the opportunity to travel and experience other cultures and healthcare systems is extremely integral to a comprehensive education in medicine. Global health experiences provide valuable insight into how socioeconomic, cultural, and systemic factors can shape patient health and, as a result, their experience with healthcare. In July 2025, I participated in a three-week internship in Cusco, Peru, through International Medical Aid (IMA). The program placed me in local hospitals and clinics, where I observed patient care in a variety of specialties such as general medicine, obstetrics, pediatrics, among others. My goal was to gain a deeper understanding of how healthcare is delivered in a country different from the United States, particularly in rural and underserved communities, and to compare these observations to my experiences volunteering in rural Pennsylvania. Peru presents a unique healthcare landscape. While the Ministry of Health (Ministerio de Salud, MINSA) provides public services for citizens, geographic and economic disparities persist. Rural communities, particularly those in the highlands, face limited access to physicians, inadequate infrastructure, and significant travel times to reach care. Language and cultural differences, such as the use of Quechua rather than Spanish in some regions, can further complicate patient–provider communication. According to the Pan American Health Organization, these barriers contribute to higher rates of preventable disease and delayed treatment in rural populations (PAHO, 2024). During my internship, I witnessed the consequences of these barriers firsthand: patients who had waited weeks for care, difficulty explaining treatment plans across language divides, and the creative problem-solving of healthcare workers operating with limited resources. These experiences not only enhanced my understanding of global health disparities but also reinforced the importance of culturally competent, patient-centered care—principles I plan to integrate into my future career as a physician. As part of our education and lecture series with International Medical Aid, I learned that Peru’s geography creates significant challenges for healthcare delivery and patient care. The Andean highlands and Amazon basin contain remote communities where the nearest health facility may be several hours or even days away by road. Public healthcare is available through the Ministry of Health (MINSA), but resources are concentrated in urban centers such as Lima and Cusco—especially with the highest-level clinics only being found in the capital city of Lima. According to the World Health Organization, rural areas in Peru have significantly fewer physicians per capita than urban regions, and residents face longer wait times for both primary and specialty care (World Health Organization, 2017). One of my first encounters illustrating this issue occurred in an emergency clinic in Cusco, where two Quechua-speaking sisters arrived to visit their critically ill mother. Their distress was compounded by the language barrier—Quechua is Peru’s most widely spoken Indigenous language—and luckily, the nurse I was shadowing knew enough to help quell the sisters’ frustration and uncertainty. In another instance, while shadowing in general medicine, I met an older man suffering from a severe case of bronchitis. He had been ill for over a month before reaching the clinic, unable to access a physician sooner due to the distance from his rural home and limited transportation options. These experiences reflect a broader pattern in rural Peruvian healthcare: geographic isolation, limited infrastructure, and language barriers not only delay treatment but also erode trust in the medical system. Studies have shown that such barriers contribute to poorer health outcomes, particularly for preventable or manageable conditions (Houghton et al., 2020). Addressing these challenges requires a multifaceted approach, including expanding rural healthcare infrastructure, improving transportation networks, and increasing the availability of trained medical interpreters. Rural communities worldwide often face significant barriers to accessing timely and quality healthcare due to geographic isolation, limited infrastructure, and workforce shortages (Strasser et al., 2016). My experience in the rural area of Casacunca in the Anta province of Peru exemplifies these challenges. Located several hours from the regional hospital in Cusco, Casacunca is a community where many residents must navigate difficult terrain and scarce transportation options just to reach basic medical services. During my internship with International Medical Aid, I participated in a rural outreach clinic in Casacunca, which provided critical primary care services at a primary school directly within the community. This model addresses some of the obstacles residents face by bringing healthcare closer to patients, reducing travel time and associated costs. At the clinic, I observed patients presenting with a range of conditions, from chronic diseases such as hypertension and diabetes to acute respiratory infections—many of which had worsened due to delays in care. During one memorable case, I could only watch as a doctor diagnosed an eleven-year-old child with malnourishment after finding him 10 kilograms underweight and very small for his age. It was hard to watch, knowing I could not even offer verbal comfort as I was unable to speak the mother’s language as she walked away with her son looking utterly defeated. This experience in a remote rural community highlighted the importance of preventive care and consistent management in rural settings, which are often under-resourced. During this time, I also learned about Peru’s SERUMS program, where medical students are required to complete a mandatory one year of service in a rural or low-resource urban area. This year of service is a prerequisite for medical graduates who want to work in the Peruvian public health system or pursue a specialization. As someone interested in rural medicine, I found this program very compelling and found myself wondering why we do not have similar programs in the United States. My experience in Casacunca deepened my understanding of how rural outreach programs can mitigate healthcare disparities by improving accessibility and fostering trust within communities. It also echoed themes I had seen earlier in my volunteering with patients in rural Pennsylvania, where similar barriers (geographic, economic, and cultural) affect health outcomes. These parallels reinforced my commitment to practicing medicine that not only treats disease but also proactively addresses social determinants of health. My clinical experiences in both Peru and rural Pennsylvania have profoundly shaped my understanding of the multifaceted challenges that affect health outcomes in underserved populations. Witnessing firsthand the geographic, cultural, and systemic barriers in Casacunca, Anta, alongside my work at a rural hospital in Pennsylvania (Evangelical Hospital) and local outreach programs, emphasized the critical need for adaptable, patient-centered care that considers the whole person. These experiences have reinforced the importance of cultural humility and effective communication in building trust with patients. In Peru, I observed how language differences and cultural beliefs could complicate healthcare delivery, highlighting the necessity for physicians to engage respectfully with diverse worldviews. Similarly, in rural Pennsylvania, I see how religious and cultural norms influence patients’ healthcare decisions, reminding me that medical knowledge must be paired with empathy and contextual awareness. As an aspiring future physician, I am especially drawn to the holistic approach central to osteopathic medicine, which emphasizes the interconnectedness of body, mind, and community. This philosophy aligns with the lessons I learned abroad and at home—treating patients not merely as clinical cases but as individuals shaped by their environments and experiences. By integrating osteopathic manipulative treatment with culturally competent communication and community engagement, I aim to address both the physical and social determinants of health. Furthermore, my time with International Medical Aid has inspired a commitment to serving underserved and rural populations. I recognize that improving healthcare access requires not only clinical expertise but also advocacy for systemic change, including expanding rural healthcare infrastructure, enhancing interpreter services, and supporting community-based health initiatives. These goals will guide my future medical practice, ensuring that I contribute to reducing disparities and promoting equitable care. My internship with International Medical Aid in Peru offered far more than a glimpse into another healthcare system; it fundamentally reshaped how I view the practice of medicine. From the bustling clinics in Cusco to the rural outreach program in Casacunca, Anta, I witnessed the resilience of patients and providers working within the constraints and stress of limited resources. These experiences highlighted both the universality of health disparities and the shared human need for trust, respect, and access to care. When compared with my work in rural Pennsylvania, the parallels became strikingly clear: geography, culture, and systemic inequities create barriers to care regardless of national borders. Yet in both settings, I also saw the profound impact of providers who listened, explained, and treated patients with dignity. This reinforced my belief that the most meaningful medicine is practiced at the intersection of clinical skill and human connection. As I move forward in my medical career, I will carry with me the lessons of cultural humility, the importance of preventive and community-based care, and the value of addressing the broader determinants of health. I aim to practice medicine within a framework that aligns seamlessly with these insights, emphasizing the treatment of the whole person rather than just the disease. My goal is to apply this perspective in rural, underserved, and global contexts—wherever the need is greatest—helping to narrow the gaps in healthcare access and equity. The internship not only deepened my passion for medicine but also clarified my purpose within it: to serve as a physician who advocates for patients, bridges divides, and delivers care that is both clinically effective and profoundly human.

Hans was an amazing tour guide both times we had him. I learned so much about Incan culture because he was so knowledgeable and passionate about the subject. I felt incredibly safe the entire time I was there—at no point did I feel like I was in a shady area or surrounded by questionable people. The accommodations were good. As expected, there was no central heating system, so I was perpetually cold, but still comfortable. Our mentor staff, Surabhi and Juda, were incredible—supportive, kind, and always there when we needed them. I never got the name of our chef, but she was amazing as well and very receptive whenever we requested specific foods.

This experience has truly been one of the best of my life. The entire staff was incredibly kind, supportive, and understanding in every circumstance. They were always willing to help us, and I felt cared for throughout the program. The food was also amazing—I still miss it! My favorite part of the internship, however, was being able to learn how another country runs its healthcare system and what the people there need, while also doing our best to help with the guidance of local physicians who showed us how to examine patients and think through cases. As a young girl, I had always aspired to become a doctor. This pre-medicine internship in Peru was my first real experience in a hospital setting and my first time shadowing physicians. Before arriving, I was extremely nervous and unsure of what to expect. However, from the moment I met the staff at International Medical Aid (IMA), I felt welcomed. Their warmth and professionalism immediately eased my anxiety. We were given an overview of our schedule and provided with scrubs, which made everything feel exciting and real. The next day, I was assigned to a physician in the general medicine department. I was struck by the types of cases we saw and the way care was delivered. The doctors conducted consultations, prescribed medications, and referred patients to other specialties when needed. Being a Spanish speaker gave me a meaningful advantage, as it allowed me to fully understand patients’ concerns and connect with them more deeply. One case that stood out to me involved a woman with paralysis on the right side of her face. The doctor explained that it was likely caused by stress, and the patient shared that family issues were affecting her well-being. This experience highlighted the powerful connection between mental and physical health. Throughout my time in the hospital, I noticed many cases of diabetes and high blood pressure, often related to poor diet and limited use of preventive care. Many patients delayed seeking medical attention and relied on home remedies instead. I also learned about the referral system, where patients needed a formal reference to be seen in another department. One patient had been waiting over three months for a follow-up X-ray and still did not have an appointment. I was surprised to learn that waits of up to six months were not unusual. This was very different from what I had seen in the United States, where imaging is typically completed within days. One of the most impactful days of the internship was a community outreach initiative in a small rural town with very limited access to healthcare and diagnostic equipment. Many patients had poorly managed chronic conditions, such as diabetes and joint problems, and had gone a long time without proper care. We saw clear signs of unmet health needs, even in small details like the condition of people’s nails, which reflected years of limited access to services compared with the urban population. Many individuals depended on the medications and supplies we brought with us, even though we knew that long-term solutions were still needed. During this outreach, I met physicians who travel from the city to this rural area once or twice a week to support the local community. Their dedication inspired me and gave me a clearer picture of the kind of physician I hope to become. Witnessing these healthcare disparities firsthand strengthened my commitment to serving vulnerable populations and pursuing a medical career grounded in compassion, service, and global health equity. I now understand that being a physician is not just about diagnosing and treating illnesses. It is also about recognizing the social, cultural, and systemic factors that shape people’s health. Moving forward, I plan to continue working in underserved communities, participate in global health initiatives, and advocate for more equal access to medical resources. Most importantly, I will carry with me the empathy, responsibility, and perspective I gained through my pre-medicine internship with International Medical Aid in Peru—lessons that will guide how I care for patients and contribute to the healthcare system in the future.

I honestly loved it there. If I could, I’d do it often. The food was delicious, the people were very welcoming, the hospitality was outstanding, and the team of mentors we had were super great (I don’t think we could’ve asked for better ones). I learned so much; everyone was so insightful, and the doctors and even patients were super nice and open to letting us learn everything. The treks and tours we took were so good and educational (the tour guide we had was amazing, I loved the guy). Overall, a 10/10 experience—if it wasn’t as expensive, I’d do it all the time. I did the city tour and the museum walk and honestly it was so good. The tour guide we had explained everything in so much detail; we could tell he enjoyed doing what he was doing. What we saw was beautiful, and the amount of culture we saw was incredible. “Lub dub, lub dub, lub dub” were the sounds echoing in my ears as the people around me walked up to their gate waiting to board their plane. “Lub dub, lub dub, lub dub” were the sounds I was so sure everyone around me in the JFK airport could hear as I stared at that text message wishing me a safe flight. Beads of sweat started to form on my forehead as I sat there deaf to my surroundings but painfully aware of the sounds my heart was making. Being anxious was usual for me; however, traveling to a new country where I knew absolutely nobody was out of the ordinary. New levels of anxiety were reached that night, and the pounding of my heart was the only thing that brought me comfort. I was sure all the anxiety would dissipate the moment I landed back in New York after the two weeks of interning; however, I was proven wrong. From the moment I heard the first “lub dub, lub dub, lub dub” coming from the stethoscope and not my own chest, I knew I was exactly where I was supposed to be, and this realization excited me and calmed me down. Interning in Peru was an eye-opening experience where I learned what it would've been like to grow up in South America (I’m from Ecuador) and receive medical care. I learned a lot about the people in general and how a different environment (altitude, vegetation, climate, etc.) can have different effects on their bodies and lifestyles. I learned how medicine is practiced and, most importantly, the sanitary precautions doctors take on a day-to-day basis. I learned the difficult choices that are made when there is a lack of resources. And last but not least, I learned the difference between having money and not when it comes to getting better healthcare. Cusco is at 3,400 meters above sea level, it has a dry season and a wet season (while I was there it was dry season), and some of the common food items are potatoes, pasta, corn, and rice. These aspects of Cusco shape the lifestyles of the people and that influences their health. When I was doing hospital rounds my first week in Peru, I noticed a peculiar pattern; most of the people going to see the doctor had hypertension (high blood pressure) or diabetes. As I was taking their blood pressure, one after the other I would see blood pressures like 148/90, 160/95, and even one that reached 177/89 (this one was due to not taking medication). Curiosity got the best of me, and when I was with the nutritionist we discussed some of the causes for hypertension. She explained to me that most people have hypertension and/or diabetes because of their diet. Since Cusco is so rich in grains like potatoes, rice, and corn, and their gastronomy includes a lot of pastas, most of the people eat that and don’t watch the amounts they eat. Poor diet quality alongside the low intake of healthy food groups eventually leads them to develop conditions like hypertension and/or diabetes (Tarazona-Meza et al., 2025). As well as this, the people were not very trusting and/or educated about the medication for these conditions and were stuck in their old ways, so many of them did not take them as directed by their doctor. Additionally, with Cusco being at such high elevations, the UV rays coming from the sun are hitting the people more directly and intensely. With this said, when we did the mobile clinic in Maras, I made another peculiar observation. Many of the younger women that came to see the doctors did not appear their age. Most of the population in Maras did outside field jobs, so they spent most of the time under the sun. When they came in to get checked, women in their 20s looked like women in their 30s or 40s. Being under the sun and the lack of sunscreen affected their skin and made them appear older than they were. Following this, I also learned the differences between the sanitary precautions they take in Peru versus the ones in the United States. My first observation was made in the ESSALUD hospital in Cusco while doing rounds in the general medicine area; I noticed that all doctors wear masks during consults. From the nutritionist to the general medicine doctors, there was not one nurse, doctor, patient, receptionist, security guard, etc. that wasn’t wearing a mask. On the contrary, in the U.S.A., when you go to any doctor’s office, after COVID it is recommended to wear masks but not everyone does it. I’ve had my gynecologist not wear a mask during my consults. In Peru, masks were enforced. Another key difference was the sanitary precautions taken—or the lack of sanitary precautions taken—in between patients. In Peru, I noticed that in between patients there was no attempt to clean and sanitize the bed where the previous patient was seen. They would have a blanket-type cover on the mattress but it would not get changed in between patients. There was one instance where a patient (female) walked in with a cold; she was coughing all over the place and she sat on the bed and coughed on it. After her, we had a patient come in to discuss his lab results and sit on the same bed. The lack of sanitation could have resulted in the patient coming in for the results to get sick just by sitting on the contaminated blanket. On the other hand, in the U.S.A., after every patient, I see the medical assistants or nurses or PAs sanitize the space. When I go to my primary doctor, they have the paper lining on the beds and after every patient, they change it and sanitize the bed. Furthermore, I noticed that in Peru they don’t wear gloves when working with needles. For example, I was doing rounds in the Geriatrics department when I was taught to take the glucose level of the older patients. When the nurse was showing me, she took the needle with no gloves and took a tiny blood sample to check the glucose levels. It was a culture shock to me because I had never seen anyone take blood samples of any kind without gloves. In the U.S.A., when taking blood samples, every doctor, nurse, PA wears gloves. Furthermore, during my internship I learned that the lack of resources has a great impact on the quality of care patients get in Peru. From my observations, I noticed that the hospital lacked newer equipment, they ran out of instruments such as lancets at times, and/or they didn’t have the facilities to take care of some patients’ needs. For example, while working in the Geriatrics department, I noticed that we ran out of lancets often. We would have to ask the nurses to get them for us, and there was one time we were told there were none left, that the delivery wasn’t in yet. This caused a lot of time to be wasted and the patient care decreased (seeing how some of them had to wait for longer periods of time). Additionally, when I did rounds in the ultrasounds section, the machine stopped working for a while. It was a really old machine and definitely not up to date (the doctor even explained that it wasn’t the first time it had happened). This also decreased patient care because time is not cheap for people. They take off from their jobs to get examined, and when the hospital is not up to par, time is wasted and so is money. Alongside this, when we went to Maras, we didn’t have a lot of the medication people needed. The people would get prescribed medication to treat their illnesses; however, we couldn't provide that at our makeshift pharmacy, so they had to walk out of the consult with no medication. Because we couldn't provide these basic medications, patients had to buy it from private sellers at unaffordable prices (Herrera-Añazco et al., 2021). Having money in Peru also had a huge impact on whether you got better healthcare than others. With having money comes great benefits, such as being able to afford private clinics where the equipment is up to date, medication is available, and being able to travel further distances for better care is not a big issue. However, that is not the case for most people in Peru. Most people have access to some type of healthcare; however, it is not what it should be. The waiting times for people to be seen are ridiculous (one patient had to wait more than 6 months to get an appointment to be seen), the equipment in the public hospitals and clinics is not well equipped, and people can’t travel far to be seen because of their jobs. When we went to Maras, most of the people we saw had not been seen by a healthcare professional in years. Maras is a couple of hours away from the main city and it doesn't have a main hospital facility like ESSALUD, so going to one was expensive. The lack of money, long waiting times, main hospitals being too far away, and being uninsured prevents the people from having access to better healthcare (Aguirre Martens, 2023). With everything that I observed and learned in those two weeks, the drive towards my future goals only got strengthened. When I’m older, I hope to join a non-profit organization (like Doctors Without Borders) and/or create my own to help countries that lack the resources that prevent their people from good healthcare. My perspective on how the world is has definitely changed because I am no longer trapped in a bubble that keeps me from seeing how not every country is like the U.S.A. I plan on using what I learned to be more sympathetic towards others and understand that not everyone has it like me. I know that with this newfound knowledge I will become a great surgeon, one that isn’t about the money but is all about the people. “Lub dub, lub dub, lub dub” are the sounds that I hear in my ears at the moment, but it’s not anxiety-driven; it’s from the excitement of knowing that soon I will be out there in the world applying what I learned and educating others for a better future in healthcare worldwide.

This was an incredibly full and insightful experience for me as a pre-physical therapy student. I had never had language or cultural experiences like this before, and I learned so much. Everyone at IMA and the hospital was patient and kind to me and supportive of all of my experiences (good or challenging). I loved this internship and would highly recommend it to other students interested in healthcare, rehabilitation, and global medicine. Thank you for everything! Cusco, Perú was a surprise, to say the least. I had not expected to fall more in love with healthcare—or with a place—quite so much. To start, I was nervous to begin my International Medical Aid (IMA) adventure, but I had been in uncomfortably new situations before. I had jumped into the unknown and reminded myself that it wouldn’t be unknown forever. When I first arrived, I remember thoroughly investigating the schedule and looking around at my fellow cohort members. Little did I know that my roommate would become one of my best friends and that I would learn more about what it means to become a healthcare provider—and future physical therapist—than I ever thought possible. One of the most memorable lectures given, in my opinion, was about the differences between Peruvian and U.S. healthcare systems. Dr. Fabricio began the lecture by asking us to define the word health. Health. This word is used in almost every sentence or conversation in the healthcare profession—it’s literally in the name of the field. So it was surprising when we all looked a little incredulous and were unable to give an articulate answer. Health is defined as the complete state of well-being (Fabricio 2025). This understanding—that all parts of being human are essential to understanding the whole—is fundamental to healthcare and especially meaningful in physical therapy, where we treat function, lifestyle, and the person as a whole. I loved this lecture in particular because it highlighted how being holistic is important in becoming and being a great clinician. One of the primary differences between Peruvian and American healthcare is the emphasis on understanding other approaches to medicine, including traditional or holistic methods, apart from symptom-based diagnoses. From herbal remedies such as coca tea to alternative religious or spiritual solutions, doctors in Peru look at a multitude of options when working with patients. “The investigation of plant mixtures used in traditional medicine in Northern Peru yielded a total of 974 herbal preparations used to treat 164 different afflictions” (Bussmann et al. 2010). Traditional medicine is given serious consideration alongside formally trained medicine. There isn’t always a black-or-white solution, but rather many different ways of solving a given issue. This holistic approach is incredibly different from how allopathic medical training in the United States often functions, which is primarily symptom-based. This was very impactful to me, as I think that holistic healthcare is often lacking in the United States. It is invaluable to look at the entirety of a person’s health rather than just their symptoms. One of the main aspects of healthcare that was further developed during my experience with International Medical Aid was the reminder that, whether as a physician, physical therapist, or any provider, you are working with people—not just their symptoms. Your patients are more than the sheet of paper in front of you. A very interesting traditional medicinal approach that was widely used was chewing coca leaves. “Andean Indians have used coca leaves (Erythroxylon coca and related species) for centuries to enhance physical performance” (Casikar et al. 2010). It was common knowledge that coca tea was invaluable at high altitudes and for physical exertion in the Andean climate. For many problems involving headaches, nausea, or other symptoms of altitude sickness, coca leaves were prescribed. While there are some traditional medicine types in the United States, most are not considered central in general practice and are rarely integrated into mainstream care. As I am from a moderate altitude, I did not drink coca tea very often, but the times that I did, I noticed that the caffeine and properties of the leaves helped to alleviate uncomfortable symptoms I was experiencing. One of the most memorable times that I took advantage of coca leaf properties was on IMA’s clinical outreach day in a rural community in the Andean mountains. The community was settled at approximately 13,000 feet in elevation, so I had a slight headache driving up. This was one of my favorite days during my IMA experience due to the connections I made with the doctors and community members, as well as the sheer amount of knowledge I gained. I learned more than I could have imagined about rural health clinics—how doctors and providers properly evaluate patients in low-income settings and how to ask genuine questions that look at an entire person, not just their pain. As someone interested in physical therapy, this was especially powerful: I saw that medicine and rehabilitation are about the health of a person’s life and who they are, not just their list of symptoms or their diagnosis. I was able to see the true care that doctors and providers put into their work and their patients. This is what I wish to emulate when I become a physical therapist. I want to truly see people for who they are, not just their problems or functional limitations. International Medical Aid was an incredibly impactful experience that I would recommend to any student interested in cross-cultural experiences in healthcare, especially those exploring careers in physical therapy, rehabilitation, or patient-centered care. I am incredibly grateful to the IMA staff and the doctors at EsSalud for their patience and guidance, without which I would not have created such valuable connections or learned so deeply about what it means to be a healthcare provider.

I truly enjoyed my time in Peru. It was fulfilling and humbling being able to experience all the amazing people there. Their kindness does not go unnoticed. Being able to practice my Spanish was also a highlight of my time. The staff was so amazing. I did become ill but they were my home away from home. Being able to experience the culture was great. I felt safe throughout the entirety of my stay. My roommate was great, and while it was a bit challenging going to sleep with someone who had different sleeping habits, it helped me become more flexible and understanding. Being able to serve was my favorite part and the hospital staff was amazing. I truly learned so much intellectually and hands on. I would do it again if I could and it is my wish to return again. I can’t wait to see all those kind people and smiling faces. Volunteering at EsSalud Hospital in Cusco, Peru, was an eye-opening and humbling experience that deeply impacted me as a pre-medical student. I learned the importance of patient-centered care, especially in a setting where resources were often scarce and the system faced numerous challenges. Greeting patients with warmth and empathy was crucial, as many came in distressed and vulnerable, some crying due to their diagnoses, such as cancer. I was struck by how patients, despite their struggles, greeted me with gratitude and trust. I had the opportunity to wash feet and clean wounds, which was humbling, as I had never experienced such intimate and personal care before. Seeing the everyday resilience of people enduring conditions like osteoporosis, respiratory problems, and parasitic infections opened my eyes to the vast difference in healthcare challenges between the U.S. and Peru. I realized that though my contributions were small, they meant so much to these patients, who were often at their lowest. This experience fueled my passion to serve others and deepened my desire to become a doctor. It was both challenging and inspiring to witness the limitations of the healthcare system in Cusco, especially when many patients came in with conditions that could have been easily prevented or treated with more resources. However, I left with a renewed sense of optimism, believing that change is possible, both in the U.S. and abroad. The cultural richness of Cusco, the kindness of the people, and the everyday struggles they faced shaped my perspective on medicine. It reinforced that being a doctor is not just about treating physical ailments, but about providing comfort, support, and hope to people in their most vulnerable moments. This experience made me more excited about pursuing a career in medicine, committed to making a difference not just through medical knowledge, but also through compassion and service to those who need it most. Healthcare systems vary significantly across the world, influenced by economic resources, government policies, and cultural factors. Comparing the healthcare system in Cusco, Peru, to that of the United States highlights important differences in accessibility, quality of care, and cost. While both systems strive to provide essential medical services, they differ in their infrastructure, affordability, and overall effectiveness in addressing public health needs. One of the most notable differences between healthcare in Cusco and the United States is the level of infrastructure and accessibility. In the U.S., healthcare facilities are generally well-equipped, with advanced medical technology, specialized hospitals, and a wide network of healthcare professionals. However, access to this care depends on factors such as health insurance and socioeconomic status, and many Americans struggle to afford medical treatment due to the high costs associated with private healthcare. In Cusco, healthcare infrastructure is more limited, particularly in rural areas. The city has public hospitals, private clinics, and smaller community health centers, but many lack advanced medical equipment and specialized services. Rural communities surrounding Cusco often experience difficulties accessing healthcare due to geographic barriers and a shortage of medical professionals. The Peruvian government provides public healthcare services through the Seguro Integral de Salud (SIS), a program designed to offer free or low-cost medical care to low-income individuals. However, overcrowding in public hospitals and long wait times are common challenges. Quality of healthcare in the United States is among the highest in the world, particularly in specialized treatments and medical research. Patients have access to cutting-edge treatments, highly trained medical professionals, and state-of-the-art facilities. However, the quality of care often varies depending on factors such as location, insurance coverage, and financial means. Wealthier individuals have access to top-tier medical institutions, while lower-income populations may struggle with limited options and high costs. In Cusco, the quality of healthcare varies significantly between public and private facilities. Private clinics often provide excellent services, shorter wait times, and more modern equipment, but they are expensive and inaccessible to many residents. Public hospitals, while affordable, often face challenges such as understaffing, outdated equipment, and shortages of medication. Traditional Andean medicine also plays a role in healthcare in Cusco, with some individuals relying on herbal remedies and indigenous healing practices alongside modern medicine. One of the most significant contrasts between healthcare in Cusco and the United States is cost. The U.S. has one of the most expensive healthcare systems globally, with high insurance premiums, medical bills, and prescription drug costs. Many Americans rely on employer-sponsored insurance or government programs such as Medicare and Medicaid, but uninsured individuals face significant financial burdens when seeking medical care. Medical debt is a common issue, even among those with insurance. In Cusco, healthcare is generally more affordable, especially within the public system. The SIS program provides free or low-cost medical care to those in need, and out-of-pocket costs for medical services and prescription drugs are significantly lower than in the United States. However, the trade-off is that public healthcare services are often underfunded, leading to resource shortages and long wait times. Private healthcare in Cusco offers higher-quality services but is costly, making it inaccessible to many lower-income residents. The healthcare systems in Cusco, Peru, and the United States reflect the broader economic and social structures of their respective countries. While the U.S. offers high-quality medical services, its system is expensive and can be inaccessible to those without adequate insurance. Cusco, on the other hand, provides more affordable healthcare options, but with limitations in infrastructure and quality of care. Both systems have strengths and weaknesses, highlighting the ongoing global challenge of balancing accessibility, affordability, and quality in healthcare. Overall, there is no better feeling than holding the future of the world. I always envisioned my life as an anesthesiologist, but holding those babies truly warmed my heart. The idea of watching these little humans grow into adults sounds so fulfilling. If the opportunity ever arises, my only goal will always be to serve, be an advocate for my patients, and spread endless amounts of love with every patient I meet, no matter what specialty I go into. I know that is my purpose here. I know now that there is no language barrier to love and care. I know that cultural differences can bring people together. Leaving my little island and traveling was the best decision I could make. Seeing how a “buenos días” and a smile can light up a whole room was my awakening. Leaving with so many hugs from patients and hospital staff warmed my heart more than anything else. Until I return to Peru again, chao! Be sure to look out for the traveling doctor.

I had a great experience during my Pre-Medicine Internship with IMA in Peru. It was wonderful getting to learn the history of Peru, Cusco, and the healthcare system. I enjoyed trying new foods and drinks that are not common or available in the U.S. My mentorship was spectacular—every doctor took the time to answer my questions and explain everything in detail. The directors and other staff were amazing. They always put our safety and health first, while also ensuring we had a truly wonderful experience. Our days in the clinics were informative, and our leisure time exploring Cusco was exquisite. I was greatly impacted by learning about the state of Peru and the people living there, and I will carry these lessons with me for the rest of my life. I truly consider the directors of the program friends in another part of the world.

I loved each of the Mentors (Manuela, Cinthia, and Wilo). They were all very helpful and kind. Also, the highlights of the program include watching surgeries, the rural community clinic, and the at-school presentations. Thank you so much, International Medical Aid, for an incredible experience. I loved teaching about feminine hygiene, oral health, and more, and learning about the differences in healthcare systems and their outcomes. In addition, all the people in this group and country are incredible. Until next time, Peru! My internship with International Medical Aid (IMA) in Peru has profoundly influenced my understanding of healthcare and strengthened my commitment to pursuing a career in this field. Immersed in a healthcare system vastly different from what I had known, I gained invaluable insights during my three-week experience that will forever shape my future endeavors. This opportunity allowed me to analyze differences in healthcare delivery systems, cultures, and patient-doctor interactions. As I work towards my goal of becoming a physician, I will utilize these experiences and insights to address disparities in medical care and become a resourceful healthcare provider. The healthcare systems of the United States and Peru differ significantly in terms of infrastructure, accessibility, and resources. In the U.S., healthcare is generally well-funded, with advanced medical technology and a wide array of specialized services. However, access to this care is greatly unequal, largely influenced by factors such as insurance coverage and socioeconomic status. In contrast, Peru's healthcare system, while making strides in recent years, still faces challenges due to limited resources, especially in rural and underserved areas. Healthcare in Peru is often more reliant on primary care and community-based interventions, with less access to specialized care and modern medical equipment. Additionally, there are statistically significant differences in health outcomes between the United States and Peru, which I observed firsthand. For instance, the likelihood of a child in Peru dying before the age of five is 1.4%, compared to just 0.1% in the United States (The Borgen Project, 2020). In 2022, the US spent approximately 16.57% of its GDP on healthcare, whereas Peru spent approximately 6.15% of its GDP (World Bank, 2024). These disparities in both morbidity and mortality rates, as well as healthcare spending, highlight the profound inequalities between the two countries. During my time in Peru, I was able to personally witness the impact of social determinants and the resulting disparities in health. Traditional medicine is far more prevalent and accepted in Peru compared to the US. Upon arriving, I immediately noticed this difference: local Peruvians, including doctors, advised me to drink coca tea as a remedy for altitude sickness. Before this experience, I had never been recommended tea, or any other herbal remedy, as a treatment for an illness; typically, I would be prescribed medication or advised to take over-the-counter medicine. In general, traditional medicine tends to be less regulated and scientifically validated than modern medicine. For instance, there is no proof of the effectiveness of coca leaves for a cure for altitude sickness (Bauer, 2019). This contrast highlights the differing approaches to healthcare, where traditional remedies may be based on centuries of cultural practices rather than rigorous clinical testing. Although the effectiveness of coca leaves remains unproven, research has shown that traditional medicine can offer notable benefits. In some cases, it has demonstrated greater “clinical efficacy, user satisfaction, and future risk reduction”—all while being more cost-effective than conventional treatments (Bussmann, 2006). This suggests that traditional practices may complement modern medicine, providing holistic care that resonates with cultural values and individual preferences. During my time in Peru, I observed how local healthcare providers often integrated traditional remedies with conventional treatments, offering patients a more holistic approach to their care. This exposure allowed me to appreciate how these practices can work together to address the physical, emotional, and cultural needs of patients. I also engaged with the local community, listening to their experiences and understanding the deep cultural significance of traditional medicine, which further enriched my perspective on how these practices resonate with individual values and beliefs. Seeing firsthand how traditional medicine is deeply woven into the fabric of daily life, I realized that while modern medicine offers precision and reliability, traditional practices provide a sense of continuity, identity, and holistic care that can be just as vital to overall well-being. Additionally, through my experience with International Medical Aid, I observed significant disparities between rural and urban areas in Peru, as well as notable differences in the trends of prevalent diseases when compared to the United States. With IMA, I had the opportunity to assist in running a day clinic in Pisac, Peru, a rural town about an hour and a half from Cusco. At the clinic, we assisted approximately 85 patients in receiving baseline medical care. There were stark differences between the level of medical attention these people receive compared to residents of Cusco. In Pisac, medical care and appropriate treatments are not a high priority for many individuals due to the community's limited resources and the significant effort required to travel to hospitals in Cusco. As a result, many locals rely on traditional medical practices and often delay seeking medical treatment until their symptoms become severe. These norms have many implications, including 1) delayed diagnosis and treatment, 2) increased rates of morbidity and mortality, and 3) an overburdened healthcare system. Moreover, the delayed diagnoses are problematic as waiting until symptoms become severe often means that conditions are diagnosed at a more advanced stage, making them more difficult and costly to treat. This ultimately corresponds to the higher rates of morbidity and mortality in Peru. Additionally, when patients finally seek medical care, they may require more intensive treatment, which can strain the already limited healthcare resources in nearby urban centers like Cusco. Beyond the rural and urban disparities, the most prevalent diseases also differed between Peru and the United States. While shadowing at Hospital Nacional Adolfo Guevara Velasco EsSalud in Cusco, I noticed that hypertension and diabetes were highly prevalent among adults, while anemia was common in children. For instance, approximately 32.9% of children aged less than 5 years are diagnosed with anemia in Peru (Al-Kassab-Córdova, 2023) whereas in the United States the prevalence is 3.2% (Gupta, P. M., 2016). Additionally, in 2019, the top 10 causes of death in the U.S. were all due to non-communicable diseases, with ischemic heart disease as the leading cause. In contrast, in Peru, the leading causes of death that year included a mix of injury-related, non-communicable, and communicable diseases, with lower respiratory infections being the most common cause (WHO, 2019). The differences in leading causes of death between the U.S. and Peru highlights the distinct public health challenges faced by each country. In the U.S., the dominance of non-communicable diseases reflects the impact of lifestyle factors, aging populations, and chronic health conditions. In Peru, the mixture of leading causes of death indicates the broader spectrum of health challenges. The prominence of lower respiratory infections as a leading cause of death indicates gaps in access to basic healthcare, sanitation, and public health interventions, while reflecting the ongoing burden of infectious diseases in less-resourced settings. Through my experience and newfound understanding, I have enhanced my cultural competence, allowing me to provide more sensitive and tailored care to patients from diverse backgrounds. It has also deepened a passion of mine to improve healthcare, ultimately inspiring me to advocate for preventive measures and community health initiatives. Overall, I will be better equipped to inform my patients on managing chronic conditions, adopting healthier lifestyles, and the importance of early treatment for infectious diseases. Furthermore, my internship with International Medical Aid in Peru was a transformative experience and profoundly enriched my understanding of global healthcare disparities and deepened my commitment to becoming a physician. By witnessing firsthand the contrasting healthcare systems, traditional practices, and regional challenges between Peru and the United States, I have gained invaluable knowledge into the complexities of delivering equitable care. The stark differences in healthcare access, disease prevalence, and treatment approaches between these two countries have highlighted the need for a more integrated and culturally sensitive approach to medicine. As I continue my journey towards becoming a physician, these experiences will guide me in delivering compassionate, patient-centered care. This internship has not only broadened my perspective but also strengthened my desire to contribute meaningfully to the field of medicine.

I enjoyed the experience in Peru. In the future, I look forward to seeing more medical procedures and surgeries as I gain additional necessary experience. I learned so much from my experience in Cusco, Peru with the International Medical Aid organization that will greatly influence how I approach healthcare in my future. The Spanish immersion aspect of my trip was a bit challenging at first, but I learned quickly so that I could understand people in the facility better. I am a person who thrives in new environments, and I learn best from overcoming difficulties. I was able to see how crucial the nursing department is to any healthcare facility, and I found it very interesting to learn about proper procedures for cleaning wounds and administering injections. Of particular interest to me was when I was able to observe an appendectomy with tubes and cameras because I did not previously know this surgery was completed in this way. I believe that I would like to study more about surgery in medical school, so anytime I can observe these procedures is of great value to me and my future. A doctor also taught me how to do CPR, and I also found it interesting to learn how to correctly complete suturing as well. I was also surprised that it was very common for the Cusco population to suffer from respiratory illnesses and infections. Healthcare is the backbone to the well-being of any society, and I will explore some of the ways that Peru and the United States are similar and different in their approaches. I was able to see how difficult it was for those who live in rural areas to obtain necessary healthcare because of challenges with transportation, which highlights a similarity between Peru and the United States. Individuals in the U.S. who live in rural areas often have reduced access to healthcare as well because of transportation, but other factors such as affordability, quality of care, insurance coverage, and race play a major role as well (Commonwealth Fund, 2022). In Peru, during the early part of the 20th century, healthcare was provided mainly as charity or from the state, but this idea has been met with changes to provide Universal Health Insurance to Peruvian citizens in 2009 (Borgen Project, n.d.). Both Peru and the United States are striving for universal healthcare coverage, but in the U.S., limitations arise which deal primarily with high costs for coverage. Employers sponsor healthcare plans for employees, but individuals pay for their deductibles, coinsurance, and copayments. These costs can be quite costly and can deter people from obtaining healthcare which they need (Commonwealth Fund, 2022). Even though the United States is known for being a global leader in medical technology and innovation, there are too many variations in the care that its citizens receive (Commonwealth Fund, 2014). In Peru, urban areas often have a better quality of care, and rural areas suffer because of the lack of insurance coverage and economics (Country Reports, n.d.). In the public sector, MINSA and EsSalud are funded through taxes, but costs are still prohibitive for some Peruvians (Pacific Prime, n.d.). I look forward to my future in healthcare, and I will always cherish my experience in Peru as a starting point to this important journey. I am currently in my last year of college at the University of California at San Diego (UCSD), preparing to take the MCAT exam and apply to medical schools within the next year. My experience in South America has opened my eyes to other cultures and healthcare systems to see that the world can and should be seen from a wider lens. As I become a doctor, I would like to also assist impoverished people in the world to obtain high-quality healthcare that they deserve. Some ways I might like to do this are to do more work for International Medical Aid or help on the Mercy Ship as a surgeon to provide vital surgeries for those who would otherwise not be able to receive these procedures. I would like to be a part of helping others receive life-changing treatments to improve their quality of life, and I would like to thank International Medical Aid for providing me with such a valuable starting point on my life journey.

In-country support was great, and all the mentors were super helpful and caring from start to finish. Any time someone wasn’t feeling well, the staff were incredibly sweet and checked in often to make sure we were comfortable, had what we needed, and knew we were supported. That level of attentiveness really helped me feel safe and taken care of, especially in a new country and a new healthcare setting. My favorite part of the program was going out to local schools and educating the kids on how to wash their hands and brush their teeth. It was such a simple but meaningful form of outreach, and seeing how engaged and curious the students were made the experience even more rewarding. Moments like that reminded me why public health education matters and how much of a difference small interventions can make at the community level. Clinically, I learned so much about the differences in healthcare systems between the U.S. and Peru. Being in hospitals and clinics there gave me a new perspective on how resource availability, patient needs, and cultural context shape medical care. Honestly, I also ended up learning things about the U.S. healthcare system that I didn’t even realize before—this internship pushed me to think more critically about access, prevention, and what quality care really looks like in different environments. On top of everything, I feel like we all grew really close with our program mentors while we were on the trip. They weren’t just there to guide us in the hospital—they helped create a supportive community, answered every question we had, and made the whole experience feel personal and meaningful. Overall, this program was such a positive, eye-opening experience, and I’m leaving Peru feeling more inspired, more informed, and even more excited about my path in medicine.

I feel incredibly grateful that I was able to spend three weeks in Peru. The accommodations and in-country support through IMA made everything smooth and efficient, and the staff consistently went above and beyond to ensure we felt safe, supported, and cared for throughout the program. One of my favorite aspects of the internship was the community outreach. Giving presentations at local schools and helping host the clinic outside of Pisac were the most fulfilling experiences for me because we were able to connect with so many community members in a meaningful way. I also loved exploring such a beautiful country. During my time there, I had the chance to visit Rainbow Mountain, Red Valley, Maras, the Inca Trail, and Machu Picchu—each place was unforgettable and added so much to the overall experience. I loved all of the treks I embarked on. Peru is a very beautiful country! The guides for all of the treks were awesome and very educational. I anxiously craned my head to peer out of the airplane window at the mountains that carved the landscape beneath me. As the plane descended, hundreds of pale brown houses scattered across the ridges came into view. I wondered about the people who lived in those homes and whether I would encounter any of them once I landed in Cusco. I thought about everything my impending internship would bring as I landed in this new country without knowing a single soul. Even though I can’t attest as to whether I came across anyone who lived in the homes I gazed over while landing in Peru, I can say, without a doubt, that my three-week internship with International Medical Aid fostered genuine connections with other interns, staff, physicians, and locals that will last long beyond my stay in Peru. Beyond these connections, this experience allowed me to cultivate new knowledge that will shape my journey into the medical field by thinking about how one’s healthcare system and environment shape the way in which a physician provides care. While working at Hospital Nacional Adolfo Guevara Velasco–EsSalud, our assigned hospital in Cusco, I found myself conducting patient exams, watching procedures, administering injections, and connecting with patients, all alongside the most excellent and educational doctors. One of the most engaging, kind, and patient doctors I worked with at the hospital taught me why it’s crucial for a patient to trust their physician. At a clinic we held outside of Pisac for a local community, this doctor highlighted how connecting with a patient in a meaningful way will make them more inclined to disclose their complete medical history to you. This way, you can properly treat the whole picture of the patient rather than just a snapshot they may give you. This lesson arose when a middle-aged woman came into the clinic complaining of severe knee pain. The doctor initially had us inquire about her diet, to which she responded, “fine,” but quickly brushed it over. However, after a few more questions and assuring the patient that her knee pain would be resolved with the proper steps, the doctor returned to the importance of diet and exercise. The patient finally revealed that she doesn’t have a great diet and doesn’t engage in physical activity. We explained to her then that the knee pain could be due to unnecessary weight, but also that this lifestyle could lead to further issues such as hypertension and diabetes. If the patient didn’t trust her doctor, she may have felt attacked and not revealed this information. Thus, she would not know she had to make adjustments in her lifestyle. This patient interaction shows how connecting with your patient is two-fold: it’s a fulfilling part of being a physician to create human connections, but also a necessary skill to give optimal care. In this same doctor–patient interaction, I also was reminded of the importance of performing the physical exam. I was instructed to examine the patient’s knee, so I told her to “doblar y extender” (bend and extend) her knee as I felt the joint with my hand. I could hear a clear pop of the joint, which supported her pain, but I also noticed a large scar on her knee. I inquired about the scar, and we learned that she had a procedure to drain a cyst when she was a young girl. The doctor highlighted how we would not have had this additional information if we hadn’t performed the physical exam, because the patient didn’t mention this relevant injury until we inquired. Another instance where I learned the importance of the physical exam was working in General Medicine with Dr. Turriago. Through a lecture series with Dr. Fabrizio, we learned how to give respiratory, cardiac, and gastrointestinal exams, which I was able to use in practice in a time-sensitive situation. The patient came in complaining of severe chest pains; we heard tachycardia during the cardiac exam and shortness of breath during the respiratory exam. All of this information was collected in a matter of minutes through a physical exam. Dr. Turriago ended up sending the patient to the Emergency Room because her symptoms from the physical exam were indicative of a heart attack and she needed immediate treatment. These experiences emphasized the importance of the physical exam for me. In the United States, while a physical exam is almost always conducted, its importance is minimal due to the reliance on tests and scans. While tests and scans hold an invaluable place in medicine, the practices of the physical exam were instilled in me throughout this experience because they can offer a lot of information in a very short amount of time. Seasoned physicians across the United States have noted how there is “a generation of physicians who have not been widely exposed to the physical exam” (Yale, 2009). Dr. Turriago’s words ring true in my ear that most medical students in the United States don’t learn how to give a physical exam until after medical school. Seeing firsthand how a physical exam can save someone’s life made me want to be in the generation of physicians in the United States who practice this “lost art.” Beyond these physical lessons I can practice in my medical future, I also learned intangible things about medicine, like how one’s health is intricately linked to their environment. I’ve always viewed health as a very individual issue, but my time in Peru allowed me to firsthand see diseases that affect entire communities because of environmental factors. While working in Pediatrics with Dr. Salazar, I saw and learned how prevalent malnutrition and anemia are in Peru. Dr. Salazar explained how Peru, as a whole, has had a steady decline in pediatric malnutrition over the past decade, but to sustain this trend they have to be adamant to parents during their children’s wellness check-ups about the importance of proper nutrition. Malnutrition needs to be prevented from birth because it can lead to permanent damage and stunt development. However, this progress isn’t widespread in all areas of Peru because “children in rural areas are three times more likely to suffer from stunting due to malnutrition than those in urban areas” (Sherry, 2021). This demonstrates the disparities in healthcare issues between rural and urban areas of Peru. Furthermore, at EsSalud in the city, all children have a wellness card that tracks their height, weight, developmental milestones, and hemoglobin levels, but the health of children in rural areas is not checked regularly through wellness cards or any other manner. Hemoglobin levels aren’t regularly tracked for children in the United States because American youth aren’t facing the same risk factors as Peruvian youth in Andean elevation. As elevation increases, the percentage of oxygen in the air decreases, so there’s less oxygen for the lungs to take in and be transported throughout the body. Anemia can be diagnosed with a blood test to see if hemoglobin levels are below normal levels, but other signs can also be indicative of anemia such as fatigue, cold extremities, delayed growth, amenorrhea (delayed menstruation), tachycardia, headaches, and pica (craving and eating substances that have no nutritional value) (Boston Children’s Hospital). Since I was staying at these high elevations in Cusco, I was able to see the prevalence of this disease, as there were many consultations to aid parents on how to treat their child’s anemia. This is just one instance of disease a physician commonly treats in Peru that a physician in the United States doesn’t see quite as often, showing how our environment affects our healthcare systems. Even within Peru, the issues a healthcare provider has to tackle will vary greatly depending on whether they’re located in a rural or urban area. Anemia and malnutrition, along with many other health issues, are more common in rural areas because there’s less access to treatment and healthcare. This shows how we have to mold how we practice healthcare to the environment in which we’re living and thoughtfully think about how the conditions impact the community’s health. My internship through IMA also allowed me to consider my own privilege to healthcare by immersing myself in a different healthcare system. Growing up, whenever I had a broken bone, strep throat, or needed access to birth control, I had these services right at my fingertips. This was made possible by the type of insurance my parents provided and geographical accessibility in my area. Though the U.S. and Peru have different types of healthcare systems—the U.S. is mainly private-sector whereas Peru is mainly public—both face similar issues of leaving the most vulnerable groups of people lacking proper healthcare. In the United States, people who are more vulnerable in lower socioeconomic brackets will avoid seeing a provider for a minor issue because the expenses are too high, but then this once manageable issue can grow into something life-threatening and even more expensive. Healthcare is dished out on a socioeconomic hierarchy and perpetuates a cycle that makes already vulnerable groups even more at risk. Peru faces socioeconomic barriers in healthcare, but geographical barriers pose more of a challenge because there are such large disparities between health services in the major cities compared to rural areas. The doctor I worked with in the clinic outside of Pisac highlighted these issues very clearly for me with the same patient who came in complaining of knee pain. She recommended that the patient needs to go into Cusco to obtain a referral for an ultrasound from a general doctor. She would then have to go back a subsequent time to actually receive the ultrasound. Finally, she would have to go back into Cusco a third time to get the results, treatment, and any additional referrals. Is this patient going to take all of these steps? No. The patient would need the time and money to fund three there-and-back two-hour bus rides, which is highly unlikely. The doctor noted how this is the sad part of Peruvian healthcare: patients from rural areas don’t end up receiving the treatments they need because they’re inaccessible due to long waits and far distances to travel. In the United States, if I were to have knee pain, in just one appointment I could see a doctor, receive a scan, and get a treatment plan, but this treatment may be expensive even with insurance. Though Peruvian healthcare is free, there are major barriers to accessing healthcare services that forced me to think about the barriers within my own healthcare system. Another eye-opening experience was coming to understand how there are limited public conversations in Peru on topics such as mental health or violence against women. In fact, some don’t even view these as “real” issues within the healthcare system. Many women in Peru don’t even realize the violence they are facing is a violation of their human rights because it’s so normalized. This is because “gender-based violence is widely tolerated, with roots in the complex culture of the country” (Rondon, 2009), and gender inequalities remain deeply embedded into society. I witnessed the lack of education surrounding gender-based harm while giving a presentation on sexual violence to the women coming through the clinic we held. This presentation talked about what sexual violence is, what resources they have access to, and also the opportunity to talk to a psychologist after if anyone needed it. Some women had never even heard the term “sexual violence,” and most didn’t know these resources existed. At home, I work as a peer educator at UCLA, working to prevent sexual violence on my campus through giving preventative workshops and doing social media outreach. Having the opportunity to connect with women on the other side of the world on a topic I’m so passionate about was simultaneously empowering yet devastating. It was startling to see an issue that’s taboo in the United States to be an even less openly discussed topic in Peru because the violence is so normalized. Another way in which we provided education surrounding women’s wellness was when we gave a menstruation and feminine hygiene presentation to the girls at a local school in Cusco. During this talk, we talked about the importance of female hygiene to avoid infections, as well as what menstruation is and how you can take care of yourself during your period. I was able to notice even more cultural differences in how young girls are educated on menstruation in Peru compared to girls in the United States. For instance, girls asked why we didn’t mention things their mothers taught them about their periods, such as wrapping the traditional blankets around their stomachs tightly for cramps or not going in water during their period. We responded that they should take care of themselves in whatever way feels most comfortable, but also noted that these are cultural practices rather than medical ones. It was a very fulfilling experience conversing with some of the girls after the presentation because groups of friends would come up to us, the interns, with a bundle of questions. They’d anxiously glance amongst themselves before one of them felt brave enough to ask. Many girls were very anxious about irregular periods, but we reassured them that this is very normal during adolescence and will regulate with age. However, they were so anxious to ask because no one had ever told them this was normal before, making menstruation somewhat of a taboo topic and leaving young girls worried about their bodies. This experience allowed me to express my passion for educating others on women’s wellness and catalyzed my desire to provide women’s healthcare to underserved communities. Taking off from Cusco three weeks later, instead of contemplating everything that was to come, I marveled over the multitude of lessons I will carry with me throughout the rest of my healthcare career. I had many practices instilled within me, such as the importance of connecting with your patient, how essential giving a physical exam is, and taking into account how environmental factors affect how healthcare is provided. While learning these lessons, I also was able to notice the differences between the healthcare systems in the United States and Peru. Clearly, both systems have flaws, but in both countries, it’s every physician's responsibility to view healthcare as a human right even when the systems don’t fully view it that way. All of these lessons and experiences reinforced my desire and excitement about going into medicine, especially working towards improving women’s healthcare. I feel overwhelmingly grateful I was given this opportunity to work with and learn from such amazing doctors in such a beautiful country. Flying over the mountains as I left, I felt an immense appreciation to be surrounded by people who love and respect “Pachamama,” or Mother Earth, so much. Immersing myself in a new culture opened my view of the world and reminded me to never feel limited by my current circumstances because there will always be more to see and learn. My internship with International Medical Aid permanently altered my trajectory into the medical field by making it a more clear and passionate path.

I feel extremely honored and grateful to have been a part of this program and to have experienced everything that came with it. I interned with the program in Mombasa, Kenya, for a duration of two weeks, shadowing in the pediatric, radiology, maternity, surgery, and emergency departments. Over the course of these two weeks, I learned a lot about medicine—not only various conditions and types of medical practice, but I also discovered the type of physician I want to be. I discovered that, to be a “successful” practitioner, one must not only have extensive medical knowledge and advanced skills, but also demonstrate compassion towards all patients. I also realized the extreme importance of adaptability in medicine. I observed practitioners as they navigated procedures and protocols with limited resources, determined to provide the best possible care. One of the moments I valued most from this experience was the opportunity to observe cesarean sections, including a case involving an ectopic pregnancy. I am deeply grateful for the International Medical Aid staff, the healthcare professionals who welcomed me to their work, and my fellow interns who shared the same deep desire to learn more about both medicine and culture.

My experience with IMA in Kenya was nothing short of memorable and deeply reflective. It reaffirmed my purpose for wanting to attend dental school. From the moment I arrived, I was warmly welcomed by Michelle and Teddy, whose kindness immediately put me at ease. The kitchen staff, especially Joshua and Maria, went above and beyond- helping me open my charger adapter and telling me, “We are here for you.” That simple gesture made me feel truly at home. Whether it was baking donuts with Erastus or building meaningful friendships with the other interns, every moment contributed to an unforgettable experience. I’m also incredibly grateful to Naiomi for coordinating everything so seamlessly and always being available to answer any questions. One of the highlights of my time was the community clinic- an opportunity I almost missed due to a flight change. I’m so glad I made it. There, I was able to contribute by recording teeth numbers during oral diagnoses and cleaning instruments for extractions. It was in this clinic that I truly saw the heart of IMA’s mission in action. This experience was especially meaningful to me, as I hope to one day practice dentistry in a charitable manner.

Where to begin? I cannot tell you how grateful I am for interning in Mombasa through IMA. This program is filled with incredible mentors and residence staff, making my experience unforgettable. From the moment my journey to Mombasa began, the mentors kept track of my flights and were waiting with a sign as I exited the airport. They were so thoughtful and welcoming. The residence was absolutely gorgeous and made interns feel very safe. It is in a secluded neighborhood, surrounded by two gates and guarded by very sweet security staff who keep track of your whereabouts. Personally, I felt so safe and at home in Mombasa because the people make you feel like part of their family. The food was amazing—especially the chapati. I could eat that for days. Shout out to Grace and Erastus, who made my experience at the residence so peaceful and enjoyable. I miss them so much. I can’t even begin to explain how amazed I was by the opportunities we were given at the hospital. As someone interested in surgery, I was able to see a myriad of cases from start to finish. The majority of doctors at Coast General Teaching and Referral Hospital (CGTRH) are more than willing to answer your endless questions and love teaching you new things. We were also given incredible opportunities to participate in cultural treks, seeing giraffes, crocodiles, ostriches, and more. My favorite part of my internship was teaching during the hygiene and menstrual health clinics. It is incredibly meaningful to go directly into schools, teach students about such important topics, and distribute hygiene materials to them. All in all, I loved this experience and will be telling other pre-meds about it. It’s beautiful how overwhelmingly diverse a simple piece of paper can be. It can be folded into a plane to soar the skies, a boat to sail the seas, or an intricate crane to simply admire. These seemingly meaningless objects have the power to change someone’s perspective on their day—or even their life. I experienced this revelation during my internship at CGTRH while folding a dull little crane. On my first day of rotation in the pediatric inpatient ward, my heart completely broke from what I saw: countless kids, from toddler to teen, hanging on to life by a thread with their mothers anxiously lying by their side. Each bed was separated by only a few inches, without curtains or sheets for privacy from neighboring patients and interns. Although the children were fully cared for by nurses and doctors, the number of patients completely outnumbered the available support. As I witnessed these conditions, I noticed a beautiful 14-year-old girl lying motionless on her broken cot, seemingly lost to this world. Her mom did everything she could to provide joy in such a dismal situation, but nothing brought happiness to her solemn face. As I watched them, my hands began to fold a piece of paper ripped from my International Medical Aid journal. With each crease, a simple crane came to life. Even though it lacked any glamour or decoration, I handed it to the little girl and watched a small spark appear in her eyes. With a quiet “asante,” her mom began using the crane to play with her daughter, moving the little creature around the cot. My heart leaped as I saw the girl examine the paper crane in her fragile hands and finally smile. It wasn’t until that moment that I realized how impactful a simple piece of paper can be. I have never been someone who was naturally great with kids. To the shock of many of my female friends, you could never catch me babysitting or experiencing any kind of “baby fever.” However, I will never look at children the same way after this unforgettable experience, thanks to International Medical Aid. Throughout my time in this internship, I gained a deeper understanding of the importance of proper patient care despite difficult circumstances. From witnessing the first breaths of a newborn baby to watching a 2-week-old take their final breath, this experience pushed me emotionally and mentally, testing my perceived limits in the medical field. In every department, I witnessed a sense of adaptability and resourcefulness that embodied the beautiful phrase painted on the hospital walls: Huduma bora ni haki yako—good service is your right. I hope to live by this motto and the examples of those in this hospital for the rest of my life. Throughout my experience with International Medical Aid, I gained countless skills, especially adaptability, compassion, and curiosity. From the moment I arrived in Mombasa, I fell in love with the people and the unique culture surrounding me. Although I experienced a bit of culture shock at first, I quickly learned the importance of adapting and learning from those around me—something I have experienced my whole life as a military kid. With each interaction in Mombasa, I felt appreciated and supported, sharing in the excitement when people talked about their cultural practices and history. The mentors and workers with IMA made me feel like part of a rambunctious and beautiful family. Everyone took the time to answer my “dumb” or culturally naïve questions with patience and kindness. I learned the importance of adaptability most clearly in the hospital. As students, we are given the incredible opportunity to witness the medical system in Mombasa at CGTRH and to learn about the cultural and political factors that influence patient care. When I first arrived, knowing it is one of the largest hospitals in Kenya, I was blown away. Its massive structure resembles a brain, with wards and passageways connecting like neural networks throughout the hospital. Although I had done some research on the healthcare system in Mombasa before arriving, the complexity and organization of this hospital far exceeded my expectations. That said, the hospital faces daily challenges in providing care across departments due to shortages in supplies, equipment, doctors, nurses, and funding. The public health sector has historically had a very low doctor-to-patient ratio, meaning that CGTRH staff are pushed past their limits, sometimes working 24-hour shifts. Because less than the recommended share of the national budget is allocated to healthcare, Kenya relies heavily on international funding. The recent loss or freeze of some funding streams has made things even harder. During many discussions with doctors and nurses, I heard concerns about the shift from the National Hospital Insurance Fund (NHIF) to the Social Health Authority (SHA). Many believed that this change left a large number of patients unable to afford medical bills or receive proper treatment, as it fails to adequately cover outpatient care. These political and economic factors have left many departments without the materials or manpower they need to provide care at the level they desire. For example, during my time in radiology, numerous patients coming in for a CT scan had to be turned away because of a shortage of contrast or because the scanner was malfunctioning, forcing them to rely on private hospitals. While shadowing in the Accident & Emergency Department, we saw countless issues in patient support due to lack of beds, materials, ventilators, and more. All of these factors directly and indirectly affected patient care and access for those who needed it most. Despite these challenges, I have never met more resourceful and dedicated doctors than those at this hospital. Because of IMA, my perception of CGTRH and clinical practice has completely changed. I now see the endless number of patients they serve daily and the immense expectations placed on healthcare providers there. During my fifth week in the Comprehensive Care Clinic (CCC), which specializes in HIV diagnosis and treatment, I learned about the reality of losing key financial support. For example, syringe imports used in HIV diagnostics were dwindling. Rather than panicking, many doctors in the CCC improvised with damaged or repurposed equipment to continue providing care. I was in awe of their adaptability. Even in the Surgery Department, I witnessed one of the most jaw-dropping procedures I have ever seen: repairing tendons in a severely damaged hand after electrical burns. When I first walked into Main Theatre 3, I saw the patient’s hands almost annihilated, with bones exposed. Although he had lost full function of his right hand, Dr. Ruth was determined to restore as much control as possible to his left hand. During an incredible four-hour procedure, she and her team adapted their original plans—using catheters as temporary connectors for his tendons. Their willingness to think outside the box gave this patient a chance to use his hand again. This kind of adaptability was present in every department I visited, from Pediatrics to Accident & Emergency. All of the nurses and doctors at CGTRH use these stressful conditions to prioritize patients, sacrificing their time and energy to save lives. I will use their example to loosen my perfectionist tendencies in medicine and instead adapt to each patient’s needs, showing compassion even in the most stressful circumstances. Compassion is monumental when it comes to providing care in the medical field. Sometimes the smallest acts of kindness are all a patient needs to get through their situation. This internship pushed me outside my comfort zone, teaching me to prioritize others before myself and quiet the self-doubt that can block genuine connection. As someone who struggles with social anxiety, meeting new people in a foreign country with language barriers was daunting. Realizing I would be meeting new people every week for six weeks—both at the hospital and at the residence—made my head spin. However, this program helped me focus on compassion when I felt overwhelmed. Before arriving in Mombasa, I could not imagine forming deep, lasting friendships in just a few weeks. I stand corrected. Through hygiene clinics and cultural treks, I built meaningful connections with like-minded students who value community and medical outreach. I am so grateful to have met such inspiring interns, like Melody, who taught me to trust myself, support others when they need it most, and appreciate the little blessings in life. I also learned how important compassion is when connecting with patients, even across language barriers or time constraints. Taking a few seconds to smile or greet someone in their own language can make all the difference. While working in maternity during a night shift, I met a warrior of a mom named Mercy who was giving birth. I had no idea how to support someone in such a stressful moment, but all she wanted was someone to hold her hand. We could barely understand each other verbally, but we both understood the power of physical touch during trying circumstances. Through tears and hand squeezes, we relied on compassion to support each other. That night, she gave birth to a beautiful baby and made it through her excruciating pain. Although I never saw Mercy again, I know wonderful things are being done through her life. Compassion does not need to be flashy or grand. For me, compassion is putting the needs of those around you first and letting love and kindness guide your actions. I believe compassion is crucial in medicine, and this experience only amplified that belief. I have never agreed with the phrase “curiosity killed the cat.” Ever since I was little, I’ve been known as the kid who asks weird and unexpected questions. In many settings, people find that annoying—but in Mombasa, I was encouraged to constantly ask questions and learn from doctors, interns, Uber drivers, guides, and more. During my first week at the hospital, I felt like a fish out of water, drowning in medical terminology bouncing between doctors and interns. I couldn’t tell you the difference between a cyst and a mass or how to read a CT scan before this internship. Through patient explanations from doctors and interns, I was able to embrace my curious nature and learn both techniques and theory, often translated from Swahili to English. With each simulation class and lecture, I could see the puzzle pieces of my understanding of the medical system in Mombasa slowly coming together. As someone passionate about understanding the cultural and political influences on HIV/AIDS in Mombasa, I have never felt more supported than I did in the CCC. Peter Mwazigne, the Medical Laboratory Officer of the CGTRH Molecular Laboratory, took precious time out of his day to show us around the research and microbiology labs and answer all my questions about the role of international funding in HIV diagnostics and treatment. Because of him, I gained a deeper understanding of this stigmatized disease, and I hope to share that knowledge with my friends and family. Outside of the hospital, I learned just as much from IMA mentors, staff, fellow interns, and even strangers. In countless conversations with Uber drivers and people we met in town, I developed a deeper grasp of Mombasa’s history and the concept of tribal lines. Everyone was more than willing to answer my naïve questions about tribe names (I can still only remember Luo, Luhya, and Giriama out of 44 tribes) or recommend places to visit. Every person I met taught me the importance of being curious and truly caring about what others are passionate or knowledgeable about. Providing this kind of support and prioritization is a skill I will carry into my future medical career. From baking with Erastus to receiving inspirational advice from Grace, I have learned so many lessons and gained a deeper understanding of myself mentally, emotionally, and spiritually. Curiosity is contagious; it inspires those around you to want to learn more. I hope to be that person wherever I go, encouraging people to never stop asking questions. I am incredibly grateful that IMA gave me the opportunity to be surrounded by such impressive and creative mentors, colleagues, doctors, and interns. As an undergraduate student just starting my medical journey, being around such intelligent and dedicated individuals pushed me to go beyond my perceived limits and try new things despite my fear of failure. As someone who is passionate about the brain, this internship only deepened my dream of becoming a neurosurgeon and using my skills to help those who need it most. You are never too old or too educated to learn from others or to make mistakes. No matter how prepared I think I am, this internship taught me to expect the unexpected in medicine and to welcome the unknown with open arms. I still have a long road ahead of me on the path to neurosurgery. That said, this internship has reinforced a passionate fire in my heart that will guide me toward my medical dreams through the power of God. Even as a future surgeon, I hope to support hospitals like CGTRH and remember why I entered medicine in the first place: to serve those who need it most. I cannot express my gratitude enough for this life-changing program, and I will never forget the lessons I gained from this experience.

My time in Mombasa, Kenya was amazing. The staff were great support and always friendly and willing to help you in any capacity. The food was amazing with a variety of familiar and local cuisine. Being able to visit the local schools and talk about hygiene was a highlight, with the children being so welcoming and kind. I was very impressed that there were opportunities to go on cultural treks during my stay there as well as visiting various landmarks and the market. By far, my favorite part was being in the hospital. There was never a dull moment and always something to learn. With brilliant, compassionate and innovative doctors I learned more than I could have ever imagined. My time in Mombasa, Kenya has cemented my dream to work abroad in developing countries and provide healthcare services. The doctors I shadowed showed what it truly means to be a great doctor regardless of intelligence. This experience was life-changing, broadening my perspective on the world and allowing for great reflection on my own life and opportunities. My journey to Kenya is one I will never forget and take with me through my education to becoming a doctor continuing through when I become a practicing physician. During elementary school is when I first heard about organizations where doctors go to underserved and underdeveloped countries to provide healthcare. It was at this time that I knew I wanted to go to medical school to become a doctor and go abroad with these organizations. Having the opportunity to go to Kenya has solidified these dreams of working abroad and providing care to those less fortunate. The doctors I was able to shadow showed through their actions what it means to be a great doctor. It was eye-opening to see firsthand the struggles of those in the lower class of society concerning access to healthcare and the difference between Canadian and Kenyan healthcare systems. Overall my experience in Kenya has shown me what I truly want to do as a doctor, what type of doctor I want to be, and has allowed me to further put into perspective how privileged I am. My experience in Kenya has provided me with a wealth of knowledge firsthand of what a doctor's job in a developing country entails. The doctors at Coast General Teaching and Referal Hospital (CGTRH) are some of the most innovative and brilliant people I have met. This is due to their need to be creative in their approach to treating patients whether it is to help keep costs down for the patient or due to the lack of resources. I witnessed several ways the doctors have had to be innovative due to a lack of resources, for example when taking blood samples they cut the cuff off of an examination glove and use that as a tourniquet. Compared to Canada, we have an abundance of rubber tourniquets and may use more than one on a patient if the first poke for blood draw does not work. The doctors at CGTRH and their ability to think outside the box to serve their patients with the highest degree of care have solidified my dreams of working abroad in underdeveloped and underserved countries and communities. The doctors at CGTRH have taught me so much not only in medical knowledge but about what traits make a great doctor. Some of the best doctors I had the privilege to shadow had a common trait that I quickly recognized to be compassion. This trait I find is often seen as lacking in the western world where everyone is in a rush, either to get you out of the hospital or the exam room at your family doctor. What the Canadian and Kenyan societies prioritize are different. In Canada, it is a fast pace society mainly focusing on one's self, whereas in Kenya it is more of a collectivist society focusing on family and helping out one another. This difference between societies can be seen in the way doctors treat their patients. An example of these doctors' altruistic behaviours was when a patient needed blood work to see if their levels were back to baseline in order to be discharged, as they were feeling a lot better the doctors felt no need for her to continue staying. Although they were still held because they couldn’t afford the cost of blood work, this lead to the doctors themselves paying for the patient's bloodwork so they no longer had to stay in the hospital. These actions of the doctors not only allowed the patient to go home to their family, but also served the patient because as found by Hauck and Zhao (2011) “A hospital stay carries a 5.5% risk of an adverse drug reaction, 17.6% risk of infection, and 3.1% risk of ulcer for an average episode, and each additional night in hospital increases the risk by 0.5% for adverse drug reactions, 1.6% for infections, and 0.5% for ulcers.” Seeing how the doctors cared for each and every patient, treating them as equals and with compassion has really shown me the traits of a doctor I strive to be. In Canada, we have universal healthcare furthermore, I have insurance provided to my parents through their work that continues to cover me as a student. These two combined allow me to go to my family doctor, the emergency room, physiotherapist, massage therapist, chiropractors and more without enduring any cost and not putting any financial strain on my family. This fact until recently was nothing special to me, I never appreciated how fortunate I am as a Canadian to have access to healthcare anytime I need without thinking of how I am going to afford it. As I grew up I learned in the USA healthcare can be very expensive and it deters a lot of people from visiting the doctor. Upon arriving in Kenya I learned despite volunteering at a public hospital, patients still needed to pay. This was quite a stark difference between the Canadian and Kenyan healthcare systems as Canada only has a public sector that does not bill you. Although the Kenyan public sector is heavily subsidized by the government non the less, I saw many families unable to afford certain tests and treatments due to the financial strain. The cost of tests and treatments at a first glance looks very low, especially compared to what I have heard about treatment costs in the USA. But as I continued to learn more about Kenya I was informed that 36.1% of Kenyans live below the International poverty line (International Medical Aid, 2022) and the international poverty line is $1.90 (World Vision, 2021). I was humbled in seeing the difference in healthcare systems and these facts were able to put into perspective why what at first seemed like low prices for healthcare was truly a financial burden for so many Kenyans at CGTRH. My time in Kenya is one I will never forget, it was a once-in-a-lifetime experience that has further allowed me to appreciate my opportunities in Canada and broaden my world views with regard to developing countries. CGTRH and their doctors have really given me a new perspective on what it means to be a doctor and a healthcare provider. I enjoyed witnessing the many facets of what being a doctor is, and how doctors working in regions with limited resources go about treating patients. Being able to shadow doctors in a country that has alternative priorities than the western world truly showed me various attributes that go into being a great doctor regardless of how intelligent you are. Being able to witness and learn firsthand about a different healthcare system was humbling and gave me a greater appreciation for what I have. I am grateful to International Medical Aid for providing such an eye-opening and life-changing experience that has allowed me to truly find what I am passionate about.