Before I left for the rotation in Kenya I wasn’t sure what to expect. I knew that it was going to be a life changing experience. The rotation by far, has exceeded all of my expectations I have had from a rotation. This rotation has been one of the most challenging, inspirational, and influential educational experiences that I have ever witnessed throughout my entire twenty three years of life.
This rotation was challenging for me because this was the first time in my life that I have been across the country away from both my family and loved ones. There were barriers of communication which made it difficult to correspond back and forth. Nevertheless, this particular challenge began to cease after my heart went from worrying about home to caring after all of my patients and seeing the poor conditions of the hospital in which we would be practicing. I can still remember my first day at the hospital as if it were yesterday. Taking our first step into the ward, there was such a distinguishing smell that would hit you hard and make you feel sick in your stomach. It was very disheartening and one had to truly fight to not shed tears in front of the patients. I thought that it was imperative for me to maintain my poise so that the patients could uphold their dignity. I didn’t know whether or not the conditions that the patients saw themselves were even poor at all, for this is all that they know. I just kept reflecting back to the environment of our hospitals back in the States. Here in Eldoret, where there are eight beds with two patients per bed in one cube, this would have been a single or double patient room in the States. I have seen patients who are malnourished, in pain, patients who are actually dying. Come to think of it, I have never seen a patient in such conditions like this in the States. Patients with tuberculosis are spread all throughout the wards whereas in the States they would be in isolation. Worst of all, I have seen patients without life, patients who have passed away and their bodies become stiff as one tries to transport their body from the ward to what I am assuming is their mortuary. My heart goes out to all of these patients and I consider myself fortunate enough to be apart of such a collaboration between Indiana University-Purdue University and Moi Hospital, even if it is only for six weeks. Since I knew that we were going to be here for a short period of time, I aspired to put 110% effort in all of my work pertaining to Pharmacy and the hospital.
There were days where I became frustrated because patients were not receiving their medications and many drugs became out of stock. I found myself becoming more aggressive with the nurses in questioning why a certain medication wasn’t given or stressing the importance of giving medications “stat”. It was amazing because after a week or so, I saw the Kenyan interns on my team taking the same approach with the nurses, this was essential because nurses are more likely inclined to listen to them than they are to me, “the Muzungu”. Nevertheless, what I care about is the end result, patients receiving their medications, and not necessarily how we get there whether it is through me or the Kenyan medical staff. I have solely made decisions about my patient’s medications and treatment plans that I know I wouldn’t be allowed to if were practicing in the States. It may take awhile for few to realize, but here you get the sense that if you don’t take the necessary steps to optimize treatment plans, no one else will. I even shocked myself at some of the changes I recommended, or therapies I interchanged. I was faced with many days where I became saddened and had to take a moment outside to regain self-control. I’ve seen patients with lymphomas, patients with stage four heart failure, patients with all types of opportunistic infections, and patients with HIV/AIDS, etc. Back in the States, most of the patients that I have seen would be in the Intensive Care Unit (ICU), or the Progressive Care Unit (PCU), and not mixed throughout the medical ward. I know that I have seen and done things that not a lot of pharmacy students will get the opportunity to. It is wonderful seeing all of the ideals and aims of AMPATH come to life. I have had the opportunity to work in the diabetes clinic, see a satellite clinic and know there are plans on developing a future Coumadin clinic. I am excited to see where healthcare in Kenya will be within the next five to ten years.
This rotation was challenging for me because this was the first time in my life that I have been across the country away from both my family and loved ones. There were barriers of communication which made it difficult to correspond back and forth. Nevertheless, this particular challenge began to cease after my heart went from worrying about home to caring after all of my patients and seeing the poor conditions of the hospital in which we would be practicing. I can still remember my first day at the hospital as if it were yesterday. Taking our first step into the ward, there was such a distinguishing smell that would hit you hard and make you feel sick in your stomach. It was very disheartening and one had to truly fight to not shed tears in front of the patients. I thought that it was imperative for me to maintain my poise so that the patients could uphold their dignity. I didn’t know whether or not the conditions that the patients saw themselves were even poor at all, for this is all that they know. I just kept reflecting back to the environment of our hospitals back in the States. Here in Eldoret, where there are eight beds with two patients per bed in one cube, this would have been a single or double patient room in the States. I have seen patients who are malnourished, in pain, patients who are actually dying. Come to think of it, I have never seen a patient in such conditions like this in the States. Patients with tuberculosis are spread all throughout the wards whereas in the States they would be in isolation. Worst of all, I have seen patients without life, patients who have passed away and their bodies become stiff as one tries to transport their body from the ward to what I am assuming is their mortuary. My heart goes out to all of these patients and I consider myself fortunate enough to be apart of such a collaboration between Indiana University-Purdue University and Moi Hospital, even if it is only for six weeks. Since I knew that we were going to be here for a short period of time, I aspired to put 110% effort in all of my work pertaining to Pharmacy and the hospital.
There were days where I became frustrated because patients were not receiving their medications and many drugs became out of stock. I found myself becoming more aggressive with the nurses in questioning why a certain medication wasn’t given or stressing the importance of giving medications “stat”. It was amazing because after a week or so, I saw the Kenyan interns on my team taking the same approach with the nurses, this was essential because nurses are more likely inclined to listen to them than they are to me, “the Muzungu”. Nevertheless, what I care about is the end result, patients receiving their medications, and not necessarily how we get there whether it is through me or the Kenyan medical staff. I have solely made decisions about my patient’s medications and treatment plans that I know I wouldn’t be allowed to if were practicing in the States. It may take awhile for few to realize, but here you get the sense that if you don’t take the necessary steps to optimize treatment plans, no one else will. I even shocked myself at some of the changes I recommended, or therapies I interchanged. I was faced with many days where I became saddened and had to take a moment outside to regain self-control. I’ve seen patients with lymphomas, patients with stage four heart failure, patients with all types of opportunistic infections, and patients with HIV/AIDS, etc. Back in the States, most of the patients that I have seen would be in the Intensive Care Unit (ICU), or the Progressive Care Unit (PCU), and not mixed throughout the medical ward. I know that I have seen and done things that not a lot of pharmacy students will get the opportunity to. It is wonderful seeing all of the ideals and aims of AMPATH come to life. I have had the opportunity to work in the diabetes clinic, see a satellite clinic and know there are plans on developing a future Coumadin clinic. I am excited to see where healthcare in Kenya will be within the next five to ten years.
I was very fortunate to have been apart of such a great medical team. It wasn’t as if I were just some voyeur on the team observing quietly in the background. I actually had an active role in each of my patient’s treatment plans. I am very intrigued with this practice. Most importantly, I am intrigued with this rotation because it offers a bilateral exchange between both the American and Kenyans. I have to admit, before I came to Eldoret, I assumed that this rotation was going to be a unilateral exchange from the Americans to the Kenyans. But what I have found is that I have learned so much more. Yes, it is true that
Kenyans have some lack of resources (i.e. certain medications, laboratory tests, space, etc.); however, my consultant and some of the interns here practice at such an impressive level of acuity for care. We all (including medical students) can learn a lot from how the Kenyans perform and diagnose varying disease states just from physical examinations. My consultant, Dr. Siika, even included me in findings of certain clinical presentations on some of my patients (i.e. hepatomegaly, hepatosplenomegaly, and ascites). I was challenged from my consultant, and even challenged back. I was given assignments from my consultant to further develop my clinical knowledge and although I may have questioned the intent in the beginning, I now truly appreciate all of the time and effort put into me because I know this will only make me an improved Pharmacist in the near future.One of the things I truly admire about this rotation is the relationships that are developed throughout our time here. I have developed friendships with Kenyan and American medical students, medical residents and even Kenyan pharmacy students. I can’t say that I have even had a preceptor with more passion about his/her job than Sonak. One of the reasons I chose to pursue Pharmacy as a career is that I have a passion for people and take a special interest in the care and well-being of others. I am very extroverted and love developing relationships and a sense of community with my patients. It is wonderful working under someone with the same beliefs about patient care. His drive is a motivation and inspiration to work even harder and contribute to making a difference here at Moi. The “buddy system” that he developed between the American and Kenyan pharmacy students will certainly go a long way and definitely contribute to developing both professionally. This rotation was very thought provoking and intellectually stimulating. I have gained so much knowledge and I am intrigued to share my experience with colleagues, future preceptors, and loved ones upon my return.
This has truly been a humbling experience for me and I am grateful and thankful that I have been given this opportunity. It touches my heart everyday, some of the things that I have seen and some of the interactions that I have had with the people here. I have fallen in love with Africa. It is overwhelming that in a land so beautiful, so much pain is taking place. Six weeks was not enough time for me and it is my desire that I come back and help in any way possible. When I was in high school, I attained a Certified Nursing Assistant license and that experience taught me to be so much more appreciative of life. I have been faced with yet another life-changing experience that far surpasses anything I have ever dealt with and for that I will always hold dear to my heart. Words cannot describe how this rotation has made me feel. From this, I have become a better person, a better Pharmacist, a better daughter, a better sister, a better friend, etc. I have also learned to become more confident in myself. Above all else, what are most important are the patients. I truly feel in my heart, that this program exemplifies never-ending commitment to sustaining life and improving health care practice in Kenya. I know that we are only here for six weeks, but the greatest thing about this rotation is that after we leave, other Purdue Pharmacy students will arrive and carry on the continuity of care and I know that this in itself will go far.
Kara Davis, PharmD Candidate, Class of 2008
Purdue University School of Pharmacy
