Internships in France

My overall experience with IMA was terrific. The house was spotless, with helpful staff. Interning in the hospital was a great learning experience. I thoroughly enjoyed every community outreach opportunity. Coming to this internship experience, I hoped to gain the hours needed to become a strong applicant for PA school. However, my internship experience in Mombasa instilled a new outlook on the medical field and invigorated my pursuit of a healthcare career. While in Kenya, I discovered my strengths and built the confidence needed to thrive as a provider. I plan to incorporate the same passion and dedication Coast General Teaching and Referral Hospital's medical staff displays into my career. I wish to educate my American colleagues about our privileges compared to others worldwide to create change. Kenya will forever have a place in my heart, and I aim to continue to support the people of Mombasa by building a non-profit while working for my medical license. "Bahati haibish mara mbili" is Swahili for "luck doesn't knock twice" and reminds people to take advantage of the opportunities that present themselves in life. I took full advantage of the opportunity to discover Mombasa; my lessons will live with me forever. Studies show that our brain is continuously changing through the process of neuroplasticity. Triggered by new stimuli, neuroplasticity is the ability of neural networks in the brain to change through growth, and reorganization. Neurologists suggest that traveling to a new location has been found to stimulate the brain, allowing neurons to form new connections with other neurons, generating more dendrites, and thus increasing neuroplasticity. That being so, the month spent in Kenya not only opened my eyes, it rewired my brain. Adapting to a new environment, learning the Kenyan culture, conducting a weekly community outreach, and assisting at Coast General Teaching and Referral Hospital (CGTRH) reframed my view of the global healthcare system and the world. Understanding the infrastructure of the Kenyan healthcare system was crucial to adjusting to the medical environment at CGTRH. The Kenya healthcare system is divided into three divisions: public health sector, commercial private sector, and faith based organizations. CGTRH is a part of the public health sector and provides the most affordable and accessible care to the majority of the Kenyan population. Unfortunately, these public facilities are often short staffed , low on medical resources, and provide a lower quality of patient care. During my time at CGTRH I was able to experience these disparities first hand as I shadowed in various departments around the hospital. For example, instances when a tourniquet was needed, a glove was used instead, lack of sterile technique contributed to high incidences of hospital acquired infections, and many wards were short staffed and run by residency doctors. However, aside from the lack of resources, all medical staff were knowledgeable , precise, well versed, and spoke multiple languages. I observed, as medical officers maneuvered through crammed wards with no central air conditioning, to monitor the health status of each patient and create a specialized plan of care. It was during these times that I was able to understand the true meaning of what it takes to be an exceptional healthcare provider. Even in the least desirable circumstances, all medical staff remained on the same mission; to listen, treat, and heal in the most efficient way possible. This was the case for an infant girl with hydrocephalus. Hydrocephalus is a neurological disorder caused by a buildup of cerebrospinal fluid deep within the brain. The excess fluid causes the ventricles to widen, putting pressure on the brain, potentially causing brain damage or early death if left untreated. A prominent indicator of hydrocephalus in infants is an enlarged head and swollen veins on the scalp. Due to lack of prenatal care in Kenya, hydrocephalus is commonly caused by deficiencies in folic acid and vitamin B12 during pregnancy , as well as neonatal infections like neonatal meningitis and ventriculitis. I observed as neurosurgeons skillfully performed a Ventriculoperitoneal shunting, or VP shunt, procedure on the small infant.The procedure consisted of drilling a small hole in the skull, making a surgical cut in the stomach, and passing a catheter through a ventricle of the brain down to the abdomen to drain the excess cerebrospinal fluid. Almost immediately after the shunt was placed into the ventricle, the excess fluid began to drain, indicating a successful procedure. Witnessing this operation awakened a new interest and enthusiasm for surgery , and the surgery department soon became my favorite rotation. I took full advantage of my time there, and observed over 10 major surgeries including an appendectomy, a skull elevation, a coccygectomy, and a foot amputation. During each operation, I had the opportunity to ask questions, take notes, and get an adjacent view of procedures I had only read about in books. This up close perspective helped me recognize that I am not a squeamish person, and am able to stay calm in paramount procedures. I continued to learn more about myself as I rotated throughout CGTRH, and my confidence grew as I shadowed and learned from medical and clinical officers in internal medicine, pediatrics, maternity, and the newborn unit. Outside of the hospital, I had the chance to display that confidence while hosting community outreach clinics. Every week, the IMA interns and I traveled to local primary and secondary schools to teach lectures on hygiene education, and women’s health. During these lectures I sharpened my public speaking skills, while engaging in important conversations. I enjoyed volunteering as a team leader and collaborating with the other interns to create fun and memorable lectures. However, the most rewarding part was being able to distribute items like toothbrushes, toothpaste, and menstrual pads. It was humbling to see how something as trivial as a toothbrush could bring so much joy to a child. Days like this put into perspective how privileged life in America was, and every week I became eager for the next clinic. Aside from hygiene and women’s health, the IMA interns and I also collaborated with psychologist and medical officers from CGTRH to host a mental health clinic, and a free community medical clinic servicing hundreds of civilians.The mental health clinic gave the interns and I a chance to speak with high schoolers and gain an insight on the day to day pressures they face. It was refreshing to learn that they deal with the same problems and insecurities as teens in America, and being able to relate to them made it easier to teach them positive mental health practices. The community medical clinic required a more hands on approach, as we provided essential healthcare services to those in need. Here I had the opportunity to work alongside pharmacists and learn how to fill free prescriptions for the community. Experiencing this level of philanthropy was profound, and made a lasting impression on me. Coming into this experience I hoped to gain the hours needed to become a strong applicant for PA school. However, my internship experience in Mombasa instilled a new outlook of the medical field and invigorated my pursuit for a career in healthcare. While in Kenya I discovered my own personal strengths, and built the confidence needed to thrive as a provider. I plan to incorporate the same passion and dedication displayed by the medical staff at Coast General Teaching and Referral Hospital into my own career. I wish to educate my American colleagues of the privileges we have compared to others around the world in hopes to create change. Kenya will forever have a place in my heart, and I aim to continue to support the people of Mombasa by building a non-profit while working for my medical license. “Bahati haibish mara mbili” is swahili for “luck doesn’t knock twice”, and reminds people to take advantage of the opportunities that present themselves in life. I believe I took full advantage of the opportunity to discover Mombasa and the lessons I learned will live with me forever.

My time in Mombasa, Kenya, was absolutely fantastic. When I first arrived in the country, I was graciously met by Teddy with a great big smile on his face and holding an IMA flag. When I made it to the residence, I was met by multiple friendly and smiling IMA staff members. The in-country support from the staff members went above and beyond my expectations. There were multiple times when I would submit a request for a night shift late but my program mentor still proceeded with accommodating me with any shifts or treks that I wished to participate in. If there was any issue I had with anything, the IMA staff would try their absolute best to help resolve it as soon as possible. Their actions showed me that they truly cared for my well-being and comfort. Also, never once was I concerned about my safety. The wall, gate, and security around the residence helped ease any tension that I may have had. The room that I stayed in was always cleaned everyday and kept neat. The residence as a whole was always kept clean and pristine. The food at the residence was very good as well. I enjoyed myself eating Kenyan cuisine for the first time. I enjoy starting and experiencing new things, so eating Kenyan food was a great experience. Finally, the impact this experience had on me was astronomical. I never thought that going to Kenya would leave such a lasting impression on me. During and after my trip, I started to look at things with a new eye and perspective. It made me more grateful for everything that I have in my life. It also showed me the pride and spirit that the Kenyan people embody, which motivated me to do better as well. I believe that our cultural treks left a lasting impression on the community as well. With the help of out program mentors and staff, we provided the local communities with valuable knowledge about health and hygiene. I believe that this knowledge will stay with them and will be passed down to posterity. Overall, my time in Kenya was absolutely transformative. I had zero problems with the loving staff, beautiful residence and accommodations, and safety precautions that were in place. The resin w in Mombasa, Kenya, really felt like a home away from home. Ever since I was a child, the field of health care has always caught my eye. My father was a teacher, and my mother has bounced around several odd jobs over the years. I was not too sure where the inspiration to go into healthcare came from, but it always piqued my interest. I remember as a kid always fantasizing about what kind of person I would become. I would often think about what the future would hold for me and what type of medical specialist I would become. Without much experience or connections in the field of healthcare, I did not have that much knowledge about the field itself. As I got older, some of my friends also decided to go into healthcare and I would always hear them talking about topics that I was not truly knowledgeable about. Because of these conversations, doubt had already begun to wander in my mind if I was cut out to join the field. It seemed to me that I had already fallen behind the group early in the race. As I entered college, I still wanted to join the healthcare setting, but the thoughts of self-doubt still lingered. A couple of years passed by, and I got my first job in a healthcare setting, as a medical assistant in an asthma and allergist’s office. My job gave me some great medical knowledge, patient interactions, and experience. However, even with working at this job, it still felt like I was missing something big. Something that would help put all those thoughts of self-doubt away. And that something was a trip to Mombasa, Kenya, in East Africa. When I heard the news that I got accepted into the program, I was ecstatic. Travelling has always been at the top of my bucket list, and I have never done that much of it. Also, this adventure came with much more than just an opportunity to go to a foreign land, it also came with the once in a lifetime opportunity to work in a public hospital and expand my knowledge of the field that I so desperately wanted to be a part of. The weeks leading up to my departure were some of most stressful ones I had in a while. They were stressful because I wanted to make sure that I had everything in line for a smooth trip. This trip to Kenya was the first time I ever stepped off the United States of America’s soil, so it was important for me. It was also a big deal for my family because most of my family has never left the United States as well. When I finally made it to Mombasa, I was ready for my journey to begin. While in Mombasa and Coast General Teaching and Referral Hospital, I learned vast amounts of medical knowledge, experienced differences in the delivery of medical care, and learned about the political system of the country. One of the biggest takeaways I had from this experience was the vast amount of medical knowledge I learned. I learned many things involving the body, what symptoms indicate what, how patients were handled, the proper course of treatment, etc. During my first week in the emergency room, I learned many new things, thanks to Dr. Faruk. Dr. Faruk was unlike the other doctors in the emergency room because if there was something interesting or unusual, he would make sure to call the group over and he would explain to us what was going on, how it would be handled, and other essential information. Dr. Faruk also went over the basics in the emergency room with us. For example, he taught us the normal range of blood range of blood pressure, the normal range for Spo2, and how to test blood sugar level. Many patients in the emergency room also had elevated blood pressure levels, so he would go through the list of medications that could help lower blood pressure, like ACE inhibitors, beta blockers, vasodilators, and calcium channel blockers. Many patients in the emergency room also had diabetes, so Dr. Faruk instructed the group about the three signs of diabetes which were frequent urination (polyuria), increased thirst (polydipsia), and increased hunger (polyphagia). Also, while in the emergency room, I was taught how to properly read a CT scan and an x-ray. I have always seen an x-ray, but never knew how to properly dissect it and look at it piece by piece. While reading x-rays, I also learned about several types of bone fractures, such as transverse fractures, oblique fractures, spiral fractures, comminuted fractures, and open fractures. While learning about the different types of fractures I also learned that fractures involving the tibia and fibula are one of the most common areas for osteomyelitis. After my first week in the emergency room, I started my second week in the surgical department. I knew surgery would be interesting for me, but I was not aware of the impact that it could have on me. Due to my one week in the surgical department, I am now considering having my future involved around surgery. I absolutely loved watching all the diverse types of surgeries that I witnessed. Some of the surgeries that I observed include a total knee replacement, endoscopic third ventriculostomy, cesarean section, nephrectomy, and intramedullary nailing of the tibia. The endoscopic third ventriculostomy was one of the most interesting surgeries I witnessed. It was so captivating because what I was watching was happening inside the human brain. All these surgeries struck me, but the ones that still stick with me the most are the orthopedic surgeries. The total knee replacement and the intramedullary nailing of the tibia were such a fascinating sight to see, and I can still remember it quite distinctively and vividly. Another thing that will stick with me for a lifetime is the differences in the delivery in healthcare between Kenya and the United States. One of the sights that stuck out at me is the lack of medical personnel present at the hospital. According to worlddata.info, for every 1000 inhabitants, there are 0.20 physicians in Kenya. For comparison, for every 1000 inhabitants, there are 2.59 physicians in the United States (worlddata.info). There are over 10x more doctors in the United States than in Kenya. I can see how this makes sense because during the orientation of Coast General, we were informed of the extreme lack of medical personnel. Another interesting statistic is that Kenya spends around 5.7% of its national income on healthcare and health resources (businesstoday.co.ke). This is apparent while going through the hospital due to the lack of resources, beds, and essential goods. Another difference in the delivery of healthcare is the overall speed with which people are taken care of. At Coast General, the doctors and medical personnel were dealing with overcrowded conditions, and it affected their efficiency in delivering care to patients. Although, due to the current state of healthcare in Kenya, this is to be expected since there are not enough doctors and resources to take care of everybody as quickly as possible. For there to be advancements in medicine, there must be a change in the country's political realm. While in Kenya, I heard the locals speak about the current president and political system quite often. One of the biggest complaints and differences I heard about the president and political system is the corruption that runs rampant. After doing some research, the level of corruption was a problem in the country. Kenya scored a 68 on the corruption index. The corruption index measures corruption from 0-100, 0 meaning no corruption and 100 meaning high corruption levels. Although corruption is a problem in Kenya, the government has still tried to implement policies that benefit the common people. For example, “The Kenyan government launched its long-term development plain, Vision 2030 in the year 2008 with the aim being to transform the country into a newly- industrialized, middle-income country that provides a high quality of life to all its citizens in a clean, safe environment” (International Medical Aid, 2023). This policy shows that the country and government of Kenys is looking out for the betterment of its people. If the government keeps on implementing policies like this one, and keeping corruption out and away, I believe that Kenya will give the people the care and lives they deserve. Overall, all this newfound knowledge will be beneficial for me in the long term because it will help me become a more well-rounded medical provider and person in the future. The information that I learned in the surgical department will be especially useful since I now have my sights set on orthopedic surgery. It will help me advance in the field, and it will allow me to take better care of my patients in the future. I believe it is essential to have a solid foundation in medicine to excel, and this experience provided me with a durable and sturdy foundation. My experience in Coast General Teaching and Referral Hospital has helped shape me into the medical provider I wish to become. It has taught me valuable life lessons, improved my interpersonal and bedside manner skills, and it has improved my overall being. This experience has helped light a bigger and brighter flame within me that wants to help people in need. It has given me the medical knowledge and confidence that I needed to be a part of this field. It has also helped silence those voices of self-doubt that had lingered for years. Thank you for the experience of a lifetime Kenya and International Medical Aid, asante sana!