Teaching Volunteering in Haiti

I enjoyed some of the activites , but not others. The rivre walk and the walk to the koppies was 10/10. No intrenet was challenging , so 7/10. Jane , Precious , Patrick and Lucas were 10/10. I woul recommend this project to anyone who needs a detox from Social media.

New culture, new people, New Life. When we exchange our perspectives, ideas and plans to make a world better place for everyone. It's good to go different places it helps me view life in many directions

Hice 5 años en haiti, me se su idioma, se toda su cultura, me gustaría volver y apoyarlos en todas las dificultades que tienen, ya que ameritan mucha ayuda de todos nosotros, para ellos poder sobrevivir

I would really like to volunteer. I am passionate about charity and showing kindness to the world. Please, give me a chance. Kindly provide Certificate of sponsorship too since I'm not able to provide for myself at the moment. Kindly put my request into consideration.

This an increasingly popular way for individuals to make a meaningful impact in communities around the world. With numerous organizations offering volunteer programs, it's essential to review and research these opportunities to ensure a safe and rewarding experience. *Pros:* 1. *Cultural Immersion*: Living and working with local communities provides an immersive cultural experience. 2. *Skill Development*: Volunteers can develop new skills and gain experience in areas such as teaching, conservation, and community development. 3. *Networking Opportunities*: Volunteers can connect with like-minded individuals from around the world. 4. *Personal Growth*: Volunteering abroad can be a transformative experience, fostering personal growth and self-awareness. *Cons:* 1. *Cost*: Many volunteer programs come with a hefty price tag, which can be a barrier for some. 2. *Safety Concerns*: Volunteers may face safety risks, such as health concerns or political instability, depending on the destination. 3. *Cultural Differences*: Adapting to local customs and way of life can be challenging for some volunteers. 4. *Quality of Programs*: Some volunteer programs may lack structure, support, or meaningful work, leading to a disappointing experience. *Recommendations:* 1. *Research Thoroughly*: Investigate the organization, program, and destination to ensure a safe and rewarding experience. 2. *Read Reviews*: Look for reviews from past volunteers to gain insight into the program's quality and challenges. 3. *Choose a Reputable Organization*: Select an organization with a proven track record, transparent policies, and adequate support for volunteers. 4. *Prepare Yourself*: Culturally, emotionally, and physically prepare yourself for the experience to ensure a smooth transition. By being aware of the pros and cons, doing thorough research, and choosing a reputable organization, volunteers can have a safe, rewarding, and life-changing experience abroad.

As a Social worker i often meet with clients to assess their needs, provide counseling, and develop individualized plans to address their challenges. This could involve sessions with individuals, families, or groups.

I did not know what to expect when I originally applied for this program. However, it ended up being everything I could have ever wanted and more! I felt safe and well taken care of during the entirety of my time in Kenya. I learned so much at the hospital and was able to enjoy numerous cultural treks in my free time. I would thoroughly recommend this program to anyone. I have always had an interest in global health but throughout my undergraduate career, I could never find the time to travel abroad. So during my first gap year, post-graduation, I was excited to finally have time to pursue this dream. I spent several weeks researching medical programs in Africa before coming across International Medical Aid. Between the glowing reviews on the website and all the beautiful Instagram photos from past interns, I decided IMA was the program for me. I was ecstatic when I received my acceptance but also incredibly anxious because what was once just an idea was now becoming a reality. I spent the next few months prepping, and then COVID hit, and I had to delay my trip to the following summer. During that year span, I changed jobs and was accepted into medical school. It felt like a lifetime since I had applied for IMA and what was once a fully planned experience, felt more like a dream again. But somehow on June 4th, 2021 I sat down on a plane in the JFK airport and departed for Kenya. When I arrived in Mombasa, a mere 17 hours later, I had no idea what to expect. The first car ride to the residence was a culture shock in itself. Beyond the initial surprise of the road system, traffic patterns, and tuk-tuks, I took immediate notice of the poverty level and the clear economic stratification. According to the World Bank, “ Kenya is East Africa’s largest economy…” and yet “36.1% of Kenyans [are] still living below the international poverty line” (The history of pre-and post-colonial Kenya lecture). This inequality is evident on the street as you see families living in huts only a few minutes away from mansions with tall gates, topped with glass shards so no one can enter. It is also evident in the healthcare systems. Private hospitals, such as Premier, offer superior facilities to those who can pay the cost, while the lower class has access to public-funded hospitals such as Coast General Teaching and Referal Hospital (CGTRH). The public facilities are “under-resourced in terms of equipment and clinical staff” and have “overall, poorer patient outcomes and higher incidences of hospital-acquired infections” (The current state of healthcare in Kenya). Equipt with this information, I was eager to start my hospital rotations and get a better idea of the true healthcare experience in Kenya. My first week in CGTRH was spent in the Obstetrics department. Within my first day, I saw six vaginal births, including a set of twins, and learned all about the different stages of labor, medications given to mom and baby, use of the fetoscope, procedures for cord-cutting and sex determination, and so much more. I felt immediately welcomed into the hospital. Everyone was eager and willing to teach and let us see everything. This was a welcome change from shadowing in the United States where pre-medical students are often treated as more of an inconvenience than anything else. This was definitely not the only notable difference from the hospital settings I was used to. The biggest difference, by far, was in the use of pain medications. In the United States, a woman laboring in the hospital readily has access to multiple forms of pain medication including the well-known and commonly used epidural. In Kenya, however, moms are not given any pain medications unless they have to undergo a cesarean section. This means that women go through the entire labor, sometimes including an episiotomy and later suturing, unassisted by analgesics. This type of strength and personal fortitude is unimaginable in the United States. The other major difference is in prenatal care. Although prenatal care is offered for free in Kenya, most people do not go to the doctor before they are in labor. This is due to a large number of factors, including lower health literacy. Due to this, most mothers go into labor without any knowledge of the sex of the baby or even the number of babies they are having. In the United States, most women receive consistent prenatal care, including “every 4 weeks until 28 weeks of gestation, every 2 weeks from 28 to 36 weeks, and then weekly until delivery” (Lockwood, 2021). This creates much more opportunity to monitor the health of both mom and baby, increasing the likelihood that any complications would be detected early and taken care of. The following week I was in the pediatrics ward. I was able to learn a lot here from the nurses and resident doctors. It was particularly interesting to learn about their top ten most common conditions -gastroenteritis, pneumonia, several acute malnutrition, neonatal sepsis, neonatal jaundice, meningitis, malaria, anemia, bronchitis, and tetanus- because they are so much less commonly seen in the US. I was also shown how to insert a nasogastric tube into a newborn which was very interesting. My third week was spent in the Accident and Emergency Department. Here I was able to see a lot of interesting and varied cases from bandage and catheter changes in the minor theater, to epilepsy and pneumothorax in the beds. But what I really enjoyed about this department was getting to talk with so many of the staff members when there was downtime. Doctors spoke openly with us about the corruption in their government and police force, the lack of resources and staffing at the hospital, the pay delay that they were currently experiencing, and the poverty that surrounds them. Here, I gained a new sense of appreciation for the level of dedication that these people were putting towards their patients. I was told that the staff is paid monthly and that although it was almost the end of June, they still had not received payment from May. They had apparently tried to strike in the past but were unsuccessful. Despite all of this, when I asked the residents if they would continue to work at Coast after their training was completed, most of them said they would because they loved the work they were doing. That is one of the biggest things I will take with me into my future practice of medicine. Always put the patients first and remember why you came into the profession. My last week was spent in the surgery department. This rotation was particularly fascinating as I have had very minimal OR time in the US. During my first day in the theater, I was able to observe a bilateral inguinal hernia repair on a five-month-old baby, a biopsy and excision of a mediastinal mass, and a bullet removal from near the spine performed under local anesthesia. On my second day, I was able to watch a broken femur repair. Then, I was even fortunate enough to get a third day in the OR after another intern had a night shift. During that shift, I was able to observe another inguinal hernia repair with a circumcision, and a skin graft from a woman’s leg onto the right side of her face after they had previously removed a neurofibromatosis. The skin graft was by far the most interesting and intricate procedure that I have witnessed. The surgeon was absolutely amazing and really took the time to teach us and show us what he was doing. I was able to learn so much from this. I was also able to learn a tremendous amount outside of the hospital. Between the clinics, the cultural treks, and the Masai Mara safari, I was able to gain a deeper knowledge and appreciation of the history and culture of Kenya. What stood out to me the most was the warmth we received everywhere we went. In the United States, especially in New York, where I am from, people aren’t very openly friendly to one another. This was not the case in Kenya. At the hygiene clinics, the children would run up to us with open arms for hugs and high fives. At the beach, people would strike up conversations about where we came from and what we thought about Kenya so far. At the grocery store, we had people thanking us for coming to the country and working in the hospital even though we got much more than we were able to give. Time and time again the people of Kenya inspired me to be a kinder, warmer person. When I sat down on my June 4th flight, a year and a half after applying to IMA, I could not have known the impact this experience would have on me. I am so grateful to the IMA staff, the hospital staff, the Kenyan people, and the other interns for making my experience everything that it was. As I start my journey through medical school, I will take with me all the knowledge I gained and the lessons I learned. I will be kinder, warmer, more dedicated, more resourceful, and above all, more appreciative for all the things that I had previously taken for granted. And once I complete my training, I would love to return and give back to the patients everything that was given to me.

Every intern and physician I had the pleasure of interacting with was incredibly welcoming and emanated such perseverance, passion, and enthusiasm. I’m forever thankful for the opportunity to absorb the culture of the Kenyan people alongside my fellow colleagues. My involvement in the hospital was a once-in-a-lifetime experience, but being able to have such intellectual and zealous interactions with my fellow colleagues and physicians was incomparable. My fellow colleagues really showed me the true meaning of how to be welcoming of others who may hold foreign ideals or passions that may not necessarily align with my own. They showed me the meaning of gratitude and optimism despite unfortunate circumstances. I will be forever grateful for my experience in Kenya and to International Medical Aid for allowing me this opportunity. My trip to Africa has broken countless boundaries and shown me what it takes to be a successful physician. As I arrived June 18th in Mombasa, I soon realized my experience in Kenya was going to be simply life-changing. On our way to the residence, I stared out the window as we drove through unfinished roads and passed what looked like destitute infrastructure. With this being my first time out of the US, the sentiment towards my journey was filled with times of uncertainty and indications of acculturation. In preparation for my trip, I often found myself looking at pictures on Google of what I could potentially expect in Mombasa; however, pictures could never truly encapsulate the extent to what I felt and experienced during my time. This experience altered my perspective on the healthcare industry while simultaneously promoting a greater understanding of myself. The knowledge I gained while in Kenya has filled me with a greater sense of gratitude and humility beyond what I could have ever found or experienced in the US. My first weekend in Kenya consisted of a tour of Coast Provincial General Hospital, which kickstarted an already eye-opening experience. Our program mentor, Dr. Shazim, began our tour in the Emergency Room where I saw a patient who had just passed being draped with a bedsheet. I had heard stories from other interns about the possibility of seeing patients pass during my time here, but this wasn’t something I could’ve expected to see on my very first day visiting the hospital. As we continued with the tour, despite the prominence of a shortage in both the accessibility of resources as well as clinical staff in the public sector hospitals such as Coast (Nejru, C.), the doctors continuously persevered and were seemingly unaffected by the dire circumstances. They only incessantly provided exceptional care for all of their patients to the best of their ability. There was an understanding amongst the interns, staff, as well as myself that we were in fact walking into a hospital that is incredibly underfunded and built by a system that was completely foreign to our traditional western medical practices. Nevertheless, I could not have anticipated to what extent this was the case until I saw it first hand. The tour was just the starting point, but I was already in amazement at the sense of gratitude for not only the healthcare workers working at Coast Provincial General Hospital, but also for the healthcare we are provided with back at home. As the weekend came to an end, I could only wait in anticipation about getting started in my first rotation, the Ear, Nose, and Throat Department. Given the often up-to-date and medically advanced technology I am used to in the US, I was baffled by the usage of ancient and considerably outdated instruments. An outdated instrument such as a head mirror and light for ear, nose, and throat examinations were being used by the physicians at Coast whereas most physicians in the states use an otoscope, which can be more efficient, reliable, and more effective than the traditional head mirror. However, the concept of reliable and advanced technology coincides with an acknowledgment of the privilege needed in obtaining those “updated” instruments. His knowledge, however, spanned beyond the beneficial aspects the otoscope might have provided through obtaining a proper diagnosis for each patient. This accounts for only one of the many instances where Coast providers amazed me with their ability in providing such admirable and impressive care given the insufficient resources allotted to them. Between each patient, he would take time to explain the different diagnoses as well as their indicators. During this week, I gained extensive knowledge on not only the different parts of the ear but also infections that could occur, which could potentially develop into more serious health issues, such as meningitis. Additionally, I was also able to learn how to conduct hearing loss tests with the tuning fork and how to read audiograms. Due to the continuous technological advancements being adopted in the US, there is often a misconception that the adoption of newer technology will enhance the work of the physician, but in my experience, ENT proved to be more about knowledge and the true understanding of the basics. Oftentimes technological advancements act as shortcuts for a lot of physicians in the US and ultimately inhibit the proper care needed in a place that lacks those same advantages. Moreover, a key component to the proper deliverance of medicare is through proper bedside manner, which was demonstrated so proficiently by the MO’s, CO’s, and nurses at Coast. I can only hope that one day I can adopt their same principle in providing the best care for my patients through extensive knowledge and patient etiquette. In my second week, I was able to conduct a rotation in the Emergency ward. Inherent in its reputation, I found my time in this department to be by far the most hectic yet interesting experience of all my time at Coast. The underlying theme throughout the hospital of being under-resourced was more prevalent in this department than ever, given its chaotic and frantic environment. They had a singular working vitals cart circulating both the triage and outpatient units. Given its inevitable mayhem, a singular working vitals cart isn’t sufficient enough to support a whole department, especially one as tumultuous as this one. Most patients that come into the ER need to be continuously monitored in the prevention of coding. A 70-year-old patient came in complaining of pain on her left side and was evidently severely malnourished, which was, unfortunately, a consistent theme amongst patients I saw during this rotation. Watching this woman pass before any treatment was administered to treat her hypertension left me with a feeling that was incredibly disheartening. I had a million thoughts going through my head and all I could do was just stand there in shock watching her daughter drop to the floor in agony. All I could think was how curable her diagnosis was and how she could have been treated if the scarcity of resources wasn’t such a pervasive issue. The unfortunate reality of the apparent low socioeconomic status amongst the population of Kenya has left a disparaging mark on their health status. Most Kenyans earn only about one US dollar per day, which cannot even cover the dollar fifty(one hundred fifty shillings) baseline pay for a visit to the hospital. Consequently, many patients entering the ER are those with severe injuries or illnesses that require immediate attention, yet the rates are still incredibly unaffordable given the general population’s socioeconomic status, leaving many worse off. My week proceeded to include learning about suturing and other infections taking place in the minor theatre as well as many wounds being re-dressed and sutured. One case, in particular, struck me; a man came in with a severe cut on his hand, which required suturing. Much to my dismay, the Clinical Officer made the patient go to the pharmacy to purchase his own sutures in order for them to proceed with the proper course of treatment. This put an emphasis on my comprehension that Coast General was not acquiring the proper amount of resources to accommodate all their patients. This brought about a state of incertitude and left me with the troubled feeling that had me pondering the luxuries granted to us in the states of never having to be responsible or obliged to bring our own medical supplies. My last day in the ER consisted of a patient who was a known HIV patient. While attempting to place an IV into her arm, blood had dripped onto the floor. As I continued to watch the course of her treatment being carried out, no staff member had attended to the blood laying on the floor. Given that HIV is the highest cause of mortality in Kenya at a rate of about 15%, I was personally taken back by the potential risks that are associated with the lack of urgency in the cleaning and disposal of the infected blood (Njeru, C.). Even so, this common communicable disease is seen by physicians on the daily. The Emergency ward gave me an immense amount of knowledge through not only an observational lens, but also through a more hands-on approach. This consisted of taking vitals and assisting the nurses and Clinical Officers during their suturing and wound dressings. The doctors and Clinical Officers were incredibly knowledgeable in educating us on the understanding of all aspects surrounding their diagnosis. Given that the interns are predominantly made up of pre-medical students, the feeling of being treated as if we were equivalent to the medical interns or residents was incredibly refreshing. The substantial amount of unique cases and knowledge that I gained during my time in this unit is incredibly valuable as I embark on my future endeavors. Once again, I was confronted with a new outlook on the healthcare field and seasoned my determination towards the pursuit of my future profession. My following two weeks consisted of my placement in two new departments: Radiology and the CCC. Personally, I could not have foreseen the possibility of either of these two units becoming of interest, but astoundingly I found that some of my favorite experiences lied in both of these departments. It was less so about the subject matter and more about the excellence exhibited by both the physicians and radiographers. Beginning in Radiology, the radiographer on staff during my week, Kelvin, provided us with the most engaging and thoughtful teachings. I imagined my time in Radiology to consist of simply viewing scans all day; however, this was not the case. As soon as we walked into the room, Kelvin immediately stood up, offered his seat and spewed his knowledge on all the doctrines associated with the operations behind understanding the usage of the CT machine. His astounding yet personable character, demonstrated through as simple of an act as giving up his seat, was striking as many radiographers in the US would have never evinced that same tutelage. Kelvin made us feel as if we were wanted and meant to be in that control chair. He started explaining the capabilities the machine could carry out, what each one was for, and how the contrast works after being injected into the patient. His esse exemplified through his eager and willful nature in trying to teach me made me feel at home given my real home being 9,000 miles away. Throughout the whole week in radiology, Kelvin took us under his wing and taught us more than I could have ever imagined. This corresponding theme was carried over into the commencement of my next department: Dermatology in the CCC. My original discernment regarding this department was once again refuted. The physician on staff during my week in dermatology within the CCC, Dr. Matunda, was by far one of the most charismatic and knowledgeable doctors that I had the pleasure of meeting while at Coast. Dr. Matunda took the time to make us feel as if we belonged in this department, similar to that of my previous mentor, Kelvin. Dr. Matunda’s effervescent self was displayed by his salutations towards every patient in the introduction of us interns as “his friends from the United States.” Shadowing Dr. Matunda was a pleasure due to his solicitude for both his patients and us interns. One instance that I remember so fondly was when he took forty-five minutes to simply explain to us everything he knew on leprosy. I found this to be one of the most intriguing parts of dermatology because of how HIV and leprosy go hand in hand. Dr. Matunda was in no way inclined to spend time outside of seeing his patients to go into such depth about leprosy given how busy he already was, but he wanted us to understand every detail of the disease because of its prevalence. Another aspect that amazed me about Dr. Matunda was the considerate and thoughtful nature he exuded on a daily basis. One patient came in with a very severe bacterial infection, but due to the socioeconomic status of the patient, he did not have the means to acquire the antibiotics necessary in treating his infection. Dr. Matunda’s following actions spoke true to his character and will be a moment that will stick with me forever. He told them to meet him outside around one o’clock, so Dr. Matunda himself could purchase the antibiotics needed for the patient to treat his infection. This was not the only time I witnessed what I believed to be a heroic doing by Dr. Matunda. He continuously upholds his values in being a good person before being a doctor. In a country that is so socially and economically challenged, oftentimes there are limitations to the value of human life. Dr. Matunda was the perfect example of what it means to uphold the value of every human life no matter the circumstance. His upstanding efforts went beyond the scope of just medicine alone, in which, on multiple occasions, patients would ask for money in order to buy food because they could not afford any. His willingness to always lend a helping hand to his patients not only clinically but in other hardships as well showed just how compassionate he really was. These two departments not only taught me a lot of the necessary medical knowledge, but also how to treat those who may be learning from me in the future. Kelvin taught me to always be welcoming to those who are new and how to make others feel as if they are equals in the healthcare field. Dr. Matunda taught me how to put being a good human being before being a doctor and how to take the time to teach others who are learning from you. These two experiences will forever stick with me through my journey into the healthcare field. I can only hope that one day I will be able to make future doctors, nurses, physician assistants, etc. feel the way they made me feel. Coast alone could never make up the entirety of the extensive knowledge I gained; infact, the cultural treks and clinics that were held outside of the hospital were some of the most memorable parts about my experience. The hygiene and menstrual clinics were incredibly educational, nevertheless, my interactions with the students at the schools was where I believe I gained the most. Upon arriving at every school, we were invariably greeted with lots of smiles, hugs, high fives, and a multitude of additional friendly gestures. All of the students emanated such enthusiasm with their ecstatic greetings and interactions. It was like nothing I have experienced before. I was ambivalent about how the interactions between us and the rest of the Mombassan community would manifest, but I could not have asked for a more inviting and heartfelt welcoming from the community. I was fortunate enough to be given the opportunity to learn more about the Kenyan culture on different treks throughout my four weeks in Kenya. The two that really stand out to me are the treks to Bombolulu and the Maasai Mara. Bombolulu was incredible in that their mission made the entirety of my experience there that much more meaningful and heartfelt. At Bombolulu they give disabled adults the chance to learn different skills in order to help provide for their families as well as themselves. My interactions with the people in Bombolulu really showed me the amazing capabilities people can possess. One of the other cultural experiences we had there was having the opportunity to watch tribal dances and walk through re-creations of the different tribal housing. The ability to see how different tribes lived and how they were able to maximize the resources offered to them given their geographical location was indelible. The tribal dances in particular were very intriguing to me because the tribal dances I have seen on the internet were nothing in comparison to witnessing one in person. Their expression through every little movement and the meaning behind each of the individual dances was captivating. Additionally, my participation in some of their dances was marvelous. It really made me feel like they wanted me to immerse myself in a part of their culture. The other experience of being able to visit the Maasai Tribe in the Masa Marai was one of the highlights of my trip. I was delighted by the welcoming presence from the members of the tribe and was grateful for a sneak peek into their lifestyle. I met some of the happiest people I have ever met during my time at the Maasai village. This really put things into perspective for me, especially when comparing it to the western world’s adoption of what I believe now to be a materialistic outlook on happiness. They were all so willing to answer the many questions we posed and even welcomed us into their homes, which was mesmerizing. We were able to watch and perform a dance with many members of the tribe. It was an amazing experience being able to meet these people and learn more about the Maasai tribe and its history. These experiences outside of the hospital will help me in my future endeavors in the healthcare field, but also have changed my outlook on my life back here in the states. These opportunities allowed me to get out of my comfort zone and really showed me that when you break the boundaries you’re used to then that's where you learn the most. Every intern and physician I had the pleasure of interacting with was incredibly welcoming and emanated such perseverance, passion, and enthusiasm. I’m forever thankful for the opportunity to absorb the culture of the Kenyan people alongside my fellow colleagues. My involvement in the hospital was a once-in-a-lifetime experience, but being able to have such intellectual and zealous interactions with my fellow colleagues and physicians was incomparable. My fellow colleagues really showed me the true meaning of how to be welcoming of others who may hold foreign ideals or passions that may not necessarily align with my own. They showed me the meaning of gratitude and optimism despite unfortunate circumstances. I will be forever grateful for my experience in Kenya and to International Medical Aid for allowing me this opportunity. My trip to Africa has broken countless boundaries and shown me what it takes to be a successful physician.

During my time in Kenya, I not only learned about healthcare in Kenya, but I also gained so much respect for the medical officers and nurses. I saw first-hand the struggles and difficulties they faced due to the lack of resources, staff, and support. Despite their limited resources and long workdays, they were resourceful, using the available equipment and supplies in unexpected and non-traditional ways, to make up for what they were lacking. International Medical Aid guided me in investigating new directions in medicine I had not previously considered. Through the doctors I shadowed, I have learned how to see and treat a person as a whole, considering their lives beyond their conditions, not just seeing the symptoms and finding a cure, but to understand the person and their individual needs for their long-term health. This will be my continued intent as I pursue a career in medicine.

This opportunity has been an eye-opening and life-changing experience that I never could have hoped to achieve without the help of IMA, the staff, and the other interns that came along with me. From even before I boarded my first flight for the trip, the IMA staff, especially my program mentor, Margaret, and director Phares, were both very hands on about answering questions quickly, and in making sure I made it to Kenya safely. Also, after arrival in the country, the staff was waiting for me with a sign, which gave me a sense of comfort and familiarity in a country in which I was completely unfamiliar. Furthermore, the staff made sure that we were comfortable and safe at all times, not only when at the residence, but also on cultural treks and community outreach events, but also during day trips that were planned by ourselves. Not only did they make sure we were comfortable and safe, but also the staff at the residence were very accommodating and made sure that we had good food, and on occasion Swahili food, to eat at all meal times, and made sure the house was always clean for us, which is especially nice during COVID. In regards to the hospital, Coast General was very helpful in my medical interest and knowledge, and helped me along every aspect of my internship. Even in a scary and traumatic place, the doctors, and other staff, and also the IMA mentors made sure I was working within my comfort zone. After each day, we followed the hospital with a debrief session at the residence, which was very beneficial for me, not only in gaining insight on what other parts of the hospital were going through that day, but also helped me to get the day off of my chest in order to move on to cultural treks, or just my next day at the hospital. In regards to the cultural treks, the staff did an amazing job ensuring that I gained full emersion into the Kenyan culture and the people during my stay in Mombasa. The treks helped me to not only gain an understanding of the medical hardships in Kenya, but they gave me a sense of cultural appreciation and admiration for the people of Mombasa, helping me to gain a greater understanding and sense of social empathy. As for the people of Kenya, from my experience, I was completely accepted in every situation I found myself in. The people of Kenya were very embracing and loving, and shared their knowledge and lives with me. Finally, I would like to say thank you for this opportunity, I never would have found myself in the position I am today had I not gotten the chance to grow as both a healthcare provider, and as an individual. This experience has been life-changing for me, and I can never thank you all enough for your support and the chance to learn and grow in Kenya with IMA. Coming into my experience with International Medical Aid, I would describe myself as a very quiet and reserved individual, so naturally I gravitated towards the idea of travelling to a third-world country alone. However, I never could have imagined the cultural, social, and emotional impact this internship would have on me and my healthcare journey. Looking back, I remember my nerves more than anything. Arriving in Mombasa, Kenya for the first time, I experienced a whirlwind of emotion. The large array of new people, culture, sights, smells, etc., swirled through my mind as a prepared for the two-week adventure I was bound for. As we headed to the residence, out of the bus window, I saw young men pulling carts full of fruits by hand, barefoot people walking along the uneven dirt roads, there were even men lining the road, with shovels and cement, paving by hand. This being not only my first experience in a third- world country, but also my first time travelling internationally, I was nervous and did not know how to cope with these newfound realities. As I reflected and learned about the culture and work ethic of the Kenyan people, my nerves quickly turned into excitement. I developed a true desire to fully immerse myself into the Kenyan people and culture, which gave me insight and knowledge on life that I had never experienced. Week one of my internship was spent in the radiology department, and prior to my time in Kenya with International Medical Aid, my career goal was to become an interventional radiologist, so the idea of spending a week learning hands-on from doctors and nurses in the field excited me. As I went throughout my week in the department I learned and grew as a healthcare provider more than I ever could have predicted. Throughout the week, I travelled throughout the different sections of the department, including x-ray, CT scans, MRI scans, and ultrasound. These rotations in the hospital lit a fire driving me into the healthcare profession more than ever before. As I watched these men and women work, I developed a passion for the field of radiology that has followed me back home. When I first found International Medical Aid’s website, I had found myself in a slump. I was losing interest in school, and healthcare, and I was ready to begin a new career path. However, I knew the internship in Kenya would give me clarity on whether I truly was dedicated and passionate for the pursuit of a medical degree. My time with IMA, and Coast General in Mombasa, gave me the clarity I was looking for, and provided me with the insight and the true passion to pursue a career in interventional radiology. My first day was spent learning how to operate the CT Machine and read scans. For around four hours, the radiologist sat around the computer with my fellow interns and I, and taught us how to read the scans effectively, and how to reach a diagnosis. This was an experience that I never could have imagine experiencing first-hand, and as I continue my studies and my career in radiology it will have a tremendous impact on my insight and overall knowledge of human anatomy. Along with learning to read CT scans, we were also guided through the process of preparing a patient and running the machine. This technical aspect of radiology also interested me because it provided me with patient interaction and hands-on care. Although patient interaction is much more limited in radiology than other medical fields, this small communication and care gave me a heart-warming feeling that has followed me back home. However, this key piece of healthcare delivery was largely impacted by the lack of access to healthcare equipment, and funding. Throughout the following weeks, Coast General was going to be using their old CT machine which does not function as effectively as their new machine, because the new machine was broken, and it was going to take at least two weeks to fix because they had to order the part to fix it from China. Coming from America, this was a surprising concept. In the United States, when any item related to healthcare is broken, it seems to be the top priority, and from personal experience, is normally fixed within the same day. After doing research, America spends an estimate of ten thousand dollars per capita on healthcare, while Kenya’s current expenditures per capita come out to an estimate of ninety dollars (The Current State of Healthcare in Kenya). This statistic gives insight into the root cause of the differences between healthcare in the United States and Kenya. Without funding, hospitals are unable to buy supplies, grow staff size, or grow the hospital. Therefore, as a result, hospitals in the United States can more effectively serve the needs of the patients because supplies are more readily available, and easily accessible. Throughout my time in Kenya, I not only noticed differences between healthcare, but I also noticed a variety of different cultural and political differences between Kenya and my home of the United States. One of the major differences I was presented with was the way people interacted with police officers in Kenya. While on our Mombasa city tour, our tour guide warned us of the corruption involved with the policing system in Kenya. This struck a nerve in me that opened my mind to understand the true differences between my home and Kenya. Also, with the prevalence of the COID-19 virus, I could also see the disastrous impact this pandemic was having on the people of Kenya. During my stay in Mombasa, due to COVID-19 restrictions, there was a city curfew at ten o’clock every night. This alone was an experience that I never had before. Coming from the southern states of Louisiana and Texas, I never had a curfew forced upon me, but the Kenyan government required its people to be at home every night before ten. These small differences in the political system and cultural norms in Kenya provided me with an insight into the culture and how the people of Keya live. Coming back to the United States I had a newfound appreciation for the freedom which can be found in America. This thought gave me recollection into an idea which we had learned in a lecture from IMA, that the Kenyan healthcare system was struggling because of “brain drain.” This “brain drain” idea is that doctors and other professionals from third world countries leave their homes in order to work in a less impoverished country (The Current State of Healthcare in Kenya). This proves to be a real problem in Kenya because while in America there is one doctor per every five thousand patients, while in America there is one doctor per every three hundred eighty-five patients, according to The World Bank (The Current State of Healthcare in Kenya). This disparity causes many problems which were prevalent in my experiences in Coast General Hospital. The lack of healthcare workers in Kenya was obvious from my first experience within the Coast General Hospital in Mombasa. During our tour o the hospital I noticed the crowded outdoor waiting rooms, the busyness of the doctors, and the tiredness in the eyes of Dr. Shazim. Because of this “brain drain’ concept, doctors and other healthcare professionals are leaving Africa in order to find more promising opportunities. This is causing these crowded waiting rooms, which lead to more disastrous complication in patients because of wait times, and less professional assistance. This acknowledgement of the complication in healthcare due to understaffing inspired me to work harder to pursue my career in healthcare. I watched the work0- ethic of the Kenyan people, and learned from their stories of hard work to become a doctor, and I realized if this was my career choice, I needed to be all in. This internship gave me that passion and provided me with the skills and cultural understanding to move forward in my career. The work-ethic, and true content spirits I found among the Kenyan people is beyond belief. From conversations witch many different doctors, nurses, and residents of the city, I learned how to find happiness, and how to want to learn and grow and move on. This experience, and these differences in how the culture, and politics, and social norms are in Kenya truly inspired me to crave knowledge and interaction with others. As I stated in the introduction, I came into this internship as a shy, reserved individual, however I learned how to love, and communicate with patients, fellow employees, interns, Mombasa citizens, and IMA staff because of the knowledge I gained from the Kenyan people. Although life is conveyed as different, and not the “American Dream,” there is love and happiness that can be found within third-world countries such as Kenya. A friend of mine once told me “You are where you’ve been,” and looking back on my experience in Mombasa I truly understand this statement. The people, the culture, and the knowledge I discovered within Kenya during my internship will stick with me throughout my entire schooling, career, and personal life. I truly learned how to love, live, and grow through knowledge and friendship not only from the Kenyan people, but from my fellow interns.

I had a really positive experience with IMA. The prospect of traveling after spending the past year and a half indoors was daunting, to say the least. However, I felt safe throughout my entire stay with IMA and found myself willing to embrace the entirety of the experience through this comfort. Safety and health were never a concern for me. The Program Residence staff were warm and welcoming and the food was pretty good as well.

IMA offered me an experience that ultimately will forever change my life. From the community outreach activities, to the rotations at the hospital - IMA offered me the most beneficial learning opportunity I could have ever asked for. From the amazing staff, to the luxurious living, and especially the knowledge I gained during my stay, Kenya and IMA will forever have a piece of my heart with them, wherever my life decides to take me. I will NEVER forget my time in Mombasa. At this point I am a walking IMA Ad! When I originally applied for the International Medical Aid internship in 2020, I never imagined just how much the internship would have impacted my life. Until traveling to Kenya, I was a doubtful young woman unsure of what my future in the medical field could hold. After a short month in Mombasa, I learned so much information, met so many wonderful people, expanded my cultural horizons, while also growing into my confidence within my career path (Shulsinger, 2021). Each week in Mombasa led me to discover more and more about myself and the beautiful country that I was staying in. From learning about all the different diseases that were affecting Kenya (International Medical Aid, 2019), to the local clinics and the rotations in the hospital – Kenya had taught me more in one short month than any other medical field job I had ever had the privilege of working. Although the internship had taught me a lot about the medical field, this internship also allowed me to see the differences amongst the same career paths in different countries while also understanding just how fortunate I am to live the life that I have. What Was Learned Week 1:Pediatric Department During my first week in Mombasa, I spent most of my time learning about the Mombasa culture while also getting used to my new job at the hospital. In my first week, I had the privilege of working in the Pediatric department and working closely with many doctors, nurses, and consulting officers. During this time, I met a consulting officer intern, Erick, who helped me intensively understand every case all the interns observed. From explaining medical plans and diagnoses – to understanding why doctors are ordering certain tests, Erick allowed me to understand the day-to-day preceding’s of doctors at Coast General while also explaining many cases that I would never have the chance of seeing in the United States, such as malnutrition, malaria, HIV and many other cases. While the interns got to view and manage many cases, we wouldn’t have the privilege of seeing them elsewhere, we also learned a lot about the cultural life and healthcare in Kenya (Njeru, 2019 & International Medical Aid, 2019). Throughout my time in Mombasa, I believe that some of the most beneficial information I gained during my stay was from the lectures and local clinics that were developed by the IMA staff and program mentors. In these lectures, we learned about the diseases the affect a vast majority of the Kenyan populations, such as different types of cancers, sexually transmitted diseases and even chronic illnesses. From what we learned in the lectures, we not only got to witness the same diseases within the hospital but also through the weekly clinics we put on for the community. The local doctors from Coast General and IMA staff not only taught us about these diseases, but how to treat them, and just why these disease’s affect so much of the country’s populations based on basic hygiene, access to medical supplies, and even medical literacy (Njeru, 2019 & International Medical Aid, 2019). Week 2: Emergency Department While my second week in Mombasa was shorter than the rest of my stay, the information I had learned in the Emergency department was some of the most impactful. From learning how to read a hairline fracture on an X-ray, to determining the effects of occipital brain tumor, to even figuring out how to test for COVID-19 in an area where COVID testing supplies are limited. Even though the information that I learned in the ER was some of the most helpful and knowledgeable information, this was not the information that impacted me the most during my stay. On the second day of my ER shift, I had witnessed one of the most heartbreaking experiences, unexpected death. Early into the shift, a patient had come in kidney failure and psychosis from a road vehicular accident and drug abuse. While the case seemed treatable for the most part, I slowly began to observe the patient’s vital signs drop and oxygen levels began to slowly deplete. After about ten minutes of observations on the patient, the blood pressure and oxygen levels were at an all-time low and it was clear that CPR was needed in order for us to save this patient. As the interns and I began CPR – we were immediately stopped by one of the doctors. She stated that CPR was not to be started and the patient would have to pass. In complete and utter disbelief, most interns stormed off in anger while I was left with the patient, I had just saw take their breath for the very last time. I was heartbroken, shocked, and in complete disbelief. I could not understand why we were to leave the patient to die when our entire job was to save the patient and make the most rational call for their wellbeing. By the end of the shift, it was apparent to the doctor that most of the interns were thrown off by the experience with the deceased patient. The doctor came up to all of us and explained why the patient could not have been revived. She stated that healthcare in Kenya is handled much differently than in the United States. For one, the protocols that would have been necessary to save the patient’s life in America would not have been easily accessible in Kenya. Secondly, she explained that even if CPR was administered, the patient would then have to be placed in the ICU to ensure adequate care could have been met. While it would not have been a second thought to do so in America, the people in Kenya and Coast General Hospital does not have the funds or room to be able to afford and transfer the patient to another department. She stated, “If the patient had survived and had been successfully transferred, the patient’s family would ultimately face the financial burden of taking care of this patient's life. They wouldn’t be able to afford the medicine, the continuous care or even prolonged stays at Coast General or any other facility in Mombasa.” After the doctor explained this information to us, the other interns and I realized just how fortunate we are to live the life we come from. While the interns and I had been introduced to the Kenyan life through lectures and local tours, none of us understood the extent of our privilege until working this shift. We knew that not everyone had access to healthcare, and we knew that supplies were limited to the area, but none of us had really realized just how much all these issues really affected Kenyan’s day-to-day life until experiencing the death of this patient. Week 3 and 4: Obstetrician and Gynecology Department Throughout the last half of my stay in Mombasa, I experienced the most influential and knowledgeable information during my rotation in the OBGYN Department. During my rotation in OBGYN, I got to personally shadow Dr. Malkia during my two weeks in the department. Dr. Malkia taught me the most knowledge about medicine while also giving me something no other medical professional had given me – confidence in my knowledge of medicine. In my shifts in OBGYN, I was able to palpate a fetus in the womb, listen to a fetal heart rate with a fetal scope, learned about pre-eclampsia, how to treat pre-eclampsia, shadow in surgeries and so much more. Unlike other medical professionals I met in Kenya, Dr. Malkia took a special interest in me and took me as her mentee. She frequently challenged my knowledge in the department, gave me homework assignments to study and work on for the next shift and even occasionally quizzed me on my knowledge of medicine. Although Dr. Malkia gave me all the tools to be a successful doctor in the future, she also gave me the reassurance and confidence that I will be very successful in what I would be doing one day. While this seems rather minuscule to the other information I learned from this internship, Dr. Malkia was the most influential person during my time in Kenya. Never before had I met a medical professional who “took me under her wing” as she did and seriously take the time out of her day, each day, to make sure I was fully grasping the information she had given to me. Dr. Malkia saw something in me no other person had seen in me before. She saw my passion for medicine and the kindness I had for others and reassured me that those are all the tools for being a successful doctor. Dr. Malkia believed in me and gave me the tools to believe in myself. Conclusion Before traveling to Kenya, I never expected to love and learn as much from the country that I thought I would. Going into this experience, I assumed I would get some shadowing hours and learn some information that would further advance my career. I would have never thought this internship would completely change my life and the way I view it. While I did get to learn more knowledge about the medical field, this internship allowed me to grow both as a person and as a medical professional, challenge my thinking on a daily basis, and even learn to appreciate the life around me a little more. It was evident during my stay in Mombasa that I got to learn and grow in my medical knowledge, but I also got to grow on a personal level as well. This internship allowed me to see and meet some of the most beautiful people in this world. From the staff at the residence to the other interns and even the local citizens in Kenya, Mombasa taught me just how fortunate I am to experience this adventure of a lifetime. Kenya not only taught me how to take better care of people’s lives, but it also taught me how to love the life I live and to take better care for my life in the process. By getting to take care of the amazing people in Kenya, I was able to reignite my passion for medicine while also learn how to take better care of those who are needing help, no matter the financial situations, supply shortages or disease burdens. Kenya gave me the confidence to continue to pursue my dreams and reminded me why I chose this field. Even though as an intern I experienced hardships from my patient’s life and loss, it also allowed me to grow into my confidence as a medical professional. It taught me that even the most trained professionals need second opinions and that even the most knowledgeable doctors were once in my shoes. Kenya taught me life lessons that will last forever, and that is why I could not be more thankful for this adventure and all the unforgettable life lessons I will cherish forever.

The very moment I took my first step into the designated program residence in Mombasa - Kenya, I was astonished. "Welcome home!", said one of the housekeeping team members. The hospitality shown was immense. I remembered how I was given a tour around to residence, as well as the two specific medical institutions; BOMU hospital, and Coast General Teaching & Referral Hospital (CGTRH), I would be working with. The various students I worked with while in the program were totally amazing. I am personally a student that one can regard as an introvert before participating in this healthcare internship abroad program. I barely come out of my shell or socialize. International Medical Aid taught me the importance of teamwork. The importance of having a me-time even after a long day. The importance of setting a moment or few apart for relaxing, networking with my peers, and getting a goodnight rest. How? I am the type of student that gives my all to the extent of overworking myself. Even while participating in this internship, I was taking two summer classes that requires me to stay up at night from 11 PM to 2 AM Kenyan time. One of my life-changing roommates, Laura, would always say, “Lola, you’re crazy. That is a lot of exhausting activity” and we would both laugh it off. But International Medical Aid brought out the best in me and I will forever be grateful for those shared moments. I realized that I do better when I pace myself and give myself time to Breath. I saw life outside just education. I met wonderful peers and it changed my perspective about been a “Perfectionist”. I realized that even when it is necessary to give our best and all, it is our flaws and imperfections that make us perfect and unique. What an irony! Sitting up at 6 AM and listening to piano songs while writing this exit survey only brought back memories that makes me emotional. To every student out there, I want to leave you with this, “Education is important, and doing what you love is equally important. However, while doing what you love, and getting educated, approach it with your whole heart. You will be surprised at how much you made a difference! You will be surprised at how much this life-changing experience prepares you for the future. You will be surprised at how this program positively brings out the best in you”. A huge thank you to International Medical Aid for pushing me a step closer to my dreams of becoming a Cardiothoracic Surgeon. I will take this gathered knowledge of mine and hold unto it dearly while continuing my medical journey. I promise to not only work hard for this dream but also enjoy the journey. You taught me this! I cannot wait to share my experience at International Medical Aid, the clinical and program teachings/mentoring, the weekly community outreaches, the sightseeing of the cities and local places, the adventures, the salivating Kenyan food, and all the love felt. I cannot wait to inspire every student out there. I cannot wait to make a difference. Thank you, IMA!

Reflecting on the days when the region of Mombasa, Kenya became my home as well as that of other colleagues, only emotions of nostalgia and joy return. My experience began from the moment I got off the plane at the Mombasa airport, where I met some of the International Medical Aid staff, who immediately made me feel not only welcome, but accepted and protected. At that very moment, I knew that it would be a long journey, but that it would be an experience that I will never forget. After they picked me up at the airport, they took me and the other colleagues who shared similar dates. Upon arriving at the residence they introduced us to the rest of the staff, who were very humble and above all welcoming, they helped me with my bags and showed me around the residence until finally showing me where I would be staying for the next three weeks. After putting the suitcases in place, I met the rest of the interns who were present at that time, with whom I created a friendship, which I will keep for my whole life. The next day we went on a tour of the hospital, where they were showing us the location of each department and a brief explanation of how situations are handled in the hospital. That same day, they took us to different places in Mombasa, where we got to learn about history and a bit of culture. Finally, when we arrived at the residence in the afternoon, as every day, they received us with a very exquisite dinner prepared by the chef. The next morning was my first rotation at the hospital, where I met many of the doctors who were assisting and teaching us as if we were one of their students. The experience in the hospital, day after day, week after week, was shocking in every way. The procedures, the handling, the love for the patient, the fragility of life and above all the respect for the patient were values that each medical officer forged while we were in their care. If I had to decide which department was my favorite, I would easily have to say that it was emergencies or casualty department which was how they called it. It was full of activity, it was very busy, but above all it was where I learned the most in all the rotations I did in the hospital that became my second home while I was there. I am very grateful for all the doctors, nurses, surgeons, anesthesiologists, all health care professionals who took their valuable time not only to teach us, but to have the intention of knowing us and knowing what our passions were. One of the most gratifying experiences that I will take from Mombasa was the visit to the school where we were conducting the hygiene sessions. Many of those children will be in my heart forever, especially those with whom I managed to interact. Secondly, it would have to be the clinics that were carried out, the trust and acceptance of the patient with which we were present and provided a service to them was something that not only impacted me, but also moved me. I am grateful to have been able to be a participant in such an internship, where I managed to expand my horizons and not only learn a little medicine and expose myself to cases that are atypical in my nation, but also learn from another cultu re, learn history, feel more human, but above all, create bonds that, no matter the distance between them, cannot be broken. Thank you very much International medical Aid for allowing me to live such an experience and sow a seed that will germinate in the future.

Everything about the program is amazing. The program places you in the safest and best place in all of Mombasa, the accommodations they make for you are there, the hospitality at the residence is amazing, the staff is extremely nice and welcoming. The hospital placement was great too, everything about the program made the journey/experience unforgettable and I would not trade it for anything else. Going into Kenya, I was not sure what to expect. I was not sure of what I was going to learn, who I was going to meet, and what my life would be like there. But at the end of my trip, I was sure that medicine is what I want to do as a career. I learned a lot about the culture of Kenya, how the hospital operated, a wide variety of cases I would never see in the United States, and the reality of what medicine looks like in a developing country. I am eternally grateful for the opportunity I have been given by International Medical Aid, the lifelong friends I have made at the residence (including the residence and transportation staff), and the hospital staff for teaching me more than I would have imagined. I plan on one day going back to Kenya as a physician to volunteer at the Coast General hospital and hope to one-day cross paths with the memorable people I met there.

Overall, I had the best time in Kenya. I believe that all aspects of the program were top tier, including the accommodations and the Program Staff. I have never felt more at home in any other place than during my time in Mombasa, Kenya. This trip made a huge impact on me and will forever be a landmark in my life. I am so happy we got to experience the Community Outreach Activities through the hygiene education sessions and medical clinics. These truly impacted my time in Kenya in the best way possible. Growing up, I was not quite set on any one career, but I was absolutely positive that whatever I was doing, I wanted it to be centered around helping others. I believe I obtained this desire for catering to those in need from my mother, who throughout my years growing up did all she could to help those around her. When I was younger my mom and I would go to food kitchens to serve the homeless, protest any issues we found disheartening, and give homeless teenagers a place to stay and get back on their feet. These influential moments in my life while growing up defined my goals and dreams with the common theme of giving back to others who have less. As I became older, I grew into loving STEM classes and by the time I got to high school I was set on my dreams of becoming a doctor. Unlike many of my peers who also wanted to be doctors, I did not want to be a plastic surgeon in Beverly Hills. Instead, my goal has always centered around helping third-world countries and working with Médecins Sans Frontières, commonly known as Doctors Without Borders. The summer after my freshman year of college I was lucky enough to be accepted into a public health study abroad program in Geneva, Switzerland where we visited and spoke with personnel from the World Health Organization, Médecins Sans Frontières, UNHCR, and the United Nations. These meetings and explorations of each organization only pushed me towards my ultimate goal of helping others. When I came back from my trip, I knew that the following summer I wanted to apply for another program abroad that was centered on the medical aspect of my career goals. When I discovered International Medical Aids program I was ecstatic, not only was it an internship program designed for pre-med students, I would finally get to visit a country I had always dreamt of working in, Kenya. In order to participate in this internship program, I received a grant from my university to focus on any research project. I knew I wanted to combine my public health and pre-med interests and decided to look at the interaction between the built environment and chronic illness. Unfortunately, this is when COVID-19 hit and the internship was pushed back to the following summer, giving me time to educate myself about Kenya and how I could incorporate my research into my time abroad. After completing my grant and officially committing to the internship, I was counting down the days until I got to Kenya. I knew that I was going to be thrown into a completely new world, one that the media displayed in the one-dimensional light of being “third world” and was curious to see the differences between my expectations and pre-dispositions versus my new reality. Leaving the airport and driving to the residence I felt an overwhelming sense of privilege and anger for the way most Americans live their lives. As my trip would continue, these feelings would only intensify and give me a new perspective on life. Our first tour of the hospital gave me a look into what the healthcare professionals were facing at Coast General and across Kenya. Although a large hospital with affordable treatment for patients, Dr. Shazim began to explain not only the understaffing issues and prolonged wait many patients go through, but how guards are located at every door because many patients try to escape without paying. Immediately following this statement, we learned that the price of being seen by a doctor at Coast General was 100 shillings, or 1 American dollar. Looking back, I believe that this statement is one of the simplest yet thorough ways of explaining life in Kenya. A minuscule amount of money to most people in America, could be and typically is, the difference between life and death there. Although a public hospital with low costs, Coast General Teaching and Referral Hospital is still exceedingly out of reach for the majority of Kenyans. As of 2016, more than one third of the population in Kenya lives on less than $1.90 per day8, meaning that for most people, a hospital visit is worth half of their income. I was very excited to begin my first week in the hospital, not only because it was going to be my first week, but also because my first rotation was in pediatrics, a specialty I was extremely interested in. In high school I was lucky enough to shadow a neonatal nurse practitioner, and immediately fell in love with the idea of becoming a neonatologist or working with children. Although excited, I was a bit weary, many of the other interns who had already been in pediatrics warned us about the slow pace and lack of action. The department was slow, but I was able to learn a lot of information about life in Kenya and small fractions of what I would continue to see over the next 5 weeks. Through the pediatrics department I was given a glimpse of the difficulties faced by the hospital staff, the patients and their family, disease and the burdens of health, and the lack of healthcare literacy. Along with working in pediatrics my first week, I also went to a night shift in the emergency department, where what I had been seeing in pediatrics was immensely magnified. There was a steady flow of patients from 8pm to 4 am, with one fourth year resident doctor managing the treatment of over 50 patients. In the moments of peace in the triage room, the doctor would go over different medical topics with us and teach us about the cases we were seeing. This is where I was first asked the daunting question of “how is this ER different than ones in America?” and “what could we do here to be more like your hospitals”. A difficult question to be asked and answered, I was trying to find the words to describe the stark differences between the two hospitals. As I started to explain a few key differences, such as the lack of vital machines and privacy, I stopped myself and really thought about the question. Instead of continuing to describe the lack of necessities at Coast General, I answered with one simple word that would come to be the answer of almost every question asked about Kenya versus America. Money. The case that stuck with me the most from my first week occurred during this night shift. A 2-year-old girl came in seizing, and like many cases in the hospital, the delay of treatment was overwhelming. With over 50 patients, the doctor was doing the best she could, providing treatment to everyone, as quickly as possible. Unfortunately, this child was not responding to any of the three combinations of treatments given to stop seizing. She was eventually transferred to the pediatric ward where she not only continued to seize but would eventually end up passing away. The emergency department doctors asked me another similar question, “this wouldn’t happen in America right?”. A question that every time asked, I would visibly wince and would disappointingly nod in response. This specific case gave me a complete picture and taught me a lot of lessons about life in Kenya and the medical field, all of which I had seen glimpses of in the first few days I was there. The initial doctor in the ER was over worked and overwhelmed, and there were not enough treatments in the hospital for the doctors to use. The parents were unaware of what was going on, and most importantly, the child was suffering. The next day, when the afternoon shift arrived back at the residence, I was told that the baby passed away. A wave of relief passed over me when I was told this, the baby had been suffering for over 15 hours and was in severe pain. Now she could finally be at peace. There are many aspects that influence the way medical treatments and facilities run in Kenya, the most influential two being the education system and the government’s role in distributing money. In the first lecture about life in Kenya, we were explained both of these important aspects of the healthcare world. Medical school in Kenya begins directly after high school and is a six-year encompassing educational program. For high school students to become doctors in Kenya, they must have all A’s and be at the top percentage of students in their classes2. If they do have these high remarks, they are given direct government admission, completely sponsored by the Kenyan government. If they did not receive these high grades but still want to be a doctor, they must have at least B+’s and pay for the education themselves. I believe that this order of education does make sense but could also contribute to the lack of experience and overall knowledge many of the healthcare workers have. When explaining the American system of education to medical staff in the hospital, the confusing aspect of being “pre-med” and not in “medical school” became a large topic of conversation. Many times, physicians would ask us to do tasks out of our scope of knowledge and would be disappointed when we said we weren’t allowed. Once we explained the system the physicians had a better understanding of our role but the lingering question of “why is this better” was always asked, usually followed up by “how much money is school in America”. Similarly, the governments involvement in healthcare has been changing from the centralized system to the now decentralized system3. The idea for this change was based off of allowing the district levels to have more autonomy and decision-making power for themselves7. Although there were positive aspects to the change, the actual implementation of this has had many negative consequences such as inconsistency and discrimination which have led to healthcare personnel resigning and having frequent strikes6. One of the most adverse effects of this change has been the discrimination professionals have faced, leading to high numbers of unemployment for healthcare professionals and low wages in the public sector. Along with this, the distribution of money for healthcare is alarming low compared to other countries. The United States spends on average 16.85% of the GDP on health expenditures, whereas Kenya averages 5.163. An alarming low percentage, hospitals all across Kenya are not given enough funding to support their civilian’s minimum healthcare needs. The education system, re-designed structure of power, and uneven distribution of money for healthcare have all contributed to major issues within the medical field, one major concerning issue being emigrating personnel. With an average income of $400 to $850 a month (USD)9, many healthcare workers are emigrating to more developed countries for better wages, more education, and better equipped facilities6. Commonly known as a “brain drain”, having a large outflow of medical personnel can contribute negatively to long term national development6. To highlight these low retention rates, the recommended physician to population ratio from the World Health Organization is 23:10,000; Kenya has a ratio of 1.8:10,0002. The large numbers of healthcare workers leaving has led to a large understaffing issue, not only leading to a lack of service but also a lack of a proper education and teaching system6. With a low retention rate, many hospitals have a lack of consultants and supervisors, or the most experienced medical professionals within the system. Unfortunately, this has a trickle-down effect and leaves less experienced medical professionals doing upper level work and procedures. With a low number of experienced physicians available, consultants have limited time to see large quantities of patients, while also teaching residents. Instead of residents and medical students being in the background of the treatment process, they are the sole ones providing complete care. From diagnosis to medical plan, unexperienced medical professionals are the ones deciding the proper ways to treat patients, many times incorrectly. There were many moments while I was on rounds where the consultant would be dumbfounded by the diagnosis and treatment plan a physician was administrating to a patient. Not only does this lead to poor health outcomes for patients, it also leads to doctors being improperly trained. One example of this lack of knowledge from lower level doctors was during a morbidity and mortality meeting with the pediatrics department. All of the doctors presenting the cases were young, lower level residents, with all of the consultants and supervisors in attendance asking questions. During the explanation of the last case the consultants were confused about not only the outcome of death, but the diagnosis and lack of treatment provided. The patient was a young child who was in the hospital for multiple days with a limited amount of treatment given and a lack of care. At the end of each case the department chair asked if this death was avoidable or unavoidable, every answer was the same. Avoidable. The consultants were once again astounded and disappointed at their young physicians’ outcomes and encouraged them to reach out and ask for their opinions when unsure of a treatment plan. Although this would be ideal and seems obvious, many of the residents have 50-100 patients, a limited number of nurses, no one to chart or do paperwork, and do not have enough time to do research and learn more outside of the hospital. When we left the meeting and talked to the medical students about the lack of supervision, the students seemed confused and again I was asked “is it not like this in America?”. Later, this got brought up during a surgery rotation. I was interested in the understaffing issue in terms of lack of teachers and the correlation between this and money. I explained how I at first was annoyed at some of the lack of knowledge and care towards patients but how I understood the connection to these issues and resources of teachers. The surgeon asked me a similar question to the many I had previously received, “residents don’t administer their own treatment in America?”. After explaining the hierarchy and system for diagnosing and providing treatment for patients in America, the surgeon looked at me stunned. He then proceeded to tell me a story that I would never expect to hear. As a novice physician, he performed a surgery that he had never done before by watching a YouTube video. In his first week of OBGYN rotation his patients uterus was not contracting, the treatment for this is an immediate hysterectomy. Not knowing how to perform the surgery, the young doctor called his superiors, all were out of town or busy. Not knowing what else to do, he pulled up a YouTube video showing the step by step procedure and followed the directions. Luckily, the surgery went well, and the patient was okay. Although a great surgeon now, at the time he had no experience and no one in person to show him what to do. A surreal story, I believe this exemplifies an accurate depiction of the medical world in Kenya and the effect a lack of materials and education has. I also believe this shows the true strength and spirit of many people in Kenya- doing the best with what they have and using their resources effectively. Each of these barriers discussed have instrumental effects on the healthcare system within Kenya. The improper training and lack of funds has an immediate effect on the patients outcomes and leaves family members wondering what went wrong. Healthcare literacy in Kenya is remarkable low. Although family members want to help their loved ones, many do not know when the right time to go to the hospital is. Paired with low wages and the hospital costing money, many families wait until it is too late for the doctors to help. In addition, when their loved ones are finally brought in, they unfortunately do not have enough healthcare knowledge to know what should and should not be happening. One example of this was during internal medicine rounds when a patient on the other side of the hallway suddenly passed away. The family was crying and screaming but the doctors continued with rounds as if there was nothing happening. Finally, once we completed our conversation about the patients we were originally on, they went to do CPR, but it had been too long of a wait. In the United States this is almost unheard of because of the persistence of many family members calling and demanding help. The difference being that in Kenya, the civilians do not know enough about health too advocate for their family. Another component of the low health literacy is fear. Many family members see their loved ones walk into Coast General and never walk out. Unfortunately, this creates many fears of doctors and hospitals, only adding to the delayed treatment process. In America, 98.4% of births happen in hospitals1, and most concerned or scared mothers prefer giving birth at a hospital for immediate access to medical supplies and doctors if needed. In comparison, 35.2% of births within the Coast region occur without a doctor present4, displaying the widespread fear, lack of knowledge, and limited resources many have in the country. During my rotation in the OBGYN department, this immense fear was highlighted. A pregnant women came in fully dilated And refused to give birth. Laying on the table, The woman was screaming and pushing the doctors off of her. The medical staff tried to explain how her baby was ready to come out any minute but the women was so frightened of the hospital that she was refusing to push and let the baby come out. Eventually, she fell on the floor and a nurse was able to catch her baby just before it hit the ground. Once her delivery was over and both the mother and child were safe the nurses began to explain how the patient gave birth to her four other children at home and did not want to come into the hospital because she was afraid of dying. Unfortunately, this lack of health literacy is passed down through generations, and with no additional education given in school, many children have the same fears as their parents. I immediately became aware of this my first week in the pediatrics department, all of the children would cry when we tried to say hi or play with them. At first I was confused by this reaction, but then I looked down and realized I was wearing the same clothes many of the doctors wore-scrubs. One of my favorite aspects of International Medical Aid is that we worked to combat this divide. All of our programs at the schools were educational on the topics but also bridged the gap between healthcare workers and civilians. Interacting with the kids showing them that people in scrubs, who work at hospitals are not scary was one of my favorite aspects of my trip. In addition, educating the kids on basic sanitation techniques allowed them to bring this knowledge back to their families and provided basic health literacy. Every facet of my experience in Kenya was life altering. I was not only able to learn a tremendous amount of information about Kenya and medicine, but I also felt useful and a part of the process of expanding healthcare to everyone in the country. Interacting with the children every week at schools and being able to help different neighborhoods during our clinics helped me bridge the gap between foreigner and friend. The goal I had set for myself before I arrived in Kenya was being able to feel helpful and apart of someone’s positive experience with healthcare. I believe that these clinics not only allowed me to complete this goal of helping others, but also immersed me into the neighborhoods and people of Mombasa. I am grateful for every person I crossed paths with in Kenya and each story of bravery and strength will continue to inspire me throughout my life. My time at Coast General was the most important and awe-inspiring experience I have had. I learned an immense amount of information about the medical field, many I otherwise would not have seen for many years. I was able to experience what life as a doctor will be like and have confirmation that I am on the right path. Coast General pushed me out of my comfort zone in the best possible way and encouraged me to continue working towards my goal of being a part of an organization providing medical care in developing countries, such as Doctors Without Borders. The doctors inspired me to take pride in my journey and appreciate the resources I have at my fingertips. My love for medicine and science grew along with my appreciation for education and resources and remembering to never take either for granted. Most importantly for my education, I experienced the connection between public health and medicine first hand and recognized the overwhelming need for global health. Mombasa not only introduced glimpses of my future life in medicine but also taught me a lot about myself and my privilege. I have a newfound appreciation for the smallest of amenities in America and feel extremely grateful to live in a place with access. I am inspired by the people in Kenya for their perseverance, strength, resourcefulness, and positive mindsets. Whenever anxious, I think of the amazing people I was able to meet and picture them saying “Hakuna Matata”. Along with a new appreciation for my environment, I gained a support system of people. Relying on each other when we needed to take our minds off of cases only solidified my admiration for my fellow interns. I have never been around a group of people with the same goals and dreams I have had since I was a young child, helping others. Being able to discuss paths, plans, and objectives with others along the same journey was astonishingly valuable and priceless. My time in Mombasa will always be remembered with high admiration and as the pivotal moment where I undoubtedly knew I was meant to become a doctor.

Highly recommend this program. My expectations were exceeded by a long shot in every aspect. I never once felt uncomfortable or unsafe in anyway. The drivers were great and very reliable. The staff was very welcoming and personable. If I or anyone else ever needed anything they would accommodate those needs very well. The food was good and had plenty to eat with all three meals a day. Kenya itself was amazing and my experience with International Medical AId made my trip that much better.

This experience has been unbelievable. It holds so many memories that I will never forget, but it was especially all the people I have encountered that have made this experience the best it could have been. Even before I landed in Kenya, I had last-minute changes in my flights and the IMA staff was very accommodating and understanding about my situation. Despite being stressed and worried, the IMA staff quickly communicated and relieved my anxiety. That was only the start of the support and kindness I received from the IMA staff. Every single person was undeniably genuine and had every interns' best interest in making this experience unique. I won't forget Kathryn, Joshua, and the rest of the kitchen staff that cooked commendable and delicious meals that surpassed my expectations every time especially Kathryn's sincere smile. I won't forget the housekeepers, who I could not imagine doing everyone's laundry every day and handling it with such diligence especially Jacqueline's earnest efforts every time I lost an article of clothing. I won't forget the personalities of every driver, Javone, Teddy, Steve, and Benson for providing us transportation in a safe form while listening and engaging in our wild conversations. Whether it was just taking us to the hospital or picking us from Moonshine, they were absolutely the best. I won't forget the endless amount of medical students, officers, interns, and doctors that I encountered who not only strengthened my knowledge of healthcare but answered all my questions about their lives and careers with pleasure. I won't forget the rest of IMA staff especially Margaret, Christabel, Vivian, Phares, and Dr. Shazim who provided us structure, discipline, but still wanted us to have a balance in learning about what Kenya had to offer. Through this internship, it has enforced my passion in healthcare and also has given me great friends. It has taught to be humble, to be selfless, and that a little goes a long way. There are enough words that can describe this experience, the people, or the culture. I am truly thankful that IMA has given me this opportunity to shape not only my career path, but my personal character.

My experience was incredibly instructive and eye-opening. I met incredible people who sought a similar career path and goal. The staff in the program location was incredibly helpful and welcoming. All of my needs were met if I had any and they sought to provide me with whatever I needed.

Two short weeks and I’d do it all over again. Mombasa, you absolutely amazed me, and rattled me in ways that words can’t express. I am so thankful and honored to have had the privilege to intern and learn about dentistry and healthcare from a different approach, especially in the beautiful country of Kenya. My time in Mombasa taught me so many life lessons that I will carry for a lifetime & will forever utilize in my future career. At Bomu Hospital, I witnessed many unique cases, treatments and learned so many approaches to handle such situations. HEALTHCARE IS A HUMAN RIGHT. Unfortunately, a vast majority of Kenyans struggle financially to get the treatment they need. In contrast to the Gold Standard healthcare in the U.S- Dentists, PA’s, Nurses, and countless Doctors are on call day and night to treat patients that need an immense amount of care and treatment. It’s nothing close to what you see on Grey’s Anatomy. I shadowed dentists where patients with little to no oral hygiene couldn’t afford a cleaning or an extraction. A 15-year-old girl came into the dental chair with severe tooth decay in need of dentures. I witnessed mothers of infants in desperate help for their babies in the NICU, with deoxygenated blood that couldn’t be transported to a different hospital with proper care due to cost, as well as mothers in labor with no epidural, birthing with strength and bravery under serious circumstances. I witnessed diseases such as Malaria, Meningitis & HIV are the harsh realities in Kenyan healthcare. Healthcare is a human right, and these physicians and nurses are working extremely hard to promote & make healthcare and the people their number one priority. Asante Sana to the incredible staff of International Medical Aid , who worked day and night to make sure we had the experience of a lifetime. Dr. Shazim, the coolest doctor who taught us basic suturing and the intubation process. To the most incredible people that I will never forget- 2 weeks was not enough & I am so thankful to have met friends who have the same passion and vision for the world of healthcare. This experience is who I strive to be, and will shape me to what I’ll become.