Winter Study Abroad 2025

My time as a Pre-Physician Assistant intern with International Medical Aid (IMA) changed me from the inside out. I went in with very few expectations, eager to embrace whatever was in store for me. I was so happily surprised with the overall program and felt so individually cared for throughout it all. The residence was such a safe, comfortable place where I felt cared for. One of the chefs, Grace, went out of her way to introduce herself to me on the very first day and make sure that I had eaten and enjoyed the food. She always greeted each intern with a smiling face and so much intentionality. My room was such a great space, and it exceeded all expectations. I always felt seen by the mentors, and they accommodated every need throughout the entire journey. I really appreciated the balance that we were given between learning and rest; while we had deeply meaningful experiences at Coast General, in clinical simulation sessions, through lectures, and at community outreach events, these were often a lot to take in, so I was grateful for ample personal time to reflect, unwind, explore Mombasa, and bond with fellow interns. Janet and Hildah were also so welcoming and personal, and they both were so great at organizing the two weekend trips I went on. Thank you so much to IMA for everything; you made this experience so life-changing and comfortable! Two words describe my overall experience as an intern for four weeks at Coast General Teaching and Referral Hospital (CGTRH) in Mombasa, Kenya: adaptability and humility. When the ENT doctor I was shadowing had her otoscope stolen and there were no funds to buy another, we used a headlamp. When a patient tested positive for cholera but there was no room in an isolation ward, we created a makeshift room for her outside. When a patient had never been seen for his heart condition and had arrived at the Emergency Department with end-stage heart failure, and there was nothing the providers could do to help, we made him as comfortable as possible and comforted his family members. As a volunteer, I worked with the local physicians to understand the best ways to provide care in a place where resources, sanitation, and health literacy are minimal. I learned that medicine is more than diagnoses; it is compassion for the person at large and resilience through obstructions. No medical education, shadowing experience, or laboratory curriculum can prepare you for the moment that a mother is lying in your lap on a cold hospital floor, hysterically crying after losing her two-year-old daughter to cholera. In that moment, explaining the physiology of the disease and treatment methods could not offer any support; I could only provide pure, compassionate human connection. This scenario occurred during my recent medical internship in Mombasa, Kenya, where resources, sanitation, and provider attention were minimal, causing the daughter to pass away from an illness that would have been preventable in the United States. As we watched her child die, I held on to the mother as she collapsed and continued to hold her through her grief. As I cried alongside her, periodically wiping her tears with my scrub top and answering her phone calls that came through from family members, I felt utterly heartbroken and helpless. More than anything, I was forced to reflect on the stark differences between healthcare in Kenya and the US, and how the diseases people face are vastly different from what I am used to. While I have worked in clinical settings at home, where many of the patient presentations are elective, noncritical forms of preventative medicine, many of the cases I interacted with at Coast General Teaching and Referral Hospital (CGTRH) were end-stage disease or emergency cases. I witnessed necrotizing fasciitis, malaria, chronic kidney disease, heart failure, enlarged malignant tumors, an electrocution injury, and Meig syndrome. Each of these was a captivating occurrence that not only taught me an extensive amount, but also opened my eyes to a new side of medicine I had never before encountered. In our “Disease Burden in Kenya” lecture, Dr. Shazim explained to us that a large majority of diseases historically present within the country are tropical illnesses (IMA, 2025). During the clinical debrief on this same day, we also learned about the intersection between healthcare and climate change that plays a drastic role in the distinct disease qualities between the US and Kenya. Cholera, specifically, is preferential to specific water temperatures, salinity, and humidity, making the bacteria more likely to live and survive in conditions like those in Kenya as opposed to the US (Lipp, 2002). While human immunodeficiency virus (HIV) is not necessarily a product of the climate, it is considered a tropical illness due to its prominent dispersion within countries of the tropics (American Society of Tropical Medicine and Hygiene). I had no prior knowledge of this virus aside from the minor details covered in my Microbiology course. During our tour, the stigma and tension behind this diagnosis were strongly apparent to me when Dr. Shazim highlighted the fact that we could not refer to HIV by its name, but rather as retroviral disease (RVD). Furthermore, patients were treated specially in the CCC, a special ward for HIV treatment where, even within its walls, the words could not be spoken. On my first day in the hospital, a clinical director told me to “assume each patient is HIV positive until proven differently” (IMA, 2025). Even with such a widespread presence, this disease is heavily looked down upon, and patients refuse to accept it as a diagnosis. Thus, it leads to a multitude of greater complications, as it destroys essential immune CD4 cells and makes individuals more susceptible to other illnesses, namely tuberculosis or chronic cardiovascular disease (HIV Gov, 2024). Because of this, HIV was consistently in attendance in each unit of Coast General throughout my internship. It was constantly lingering as a possibility in each provider’s mind, as well as my own. I quickly learned how to take this disease into account and factor it into corresponding diagnoses in order to attain a full picture of the patient and provide the best care possible. This came into great display during my last week of my internship, when I was in the maternity unit. Each mother was classified by her relation to HIV, as the virus is automatically transmitted in the birth canal to the fetus. By no fault of their own, the baby is then automatically a carrier of this illness, leading to a greater spread of it throughout the country. It was saddening, yet powerful, to witness the existence and effects of this virus in real life, as it is something that is commonly cited in medicine but not commonly seen throughout the United States. I was surprised and grateful to learn that there is antiretroviral therapy that people can begin to reverse the effects of this devastating disease, yet cost and limited healthcare literacy continue to be major barriers that inhibit people from receiving the care they need, as is the case for nearly every individual I interacted with in Coast General. A lack of health literacy, resources, and funding towards medicine leads to widespread impacts that bleed into every facet of the healthcare system in Kenya. One of the hardest moments I endured in Mombasa was on my very first day as an intern. I had been placed in the Accident & Emergency unit, where there was a surge of patients following a rainstorm the day prior. Right at the end of the shift, when the three of us interns were already drained and overwhelmed from the morning, a case came in who quickly coded in front of us. The clinical directors and clinical officers were all attending to other patients in the back, and the student nurses in charge did not know how to administer CPR. As we interns jumped in to help, we were frustrated when we found out that the oxygen mask had a tear and the only AED in the unit hadn’t worked in months. We were all left helpless, watching as this 18-year-old boy passed away traumatically. As someone who had never witnessed death with my own two eyes, I was frozen in place. It felt like life was moving around me, but I was at a standstill, brokenhearted and powerless in the moment. The three of us with IMA left, unable to verbalize to one another or the rest of the interns what had happened. Initially, I was angry—angry at the lack of provider attention; angry at the fact that they had an AED that didn’t even work; angry that the nurses had not been trained in CPR; and angry that this boy would never get to live the life he deserved. I will be the first to admit that it was incredibly difficult to go back to the hospital the following days and try to be present within my rotation. I found my mind silently criticizing everything and trying to find fault with the Kenyan healthcare system. Fortunately, I had the two other interns who had witnessed this scene, as well as supportive mentors and other clinical directors, to help me get through this barrier. The “Current State of Healthcare in Kenya” lecture opened my eyes with the fact that 5% of the total national profit of the country goes into healthcare. This was followed up by the statement: “Most healthcare funding goes to top hospitals rather than primary care or community health centers, so there isn’t much focus on preventative care” (IMA, 2025). Furthermore, we learned that Coast General cares for a primary population of 700,000 people and also a secondary population of 2 million. I remember being shocked by these truths, and immediately my perspectives were shifted. Rather than frustration towards the system at large, I felt newfound empathy for both the patients and the providers. I was able to realize that it is not the fault of the hospital workers themselves that resources, time, and skills are sparse; rather, there is a nationwide systematic malfunction that is cost-ineffective and inhibits the capacity of the caregivers. With such limited funding, there is no way that the hospitals can have updated equipment, consistent training sessions, or adequate attention from all of the providers. Moreover, the public hospitals are overpopulated in general, but especially with patients who are being seen for the very first time with chronic diseases that have progressed beyond management levels. A qualitative research study led through Health Promotion International identified several key factors as causes of low health literacy throughout Kenya: traditional cultural practices, religious beliefs, inadequate sources for medical advice, inaccessibility to caregivers, cost barriers, and personal responses to illness (Robbertz, Kim, et al., 2022). Without preventative care or basic understanding, citizens allow their maladies to develop past a point of return, and there is often nothing that can be done. While this, in itself, was still incredibly frustrating to me, I was able to enter into my clinical experience with a newfound lens. I saw that the providers were doing all they could, and they were even more defeated by the lack of consideration by the federal government. Coming full circle, this stuck out on my very last shift in the hospital, when I was engaging in a night shift in the Emergency Department. A patient came in with heart failure and COPD, having never seen a healthcare professional for either of these illnesses. I was working closely with the Clinical Director assigned to this case, and I directly witnessed the toll that this situation took on him personally. When asking him what he would do for the patient, he told me that, due to the lack of space in the ICU and end-stage progression of this disease, there was nothing that could be done. He explained that resuscitation “would be a legal formality rather than a helpful procedure” and “all that can be done is to watch his vitals and attempt resuscitation at the last minute” (IMA, 2025). I could visibly see the pain in his face as he explained the emotional and personal hardship of under-resourcing on the providers. He told me that he often feels helpless and takes failure personally, when it is really a result of systematic faults and inadequate healthcare access. Amidst all of their efforts, a single medical professional cannot take on the weight of these issues themselves, and there is clearly a federal transformation that needs to occur for every Kenyan citizen to receive the care they deserve. After hearing this analysis, many family members and friends questioned if and why I still wanted to go into medicine, a career that is quick to repeatedly break one’s heart and challenge one’s faith. Few other careers allow for such depth of connection with others; through immense vulnerability, suffering, celebrating, and intimacy, healthcare providers are able to share in people’s most significant moments. They are consistently called to consider it joy in all things, knowing that each trial brings a new level of depth that lasts far beyond the fleeting moments of this world. It is apparent to me that being a provider is my vocation; my intellectual passion for medicine as well as a love for caring for people align in perfect harmony in this profession. I realize that as a PA, I will not be immune to the many challenges that come with healthcare. My title may read PA-C, but ultimately I am a servant, and I am committed to use my gift of a medical education to serve in all capacities. Through my four weeks as an intern in the Pre-Physician Assistant Internship Program with International Medical Aid, I learned more about medicine, humanity, and myself than I ever thought possible. As I returned to life in the United States, I found it challenging to fit into my previous patterns, as I had changed in such drastic ways. While I initially went to Kenya to serve the people there, everyone I encountered instead helped me in forms that I can’t quite articulate. Seeing first-hand the disease burden, hardship of life, and difficult conditions completely rewired my perspectives. What stood out most was each person’s endurance amidst trials, and their overwhelming joy that filled even the darkest moments. The ways in which I live and practice medicine have been forever altered, and I have a profound gratitude for all that is accessible to me in the US. Still, I greatly miss the vibrant life in Mombasa and yearn for the day that I can return to this beautiful country. I will forever cherish the four weeks that I was lucky enough to spend as a student at Coast General Teaching & Referral Hospital, and I credit International Medical Aid with so much of who I am today.

At BLCU, I didn’t just learn Mandarin—I learned how language lives and breathes. Between intensive classes and lively language exchanges, characters I once found daunting became familiar friends. The campus itself was a microcosm of global connection, where a conversation in the dining hall could lead to a weekend trip to the Great Wall. What stood out was how the curriculum blended rigor with real-world application, turning grammar lessons into practical tools for navigating life in Beijing. This program is for those who want to do more than study a language—they want to let it change them.