Each year has its own surprises. Despite the challenges that accompanied Africa such as the Ebola outbreak, 2014 was a great year. Being in the healthcare industry was no small task. A lot of people and institutions worldwide came to help and continue to help up to today the West African countries still reeling from this epidemic. What is great about the year is we survived and we will continue to survive. 2014 was also fruitful because we got to grow our locations: Arusha, Tanzania and rural Migori, Kenya. We have met a lot of great people in our locations in Tanzania and Kenya and we hope to meet a lot more in 2015.

Have a read of our first newsletter issue in 2015.

For any feedback and comments contact us at info@electiveafrica.com 

Going into a different country far away from ones friends and family can be overwhelming despite the tickling excitement of a whole new adventure where you can do all crazy stuff without feeling weird. If anything no one knows you! The “what ifs…” can be so many. This piece seeks to answer some of the questions that may run in our new program participants minds as they prepare for their program.

Upon arrival, one of Elective Africa’s (EA) staff will be waiting to pick you up at the airport. If it is during the weekend, you will rest and later have the local area orientation where you will be shown the post office, grocery store, where to exchange your money to local currency and major roads to master around your location so that if at all you are alone you will always have a point of reference on how to find your way back to EA residence. The local orientation includes a brief on security precautions. If one arrives during the week, the local orientation will come after the hospital registration and orientation.

On their first day at the hospital, a student will be taken through registration, general hospital orientation and payment of the placement fee. At this point, the hospital administration gives you your placement letter, which will indicate your areas of interest and for how long you will be rotating in each department or departments. Thereafter, accompanied by your program co-ordinator on ground, you will proceed to meet the elective co-ordinator at the hospital where you will discuss your expectations and also be cautioned on specific safety measures. A tour to familiarize oneself with the new hospital will follow. This tour will basically entail visiting all hospital departments and on the first day it is upon the student to decide if they will go home and rest or if they are fit to start their rotations immediately.

For the rest of your program we will briefly describe your daily schedule while on program with EA. Every morning you will find the kitchen well stalked with breakfast essentials such as cereals, milk, hot beverages fruits e.t.c. for you to whip up as you please. It is important for students to note that the program emphasizes on the early morning rotations when the hospitals are bustling with activities. The daily round trip in a private car begins at 7:30 am to 8:00 a.m. and the students are dropped at their respective placement hospitals. Despite you sharing the house with a number of other students, placements are in different hospitals. Hospital placement choice is dictated by the number of students on ground, students interests and program applied for. This is done to maintain the level of structure, quality and clinical opportunies that you can expect from an elective placement.

Rotations at the different departments at the hospital will depend on what the student has communicated as their preference; we are flexible to meet the student’s objectives in different areas. This should  have been communicated prior to arrival for planning and will be discussed with the elective co-ordinator at the hospital. You may choose to spend your rotations in one department for the entire duration or pick different departments to rotate in, at a minimum of one week per department. In each department, you will be working with the specific supervisors in those areas for guidance and learning. The student is encouraged to meet the assigned mentor regularly where they get to discuss any events that take place in a day which a student does not understand or needs more clarification based on the local healthcare system it is also important to keep your program co-ordinator regularly updated on your progress at the hospital.

Most rotations are done for 5 hours, from 8:00 a.m. to 01:00p.m. However, the participants decide how long they want to stay at the hospital. The hospitals we work with are not so far from the residence and one can opt for the local means of transport. If you extend past the regular return trip, our program co-ordinator will give you information of who and what to use back to the residence. In some cases students opt to take night shifts especially if there are scheduled surgeries or if the student would like more personal engagement time with the mentors.

At the residence, lunch is provided and one is free in the afternoon. Three times in a week students have Swahili lessons and a volunteer activity once in a while organized by the program co-ordinator. It could be orphanage visit, tree planting, teaching a subject of your choice or giving a motivational talk. Leisure time as we have seen has been spent sight seeing, relaxing, reading and discussions among students.

On one of the weekends, you can join other participants for 3 days 2 nights safari in the respective country of placement for example in Kenya you would visit Maasai Mara to experience the wilderbeast migration. The safari dates will have been communicated in advance. We also organize mountain climbing to Mt. Kilimanjaro http://electiveafrica.com/safaris/kilimanjaro.

Our program co-ordinators are always available to assist you in any way you would like be it at the hospital, at the residence or planning any other add on activity you would like to undertake.

The Key highlights of choosing Elective Africa to organize your elective abroad or shadowing opportunities are:

• We have implemented a global health discussion forum at our residence where we welcome a mentor or supervisor during our weekly barbecue. Topics of discusion will be common cases encountered or differences in the health care systems.
• We provide customized structured and supervised placements.
• We  are operational throughout the year and are flexible with program dates.
• We provide daily private transfers to and from the placement institutions as opposed to relying on public transport.
• EA program has its own safe accomodation shared by only other program participants.
• We provide extensive pre-departure support including ensuring all your university paperwork is approved as required.
• Part of each participants fee is set aside for a corporate social responsibility(C.S.R) or volunteer activity.
• We value the continued support accorded to us by the respective hospital faculty and we show our appreciation by rewarding them financially or with well thought of gifts.
• Our head office staff is on ground and knows our partners well including volunteer organizations, hospitals and mentors we are aware of their point of need and this comes in handy to students who plan on making donations.

“My experience with Elective Africa was overwhelmingly positive. The residence that we lived in exceeded my expectations and everything from the hospital to the safari was very well organized. Our program co-ordinator was always available at a moment\'s notice to take care of any issues we may have had and was always willing to take us into the city or set up any important trips that we wanted to go on. Overall, I thought that Elective Africa did a good job taking an experience that I thought would be filled with logistical issues and uncertainty and making it very smooth and easy to deal with.”

Anthony Nguyen-University of Portland

What are you waiting for? Come Make a Difference, Learn and have Fun!

Snuggled in a wide expanse of fertile volcanic land, Arusha town is in the foothill of Mt. Kilimanjaro’s little sister Mt. Meru. It is believed that Arusha lies halfway between Cairo and the Cape marked by Arusha’s clock tower. The altitudes gives the city a pleasant climate of temperatures ranging between 13 – 30 degrees celsius with an average of 25 degrees celsius giving the city a pleasant climate and lush green environment with coffee plantations at the edge of the town.

At a glance, Arusha town is not a charmer. This is mainly because it is a hive of activities as it is considered a stop over in the heart of Tanzania’s safari industry due to its fascinating surroundings and varied national parks. Arusha’s main economic activity is agriculture; seconded by tourism.

The town is served by Kilimanjaro International Airport (JRO) approximately 50 Kilometers away. Other means of transport within the town include taxis at affordable rates on average 50 USD from the Airport to Arusha town. Small minivans locally known as “Daladala” are the main public means of transport. As an important regional business and administrative center, Arusha is the headquarters of the East African Community and a major international diplomatic hub. Since 1994, the city has hosted the International Criminal Tribunal for Rwanda. It hosts an array of colorful street markets with beautiful hand beaded jewelry, craft shops, restaurants and cafes.

Despite the many opportunities the town offers, one cannot help but fall in love with Arusha’s real beauty. The parks in the area offer one a chance to unwind from one’s hectic daily activities: be it a weekend plan or an exclusive tour for a game safari in Africa coupled with the vibrant night life for those party rockers. The residents have big hearts: they are polite, respectful and very welcoming. The main communicational languages in the region are Swahili and English.

If you are those people whom adventure makes you feel alive, while in Arusha exciting expeditions include:

• Mount Kilimanjaro climb
• Ngorongoro conservation Area
• Arusha National park on Mount Meru
• Serengeti National Park
• Tarangire National Park
• Lake Manyara National Park
• Lake Daluti
• Olduvai Gorge

For adrenaline lovers Elective Africa will help you get it flowing by climbing Mt. Kilimanjaro http://electiveafrica.com/safaris/kilimanjaro

In this issue we will be focusing on:

Ngorongoro Crater

A large caldera located 180 Kilometers West of Arusha town. This breath taking natural wonder is the largest intact caldera in the world. Some believe it might have been the highest peak in Africa higher than Mt. Kilimanjaro before it erupted. Well, either true or not the myth just makes the crater more fascinating.

Ngorongoro conservancy area is an extensive highland area with the famous 600 Meters deep lake at its focal point. It shelters one of the most beautiful wildlife havens on earth with high game conservation on the crater floor. Within the crater, there is a fresh spring and a large soda lake.

The conservancy was set up to protect the African wildlife which is endangered due to poaching and human wildlife conflict. Right now, wildlife co-exists side by side with the semi-nomadic Maasai pastoralists. Amazing, isn’t it? 

This magic only happens on a drive amongst the blue-green vistas of the Ngorongoro. It is one of Africa’s premier attractions and a United Nations Educational, Scientific and Cultural Organization (UNESCO) world heritage site.

Lions, Elephants, hippos, rhinos and giraffes can be seen roaming freely, birds on the fresh water lakes and pink beautiful flamingoes on the central Soda Lake.

While in Tanzania, this is a must adventure on your to do list…don’t just read about it, experience it for yourself. Surrounding the caldera are also comfortable resorts and hotels to make your trip very relaxing and comfortable while indulging in Tanzanian cuisine, which is a blend of dishes from various parts of the town as well as global culinary tradition, enjoy the African barbeque consisting of nyama choma or kuku choma. A favorite by the locals is chips mayai.

For more information on this safari and others offered by Elective Africa visit: http://electiveafrica.com/safaris

Meet our cool ever smiling Mombasa program co-ordinator Phares Odhiambo. Always enthusiastic to ensure everything needed for your placement is ready before your arrival and happily discusses your new cultural experiences and addresses any issues on ground.

Tell us more about you as an individual. I am a down to earth, sociable and very perceptive person. I was born and raised in Mombasa city but I have also lived in Kampala City in Uganda for a little over 7 years during my college days. One of the things I hold dearly in this life is family and true to Princess Diana’s words, “Family is the most important thing in the world”. This is because I believe family gives one a purpose for life.

When did you join Elective Africa? I joined Elective Africa (EA) in June 2011.

What did you study in campus? I studied development studies with a focus on good governance at Kampala International University in Kampala, Uganda.

How is it working as a program co-ordinator? Working as a program co-ordinator has been a great experience for me. It has enabled me make friends all over the world. I can at least say that it is an opportunity of a lifetime that I will always cherish. Although at times I have to juggle with a couple of hard decisions while making each persons program safe structured and make everyone’s stay a happy fun one while meeting each participants expectations without bridging any ethical rules. However, I have always come out stronger and such challenges have sharpened my skills on how to handle different kinds of situations.

As a program co-ordinator I have also been able to learn a lot about other cultures that are very different from what I am accustomed to here in Africa. It has been great to also share some of the customs in Africa with the students. For example, I have always been amused by how surprised some of the participants look when I tell them about payment of dowry such as how two families have to go for negotiations, agree on how much the man is to pay before being allowed to go ahead and marry the woman he loves.

What are the challenges you have faced with clients? It has always been exciting working with the clients and the challenges are very minimal. Most of the clients come with an open mind and respect the local cultures and customs and find themselves blending pretty well with the communities around including the staff both at the hospital and at the EA residence.

One big challenge is how the clients cope with the new environment during their first weeks on program with regards to the climate change and the food. There are always international recipes served to cater for everyone. Some of them instantly fall in love with African cuisine which we enjoy serving and blending the different recipes. Another challenge is language barrier especially while interacting with patients at the hospital. Apart from being overwhelmed at the hospital by the limitations in facilities and minimal resources, some clients find it really hard communicating with the locals.

Amazingly, by the end of the program, we get very different feedback and memorable stories of how students with the help of doctors sort different solutions and saved the day by working with what they had.

Tell us an experience with program participants that you look back at and you can\'t help but smile. There was a day one of the clients took all of us out for drinks (other program participants and myself). He confirmed before we left that it was his treat, I suggested some modest club in Mombasa City. We headed there and all ten of us sat by the counter. He took everyone’s order and asked the bartender to serve us. We were all in a jovial mood and having a good time: drinks were flowing. When the bartender finally asked us to clear the bill as his shift was almost over, we couldn’t see the person who brought us there so we called his cell and when he picked up, he told us that he was tired and had already gone back to the residence. We asked about the bill… He said we just settle it, as he had no money. What followed is a story for another day but you can imagine the look on everyone’s face (He says laughing).

How do you spend your spare time while away from EA? I spend most of my time with family, watching movies and documentaries especially of African political leaders. My best compilation being that of Mobutu Sese Seko: How he rose to power and his over 30 years reign at the Democratic Republic of Congo which he renamed Zaire during his tenure. I also love catching up with friends and volunteering in community projects whenever I can like visiting orphanages.

On the 11^th of February 2015, the Kenya Medical Research Institute (K.E.M.R.I) and Center for Disease Control and Prevention (CDC) confirmed a cholera outbreak in Western Kenya, Migori County through samples collected from patients (InterHealth Worldwide, 2015).

Since 1971, Kenya has had repeated cholera outbreaks. However, the cause of seasonal epidemics of cholera is not fully understood and neither are the factors that drive epidemics, both in Kenya and globally (Kimani W. Rachel et Al).

Cholera is an acute diarrhoeal infection caused by ingestion of food or water contaminated with the bacterium Vibrio cholerae. Every year, there are an estimated 3–5 million cholera cases and 100 000 –120 000 deaths due to cholera. The short incubation period of 2 hours to 5 days enhances the potentially explosive pattern of outbreaks (WHO, 2014).

In this 2015 outbreak in Migori, the key transmitters are: unsafe human waste disposal into rivers and lakes which are the main sources of water both for drinking and domestic use, food and drinks by street vendors, vegetables grown with water containing human wastes (especially in crowded urban towns) and poor hygiene and sanitation.

Cholera symptoms include: rapid heart rate, dry mucous membranes–mouth, throat, nose, eyelids, thirst and low blood pressure among others.

The case in Migori has been managed through establishment of isolation wards in Rongo Sub county hospital and Migori District Hospital, creating community awareness in the affected areas, distribution of Intestinal Epithelial Cells (IEC) materials from the county health department, total ban of food hawking in the affected areas with closure of sub standard eating joints, sampling of water from communities water sources and disinfecting those suspected sources. The United Nations International Children\'s Emergency Fund (UNICEF) donated wash equipment, intravenous (IV) fluids and medical supplies to the county (relief web).

The Medical Superintendent of Ndhiwa District Hospital Thaddeus Ondigo said the number of victims is reducing, an indication that doctors may be winning the fight against the disease. \"We are doing everything we can together with the Red Cross team in promoting hygiene. This is key in as far as cholera control is concerned,\" he said.

Our rural program at Migori is suitable for exposure to this disease and many more learning experiences in infectious diseases such as HIV, tuberculosis and malaria under the mentorship of Dr. Nalwa Wafula.

Migori District hospital is a level 4 district hospital. The hospital currently has 6 doctors, 3 being medical officers and 3 are consultants.The hospital has both inpatient and outpatient services which includes: accident and emergency, internal medicine, surgery, obstetrics & gynecology, pediatrics, ophthalmology, orthopedics and dentistry, HIV / AIDs testing and counseling, mother and child health clinic, antenatal care and community outreach projects, laboratory, radiology and pharmacy.

Dr. Wafula is both the hospitals\' medical superintendent and the District Medical Services Officer in charge mainly of medical services for the entire district assisted by other doctors within the hospital.

What is amazing at the end of the day is the vigilance with which the public health practitioners have put into fighting this disease from being a pandemic and attacking any outbreak immediately. The posters pinned in hospitals, health centers and schools are bearing good fruits.

The clock is ticking and anxiety is creeping in with a lot of despondency written all over. Instead of the earlier excitement you had planning your overseas medical experience, you are now ready to settle for a local experience because you simply cannot raise your program fee and other expenses overseas. Start planning early. Normally it takes one year but it would not hurt one to start earlier. This will provide you with ample time to identify your program organizer and research well on the expenses you will incur in your trip this includes general program fee, visas, flights, insurance, communication costs, socializing and other options to try if plans change along the way.

Here are some tips for funding your dream exposure into other healthcare systems while exploring the world.

Family and friends

These are people closest to you. They have watched you grow and they know your passion, dreams, desires and aspirations. They are the first ones you fall back to for your financing. But what if they are not in a position to support you at this particular moment?

Self Support

What can you do personally towards your overseas health system exposure? First you can start by saving any extra money that comes your way. Maybe you got an extra allowance save it or on your birthday, you were lucky to get gifts in monetary form you could put this away as part of your fees and expenses abroad.

Secondly, get a part time job over the weekends or even during your school break.  If this is not an option with your very busy schedule you could opt for a sale. There are people who naturally gravitate towards that word whether it was in ones budget or not. It is not really taking advantage at the end of the day because lets face it at each given sale, many can at least attest to the fact that they got something really nice and at a throw away price.

Types of sales to consider

• Bake sale. You can get a local function be it at a church or a fun day and sell your cakes or whatever biting people will be drawn to. You do not necessarily have to know how to bake. All you will need is to ask your friends who can bake to help you and you will mobilize people towards your sale. Ensure you let people know the reason behind the bake sale.
• Yard sale. You can sell some of your old items, clothing, shoes or bags. After all, you do not need them. Let go you are about to make more memories from your old memorable items.

Online Campaign

By now, we all know of online campaigns toward different courses. This could be beneficial to you too while planning your learning trip abroad. You really do not need to be popular on social media though it would help if you have many followers and friends. However, all you need to do is to come up with a catchy phrase and outline the purpose of your campaign, with all details clearly stated incase someone would like to contact you and how they can donate funds towards your campaign. Bring on board your peers, classmates, any club you are a member of, sports team, sorority members and let them help push forward your campaign. Also, in the course of your campaign, give people updates people will be drawn to help you reach your target just from how motivated you are. For some sites that support individual’s campaigns, visit:

www.fundmytravel.com

www.volunteerforever.com

Press Release

One can consider approaching any local publication be it a magazine or newspaper within a community. Why would this work? The community is drawn to things around it. While you embark to writing your press release, capture something that will appeal to people’s logic and emotion within the country you want to have your elective, volunteer or pre-professional shadowing in without actually scaring people for your safety. This issue could relate to both your community and your destination.  This will be the first step of even having the paper publish your press release. Remember, journalists look for oddity, prominence, bizarre, proximity among others to publish. Exploit this nature. Also follow up with the paper to know if they will publish and when.

Grants

There are a number of bodies interested in donating funds especially in the healthcare profession. This funding could be in form of bursary, prize award or scholarships. You might be familiar with these bodies and if you do not know of any or you want a bigger selection, it is very simple…use the internet. “Google is your friend” you have heard this phrase many times right? One example is searching “ Medical student elective grant” this gives you hundreds of results which not only cater for medical students but for those yet to join and those in their professional years.

After doing the entire search and getting all the funding bodies you would like to approach, what next? We advice following application processes by each body keenly. Also, take note of the deadlines by each institution and the dates you would like to have your trip. Consider this as a job interview, that moment you were applying into medicine school or what benefits having this award or scholarship in your curriculum vitae would mean. If you are a pre-health student, this will be good practice for writing your application to any university of your choice.

Be accurate and present your application well. Also make copies of your application so that while following up, you will have supporting documents if at all anything might have gone wrong along the way.

You could visit the following links to see some organizations that offer grants towards serving and experiencing healthcare systems worldwide.

www.bmdst.org/

www.money4medstudents.org/your-elective

Just like a job interview, you have to put your best foot forward. While asking be confident and make it personal. Meet your potential funders and express your passion with all the zeal in you. You never know when lady luck will offset your bill. Stay positive through it all and inform your donors your progress and after the “please help”, remember to go back and say “Thank You” with any documentation the funding body had requested from you.