Kenya Article

Below is the article I recently wrote for Iatrogenesis, IUSOM's student newspaper.


Expectations of Kenya

“Was it what you expected?” is probably the most common question I get about my elective in Kenya. It’s a hard question to answer, because I don’t think I went into the experience with any specific expectations. Or if I did, I no longer remember what they were. Yet somehow, living as a Kenyan medical student for two months far exceeded the expectations I did not know that I had. How is that possible? After nine weeks back in the U.S., that’s a question I’m still trying to answer.

I loved my trip to Kenya. I watched hippos on Lake Victoria; took a sunrise hike to the highest point in Kakamega Rainforest; fed eagles on Lake Baringo; cooked lunch in Lake Bagoria’s hot springs; went white water rafting on the Nile in Uganda; and took a three-day safari on Masai Mara National Reserve. Adventures aside, Kenya was much more than a two-month vacation for me. I made friends – good friends – of many nationalities, races, and cultures: Kenyan, Ugandan, American, Canadian, Dutch, Swedish, and Indian. I found in these communities a wide variety of people with whom I could truly relate. I discovered, to my immense surprise, that we are all very much the same at a basic level, regardless of color or nationality. Did I ever expect to learn this lesson from a medical school elective? Certainly not. And certainly not in Eldoret, Kenya.

While working on the wards at Moi Teaching and Referral Hospital, I found that the bond I had with my patients was as strong as any I had experienced in the U.S. Contrary to one of my primary concerns about the elective, language was not an issue. If anything, I learned that language at times can be a hindrance; allowing us to gloss over sensitive patient issues with a carefully chosen word or a deliberately ambiguous question. When words are no longer a concern, eye contact, facial expressions, gestures, and actions become universal and are more than sufficient. I could give my 52-year old CHF patient a bright smile every morning, which she would immediately reward with a smile of her own and rapid, animated Swahili. Over two months, I saw dozens of mothers being told that their 18-month old children were definitively HIV-negative. My congratulatory hugs did more to connect us than words ever could have. The abandoned children that lived on the ward knew that I cared about them because I smiled at them, hugged them, and played with them every day; not because I could tell them how precious they were in their native tongue. Did I expect that my connection with patients would be enhanced by the fact that we didn’t speak the same language? No.

Of course, I also learned a lot of medical stuff while I was Kenya. Treatment protocols for TB, malaria, HIV, meningitis, and malnutrition that were so foreign in August became second nature by September, and sadly were forgotten by November. But that’s all just book learning anyway; book learning that was the primary reason I went over, and the first thing that I forgot when I got back. I continue to think about Kenya on a daily basis, and I almost never think about all of the factual information I gleaned from the rotation. Could I have ever imagined that medical knowledge would become the least important part of a medical elective? Never.

While my experience in Kenya was beyond fantastic, I realize that this elective is not for everyone. The cost alone is prohibitive for many; and work, home, and family obligations do not allow others the luxury of spending two months away. However, I think that one of the most valuable aspects of the IU-Kenya program is the chance to see medicine practiced outside of the Ivory Tower walls of IU. Members of my class have done electives in Tanzania, Nigeria, Honduras, Haiti, and even Yellowstone National Park. The great thing about fourth year is that it can give us a much wider range of experience than third year clerkships alone, experiences that teach us much more about medicine than simply book learning. Whether fourth year is right around the corner or is some far-off dream in the distance, consider doing an elective outside of the med center. Even if it is ‘just’ at a local community hospital, you never know how valuable that experience may be to your training. It may even exceed your wildest expectations.