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Understanding HIV in Harare: My Internal Medicine Elective at University of Zimbabwe

Filed under: GEMx Regional Exchanges, GEMx Student Reflections

By Polibu Amos, a final year medical student of the Kwame Nkrumah University of Science and Technology (KNUST), Ghana. 

The period between 5th year and final year is always a time every medical student in my school looks forward to, as it the time for medical electives. So, I was excited when my school allowed me to apply for an elective through the GEMx program. With the help of my school coordinator Madam Charlotte, Ms. Faith (GEMx African representative), The applications for an elective in internal medicine at the University of Zimbabwe for me and my colleague went on smoothly. Once our applications were accepted Mrs. Gandara (electives coordinator, UZ) facilitated the rest of the process for us.

We left Ghana on Tuesday, 3rd of September 2019 at 9 pm, we had 2 stops at Nairobi and Lusaka and by 11 am the following day, we arrived at Harare. The weather was sunny but with a harmattan-like breeze. Thanks to Mrs. Gandara, a driver was already waiting for us at the airport. The driver Mr. Gift Tsikirayi, helped us a lot by taking us to our accommodation and all the places we needed to do our registration. It took us several days to get used to the cold weather in Harare, especially at night. We registered with the Medical and Dental Practitioners’ Council of Zimbabwe (MDPCZ) on Thursday and started the clinical work on Friday at the Parirenyatwa hospital.

CLINICAL EXPERIENCE

My colleague and I were assigned to different wards and joined the medical students there. I noticed a couple of differences in the hospital and medical school system in Zimbabwe and Ghana. In Zimbabwe, a team is assigned to a ward and they see all kinds of medical cases as opposed to Ghana where the doctors are in teams but not assigned to a ward. I was introduced to the doctors and medical students in the ward and they all warmly received me and made me feel included. We had wards rounds every day, where we get to present cases and we used to have a tutorial session with the residents (registrars as they are called in Zimbabwe) after rounds. I made a lot of friends who made my rotation interesting, they also helped in translating what patients said in Shona (the local dialect) for me.

As a student who is yet to do my senior clerkship rotation in medicine, this elective gave an overview of everything I will be doing and more. On the daily ward rounds, I saw cases I hadn’t seen before. This elective has also sparked my interest in internal medicine especially HIV and its associated opportunistic infections. As we saw patients with HIV only a daily basis, I read so much about HIV and also had several discussions on the topic.

Our clinical rotation came to a halt after our second as all the doctors declared a nationwide strike after the leader of junior doctors got abducted . Unfortunately, for us the strike wasn’t called off even after he was found, hence we did no clinical work for the rest of our stay in Zimbabwe. Some of the doctors, however, organized a few tutorial sessions for us. I learned about their health system, their culture and the country in general from the students.

 

SOCIAL

Socially, I made a lot of new friends from Zimbabwe, Uganda, Lesotho, and Sweden. We had a lot of fun together with other elective students from different countries. We visited the national art gallery where we saw a lot of great artwork. We were educated on who the artistes were and what inspired the paintings and artwork. We also attended monthly socializing event dubbed “hustlers’ market” where people display indigenous products for sale coupled with live performances. We visited the Mukuvisi woodlands where we had an amazing experience. We went on a horse safari and it was so exciting. I also ate the local dish sadza which is the staple food in Zimbabwe.

CHALLENGES

The major challenge we had in Harare is was getting cash from the banks and ATMs, other than that and the strike, we had a great experience in Harare. Don’t forget to get in touch with your embassy as Ms. Bernice from Ghana embassy made our stay wonderful, we left for Ghana on the 28th of September 2019.

In conclusion, I would like to thank GEMx for allowing me to have this experience. Special thanks to Ms. Faith (GEMx Africa), Mrs. Rachel Gandara, Madam Charlotte, doctors of ward C4 at the Parirenyatwa hospital and Ms. Bernice (Ghana embassy).

Journey To A Land Of A Thousands Hills And Unspeakable Beauty Rwanda!

Filed under: GEMx Regional Exchanges, GEMx Student Reflections

New blog by Francis Zerd MD, resident in Anatomical Pathology, Muhimbili University of Health and Allied Sciences (Tanzania) who has complete his elective in Pathology at the University of Rwanda College of Medicine and Health Sciences (Rwanada) through GEMx Electives.

It was a busy morning at our department, when an announcement was made in the departmental meeting about an elective opportunity that we could apply for. I was excited and as soon as the meeting ended I approached my senior and asked for more information. She explained very well what needed to be done, and when I saw Rwanda as one of the options for the elective, instantaneously my brain recalled all the astonishing tales of its beauty from people who have visited, without hesitation right away I started the application process and completed successfully.

Life went back to our normal busy schedules, and a few weeks later an email notification popped up in my phone, it was an email from GEMx that I have been accepted to do my elective in Rwanda. Excitement began, all preparations went smoothly with great support from my home academic staffs. On the evening of September 8th, my journey started at Julius Nyerere International Airport, Terminal 3, Dar es Salaam, with great customer care! I took RwandAir and could see the smiles and kindness in the air hostess faces and started feeling home as soon as I boarded the plane ready to depart to start my elective at University teaching Hospital of Kigali.

I spent an amazing 8 weeks at University Teaching Hospital of Kigali, had a fantastic experience, both in terms of histopathology, the hospital community, the country and its people as a whole. Hopefully this post will give some insight into my elective, and why the experience was so beneficial.

The University teaching hospital of Kigali/CHUK is the largest hospital located in District of Nyarugenge at KN 4 Ave, Kigali City. It is also the biggest referral hospital of the country with a capacity of 519 beds. CHUK provides quality healthcare to the population, training, clinical research and technical support to district hospitals. 

The hospital was built in 1918 and in 1928, it worked as health center and upgraded to a hospital in 1965. From April 1994 to 1996, the CHK served as a health center, a district hospital and as a referral hospital as well. In 2000, with the enactment of law Nr. 41/2000 of 7/12/2000 on the establishment and organization of the University Teaching Hospital “CHUK”, the CHK became a public institution with legal personality known as “University Teaching Hospital of Kigali”

The pathology department at CHUK has been active since 2013, and it has 5 pathologists currently. The normal day at the department starts at 7.15am with a meeting mainly in Tuesdays and Thursdays followed by the day’s allocated duty. Each activity is pre planned in a monthly time table which includes pathologists, residents and laboratory scientists. The main activity for residents are grossing, fine needle aspiration clinics and reporting to pathologists slide findings, usually done using a multi headed microscope where most slide review sessions are done. 

As is customary, the residents at CHUK work on rotation in different hospitals with pathology services in Rwanda. They attend to each for a period of one to three months and there is other opportunity to attend different trainings. I was privileged to visit and work in some of the hospitals for at least a day and privileged to attend one of the trainings. University of Rwanda, Huye campus, Southern province with other GEMx resident from Kenya, Dr Job, Kacyiru hospital which forensic pathology is practiced, King Faisal Hospital, one of the largest referral and the first hospital in Rwanda, University of Rwanda, College of Sciences and Technology (CST) during Molecular Pathology (micro satellite instability and short tandem repeats analysis) training, a 3 days training provided by Promega, Rwanda Military Hospital and Rwanda Biomedical Center (RBC) department, where all molecular tests are done.

I had an excellent elective at CHUK and would thoroughly recommend it to anyone who would like to get involved in a friendly, welcoming hospital in a developing country, where they will work hard but be well supported during their stay. In terms of a country for your elective, Rwanda is a great place where you will meet wonderfully friendly people and can do some exciting activities, with several must-do attractions.

In summary, I had a fantastic experience professionally and yet I also enjoyed immersing myself in the life and culture of the local area, leading to a thoroughly rewarding time.

I would like to thank GEMx-COPECSA for the wonderful opportunity and funding support for my visit and entire stay at CHUK, Ms Phionah for always providing guidance whenever needed, Dr Annette for being there whenever needed and making my stay very comfortable. Special thank the hospital staff especially the laboratory staff and fellow residents for their unspeakable cooperation they have showed me during my stay.

I would also like to thank MUHAS pathology department for giving me permission to attend this life changing opportunity and lastly I give my special thanks to my supervisor and mentor, Dr Edda Vuhahula for introducing me to this program, her encouragement and endless support whenever needed, may you all be overwhelmingly blessed.

Pediatric Nursing in the Warm Heart of Africa, Malawi

Filed under: GEMx Regional Exchanges, GEMx Student Reflections

New blog by Lubega Martin medical student form Makerere University College of Health Sciences (Uganda) who has completed his elective in Pediatric Emergency Medicine to Kamuzu College of Nursing (Malawi) through GEMx. 

In this modern digital world, it’s not rare that someone can abruptly begin smiling with their smartphone!!! That was the mood after I read an email notification from our international coordinator that my request to have a pediatric exchange experience at Kamuzu College of Nursing had been accepted. The next few weeks were filled with excitement and preparation to visit Malawi and get a feel of the pediatric nursing experience that side. Remember, Malawi is one of the African countries were most pediatric protocols like ETAT were developed, this too geared up the excitement. Surely my anticipation was high, wouldn’t wait to fly to and stay and have study experience in the warm heart of Africa. Unlike many who have their international exchange visits in the course of their training, partly triggered by the hunt for grades, our exchange visit was a month after we had finished our final university exams. All the learning was triggered by a passion for the field, not grades at all. This gave us a chance to learn and explore several things at our own pace.

The people of Malawi

Malawians call their country the warm heart of Africa and surely this one month was enough to testify this. The welcome from the airport and interaction all through the thirty days we spent on their land, just calls one to go back again and again. I come from one of the Bantu tribes in Uganda, Malawians are not different from the Bantu in Uganda. It was hard for many college students to realize that I was not a fellow Malawian, many who met me on compound or ward would rush to talk to me in their local language, we indeed resemble them!!! The historical Bantu migration is real!!! This also made it somehow easy for us to learn a few words in their Chichewa language since some words were like the words of some of our local languages in Uganda.

Learning experience

The one-month exchange period was to help us enhance clinical skills in the management of pediatric emergencies. As a prerequisite, we sought authorization from the Nurses and midwives council of Malawi. This required us to sit for interviews based on pediatric nursing only after which we were indexed and allowed to carry on our learning experience in the various pediatric wards at Kamuzu central hospital in Lilongwe.

Based on our objectives, we were attached to four wards: children’s’ OPD, children’s ward, Neonatal intensive care unit (NICU) and children’s high dependency unit. While at the hospital, we were taught and supervised by nursing instructors from KCN, ward in charges, fellow students, interns, and consultants. 

We successfully finished our four weeks of pediatric emergency experience in good health with multiple skills in pediatric emergency management, use of continuous positive airway pressure (CPAP) in management of a child with respiratory distress, application of ETAT protocols in the daily management of pediatric emergencies.

Accommodation and Meals 

We were accommodated within the college at the students’ hostels and we had most of our meals from a private supplier who comes at the college’s cafeteria. Although the meals are almost like those in Uganda, the way they are prepared and served is different and worth exploring.

 

Recreation 

We participated in the 40th anniversary of the college which took place on 12th August 2019 at the main campus in Lilongwe. The college was celebrating 40 years of service, caring and teaching the nursing profession in Malawi. It was such good timing!!!

 

It all got sweet when one of the Ugandan biomedical engineers and leaders of the Ugandan community in Malawi: Mrs. Lydia learned that a pair of Ugandan students were at the hospital for clinical experience. She invited us to her home where we met over twenty countrymen and women, had lunch and dinner, had a social warm-up, connected, shared contacts and many have inspired us to go back and practice from Malawi. 

How unfair it would be if we left Malawi without visiting the historical Lake Malawi, we spent one of our last Saturdays at Nkhotakota, one of the shores of Lake Malawi, about 200km west of Lilongwe. We participated in sports like football, volleyball, and netball with the college team as the versed a local team at the lakeshore.

Thank you, Makerere University, for this partnership with GEMx, thank you GEMx, thank you Kamuzu College of Nursing, thank you for the University of Malawi for this great opportunity. Malawi, I will soon come back.

Ndokuda, Zimbabwe. I Love You, Zimbabwe.

Filed under: GEMx Regional Exchanges, GEMx Student Reflections

Blog by Purity Wambui Nyaikamba medical student at Jomo Kenyatta University of Agriculture and Technology who has completed her elective at the University of Zimbabwe of Health Sciences through GEMx.

I set foot in Mashonaland on the 14th of August and the thought of being away from home for a little over a month was soon over ridden by the glistening sunset and the warm welcome I received. I settled in very fast and 19th August came by faster than a fleeting sunset and it was time to start my elective. I didn’t know how it would go or what to expect, but I dived into it with an open mind, ready to make it worth my while.

The School of Pharmacy received me with open arms and made me feel at home. I was given a brief induction on how everything would go for the next four weeks by Mr. Louis Gadaga, who would then be my supervisor. He also introduced me to the relevant individuals who would ensure a smooth run throughout the period.

Parirenyatwa Group of Hospitals (PGH)

I was at PGH for three weeks where I met incredible individuals at every corner who readily took me in and allowed me to be part of them over the next couple of weeks. I was attached at different areas of the Pharmacy and each department was a great learning opportunity, largely because the people were more than willing to take me through the process and satisfy the curios cat in me.

The different departments I visited included; Main Pharmacy, Casualty Pharmacy, Theatre Pharmacy, Manufacturing Pharmacy, Out-Patient Department, Maternity and Family Planning Pharmacy, Opportunistic Infection Pharmacy and Drug Stores. I was also lucky enough to attend a meeting with the Board of Directors of the PGH, an eye opening experience that clearly showcased the essence of Multidisciplinary teamwork within the healthcare system.

In addition to this, I also attended the inaugural Customer Service Week event that was initiated by the Ministry of Health and Child Care in a bid to promote proper customer service to patients and relatives. The Minister, who presided over this event, encouraged the inclusion of a customer care module in the curriculum designed to train healthcare professionals to ensure helpful and friendly cadres.

Ministry of Health

I joined the Supply Chain team comprising of individuals from the Ministry of Health, Directorate of Pharmaceutical Services among other key stakeholders in their bi-annual Quantification exercise that primarily involved forecasting and supply planning of medical products.

Pharmanova

This is a privately owned pharmaceutical Industry that focuses on the manufacture of generic products largely for domestic use with exportation to nearby countries such as Malawi and Zambia. I was taken through most of the Pharmaceutical procedures from the standard operating procedures of the various departments to quality assurance and control.

University of Zimbabwe Clinical Research Centre

This is where they conduct most of the major clinical trials in the hospital where the role of a Pharmacist in Research was clearly demonstrated and elaborated.

Medicines and Control Authority of Zimbabwe

I was taken through the various departments that ensure the regulation of Medicines in the entire country. They also regulate the practice by providing a premise licence and person’s licence to anyone intending to deal with medicines in the country. The departments visited include: Licensing and enforcement, Chemistry department, Pharmacovigilance and Clinical Trials, Medical products and devices, Microbiological department and evaluation and registration department.

Zimbabwe Pharmaceutical Students Association

I was humbled and honoured to be part of their White Coat Ceremony of the 1st year Pharmacy Students at University of Zimbabwe. I also had the opportunity to join them during their orientation.

Pharmacists Council of Zimbabwe

I was able to gather insight from the Registrar in regard to the regulation of Pharmacists and appreciated the current working structure that is being revised to include a student’s registrar where the universities report to the council in regard to their progress in school. The council contributes in maintaining discipline among the Pharmacists together with the Medicines and Control Authority of Zimbabwe seeing that they have the power to suspend licenses.

Pharmaceutical Society of Zimbabwe

I was honoured to meet the current President of the society. In addition to that I also attended a Continuous Education session organized by the society where I got to interact with some of the members.

Beyond the Elective

I planned a trip down to Victoria Falls and the Falls were a sight to behold, it was everything I expected and more. I seasoned this with an adrenaline filled Zip line activity and later a relaxed cruise on the Zambezi River. When it came to food, adapting wasn’t difficult seeing that Zimbabwean food is almost similar to East African food. “Sadza”, a bit softer than what we would otherwise call “Ugali” in Kenya, became an everyday affair and I totally loved it. As I went about my commitments, Zimbabweans impressed me day in, day out and what particularly stood out is their big hearts and warm personalities. I interacted with strangers who were quick to help and made lifelong friends from a simple hello.

This experience has enriched my life in every aspect and I am sincerely grateful to GEMx. Thank you for giving me the opportunity to see life and Pharmacy Practice through a different lens.

Poisons, Primary Care and Pediatric Pharmacy Rotation at Pari Hospital The “very informative learning voyage”of Karl Alex Mogacea

Filed under: GEMx Regional Exchanges, GEMx Student Reflections

New blog by Karl Alex Mogaka medical student at Kenyatta University School of Health Science who has completed his elective at the Pari Hospital (Zimbabwe) 

A phone call from Dr. Kahiga, the GEMx coordinator changed a rather dull afternoon. I must have been excited to learn that my school had spotted me for an exchange program. Apart from having to travel to a different country, experience a new culture, just having to fly made it more exciting.

Zimbabwe was the destination at the University of Zimbabwe. The exchange was to incorporate clinical pharmacy skills and knowledge for a month-long period. I arrived in Harare well into the afternoon, allowing enough time for Mr. Pozi, our driver to pick us up at the Harare International airport. The city was beautiful in the sky. ‘I will love the stay here,’ I murmured to my colleague Beryl, with whom I would take the elective, as the Ethiopian flight touched down minutes past noon.

Mr. Pozi easily recognized soon us after we checked out and drove as straight to the host institution where Mrs. Rachael, the elective officer, was waiting for us to provide further directions for the elective. Beryl and I spent the rest of the afternoon settling down in the institution. The weeks ahead will be engaging, but we up for it. The dean school of pharmacy, Prof. Tagwireyi was instrumental in drawing a Rota for the four weeks we would spend at his school. We spent the first week at the Drug and Toxicology Information Services (DATIS). At DATIS we were able to gather knowledge on handling of poising cases. Poisoning can be chemical, biological or physical. Most of the cases handled at DATIS were referrals from the rest of the country. It was interesting to get hands-on skills in managing poisoning cases especially ones deemed hard to handle by primary and secondary care facilities.

Mr. Gadaga, the director DATIS was very instrumental in showing us what needs to be done at every step of a referred case. For him, response time and determination of the actual poison were key to helping the patient. He also engaged in running of key tests at the specialized lab that was relevant for the poisoning case at hand. The culmination of this knowledge and skills gathering was a case presentation to the panel of DATIS pre-registration pharmacists.

The weekend was here, and being sabbath keepers, we found a local church for spiritual nourishment. It was home away from home. Mr. Nkobu, a church elder at City Church made sure we came back for the rest of the sabbaths.

Week two was yet another learning voyage. This time we hit the road 345 km west of the capital Harare to a district hospital. Themed as ‘Rural attachment,’ the week-long attachment was aimed at imparting knowledge on health structuring at primary care establishments. We made a visit to a level 3 facility as well as several level 1 facilities. Here, we appreciated the role of a pharmacist at the primary care level. Again, this exposure was very informative since such does not exist in my home country. However, the dominance of alternative medicine at rural establishments did catch my attention. The hospitals admitted that they allowed patients to seek non- conventional interventions for some “difficult cases.”

Week 3 needed some conventional medicine. We regrouped with my colleague. It was evident, the one week apart had us both missing each other. After all, we were the only thing close to home for each other. Prof. Tagwireyi organized for us to join the ward rounds at the Pari Hospital. A rotation at the hematology unit was quite a piece. We got to learn much about blood cancers. It was very fulfilling to suggest some of the management protocols for blood cancers. This case of stage 3 Hodgkin’s lymphoma complicated with anemia had the clinician, Dr. Banaman, seek the input of a pharmacist oncologist.

We also joined pediatric rounds. Here prof. Natoo was quite a bill. Her mastery of the pediatric protocols was just admirable. I loved her involvement with the caregivers of the children in the management plan of the cases.

Gynecology was another stop. We also rotated for four days as the other two. Much of the cases we came across mirrored what we had already encountered at home. However, it was interesting to note the differential management protocols for some of those conditions. The consulting gynecologist was quite patient with us for not knowing the given concepts. But again, we were open to learning as well. We wrapped it up with a rotation at opportunistic infection (OI) clinic which also doubled up as a research center for HIV/AIDS regimens for the Zimbabwe populace. I agree it was much informative.

We would not have done justice to the stay in Zimbabwe had we not visited the iconic Victoria Falls. Three days before our travel back home, we made a maiden journey to Victoria Falls, 600km west of the capital. The site of the falls is just breathtaking. We were both in awe all the while as we let the site take our breaths away. The excursion was iced up with a zip-lining experience. The learning experience at the Pari Hospital might have been fatiguing, but this experience was a deserved nerve-calmer. Soon, a flight would touch down at Nairobi JKIA. “Home at last,” I sighed as I checked out of immigrations. The new friends including one Mr. Van would be ones to keep in touch all through.

 

Rwanda: A Land of a Thousand Hills and a Thousand Opportunities

Filed under: GEMx Student Ambassador Network, GEMx Student Reflections

New Blog By: Myles Dworkin medical student at Sidney Medical College at Thomas Jefferson University who has completed his elective at the Central University Teaching Hospital of Kigali (Rwanda) through GEMx 

Rwanda is a small country located in eastern Africa covered by lush green forest and smoldering volcanoes. While the country is known as the land of a thousand hills, its capital, Kigali, might better be characterized as the city of a thousand opportunities. New businesses can be seen popping up on every corner and towering buildings appear as if constructed overnight. It represents one of the few places on earth where one can witness innovation in real-time. I have been lucky enough to work in Rwanda in various capacities for the past 5 years. When I became aware of the opportunity to formally study in Kigali at the Central University Teaching Hospital of Kigali (CHUK) through the GEMx partnership I immediately schedule my next trip.

One of the first things you notice when arriving at CHUK is the beauty of the surrounding areas. Kigali is constructed in the peaks and valleys of a series of large hills and you can see exactly what this means at the hospital. For those interested in studying at CHUK, the hospital is located close to the city center and there are several different housing options. I had a few friends living in Kigali, so I arranged to stay with them, but Airbnb and limited international student housing are also available. My colleagues at the hospital quickly made me feel welcomed and provided all the information I would need regarding where to stay and how to get around. On the first day, several of them accompanied me to the nearest market to ensure that I could get my phone and data plan set up. I cannot speak highly enough of my fellow students. Their hospitality and willingness to support me while dedicated to the rigors of medical school were fundamental to my experience and I look forward to the day when I can repay the favor.

My greatest passion and academic area of interest is surgery, specifically in resource-limited environments. As such, I arranged to spend 6 weeks working with the orthopedic surgery department at CHUK. While the international effects concerning communicable diseases have received attention in the past, the burden of surgical disease has only recently been identified as a growing public health crisis. A 2015 study performed by the Lancet Commission identified many of the areas of greatest need for improved surgical capacity to be located within low- and middle-income countries such as Rwanda. As a student pursuing a career in global surgery, I found CHUK to be the ideal place to study the intersection of surgery and public health. 

Orthopedics is a dedicated specialty is still relatively new in Rwanda as they have only recently graduated their first residency class. This provided me the opportunity to spend time with the residents and medical students in their dedicated orthopedic curriculum. Each day we would meet at 7 am for the morning conference. During this time, we would present new patients from the previous day and review approaches for upcoming cases. This was followed by a lecture by a student or resident on a relevant orthopedic topic. We would round on the orthopedic ward around 8:30 am before heading to the operating theater where we would spend the rest of the day. We would typically perform between 5-10 procedures per day with trips to the emergency room to consult new patients or lectures by attending physicians between cases.

Orthopedic trauma is a significant contributor to the burden of disease in the country, so the primary area of focus was on traumatology. This was ideal for a young student interested in surgery as it allowed for an in-depth review and exposure to anatomic relationships. I was especially interested to learn the similarities and differences in approach to care between CHUK, which is the primary trauma center in the country, and orthopedic trauma care in the US. I was comforted to find many similar protocols and procedures and was fascinated by the ingenuity and problem-solving ability of the Rwandan residents and surgeons I worked with. Despite well-documented resource limitations, they found a way to provide the best possible care to their patients allowing them to return to their friends and family. I was inspired by the compassion and work ethic of these physicians and hope to be able to obtain the education and training need to join them. I was exposed to a wide range of orthopedic trauma and learned an incredible amount in my short time at CHUK.

Despite the busy schedule at the hospital, I was able to take some time to see Kigali and the surrounding countryside. Kigali is a great city with an up and coming arts scene and great restaurants. As I have mentioned, I have been working in Rwanda for the past 5 years, so I have been to many beautiful places. This includes monkey trekking in Nyungwe Forest, safaris in Akagera National Park, and relaxing beach vacations on Lake Kivu. Unfortunately, I have not had a chance to see Rwanda’s world-famous gorilla population in Volcanoes National Park, but I guess I’ll just have to return for another trip and another opportunity.

Journey to the Art of Medicine and Life

Filed under: GEMx Student Reflections

By: Kirellos Atef Zaki Abboud from Ain shams University (Egypt) who has completed his elective at The University of Pavia (Italy) through GEMx

It was my first time in Europe. I was a bit afraid and was expecting a lot of troubles. When the plane was landing, I could see how Italy is beautiful and how it’s so green. You could only see green areas, homes, and roads. It was so charming and relieving just to look at it for 15 minutes before landing. I landed safely and started my journey in a foreign country. I searched for a place to stay hoping for an apartment and luckily, I found a suitable one. I traveled on Friday so by the time I arrived it was the weekend. I decided to have a tour on foot to explore the shops and transportation. I found it difficult to communicate at first because not many Italian speak English, but after about ten days I could speak some Italian words that are useful at shops and transportation, and of course google translator was a savior in many situations.

(Left to right) with Prof.Ciro Esposito. Prof.Massimo Toreggiani. & Prof.Marco Colucci.

I called Prof.Ciro Esposito – The Head of Nephrology Department at ICS Maugeri – and informed him that I’d arrived, and he explained to me the way and the transportation I should take to reach the hospital. I met my colleagues, there were three from Poland and one from Cameroon all on an Erasmus elective. I enjoyed their company a lot, they were kind and helpful.

My first 2 weeks at the hospital were in the ward, every morning the professors accompanied us to the inpatients and started explaining their condition, different possibilities for treatment and what we should focus on such cases. Some days our professors had some checkup visits for patients who were discharged from the hospital within the last few months. It was so informative to see such a huge number of patients in such a small time. The average number of patients we see daily was about five patients in the ward and maybe one or two for a checkup. The professors taught us a lot of things concerning Nephrology, how to take a history, how to examine patients, different kidney markers in lab tests and many things that I would list later.

(Left to right) with Professors at the Dialysis unit: Dr.Alice Mariotto, Dr.Giuseppe Sileno, Dr.Ettore Pasquinucci, & Dr.Alessandro Gaballo

My second 2 weeks were in the dialysis ward, every day the professors accompanied me for the round, we checked the patients performing their dialysis session concerning their compliance to medications, their overall health, if there is any pain, the patency of the vessels used in dialysis, their diet, and their last lab values. I noticed that dialysis session became a routine for these patients with little suffering, the hospital supplies them with the drugs and provide good, advanced and comprehensive health care services and ambulance help people with some health problems that where they provide transport for them to the hospital on the sessions days and bring them back home. I was amazed by the continuous assessment and care for the patient.

I attended some surgical procedures including:

  1. An arteriovenous fistula in the arm between the median cubital vein and brachial artery, it was done by Prof.Ciro Esposito and Prof.Massimo Torregiani.
  2. Central jugular catheterization is done by Prof.Massimo.
  3. Femoral venous catheterization is done by Prof.Massimo.
  4. Replacement of an obstructed femoral venous catheter done by Prof.Giuseppe Sileno.

I was honored to work and learn from these great professors, I owe them a lot, I will never forget what they have taught me.

Let’s talk about my daily routine there, I woke up at 5:30 every day, took a shower, brushed my teeth, drink my coffee and go out. After that, I’d spend about an hour commuting. I would arrive at 8 o’clock nearly, then I’d spend about four to five hours with the professors, after that, I’d go home to study or finish some of my work. Some days I would walk to explore the cities or visit historical places.

Visit to Como

On weekends I would travel. The first weekend I went to Como, it’s a small city with a lot of charming places and a wonderful lake. The second weekend I visited Venice, the most beautiful city I’ve ever seen. I wish I could go there every year. The third weekend I visited Milano and the Duomo; Milano is a huge city with many people. I was enriched with a lot of personal benefits and experiences, starting from traveling to a European country by myself, searching for an apartment, washing my clothes, preparing my food and doing everything alone, I had the chance also to visit a lot of beautiful historical places and cities. Italy is a country of art, that’s what I liked the most about it. I managed to deal with a wide variety of different personalities including the pedestrians, colleagues, professors, officers at different means of transportation and the friends I could make in such a short time. It was a wonderful experience that changed me a lot and the way I think and sees the world and I will do my best to repeat it.

Visit to Venice

Visit to Milano: Duomo di Milano.

With my GEMx Award

GEMx and American University in Beirut Making Dreams Come True One Robot at a Time

Filed under: GEMx Student Reflections

Blog By: Mostafa Sedky medical student from Ain Shams Univerity who has completed his elective at eye-caching American University in Beirut, Lebanon through GEMx

I went through an elective for one month at the eye-catching American University in Beirut. As it was one of my lifetime dreams to go there, GEMX provided great chance for me to apply for an elective and visit the place. Despite facing some difficulties to arrange for my travel, I used all my efforts and made it there. The amazing historical campus with the unique seafront view was fully equipped with a state-of-the-art entertainment, medical, surgical and educational equipment’s, which all added to the unforgettable learning experience.

One of my dreams that was also fulfilled was to learn more information about robotic surgery with the Da Vinci robot that was at the university and which is now the talk of the town in all the surgical fields. I had an opportunity to meet some kind and famous Lebanese professors and surgeons and learn from them about every single incision and suture while attending in the OR during my elective in the Department of General Surgery. I received a hands-on laparoscopy and suturing workshops on a simulator to add to the excitingly thrilling experience.

 

The administration has provided me with full access to the medical library which had a separate huge building with calm and encouraging weather and the latest medical news and information to indulge your knowledge with as well as a high-speed internet connection with subscriptions to open a lot of scientific databases and journals. I also had access to the student activity center which had a private beach, warm indoor swimming pool with an A/C surrounding as I was there during cold winter as well as an amazing Gym and an indoor basketball court. There were a lot of other courts like a stadium for football and tennis and volley courts but the basketball one was my favorite.

Regarding the exceedingly reputable and scrumptious Lebanese food, it was one of the best things in this country starting from the sizzling cheese of the street mankoosha to the mouth-watering ice cream of el Bachir, it was one of the best things in the country. When I wanted to be more healthy I resorted to the delicious Lebanese fruits especially apples which were unique than any other apples I have ever tried as well as the ambrosial honey from the cedars.

To add to the experience, l spent the weekends exploring this amazing country Lebanon from the far north in Tripoli visiting Faraya, Jetta, Junia, Byblos, Dora to Beirut then reaching to the south visiting EL Shouf, Beit el-Din, Deir El Kamar, Saida, Tyre to Baalbek. It was the first time in my life I built a snowman and went skiing then go to the beach on the same day. I spent some quality time talking to my new Lebanese friends and taking photos that make me perpetually happy whenever I remember them. It’s undeniable that this elective experience has called upon my untapped reservoir of tenacity, perseverance, fortitude, curiosity, and willingness to learn. It has opened the gates for me to believe more in my dreams and turned some of them into precious memories.

 

GEMx-SNO Exchange 2019: Refreshing My Passion for Medicine

Filed under: GEMx Sponsored Events, GEMx Student Reflections, GEMx-SNO

Blog By: Roxana Ramos, medical student from Faculated de Medicina UNAM who was selected as this year’s GEMx-SNO exchange winner, by GEMx and SNO TUFH and participated in a five week exchange at Flinders University NT in Darwin NT, Australia 

I am a Mexican 5th-year medical student that was selected to participate in the exchange to Flinders University in Darwin NT, Australia. It took me a while to believe the great news, and after I did, my excitement grew every minute until the day of departure.

Flinders University

I spent 4 weeks in the Pediatrics Department of the Royal Darwin Hospital, each week in a different ward: General Pediatrics and Adolescent Medicine, Pediatric Infectious Diseases and Malnutrition, Postnatal and Special Care Nursery, and the Outpatient Clinic. Every day started with the 8 am handover, where each patient was reviewed and after that everyone left with their teams to their ward. I liked this part because it was when I could hang out with the other med students for a little while. Each team was composed by a consultant, a registrar, a resident, an intern (or not), and a student. During the ward rounds it was like what I’m used to: follow the doctors, write some notes, answer questions, examine patients, get papers, and the most important job of a med student: awkwardly be in the way. Since I had already had my Pediatrics placement in Mexico, I felt confident about what I was seeing and listening, but the cool part is I got to experience different epidemiology and learn about diseases like Acute Rheumatic Fever and Rheumatic Heart Disease, that are very rare in Mexico. The two major differences I noticed from my home country to Australia are: – Doctors care for a good work-life balance and the system allows them to do it. The hours are reasonable, the pay is great and in general, the environment in the hospital is so nice and happy. Since the first day I was there I’ve been trying to think how to change the mindset of thousands of years and millions of doctors in Mexico, so that we can have a better quality of life. No clue until now, except lead by example. – Material resources are abundant, so they don’t struggle as much to give the best management and treatment to their patients. This also has to do with the Health System structure, which is very efficient in Australia. Although in Mexico we have a universal Health System, people still must pay (at least a symbolic amount) for consults, hospitalizations, and medicines. Meeting some of the doctors there gave me an idea of the way I want to be when I grow up, not just as a doctor, but as a person too. It refreshed my passion for medicine. We also had occasional teaching sessions, which were outstanding. Some of them included taking history and checking a patient by ourselves, others were to review a specific topic, etc. The Department also had other activities like the Journal Club, X-ray meetings, and Grand Rounds, which were great as well. Apart from the one-month rotation, I got to fly to a Health Clinic in a remote community called Warruwi in the South Goulburn Island. To prepare for this, I had to attend a Cultural Awareness Workshop. I enjoyed learning about the Larrakia people, mainly because I knew little about them before this exchange. I was surprised by some of their traditions, like their kin and family relationships, their traditional medicine history and their actual epidemiology.

Receiving my diploma from Justin Seeling (GEMx Manager) and Vishnupriya Vijayalekshmi (SNO President)

After those wonderful and enriching weeks, I got to assist the TUFH 2019 Conference, which was the cherry on top. I met med students from around the World, I was inspired by the talks and workshops, and pleased to know that there are good people everywhere who are trying to help others. I was excited to learn that next year’s conference will be held in Mexico City, and the best part: I’m the new Local Team Manager. I’m looking forward to the exchange and the whole event.

SNO International Executive Committee 2019-2020

It was a very enriching experience in all aspects of life. I feel blessed for this opportunity, and I think that it impacted me (in a good way) to see how Medicine is practiced in other places.

Njera, castles, and compassion: just three of the wonderful things I experienced at Mekelle University

Filed under: GEMx Regional Exchanges, GEMx Student Reflections

By: DAPHNE KIBANDA , 5TH YEAR STUDENT (MBChB) at MBARARA UNIVERSITY OF SCIENCE AND TECHNOLOGY

Day out at Emperor Yohannes’ castle with Kidus(L) myself(C) and Henry(R)
The thought of an exchange study program away from my home university and country was as excitingas it was scary. With the GEMx website and with help from Ms. Faith Nawagi, the GEMx Africa representative, the application process went smoother than I expected. Within less than a month, my colleague and I were ready to travel to Mekelle University, College of Health Sciences, in Ethiopia. Ms. Sheila and Ms. Angela Nakato from the International Relations Office were also key in our travel preparations.

At about 5 a.m. on Saturday 13th July, we landed in Addis Ababa. Our flight to Mekelle was at 7.15a.m so we had some time to lounge. This was both our first time in Ethiopia and at Bole International Airport and so locating the different terminals took some bit of time. It can’t go without mention that every single person we interacted with at the airport, both passengers and employees, was very welcoming and helpful. Unfortunately, the flight was delayed for over 3 hours due to unfavourable weather at our destination and since we had no way of communicating with our hosts yet, we missed our transport from the airport. Nevertheless, we were very well received into Mekelle by the staff, students and even the locals.

With some of the C11 class members after a management session.

We joined the C11 group on the Internal medicine rotation as soon as we arrived and made very many friends. The students always readily helped with translation during clerkships as we were not conversant with the local language. I particularly remember an incident where I went to the ward to clerk a patient and all the members of my group were not around. I walked through the ward looking for a familiar face in vain. Later, I met a student from another group and when I explained myself to her, she was more than willing to help. They made the environment very comfortable and conducive for the one month we spent with them. Every day on the ward at Ayder Comprehensive Specialised Hospital was a new learning experience. Although the prevalent conditions didn’t differ much from those in Uganda, we were able to compare National treatment guidelines for common communicable conditions in both countries. We also participated in ward rounds, bedside teachings, and management sessions and were able to share and expand our knowledge further.

Outside of class, we appreciated the diverse culture of the people in Mekelle. We learned several words and phrases in Tigrinya, the native language, and by the end of one week, “Selam” which is a word for “hello” came much more easily to me. They have a unique taste in food, and I fell in love with “Njera”.

Njera and stew
I could not go an entire day without this traditional dish and to date, Ethiopian food is one of my favourites and Ethiopian restaurants in Uganda are a go-to. We also witnessed a traditional Ethiopian wedding and I must say the African culture is rich and full of diversity. We managed to visit Emperor Yohannes’ castle in Mekelle city, which serves as a museum currently and had some of our new friends show us around the rest of the city.

Our stay in Mekelle came to an end after exactly 4 weeks and on 9th August, we had to travel back home. We said a couple of emotional and even tearful goodbyes and promised to keep in touch with our friends. It was an educative, humbling, inspirational and fun experience for me, and I look forward to more of these opportunities with GEMx. Thank you so much for this amazing opportunity.

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