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Volume 1, Issue 2  July 2014
In a gentle way you can shake the world

This is an interview with a past student who is now a practicing doctor.

What did you find rewarding in doing your placement with Elective Africa?

Having lived in the USA my whole life, I grew up in an upper middle class family. I am in the racial majority and I have had the privilege to go to whichever school I decided I wanted to attend – regardless of travel, cost, etc. I recognize that this is not the case for most Americans nor for most people in other countries.

Have you had an exposure to such difference in life status?

I traveled to Mumbai, India during college and first experienced the culture shock, the isolation of being a racial minority and class stratification. I volunteered in a hospital setting and clearly saw that there were major differences between them and what I was used to in the US. Though this wasn’t the best experience I have had, it stuck with me and partially drove my desire to again explore a nation less fortunate.

When I decided to go to Mombasa, Kenya with Elective Africa, I had three years of medical training under my belt – one of which was clinical work. I was excited by the possibility of experiencing a culture much different from my own, and being able to provide care to patients in a limited resource environment.

Culture shock is something you cannot prepare for, but must simply embrace and enjoy the experience.

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Why Mombasa specifically?

I don’t specifically remember why I chose Mombasa, but I can tell you it was a good choice. Mombasa is a busy, friendly, exciting and beautiful city. There are beautiful beaches to explore. There are a number of restaurants and shops to see. The people of Mombasa are hardworking and welcoming.

Tell us more of your placement with EA.

The hospital, Coast Provincial General Hospital, is the second largest in the country. They provide all services and see a large number of patients. This allowed myself and my peers to have a vast and rewarding experience. We were able to participate in the Ob/Gyn Department to assist with vaginal deliveries, cesarean sections and miscarriage management. We were also involved in the Emergency Department and Minor Theatre Surgical Department. Here is where we could triage and treat a variety of pathology. We were involved in a number of minor surgical procedures and many post-traumatic suturing.

The staff at CPGH welcomed us and readily involved us in the care of the patients. 

Major takeaways?

  • Each department: more experience in deliveries, emergency triage, procedures, suturing
  • CPGH: A large, diverse facility which openly welcomes medical trainees

How to prepare . . .

For travel:

  1. a checkup – you’ll need certain shots and prophylactic medications
  2. approval from your school
  3. a passport and a visa
  4. a mosquito net for your bed, bug spray, sunblock
  5. all other general travel stuff

What would you advise future students interested in doing their placement with Elective Africa?

For a developing country healthcare system: it’s beneficial if you can bring a lot of supplies to the clinical setting where you will be rotating. We collected donations of gloves, sutures, surgical masks, tools, etc. We also had a fundraiser before we left, to raise money for donations whole in Kenya. We donated some to the orphanage we visited, some to the hospital, and purchased an air conditioner for the minor theatre operating suite.

The hospital is very different from most westernized facilities. There is no hand sanitizer outside every patient’s room. There are no patient rooms but wards with beds aligned against the wall. The windows and doors are open to the outside. There is no endless supply of equipment. Most things are reusable and not disposable.

Most importantly, be prepared to feel unprepared. You’ll frequently find yourself in situations you haven’t experienced before, and it is essential to remain calm, apply all of the years of training, collaborate with others and work your way through. This is a unique experience that will forever change your life, your perspective of medicine and the way you practice medicine in the future.

“In a gentle way you can shake the world” Mahatma Gandhi

 

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Worlds wonderful and beautiful

Grasses, roots, leaves, small stems are what make their meal. They are sensitive and distressed just as human beings if not more when under any discomfort. When they are happy one will not need to be told. I am talking of elephants.

The African elephant is the largest of the earth’s land mammals. African elephants are differentiated from their Asian elephant cousins by their huge ears that help them cool of in the hot African climate. You will always find them near water sources as they have to drink water at least once daily.

If you adore this creature then watching it is just amazing. Did I mention I have watched them give birth? Well, it was on television but it was as close to a real encounter that most have. The magnificent delivery will leave you with a foolish grin for days. You can also watch them roll in muddy water, splashing water on themselves with their trunks and then dusting themselves. Apparently the dusting of their bodies is to protect themselves from the sun: some natural sunscreen.

Their protective instinct is very strong and their sensitivity can drive these polite animals violent. They help their young ones get on their feet within minutes after birth.

My awe of this animal is shared by many though a heart breaking trend is the poaching of these animals worldwide. In India, the poaching trend is minimal due to the high value the elephant has among the natives and also the religious aspect. In Africa, there is a different tale…they are hunted down and slaughtered every single day for their precious tusks.

Ivory is used to make jewelry and kept as a status symbol for its rare nature.

The elephant has a gestation period of almost two years and on average they take four years to be expectant. However, they are being eliminated faster than they can breed.

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Not only are the elephants in danger but also animals such as lions and rhinos are being threatened.
Some justify themselves that the animals are a bother which is truly incorrect. All animals have survival instincts and will fight back when you infringe on their territory.

We have had the opportunity to meet and see these creatures in our lifetime. Let’s leave our offspring a better world with all the beauty nature has to offer rather than them having to hear of elephants from fairytales.

Thanks to the many organizations such as Save the Elephants and Hands off our Elephants, various governments and all animal orphanages addressing the poaching menace.

The future might look dim but there is hope. Everyone can be part of this. Spread the word. Do not perpetuate poaching by buying any item made of ivory.

 

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Split Program

Elective Africa offers an opportunity for you to do your placement in more than one location. This is tailored for those who want to have further exposure during their visit to Africa in more than one culture and even make a comparison of the diverse settings which are wonderful to be part of.

The program can be split either within a country or between the countries we operate in.

In Kenya, we have rural and urban locations. One could divide their stay between Nairobi and Migori (our rural location), Nairobi and Mombasa or Mombasa and Migori. The other option is inter country such as dividing one’s time between a location in Kenya and another in Tanzania.

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This program earns one a 10% discount on the second location. All transfer costs and hospital placement fees apply to the different locations.

If this sounds like your ideal elective experience, simply indicate what destinations you are interested in and let us plan your bicultural placement.

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Malaysia meets Kenya

Our participants from Melaka Manipal Medical College in Malaysia completed their placement at the Mbagathi District Hospital, Nairobi where they got to interact with local doctors and students. In their three weeks in Kenya they were immersed into African culture. This is what Chien Xue Low had to say.

What came to mind while choosing the destination for your elective?

I chose to do my elective in Africa as back home we are not allowed to do practical procedures during our elective. Kenya provided such an opportunity for us. Apart from the learning aspect, we also wanted to have a holiday thus decided to visit an African country for the first time.

What made you choose to do your elective with Elective Africa?

We settled for Elective Africa as compared to all other elective agents we came across online, the Elective Africa website was the best and very organized. The testimonials were encouraging and generally the website was appealing and had a lot of substantial information that we needed to organize our elective.

Why specifically did you decide to focus on Internal Medicine and Surgery?
The two are major topics. And, I love surgery.

How long did it take you to plan your elective?

It took us roughly six months to plan for the elective as our school gives us a time limit to get elective locations.

How did you organize your elective?

We settled to do it with an agent as we were doing it away from home. Whereas, planning it with E.A was a bit easy and even on the ground all went smoothly, I found the pre-departure content a bit lacking though this does not mean on the ground we did not have a good experience. I would recommend them to add some information such as mode of transport to the hospital, what is the preferred attire at the hospital, what the menu would be and a brief information on the hospital one is being placed in.

What other challenges did you encounter while planning your elective?

The issue of terrorism and security was a hurdle but all went well. The other problem was the fear of tropical diseases and getting the prophylaxis for Malaria and Yellow fever for one’s safety yet the vaccines are expensive.

What would you recommend to others planning their elective?

Every student should have the vaccines. Despite the expense, it is a worthy measure for one’s safety. Also, if possible, they should organize their elective placement with an agent as it makes the planning process easier. One necessity is the safari. One should take it as it is exclusive to Africa.

 What did you enjoy most in your elective?

I really enjoyed assisting in surgery and being treated with respect by those I worked with. This made me feel appreciated. A pointer to students: you need to be proactive. If you want something and a good experience, ask. If you ask you get, I got a lot of hands on experience from requesting to be involved.

Were the doctor’s expectations of your performance at the hospital reasonable?

Most doctors were very supportive and had reasonable expectations. All one needs to do is behave in a proper manner and always ask for guidance where in doubt. The doctors and students are willing to help.

Mention some of the procedures you were involved in.

I got to dress wounds, do some bandaging, assist in surgery which I only knew the theory bit.

Would you recommend Kenya as an elective destination to other students?

Yes I would and with Elective Africa.

After your elective, what do you feel of the experience?

I will definitely be a better Intern.

What was most challenging during your elective?

I have to state that our transport and accommodation was well taken care of which made us comfortable. However, being a new environment with a lot of poverty and limited resources, one is bruised emotionally. Despite that, I still look up to the doctors who do a good job with the patients with the limited facilities.

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Did the elective meet your expectations?

Well, some of what I expected I did not get and some that I did not expect I got. It was a worthy course.

What tip would you give other students on the whole elective experience?

Have an open mind to learn, have a holiday and lots of fun. Kenya is a good holiday destination.

Do you feel this elective is beneficial to you as a doctor?

As a doctor this elective was important not only for the practical bit but theory too. The C.M.E.s were informative and if one gets the opportunity do not miss the chance to attend them.

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Safari

The hushed African wilderness is the backdrop of documentaries like the Big Cat Diaries with animals roaming freely and is a getaway to many who want to experience the real wild first hand. Take a safari, meet Africa’s storybook animals and get to capture the moments through your camera lens.

There is a lot of excitement on the shores of the crisp lakes as whistling birds singing melodiously on one\'s ears. Soak up the panoramic scenes of the Rift Valley from the escarpment view points. Revel in the majesty of the Nation’s tallest mountain. And after spending a day in the sun, top it off with stargazing under the breathtaking night sky. For those looking for a tan, working the sand between your toes and lying on a towel after a refreshing swim is ideal on the white sands at the coast.

Other activities you can enjoy include horseback riding, camel rides, private fishing and being part of the diverse and authentic cultures in Kenya.

Accommodation is nothing to worry about; there are comfortable, luxurious resorts all over Kenya. If you’re on a tight budget, camping is cheaper, comfortable and adventurous experience. 

While on your safari, safety is key. Always listen to your guide and obey the safety rules in the camp.

Why not fulfill your wish list, for a nice get away from your day to day routine?

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