1-2 Years Volunteer Programs in Mombasa, Kenya

I had a fantastic time abroad with Elective Africa. They were present every step of the way, from pre-departure planning to the entire stay. They coordinated our clinical experience, accommodations, transportation, and additional excursions in the area. My classmates and I enjoyed exploring the area and learning more about African culture and lifestyle with a visit to an orphanage, primary school, and a city tour. This was a unique experience that broadened my perspective on healthcare and patient care.

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.