I honestly do not even know where to begin. Coming to Kenya, I had such a mixed set of emotions running through my mind. The anxiety was palpable in nearly everything I did the month prior to my departure for this foreign land of which I had little knowledge and knew even less of what to expect. Though we all take the elective course to “prepare” us for what each of us will do here, to be completely honest, it does not prepare us whatsoever for the experience. It is truly a life changing experience that I wish all my classmates were able to experience firsthand. Unless you have been here and seen the wards, one is likely to never understand the difference one person can make.
My first few weeks here were an adjustment period. No doubt about that. I had many days on the wards in my first weeks that were absolutely frustrating. However, as Sonak had prefaced, “if you aren’t frustrated on the wards, then you aren’t trying hard enough”, rang true for me in my first week. I have never, and doubt I ever will feel as overwhelmed as I did my first week here in Eldoret. From anger that my patients weren’t receiving their anti-TB drugs to absolute despair seeing a patient we had just rounded on 20 minutes prior pass, without anyone even so much as batting an eye, my emotions were all over the place. It is such a stark contrast to care in the States. For someone whom has never been exposed to such a system, the differences to the American healthcare system are almost too much to bear. However, I stuck it out and continued to do my best and I am proud to say that it has made me a much better practitioner.
With only two rotations left in the year, we had all been on clinical rotations back in the States. I can easily say, that in the most of resource constrained settings; I had my best clinical rotation of my experiential year. Working with such limited resources places a huge emphasis on proper patient management that is both cost effective and beneficial to patients. It is remarkable to have such freedom in the ability to practice clinical pharmacy (as a student) and manage such a large patient load. I worked tirelessly to manage my patients’ medications, help both physicians, medical students, along pharmacy students learn about the medications used for said disease states, and ensure that they received drugs vital to their care. It is amazing to me personally, to be able to say that I had my best clinical rotation in the most of constrained settings. It speaks volumes to the ability of Sonak, and the passion that most of us bring on this rotation. It is truly amazing to know that me, a single person, can have an impact on so many patients and their outcomes.
The most rewarding experience, however, was noticing my own growth from within as both a practitioner and as a person. I knew that this experience would change who I am, but I had no idea just how it would affect me. I am proud to say that I feel I have grown both my clinical knowledge and compassion, in large part because of Sonak and his wealth of knowledge and his generosity, immensely in just eight short weeks. Sonak personifies what a pharmacist is capable of, and what a pharmacist should be. He works tirelessly to change the face of the Kenyan healthcare system, and gives to patients without ever being asked to do so. He is someone for whom I have the utmost respect and someone I hope to emulate in my own practice.
Prior to this experience, I had no ambitions of ever pursuing a career in “clinical pharmacy”. I still am planning on going into community pharmacy (as many people say its not clinical, I say to them, why can’t it be!); however, I plan on brining clinical work with me, and being a catalyst for change in my own work environment. If my employer will not allow me to practice, as all pharmacists should be able, then I plan on finding an employer that will, or changing my career path. This experience has shown me what a pharmacist is capable of, and how valued we should be in any healthcare setting. I plan on carrying that on wherever my career may take me.
I also feel that I would, at a minimum, like to precept rotation students in my future endeavors. Although I only had a week to do so, I was able to teach the Kenyan pharmacy students the ropes on rounds. It was amazing to see them learning right in front of me, solely based on the knowledge that I shared with them. Giving them a short assignment and seeing them respond with research and then present the topic to me the next day on rounds was remarkable. I am grateful for the opportunity to work with them, and hopefully have taught them along the way.
Other than my time spent rounding on the wards, I truly enjoyed seeing the healthy side of AMPATH and the difference this program makes. On the wards, it is easy to forget that most patients with HIV are now able to lead a normal life, maintain their job, support their families and are such a happy people. The days I spent out at the AMPATH satellite clinics, with the Orphans and Vulnerable Children (OVC), and my day on the AMPATH farm were a welcome sight to know that we are winning the fight here in Kenya. I cannot wait to come back in a few years and see what this program has become. I know that it will be remarkable.
I’ll close on a remark from Sonak made to me on my most depressing day here, and one that I hope everyone who reads this takes to heart. “Don’t let episodes like this prevent you from always trying to do more. Every student who truly invests time into their patients will have these types of experiences. It is how you respond that really determines the type of practitioner you will turn into.” I know what type of practitioner I will be, and I hope that everyone else carries that same attitude with them throughout their time here and throughout their career.
Avery Hagedorn
PharmD Candidate, February 2009
My first few weeks here were an adjustment period. No doubt about that. I had many days on the wards in my first weeks that were absolutely frustrating. However, as Sonak had prefaced, “if you aren’t frustrated on the wards, then you aren’t trying hard enough”, rang true for me in my first week. I have never, and doubt I ever will feel as overwhelmed as I did my first week here in Eldoret. From anger that my patients weren’t receiving their anti-TB drugs to absolute despair seeing a patient we had just rounded on 20 minutes prior pass, without anyone even so much as batting an eye, my emotions were all over the place. It is such a stark contrast to care in the States. For someone whom has never been exposed to such a system, the differences to the American healthcare system are almost too much to bear. However, I stuck it out and continued to do my best and I am proud to say that it has made me a much better practitioner.
With only two rotations left in the year, we had all been on clinical rotations back in the States. I can easily say, that in the most of resource constrained settings; I had my best clinical rotation of my experiential year. Working with such limited resources places a huge emphasis on proper patient management that is both cost effective and beneficial to patients. It is remarkable to have such freedom in the ability to practice clinical pharmacy (as a student) and manage such a large patient load. I worked tirelessly to manage my patients’ medications, help both physicians, medical students, along pharmacy students learn about the medications used for said disease states, and ensure that they received drugs vital to their care. It is amazing to me personally, to be able to say that I had my best clinical rotation in the most of constrained settings. It speaks volumes to the ability of Sonak, and the passion that most of us bring on this rotation. It is truly amazing to know that me, a single person, can have an impact on so many patients and their outcomes.
The most rewarding experience, however, was noticing my own growth from within as both a practitioner and as a person. I knew that this experience would change who I am, but I had no idea just how it would affect me. I am proud to say that I feel I have grown both my clinical knowledge and compassion, in large part because of Sonak and his wealth of knowledge and his generosity, immensely in just eight short weeks. Sonak personifies what a pharmacist is capable of, and what a pharmacist should be. He works tirelessly to change the face of the Kenyan healthcare system, and gives to patients without ever being asked to do so. He is someone for whom I have the utmost respect and someone I hope to emulate in my own practice.
Prior to this experience, I had no ambitions of ever pursuing a career in “clinical pharmacy”. I still am planning on going into community pharmacy (as many people say its not clinical, I say to them, why can’t it be!); however, I plan on brining clinical work with me, and being a catalyst for change in my own work environment. If my employer will not allow me to practice, as all pharmacists should be able, then I plan on finding an employer that will, or changing my career path. This experience has shown me what a pharmacist is capable of, and how valued we should be in any healthcare setting. I plan on carrying that on wherever my career may take me.
I also feel that I would, at a minimum, like to precept rotation students in my future endeavors. Although I only had a week to do so, I was able to teach the Kenyan pharmacy students the ropes on rounds. It was amazing to see them learning right in front of me, solely based on the knowledge that I shared with them. Giving them a short assignment and seeing them respond with research and then present the topic to me the next day on rounds was remarkable. I am grateful for the opportunity to work with them, and hopefully have taught them along the way.
Other than my time spent rounding on the wards, I truly enjoyed seeing the healthy side of AMPATH and the difference this program makes. On the wards, it is easy to forget that most patients with HIV are now able to lead a normal life, maintain their job, support their families and are such a happy people. The days I spent out at the AMPATH satellite clinics, with the Orphans and Vulnerable Children (OVC), and my day on the AMPATH farm were a welcome sight to know that we are winning the fight here in Kenya. I cannot wait to come back in a few years and see what this program has become. I know that it will be remarkable.
I’ll close on a remark from Sonak made to me on my most depressing day here, and one that I hope everyone who reads this takes to heart. “Don’t let episodes like this prevent you from always trying to do more. Every student who truly invests time into their patients will have these types of experiences. It is how you respond that really determines the type of practitioner you will turn into.” I know what type of practitioner I will be, and I hope that everyone else carries that same attitude with them throughout their time here and throughout their career.
Avery Hagedorn
PharmD Candidate, February 2009
