Global Health & Pre-Medicine Internships Abroad | IMA

My experience with International Medical Aid in Kenya is one that I will never forget. The memories I made during this program will be cherished forever. During this internship as a high school student, everything I saw was new to me. My time at Coast General Teaching and Referral Hospital was transformative. The experience of rotating through different departments was eye-opening and profoundly educational. In the pediatric department, I witnessed the severe effects of poverty and disease. The sight of malnourished children and the struggle of their families was heart-wrenching. One of the most impactful moments was observing a lumbar puncture procedure on a child suspected of having meningitis. Despite the distressing nature of the procedure, it was a significant learning opportunity that deepened my understanding of medical practices. Beyond the hospital, engaging with local communities was an enriching aspect of the program. Participating in health clinics at local schools allowed me to interact with children and learn about their lives. Despite initial nervousness about public speaking, I grew more confident as I engaged with the children, providing advice and support on various health topics. The mental health clinics, in particular, were both challenging and rewarding. Addressing issues such as domestic abuse and food insecurity, although difficult, provided valuable insights into the socio-economic challenges faced by the local population. My outlook on life will forever be altered because of this program. This program was able to convert me into a very social person that I wasn't before. I will always remember the people that I met in Kenya and the memories I made with them. My safety in Kenya was never a concern for me because the mentors told us what to avoid and recommended better and safer options. The mentors were extremely supportive and helpful if I had any questions or concerns and made sure all the interns were having a great time. The food was great and it was always a highlight to come back from the hospital and sit down for a fulfilling meal with your friends. I will forever grateful for this experience, Kenya and IMA will always have a special place in my heart. As a young girl growing up in Afghanistan, I always knew I wanted to become a doctor. I watched my father save countless patients, whether they were strangers or family members, and his calm demeanor during crises inspired me deeply. One moment that stands out is when he saved my grandfather's life, maintaining his composure even as his own father coded right in front of him. My father's dedication and resilience fueled my desire to become a doctor, to be in the midst of action, and to make a tangible difference. Being born and raised in Afghanistan, I was familiar with the challenges of the healthcare system in a developing country. However, it was not until I went to Kenya that I truly understood the depth of these challenges. As a child, I watched from the sidelines, but as an adult, I became physically involved and saw firsthand how limited resources and understaffing profoundly impact healthcare delivery. My exposure to healthcare in the United States further highlighted these disparities, making it evident how financial struggles and a lack of resources hinder the ability to provide adequate care. My experience in Kenya has been bittersweet. I am deeply grateful for the opportunity to gain exposure to medicine, surgeries, and diagnostics. However, it has also exposed me to the harsh realities of healthcare in developing countries. In America, there is greater access to healthcare, and most patients receive treatment at the early onset of disease because they visit the hospital as soon as symptoms appear. In contrast, many people in Kenya cannot afford their medication or delay treatment due to cost, which worsens their condition by the time they seek medical help. Witnessing patients die due to lack of treatment, resources, or financial means is incredibly difficult. Many of these patients would have survived if they had access to care in a more developed country. For instance, during my time in the Accident and Emergency department, we had a patient suffering from an intervertebral hemorrhage who also presented with aspiration. The patient was given oxygen and medication. The next day, when I had my shift, the patient was still in the ER, oxygen saturation was low, and 30 minutes later, the patient passed away. The patient was in the emergency room for over 24 hours, but his surgery and treatment were delayed. Many patients with intervertebral hemorrhages required surgeries such as External Ventricular Drain (EVD), but due to the unavailability of ICU beds or lack of finance, these surgeries are often delayed. This is a frequent occurrence, with surgeries being postponed due to the lack of available surgeons, operating room, ICU beds, or because the patient cannot afford the procedure. In the coastal region, there is only one neurosurgeon and one psychiatrist, and the ratio of doctors to patients is a staggering 19 practitioners per 100,000 people, which is far off the 1:1000 ratio recommended by the World Health Organization (Mwaura, 2024). Seeing patients pass away due to these systemic issues was the hardest thing to watch and it was a reminder of the disparities in healthcare access. Additionally, financial constraints prevent patients from seeking timely medical help, exacerbating their conditions. Many cannot afford insurance, medical fees, or medications. Kenya’s medical insurance, NHIF, covers hospital stay, consultation, procedure, treatment, and medication (NHIF, 2023). The medical insurance cost in Kenya is approximately 500 Kshs per month, equivalent to three dollars, yet many families cannot afford this for each member. Also, Patients residing in rural areas often face limited access to healthcare services. For those in remote locations, traveling to urban centers for medical care not only delays treatment (Bakibinga et al., 2022) but it may also cause lack of awareness about available health insurance options among these communities, further complicating their access to timely and effective healthcare. These factors combined lead to worsening health conditions, and ultimately, preventable deaths. Being in the hospital also exposed me to issues related to malpractice and personal protective equipment (PPE). I observed practices such as nurses reusing needles by sticking them back into saline solutions and staff using their phones while wearing gloves before intubating patients. Such lapses in hygiene and protocol contributed to the risk of post-operative infections in the hospital. Understanding these issues has deeply informed my perspective on healthcare in developing countries. This experience has instilled in me a profound awareness of the realities of healthcare in developing countries and strengthened my determination to make a difference. Proper equipment, medications, resources, and adequate staffing are crucial in transforming healthcare delivery. Increasing the number of ICU beds and ventilators, ensuring proper sterilization, improving facilities, and updating equipment can not only reduce infection rates but also save countless lives. I had the privilege of working with some of the most talented doctors. Despite their skills, it was heartbreaking to see how many more lives could have been saved with proper equipment and resources. One crucial lesson I learned was from Dr. Rashid during my surgical rotations. He advised us to "promise less, but deliver more" to patients. Doctors are not infallible; mistakes can happen, and complications can arise even in seemingly routine surgeries. His words emphasized the importance of managing expectations while striving to exceed them through dedicated effort and skill. During my time here, I also realized that unlike in the U.S., where a doctor's visit is typically only 15 minutes, doctors in Kenya do the majority of the work themselves. They are thorough in their examinations, meticulously collecting past medical histories and conducting diagnostics. They spend significant time with patients, ensuring they are well cared for and quickly assessing their needs. The doctors were great mentors who truly cared for their patients, reflected in the quality of care they provided. There are misconceptions about doctors in third-world countries, but I quickly learned that the doctors in Kenya are exceptionally talented. They constantly adapt to provide patient care based on a wide variety of diseases and conditions, often dealing with advanced stages of illness due to delayed visits. Despite limited resources, they swiftly treat patients with worsened conditions. The resourcefulness of Kenyan doctors in the face of adversity left a lasting impression on me. They often had to think outside the box to overcome challenges, adapting to the limitations they faced. For example, I witnessed a patient presenting with cervical spondylotic myelopathy, a herniated disk in the cervical spine, which put the patient at risk of paraplegic paralysis. This patient required emergency spine surgery but could not afford the procedure, as they did not have insurance and the cost was significantly beyond their means. Dr. Rashid, demonstrating remarkable adaptability, opted to use an artificial bone graft from the iliac bone instead of the more expensive artificial intervertebral disk. He also made every effort to lower the cost of the procedure to ensure the patient could afford it and have a better quality of life. I respect the determination of these doctors to treat patients and save their lives, despite financial constraints. They consistently found innovative solutions to provide the best possible care with the resources available. My experiences in each department were distinct and unique, offering valuable learning opportunities, and some were more surprising than others. For instance, the first time I entered a maternity ward in Kenya, I was utterly shocked. While I had an idea of what to expect, the reality was far different. Having been familiar with how OB/GYN and maternity wards operate in the United States, I was aware that third-world countries faced limitations, but I was unprepared for the extent of these limitations. The small concrete walls, metal beds, and only two cribs for newborns were truly startling. And the labor and delivery ward of vaginal births were primarily managed by nurses, who serve as qualified midwives. Witnessing how childbirth was practiced and how babies were delivered was equally shocking. I was a nervous wreck observing deliveries, from nurses holding the baby upside down and slapping it to delayed suctioning of the airway. Pregnant women did not receive epidural for vaginal births or local anesthesia for episiotomy when their vagina is cut diagonally to have a controlled vaginal tear. In the United States, mothers have their own bed and room, and babies have their own cribs. Epidurals are available, and immediate suctioning of the airway is standard. Babies are not held upside down but supported carefully, and gentle slaps are administered on the back if necessary. At the start of one of my maternity shifts, I observed an emergency C-section. I watched silently as the surgeons began the procedure. When the baby was delivered, there was no cry. I quickly learned that the cry of a newborn is the sweetest sound, a symphony of life that fills the air with hope. As a healthcare provider, one yearn for that cry more than anything else. Each cry signifies a new beginning, a promise of life. There are moments when that anticipated cry never comes. The baby does not breathe, does not move, and has no heartbeat. In those heart-wrenching moments, you feel utterly powerless. Despite all your knowledge, skills, and drive, you cannot bring life back to the tiny, lifeless body before you. The weight of helplessness is crushing as you realize there is nothing more you can do. Unfortunately, I witnessed many stillborn babies during both C-sections and vaginal deliveries. One of the hardest tasks is breaking the news to the family. I saw hope drain from their eyes, replaced by unfathomable sorrow as they came to see their baby, lying still and silent amidst the cries of healthy newborns. One mother spent the night in the maternity ward with all the other mothers, surrounded by those nurturing their living, breathing babies. She watched them feed, cuddle, and care for their little ones, each cry a painful reminder of what she had lost. This scenario would be different in the United States, where a mother with a stillborn child would have privacy in her own room, away from the other mothers with their newborns. This difference highlights another issue: the mental health impact on mothers who lose their newborns. Being surrounded by what they have lost immediately after giving birth is unimaginably excruciating. During my clinical rotations, I also observed the significant impact of religion and culture on medical treatment in Kenya. Women who become pregnant before marriage are often abandoned by their families, which worsens their financial struggles. One patient, a young woman in her early 20s, had a stillbirth after a vaginal delivery. Alone and grieving, she asked me for water. When I approached the nurse, I was told the patient either needed a family member to bring her water or she had to buy it herself. I bought the water for her, but the harsh reality of the situation struck me. It made me reflect on the many mothers who give birth without any support. This patient received no assistance from the hospital due to limited resources and no support from her family due to cultural and religious reasons. Amidst these moments of deep sorrow and reflection, I also experienced the incredible highs of the medical profession. While I witnessed the hardest parts of death, I also experienced the profound joy of saving a life or seeing a newborn take its first breath and hearing its first heartbeat. One case involved a mother delivering twins, with one twin in a breech position. The staff proceeded with a vaginal birth for one twin and an emergency C-section for the other. When the second baby was delivered, it was lifeless. I held my breath, waiting for the cry that never came. The nurse began suctioning the airway and asked if anyone could perform CPR. As an EMT trained in the United States, I had only performed CPR on adults. My first thought was fear of hurting the baby, but I quickly realized we were the baby's only hope. Everything felt like a blur as I donned gloves and began CPR. The only thought running through my mind was “please live” over and over again. I do not remember how long I performed CPR, but when I finally felt a heartbeat, a profound sense of relief washed over me. The joy I felt at that moment was indescribable. It felt like I could breathe again. That experience reaffirmed my decision to pursue a career in healthcare, solidifying my commitment to making a difference in people's lives. I knew I had chosen the right path because the joy of saving a life is something I want to experience repeatedly. While I understand that being a healthcare provider has its ups and downs and that losing patients is inevitable, saving lives is what I strive for. I may not be able to save everyone, but doing my best to the fullest of my ability is what truly matters. My shifts in the surgical rotation were truly captivating. Standing in the operating room, watching surgeries, and observing the various techniques employed by surgeons were invaluable experiences. The surgeons were exceptional mentors, providing thorough explanations of different procedures and potential complications associated with each surgery. I had the privilege of observing a range of specialties, including neurosurgery, spine surgery, general surgery, ENT, orthopedics, and ocular surgery. These experiences solidified my passion for medicine and surgery. The excitement of learning something new and witnessing different surgical techniques after each procedure was profoundly inspiring. The dedication and expertise of the doctors not only motivated me to pursue a career in this field but also deepened my understanding of the risks and knowledge required to become a skilled surgeon. The intricate nature of the work underscored the importance of minimizing mistakes and meticulously assessing and performing each procedure to deliver the best patient care. This experience also taught me the critical importance of early recognition, treatment, and diagnostics. The doctors were prompt with lab work, treatment, and patient diagnosis to ensure timely care. In Internal Medicine, I learned to appreciate the significance of patient family history, medical background, and living conditions when diagnosing illnesses. In Kenya, where patients are more susceptible to infectious diseases, such as malaria, TB, HIV, cholera, dengue fever and typhoid fever, understanding these factors is crucial. The doctors utilized information about patients' locations to diagnose various bacterial infections, recognizing that some communities are more vulnerable to specific diseases due to environmental factors. Furthermore, during my ward rounds in Internal Medicine, I had the privilege of learning extensively from the doctors. They conducted thorough assessments of patients and engaged in detailed discussions with residents about potential diagnoses based on patient history and lab results, as well as treatment plans and their rationale. This approach provided me with valuable insights into recognizing symptoms of a range of conditions, including malaria, hypertension, diabetes, chronic kidney disease, urinary tract infections, tuberculosis, stroke, and other diseases. During my clinical outreach and women's health volunteering event, I gained deeper insight into Kenya’s culture and people. It was heartwarming to be surrounded by enthusiastic young children who were thrilled to see "Americans" in blue scrubs. They were incredibly welcoming and kind, making it easy to form connections despite our brief visit. However, The women’s health events highlighted a range of issues, especially when young girls inquired about topics such as menstruation, medicine, and pregnancy. A recurring concern was infections following female genital mutilation (FGM). In Kenya, the prevalence of FGM is 15%, and Kenyan Somalis practice FGM with a prevalence of above 90% (Sheikh et al., 2023). FGM is often carried out at home in non-sterile conditions, which increases the risk of infection. Faced with these concerns, I had to find respectful and culturally sensitive ways to address their questions. Common queries included whether undergoing the procedure was advisable, how to prevent infections, and what steps to take if an infection occurred. Additionally, we encountered individuals in need of financial assistance for treatment, who might not be able to afford it. Balancing respectful dialogue with practical advice and addressing financial constraints presented a significant challenge during these interactions. During my hospital rotations, I encountered a wide range of illnesses and treatments. While gaining knowledge about these conditions was exciting, I was soon confronted with the harsh reality of inadequate resources. Many patients faced severe challenges in receiving or affording proper care, highlighting a stark contrast with healthcare accessibility in the United States. The disparity was evident, with financial constraints often preventing patients from accessing essential services such as procedures and medications. This exposure made it clear that while doctors and nurses are dedicated and provide quality care to the best of their abilities, they face limitations beyond their control. I observed that despite their best efforts, the broader socio-economic issues often impede effective healthcare delivery. This realization emphasized the need for systemic changes to ensure that quality healthcare is available to all. Before going to Kenya, I was determined to volunteer outside of the United States. This experience not only deepened my motivation to pursue a career in medicine but also gave me invaluable insights into volunteering abroad. My goal was to better understand the culture, people, and healthcare systems in third-world countries and how these factors impact healthcare delivery. I believe that healthcare should be accessible to everyone, and this experience clarified the type of doctor I aspire to be: compassionate and committed to the principle that every life matters and everyone deserves equitable treatment and healthcare. My goal is to return as a qualified doctor and contribute to improving healthcare delivery in third-world countries. The disparities in healthcare access and resources greatly impact patient outcomes. Witnessing these challenges has fueled my determination to be part of the solution, to drive change, and to help as many people as possible in underprivileged areas.

My experience with International Medical Aid in Kenya is one that I will never forget. The memories I made during this program will be cherished forever. During this internship as a high school student, everything I saw was new to me. My time at Coast General Teaching and Referral Hospital was transformative. The experience of rotating through different departments was eye-opening and profoundly educational. In the pediatric department, I witnessed the severe effects of poverty and disease. The sight of malnourished children and the struggle of their families was heart-wrenching. One of the most impactful moments was observing a lumbar puncture procedure on a child suspected of having meningitis. Despite the distressing nature of the procedure, it was a significant learning opportunity that deepened my understanding of medical practices. Beyond the hospital, engaging with local communities was an enriching aspect of the program. Participating in health clinics at local schools allowed me to interact with children and learn about their lives. Despite initial nervousness about public speaking, I grew more confident as I engaged with the children, providing advice and support on various health topics. The mental health clinics, in particular, were both challenging and rewarding. Addressing issues such as domestic abuse and food insecurity, although difficult, provided valuable insights into the socio-economic challenges faced by the local population. My outlook on life will forever be altered because of this program. This program was able to convert me into a very social person that I wasn't before. I will always remember the people that I met in Kenya and the memories I made with them. My safety in Kenya was never a concern for me because the mentors told us what to avoid and recommended better and safer options. The mentors were extremely supportive and helpful if I had any questions or concerns and made sure all the interns were having a great time. The food was great and it was always a highlight to come back from the hospital and sit down for a fulfilling meal with your friends. I will forever grateful for this experience, Kenya and IMA will always have a special place in my heart. I tried as best as I could to show no fear about this internship, I wanted to trick myself into thinking that I wasn’t scared. I was able to keep my composure until the 15-hour flight from New York to Nairobi, that's when it hit me. The fact that I wouldn’t see my family for four weeks on a continent I have never been on, with people I have never met. It was a lot, I just hoped that I could get through it. It wasn’t until I met a couple of other interns in the Nairobi airport that I knew I would be just fine. As soon as the wheels hit the tarmac in Mombasa I knew that this was going to be a once-in-a-lifetime opportunity that would change my life forever. Despite being a high school student, I was fortunate enough to have access to Biomedical Science courses that my school which opened my eyes to the medical field. Having only ever shadowed a physician's assistant for a couple of hours before coming here, I had no idea what to expect especially in a foreign country. For four weeks I was constantly learning, my brain never relaxed, fascinated the whole time. Even the car ride from the airport to the residence was shocking, the ability to drive without stop signs, and traffic lights was something I had never seen. One of the biggest takeaways I have from this experience that I didn’t think about before arriving was the social aspect of this trip. I have never been the most social person when it comes to meeting new people but this trip changed that tremendously. I was truly surprised about how nice and talkative everyone was to all of the new interns, by the end of the night I think I said my name and where I am from over 20 times. I was super excited to get to know everyone and learn about them. I knew that most of the interns would be in college so I wanted to learn a lot from them about college and their advice for me at my age. My biggest fear before arriving was that I wasn’t going to find a group to hang out with but after the night I arrived I knew I had nothing to be worried about. This internship truly changed my entire perspective on people and my opinion of myself. I used to struggle with social anxiety and my ability to be myself around others that I didn’t know. I realized that I should be myself and not what I think others want me to be, if people don’t like me for being me then that is their issue. When I arrived the other interns made me feel like I belonged and that I was liked and appreciated. I knew that this was how I wanted to treat all of the new interns who would come in during my internship. The group of interns that I came in with were mostly high schoolers which made it very easy for us to become good friends during the trip. This experience let me know a lot about myself and the first impressions I gave to people. I was surprised to find that everyone thought I was a lot older than I was and they thought that I was very mature for my age. I appreciated this because I have always thought that I struggled with first impressions and meeting new people. After two weeks, a large amount of people left especially people who I was close with. This left me wondering about who I was going to hang out with for my last two weeks leaving me with only one choice. I need to find other interns and become really good friends with them, I thought that this was going to be a lot harder than it was. Making new friends is something that I have struggled with my whole life, once I get close to people it is hard for me to move on once they leave. I have always viewed myself as not enough for people to have me as their friend but this internship changed that. The newfound social skills that I was able to learn during this experience will forever impact me in the future. All conservations and interactions I have with people will now be changed because of this internship. Every time I think back to this unparalleled experience my mind will always go to one place, Coast General Teaching and Referral Hospital. The combination of knowledge, information, and lessons that I learned about there is something that I will never forget. Since I haven’t had a lot of experience in Western hospitals, everything I saw was truly fascinating. My first rotation was in the pediatric department, where I saw which diseases and illnesses were affecting the children of Kenya the most. I gathered so much knowledge during this week because it was the first time I was able to see the effects of poverty and health issues in Kenya. I have always known that Kenya and other African countries are plagued with malaria, poverty, food insecurity, and lack of access to clean water. But to see the effects of the combination of those on a child was astonishing. The hardest thing for me was seeing how much malnutrition was in the wards with almost every child being diagnosed. It was hard seeing such young patients in so much pain and having to see mothers wonder if their child is going to survive. The most memorable moment in pediatrics was when a young boy was suspected of having meningitis and needed a lumbar puncture. In school, I learned a lot about meningitis and lumbar punctures but to see one in person was a full-circle moment. It was difficult to watch the boy having to be held down by a nurse as he was sobbing because there was no anesthesia used. The doctors and nurses struggled to extract the spinal fluid and it took them many tries to get the sample which caused the patient a lot of pain. Despite the pain that came with the test I was captivated by it. It was the first medical procedures/tests that I have ever seen and I just couldn’t stop watching. One of the interns who was also watching the lumbar puncture has had one before in a western hospital and it was cool to hear about how his experience was different. The doctor who had the biggest impact on me during my time in pediatrics was Dr. Ken. He was such a good teacher and I learned so much about the different illnesses as well as the most common symptoms that the patients come in with. The tuberculosis clinic with Dr. Ken was where I learned the most because TB is rare where I live and did not know much about it. After just a couple of hours in the TB clinic I gained so much knowledge about it and its effects on the people of Kenya. It was scary to learn about how TB can spread anywhere in the body besides a person’s nails or hair. During my time in pediatrics, I got my first taste of how patient care was in CGTRH and how different it was from the US. It was quite scary and infuriating at times to hear the doctors yelling at the nurses. The nurses would be scolded for not changing IVs, not administering antibiotics, and just negligence in general. Also, the lack of communication between the doctors and patients was stunning, many times the patients did not know why they were getting a certain test or treatment. Throughout my time at CGTRH, I was able to realize a lot about healthcare especially when it comes to having skilled and caring doctors and nurses. The biggest difference that leads to such a gap in healthcare between the Western world and developing countries is money. The employees at CGTRH do not get compensated for the amount of work they do which harms everybody. Just a couple of months before I came to Kenya there was a strike of Mar 14, 2024 where almost every doctor in public healthcare went on strike which led to many people dying (Raballa, 2024). The doctors wanted better welfare because they knew that they do a lot more work than what they get paid for. The patients suffer so much due to the negligence of the healthcare workers that they trust to help them. Despite some nurses caring less than others there were still a great deal of people who were amazing to the patients and who I wanted to be model myself after. Seeing the patients interact with doctors gave me a detailed insight into the dos and don’ts of how to treat a patient which I couldn’t get where I live. My main goal for this internship was to try and get a better understanding of what I want to specialize in as a doctor, in my second week I did just that. Coming into this internship I was most excited to see what surgery had to offer especially in a foreign country. I had never seen a surgery in-person before and I had no idea what to expect. As soon as I walked into the OR for the first time I immediately was mesmerized, I saw a surgeon with a mallet pounding away at the patient's tibia to put it back in place. Before my week in surgery, some interns were talking to me about surgery and how they almost passed out during their first time. This made me a little nervous but I was confident that I was going to be fine in surgery. Everything I saw in surgery was a first, the bones, tissue, the sheer amount of blood. It was the coolest thing I have ever seen, I couldn’t look away even for a second. I watched a newborn with hydrocephalus go into cardiac arrest on the operating table and get revived by the doctors. It was hard for me to wrap my head around the fact that the patient was dead in front of me before he was resuscitated. The surgeons and nurses were extremely calm during the cardiac arrest, they just started CPR immediately and were able to save the child. The entire surgery process was incredible from start to finish. I found it especially interesting when the surgeons were suturing the patient back up and I could see the different types of sutures they used. The night shift I did in surgery is an unforgettable experience that I will always look back to when I think about this internship. Due to the protests occurring the night of my night shift the entire night was something out of a TV show. Throughout the night, my fellow interns and I saw four gunshot wounds over the course of around five hours. Being fortunate enough to be allowed to watch the surgeries of these patients is something that I will forever be grateful for. I never thought I would ever see a gunshot wound in person but seeing four in one night was shocking. The most memorable surgery during that night shift was the second one that I watched. The craziest part about it was that the patient was the same age as me, 17 years old. He wasn’t even a part of the protests, he was standing in his yard and then got shot in the hand by the police. The patient was braver than I could have ever been, after only being given a local anesthetic he was looking at his thumb that was falling off the rest of his hand. He was very interested in the mutilated hand especially once the doctor drilled a nail into his thumb to put it back in place. I was in awe, watching a kid my age get his thumb drilled back into place and he was fine, with no tears or signs of pain. After the second surgery, the other interns and I left to surprise another intern for their birthday, and on our way out we had an unforgettable moment. As we were leaving the 17-year-old’s Dad was outside and asked us if his son was going to be okay. We assured him that we were going to be fine and that the surgery went well. As soon as he heard that, his eyes lit up and he started thanking us saying, “God bless you”. Even though I knew we didn’t help with the surgery at all just being able to give the Dad peace of mind about his son is a feeling I will never forget. I knew that I wanted to chase that feeling for the rest of my life, being able to help people and just knowing how much it means to them. I thought about that moment every day for the next week and just remembered how happy it made me feel that I could help somebody who needed to hear some good news. This was my biggest takeaway from the entire 4-week experience because I realized how much I love helping people more than I ever did before. I also realized that I want to be a surgeon because of how interesting and how there's a lot of pressure but it is also very meticulous. I loved the atmosphere during surgery because it was fully dependent on the surgeon, some would listen to music during the surgery while others kept the room very tense and serious. There was another very memorable surgery that I watched during an afternoon shift that has also stuck with me. A man was attacked by another person who was armed with a machete and the man needed emergency surgery. It was the most hectic surgery that I watched because of how much was going on at once. The man was having the tendons in his hand sutured back together so he would be able to use his fingers as well as having brain surgery. The aspect that made this so memorable was when I could see a part of his brain pulsing which I thought was intriguing. One of my favorite things about International Medical Aid was doing clinics at local schools and being able to interact with all the kids and people there. The clinics were so fun and I would always be so happy when could greet all the kids and give them all high fives. The fact that they were so excited to see all of the interns was so heartwarming and I loved every minute of it. Once I learned about what terrible things a lot of the kids were going through at home it felt even better that I was able to brighten their day. It was also a great learning experience for me because I have always struggled with public speaking and I was quite nervous in my first clinic because there were so many kids. I was able to get a lot more comfortable with public speaking and with coming up with things to talk about on the spot. The mental health clinic was very memorable for me because I felt that the kids got a lot of good advice from everybody especially when they would ask questions. It was hard to answer a lot of the questions that kids would give to us because I had never done anything with mental health before. The questions were also about things I have never experienced such as domestic abuse and food insecurity. Even though I wasn’t able to answer a lot of the questions the other interns were still able to give good answers and I think helped the kids get a better understanding of what to do. After we finished the mental health part of the clinic all of the interns danced with all the kids which I had a lot of fun doing. It was great seeing so many people with different backgrounds and experiences be able come together and just dance. It was cool to be able to see how the education system works in Kenya versus how it is back in the US. The first thing I noticed when I first arrived at my first clinic was how the teachers and structure of the education were very strict. The teachers would carry around sticks and it made me wonder if this was more or less effective and getting the kids to stay on task. During the clinics, I learned a lot about how serious the students are about exams and getting good grades which I thought was good. Being able to have kids realize how important school is at a young age is crucial to them being successful. During my time in Kenya, I found that I very much enjoyed learning about the similarities and differences between the US and Kenya when it comes to health. The lectures and Dr. Shazim were very useful in helping me learn differences that I couldn’t see at the hospital. However, learning about Kenya’s healthcare also came with some appalling information about how they struggle with certain parts of healthcare. The statement that stuck out to me the most was, “This translates to an average of 21 doctors and 100 nurses per 100,000 people compared with the WHO-recommended minimum staffing levels of 36 doctors and 356 nurses per 100,000 people” (International Medical Aid 2024). I was shocked when I heard this because when I work I know what being understaffed feels like but I couldn’t even imagine what it is like being a healthcare worker in Kenya. The fact that nurses have to do 3 times the work that they should be doing. After hearing this information I realized that even though the nurses and doctors do a poor job sometimes they are doing so much more work than they should be doing. I remember during one of the debriefs or lectures I was told that the ratio of doctors to civilians in Kenya was 1:16000, this left me astounded. I couldn’t wrap my head around this statistic because of how unreal it sounded. Just seeing how long the time was outside of Coast General was so depressing that most of those people would not even get seen by a medical professional that day. During my third week of the program, I was placed in the Internal Medicine department of the hospital which helped me learn a lot of valuable lessons. Internal Medicine was a very sad and sorrowful place to be in because I knew that the wards had a high mortality rate. I would constantly be thinking about how many of the people in this ward were going to die soon and I couldn’t help them. Internal Medicine was a variety of cases ranging from cancer to heart failure and many things in between. After learning about how non-communicable diseases are plaguing Kenya I was able to see the real-time effects of them on people. I was able to see real people instead of just statistics such as the fact that non-communicable diseases cause 27% of the deaths in Kenya (International Medical Aid 2024). Being able to see humans instead of just numbers was eye-opening because I see a lot of crazy statistics but being able to see them in real-time is horrifying. One patient in particular that I saw was a woman who had her eye removed at another hospital but she didn’t know why and neither did the doctor at Coast General. This shed light on how bad things can get when a healthcare professional doesn’t communicate their decisions with a patient. The conditions of the wards in Internal Medicine were also quite shocking because of the difference between the male and female wards. The male wards had curtains that separated the patients and allowed them to have some privacy. The female wards and no curtains and had the patient's bed around 3 feet apart from one another. Also, both wards had beds that were outside in the heat which was something I never thought I would see especially in such a hot place. Birds were flying in and out of the windows as well as the patients constantly had flys landing on them, for the most part, it was the unconscious patients who would end up flys buzzing all around them. Since I am a high school student I was afraid that my age was going to be a disadvantage during the trip because I wouldn’t be as knowledgeable as the other interns. While I was not as educated as the other interns I was able to use my age and lack of experience as an advantage. I was able to learn so much because everything I saw was new to me and allowed me to get the most out of this program. The one drawback I discovered was that I couldn’t compare the Western hospitals to Coast General as much as the other interns could. But this meant that when I would hear them talk about the differences I was able to gain a better understanding of western hospitals. The coincidence of the protests occurring during the same time I was in Kenya was very tragic yet gave me an interesting perspective. After learning what the protesters were calling it was a surreal thing to think about because during school I learned about times in history where civilians have called for political change. I was able to experience Kenyan history happening in real-time and feel a part of it because I was able to see the tragic moments while in the hospital. I will forever be grateful for this unparalleled experience and how much I was able to take away from it. From the pages and pages of notes I took during my time in the hospital to the unforgettable nights with the other interns, I will always reminisce about this program. Interacting with the local children and being able to teach them about hygiene, mental health, and women's health was so much fun. Being able to see the coolest and most gruesome things I have ever seen in a hospital was incredible. Kenya and International Medical Aid will always have a special place in my heart.

The IMA staff were always there to answer any question in a timely manner. One time, we were out of filtered water at the program residence and I texted Bella to ask what we should do at 11 at night. About 5 minutes later, one of the staff members arrived with more jugs of filtered water. There were many more examples of the hospitality provided by IMA while in East Africa as well. I never felt like my safety was in jeopardy as there were 24/7 guards and large fences at the program residence. Bella, Hilda, Michelle, Margaret, Benson and all the other IMA staff made the trip feel like home away from home. There was daily housekeeping and laundry service which was super helpful and Naomi and her staff were very friendly and accommodating even if you were late to put your laundry in. The food was also fabulous and introduced me to Kenyan culture while also still always providing me with American fare if that was what I had desired. The chefs always wanted to make sure that I was eating enough so it is definitely important to speak up if you have dietary restrictions or even just food preferences as they were more than willing to accommodate the many times I asked for chicken :) Overall, my experience in Kenya couldn’t have been better. The friends and mentors I met on this trip guided me through some of the most impactful weeks of my life. While things were understandably challenging at times, everybody was willing to try to help in any way possible even just as a listening ear. Overall I 10/10 recommend this program to any high schooler or college student considering medicine as it confirmed my strong interest in the profession. Asante sana International Medical Aid for this incredible opportunity.