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My Elective Exchange at The University of Zimbabwe College of Health Sciences

Filed under: GEMx Regional Exchanges GEMx Student Reflections

Joy Kinya Kimathi

Post by Joy Kinya Kimathi, a 5th-year medical student at Jomo Kenyatta University of Agriculture and Technology in Kenya who has completed an elective exchange at the University of Zimbabwe College of Health Sciences.

I was granted an opportunity to participate in an elective program in the University of Zimbabwe at the Parirenyatwa Group of Hospitals in Zimbabwe, from the 20th of August to 30th September, 2018 by GEMx. I found this as a great opportunity to learn, a stupendous chance to mingle with new people, explore a new culture, food, and new places. It’s worth noting that Zimbabwe is a vibrant country whose occupants mainly speak Shona and Ndebele, and are amazingly hospitable.

 

Reception and Accommodation

On arrival at Zimbabwe, I was treated to a very warm reception by the University of Zimbabwe elective office. We were 2 students from Kenya at the time of my elective. Throughout my stay in Zimbabwe, I was accommodated at the Medical residence elective flat within Parirenyatwa hospital grounds. This was a very convenient spot to access the hospital, and I wish to pass my gratitude to the Accommodation office at the University of Zimbabwe for this consideration.

At the Medical and Dental Practitioners Council of Zimbabwe (MPCZ).

Academics

As a prerequisite to working in any clinical area within Zimbabwe, one needs to register with the Medical and Dental Practitioners Council of Zimbabwe (MPCZ). This was one of the first exercises that I embarked on just after settling down. The elective office was kind enough to offer transport to the Board’s premises to register with them.

Clinical Areas

Being a very adventurous person, I explored various departments within the hospital during my elective. These included: Medical Ward, Hematology Department, Urology Department, Oncology Department. I have to admit that I had an awesome learning experience within the institution. The consultants were very enthusiastic and more than ready to impart their knowledge and skills to me. Special thanks to Dr. Marejela (Consultant Physician), for his well-researched discussions crowned with a special sense of humor. Being in your ward round was something each of us looked forward to every single day.

Special thanks to Dr. Mberi (Hematologist Consultant) together with the whole Hematology team, for your dedication to teaching me. Lots of gratitude Dr. Chikore for teaching me how to administer Chemotherapy.

At the Hematology Laboratory

It was a great honor to work with Mr. Dube (Consultant Urologist). His austereness kept us on our toes bringing out the best in us. A shout out to the Oncology team for being one of the most amazing teams to ever work with. I was able to participate in cancer diagnosis, staging, planning of management, radiotherapy, brachytherapy and chemotherapy sessions. Above all the team got to include me in most of their social events making me feel at home.

The junior doctors (JrMOs) in all the departments I rotated in, occupy a special part in my heart. They were not only colleagues but also mentors and probably the greatest friends I’ll ever make within such a short period of time. They shared with me tips on how to navigate around Zimbabwe and were really great chaperones.

In a nutshell, the academic part of my elective was marked with new amazing and interesting exposures. Of special note is the fact that the whole experience sparked in me, a special interest in oncology, a field that I had never ever considered prior to my elective.

Interacting with local students ZiMSA dinner

Social

Over my stay in Zimbabwe, I got to visit many astounding places. It all began with a tour around the University of Zimbabwe main campus. The institution is located in a vast piece of land, in an exquisitely serene environment at Harare.

Some of my major highlights were: A visit to the agricultural showground, visiting the National Gallery of Zimbabwe, Grabbing lunch and dinner with the Zimbabwe Medical Students Associations (ZiMSA), and visiting the Bally Vaughn Animal Sanctuary

Challenges

Zimbabwe cash crises:

I found myself in the middle of a Zimbabwe Cash crisis right from the time I landed at the airport. The challenge was brought by the fact that I couldn’t withdraw any money from the banks due to acute cash shortage within the country. This was a very unique challenge that I had never anticipated at all. To add insult to injury, some of the swipe machines in the country were not compatible with my visa cards making it almost impossible to pay for accommodation as well as the Board fee. However, I would like to take this chance to thank the UZ elective office for being patient and resourceful in handling any new challenge that came up.

At this juncture, I would also like to pass my heartfelt gratitude to the Kenyan Embassy in Zimbabwe. They went out of their way to enable us to get Hard Cash when all our efforts had hit the wall. God bless you richly.

Photo at the Kenyan Embassy

Lesson Learnt

To any student planning to travel out of their country, make a habit of getting in touch with your embassy on the intended country of travel before leaving your country. Let your embassy advise you accordingly pertaining your travel expectations and expected challenges. This will help with your planning and cushion you from any unanticipated shock.

Conclusion

My trip was amazing. In the beginning, I faced a few strains, but I still got the best out of this elective both academically, socially, and culturally. I greatly appreciate the opportunity afforded to me by GEMx team. I wish to thank everyone who went out of their way to ensure that I had the time of my life. The GEMx initiative is a great one, and I take this opportunity to encourage more and more students to enroll and be part of it.

Cardiology Electives in Uganda

Filed under: GEMx Regional Exchanges GEMx Student Reflections

Lindokuhle DIamini

Post by Lindokuhle Dlamini MBChB 5 student UKZN Nelson Mandela School of Medicine, South Africa

Preparations and Travelling to Uganda

During the time I was preparing for my trip to Uganda for my Cardiology electives for three weeks. I was not sure whether it was going to be possible for me to go to Uganda or not due to the fact that this was my first time traveling to a place that is outside of my own country. Immediately after my online application through GEMx, everything was easy for me because I received the help I needed on time and hence it was easy to get Immunizations, Visa, and other useful information about the place I was traveling to on time. Many people intervened and assisted a lot, Prof. Mergan Naidoo who is the GEMx Manager at UKZN, Professor Ncoza Dlova the dean of clinical medicine at UKZN medical school, Faith Nawagi from GEMx and Sunga Chumia helped me a lot with the whole process.

During the day of my trip to Uganda, I missed my flight from South Africa to Entebbe in Uganda, and this was due to the fact that there was a very long immigration cue at the airport and very few consultants, this was the only challenge I faced, but I did rebook the flight and the following morning I then traveled to Uganda, it was a good experience indeed.

Arrival and General Impression about Uganda

I arrived at Entebbe, and I checked in in the country after that I went to the Mugalo Hospital guest house where I was staying for my electives, I met many people in Uganda, but the common thing I noticed about every individual I met is that they were so welcoming and respecting as well, even though sometime I would not feel well because I did not fully understand their culture during the few days of my arrival in Uganda, and my fear was that maybe I will do or say something that means something bad or rude according to their culture, but their respect always kept me feeling at home. Uganda is a very good country but very expensive. I went to Shoprite just to get a few items at Acacia Mall and while comparing prices with the South African Shoprite, it was a lot more expensive. Staying at Mulago Hospital guest house was very good I met few Medical students from other countries and it was very nice to meet them, listen, and observe them as well I learned a lot from them both academically and socially.

Lindokuhle posing for the camera

My first day of Cardiology at Uganda Heart Institute, as I was still battling with the one hour difference between South Africa and Uganda, one of the Medical Students from the College of Health Sciences was sent to come and give us a tour around the Mulago Hospital, it was so useful because from then I did not struggle with directions around the entire hospital. On my first day, I met Dr. Isaac Ssinabuyla who is the manager of the GEMx at Makerere University, who is also a Cardiologist at Uganda Heart Institute, I also met Phionah Kinwa who is the Associate Coordinator for International Programs at Makerere College of Health Sciences. Dr. Isaac Ssinabulya took us and we went to the Heart Institute, we arrived the ward round had already started and he introduced us to the team. The Cardiologist who was in charge was Dr. Lugero Charles.  I learned a lot, most of the patients we saw were mixed valvular disease patients. The team I was with at the Uganda Heart Institute were so keen to teach, I learned a lot from them, not only academics but even the conduct of a Medical Doctor, being part of the team equipped me, to such an extent that I now consider Cardiology my first choice specialty. On Tuesdays, I attended major ward rounds where I met Dr. Batambuze an old Cardiologist who received his training in the United States. He taught me Cardiology, most patients presented with the mixed Valvular disease, coronary artery disease, Aortic dissection mostly caused by hypertension, and congestive Cardiac failure.

Lindokuhle and his colleagues

I clerked and presented patients to the doctors during ward rounds, and the most important thing Dr. Batambuze use to emphasize was the issue of being able to pick up clinical signs and being able to interpret them, as well as the importance of demonstrating how you elicited the clinical signs you mention. My Cardiology clinical attachment helped me a lot; it taught me to work with other people. Dr. Batambuze organized tutorials, and he uses to give both us medical students and MMed students tutorials, it is quite good to be involved in a clinical setting with many medical doctors, because you get different views and approaches as well which broadens your horizons. After the ward round, I used to study a lot, to try and cover as much work as possible. It was much discouraging to learn that Doctors are underpaid after so much hard work of their training, and the type of care they give to patients. It was also sad to see some of the patients in beds because nothing can be done but only palliation and some of them cannot afford to pay for the surgery procedures more especially the Type A Aortic dissection patients, because of limited resources at Uganda Heart Institute, and patients have to be transported to Kenya for such procedures only to find out that patients cannot afford, but I was glad because even though most patients could not afford, Doctors use to continue with medical treatment learned that there is a lot of communication in medicine, and to be a good doctor does not only require excellent academic record but it requires a lot of passion, patience, and commitment. I also learned to approach patients as a whole, not only to treat the disease but also to focus on other aspects of life, because they might be the precipitants and the cause of the disease. And now that I am at home I will make sure that I help other fellow students, and furnish them with all the information I received at Uganda Heart Institute. I really appreciate the experience I had at the Uganda Heart Institution.

Lindokuhle in his medical cap and stethoscope

Acknowledgments

I would like to thank GEMx for offering this exchange program, which made everything easy on my side as far as applications and other important information is concerned, thanking SAMA Scholarship for offering me funding. Prof Mergan Naidoo who is the manager of GEMx at the University of KwaZulu Natal(UKZN), Prof Ncoza Dlova who is the dean and head of the school of clinical medicine at UKZN who encouraged me to apply and further assisted me with finances where they were loopholes, Miss Sunga Chumia who assisted me with logistics. I would also like to thank Dr. Isaac Ssinabuyla who is the manager of GEMx at Makerere University in Uganda for the help and for hosting us as well as Phionah Kinwa.

Learning about the Healthcare System in Kenya

Filed under: GEMx Regional Exchanges GEMx Student Reflections

Post by Frank Mayindi, a GEMx Medical Student from Makerere University College of Health Sciences [MEPI] taking an elective program at Kenyatta University

Frank Mayindi is my name, from Uganda, a Muganda by tribe, 24-year-old male currently pursuing a bachelor’s degree in medicine and surgery at Makerere University Uganda-Kampala College of Health Sciences currently in my fourth year of study, with a very strong passion for surgery, aspiring to be a neurosurgeon in future.

FRANK MAYINDI(1) EBELE GIFT ISAAC(2) MRS DOROTHY .W(3) AND KIKOYO JOACHIM(4) from the left side at the safari park in Kenya.

I undertook an elective placement at Kenyatta University Nairobi, Kenya through the period of 2nd June to 1st July under the Global Education in Medicine Exchange (GEMx) and I take this opportunity to extend my heartfelt gratitude to everyone that made this possible. ( Makerere University international office, Kenyatta University, and the GEMx co-ordinators).

My stay in Kenya was full of many experiences. While at Kenyatta University I rotated in the Department Of Surgery at the Kiambu level 5 hospital.

For the time I was in the hospital, I participated in ward rounds (major and grand), clerkship, and examination of patients, follow up of care of patients and bedside teachings. These activities enhanced my clinical skills especially in surgery and also served as a stepping stone to pursue my career in surgery.

I also attended CME’S (Continuous Medical Education sessions) and Morbidity and Mortality reports in which I got updated about some of the current medical practices and different approaches to patient care. I also appreciated the key leading causes of mortality and morbidity in the hospital’s catchment area.

Photo with the rest of the GEMx members at the postmodern library in Kenyatta University

Through my interaction with fellow students, I learned a lot about the Kenyan culture in terms of language, culture, and entertainment. I cannot withstand the temptation to mention about the wedding I attended at one of my friend’s place and the fact that most of the weddings were held on Saturdays and all vehicles attending a burial had to bear a red cloth tied to side mirrors or any available place as a mark.

I managed to attend a community outreach held at Brydges Home Center in Kajiado County, it was a place away from Nairobi and I managed to have an experience of Kenya outside the main capital city. While at the outreach I stationed in the pharmacy department where I managed to dispense different medications to the different patients, it gave the opportunity to interact with the pharmacy students and also learn briefly about the common drugs used in Kenya.

Group Photo was taken at the community outreach

Through my stay in Kenya, I realized that it was a cold country compared to my home country, however, I managed to maneuver through the weather through the use of jumpers and very thick sweaters. However, there were no unexpected outcomes through my stay in Kenya.

I was warmly welcomed by the student community especially the students I was to rotate with, at a moment I didn’t feel I was in a different country, they played a major role in my stay in Kenya. They taught me a lot of Kiswahili and Kikuyu, allowed me to join them in their co-curricular activities like football matches plus tennis and also I participated in their discussions as early as the 4th day of my stay. Still, through the guidance of my fellow students I managed to visit the national hospital of Kenya-Kenyatta National Hospital-and this broadened my picture of the health care system in Kenya. All in all my interaction with the students was far-reaching and up to now I still maintain communication with them and there was no moment I felt unsafe and not welcomed by them. Through interaction with the lecturers, I managed to meet with surgeons practicing in Kenya and the chairman of the department of surgery at the hospital, these greatly natured me in the field and encouraged me to pursue my career further.

The picture was taken at one of the clinical teaching sessions in Kiambu

To any student out there planning to partake a GEMx elective in a country away from home, I strongly encourage you not to hesitate to pursue such an elective. Learn about the language of the host country especially the basic words for basic community survival and also while in the host country make as many contacts as possible to further grow your carriers and to enhance your international relations and let every day that you spend for your elective count.

 

Ntuthuko Mkhabela’s Cardiology Elective Exchange to Uganda

Filed under: GEMx Regional Exchanges

Ntuthuko Mkhabela

Post by Ntuthuko Mkhabela, a 5th- year medical student at the University of KwaZulu- Natal in South Africa taking an elective program to Makerere University in Uganda. (Student on the left)

Introduction

My name is Ntuthuko Mkhabela, I am a 5th-year medical student at the University of KwaZulu- Natal in South Africa.

I was afforded the opportunity to do a Cardiology elective program in Makerere Univerity in Uganda at the Mulago Hospital Heart Institute from the 4th until the 23rd of June 2018 by the GEMx.

I found this to be a great learning opportunity and also a very prodigious chance to explore new places and meet new people. From when I got to Uganda I found that everyone was very friendly, though it was difficult at first to settle in and comprehend how somethings are done but within a few days, it really felt like home.

Academics

Group photo at the hospital

I had to admit that I had the best bedside teaching at the Heart Institute and they have the best grand round on Tuesdays with the best and most enthusiastic teachers I have ever had any chance to meet.

I was a great honor to get teaching from Dr. Batambuze “The Lord of the Heroes” as he refers to himself when entering the ward, he isn’t only a great consultant but also offers the best form of teaching in a very passionate and motivating way; and he also has a great sense of humor.

He was very patient with us and even though he had not come to teach undergraduate students. He made us feel welcome and were willing to assist us wherever we got lost. He would take us all the way from basic science and anatomy up to the clinical and bedside medicine and the one thing he really enforced was the importance of proper and evidence-based bedside clinical medicine and how it would assist in saving a patient’s life and for that I would like to forward my special thanks to him.

Ntuthuko Mkhabela and Lindokuhle Dlamini

We also had the best team in the ward led by Dr. Majwala who also held our hands throughout the period together with his MMed students: Dr. Ssibuliba, Dr. Were, and Dr. Herbert. They were willing to not only share their much valuable knowledge with us but also even shared some of their resources with us.

It was really a great motivation to me and if given the opportunity I would definitely love to work with them again because I think there is a lot that I could learn from them and it wouldn’t be just for me to not appreciate these great individuals. It also wouldn’t be just for me not to appreciate Dr. Lugero for his great teaching, he was the first to welcome us and he rightfully told us that he cannot welcome us with a party or whatever but he can only welcome us with academic questions and indeed his teaching remains highly appreciated. I would also like to appreciate all the other doctors I have not mentioned above who also were willingly and undoubtedly making efforts to ensure that we are trained to become great clinicians.

I also had an opportunity to spend some time in the Cath Lab to see how coronary stents are inserted and again we were welcomed with warm hands and without any objections taught us as much as they could within the little time we had in there and it was again a memorable experience.

Briefly, I would just say I the academic side of my visit had the best teaching I have ever been exposed to in my life and I remain grateful, and one would then safely say the purpose of the trip was fulfilled.

Social

Ntuthuko Mkhabela selfie

During my stay in Uganda, I had a chance to explore a number of places in the area, starting with the tour around Makerere University which we had with Clement who was a great host and was always there when we needed him. He became more than just ‘a student who was supposed to show us around’, he became a friend and a colleague who we shared a lot of great moments with and also shared knowledge.

He is a great leader and has been in the student leadership myself, we actually shared a lot in common hence we got along very easily and I sure do wish him well in the future and hope we do meet again at some point.

I also had an opportunity of watching the multicultural tribes of Uganda performing their traditional dance TWICE because for some reason I just couldn’t have enough of their dance,  jokes,  music and of course the food courtesy of Dr. Isaac.

Ntuthuko Mkhabela enjoying traditional activities

This was a great experience and it made me wish to get a chance to go live in their rural areas for at least a day so I could be part of the traditional activities and have the first-hand experience of how it actually feels to be one of them because I was already feeling like one of them even at that time. I couldn’t really tell whether this gentleman was too tall or it’s just that I am very short but I honestly had the most fun at this cultural dance event I also had an opportunity to go and watch a local rugby tournament and also meet up with other medical students from different other countries from all around the world. I made a lot of friends who I learned a lot from; we also watched a number of world cup games together and shared a lot of fun moments. With some, we even share the same accommodation which allowed us to get to know each other even more.

Unfortunately, I didn’t get to go to the Safari and to Lake Victoria with them, which I really think it would have been really great adventure given the fact that it was in the home of the Nile Rivers its self.

Ntuthuko Mkhabela enjoying his stay in Uganda

Conclusion

Even though the trip started off on a very frustrating note from missing our flight and having to spend a night in Johannesburg to serious financial constraints but in the end, all the efforts were worth it and I definitely would relive every moment of it if given the chance again. I appreciate the opportunity that was afforded to me and would like to thank everyone who put their efforts into ensuring that this trip became a success.

Smiling with my new friends

I think this GEMx initiative is a great one and really I would like to see more people from our school taking part in it.

Thank You

 

 

 

 

Get to know Mercy Muhadia Okova

Filed under: GEMx Regional Exchanges

Post by Mercy Muhadia Okova, a 5th-year medical student at Jomo Kenyatta University of Agriculture and Technology. 

I spent most of my childhood days in the rural area, the western part of Kenya and my high school and college days in the capital city Nairobi. I have a taste of both rural and urban life which makes life easier for me because I know how to deal with people from both sides.

When I was young I would sing the common song of many children that when I grow up I would like to be a doctor. However, that dream made sense when my dad fell critically ill and I wanted to understand what was happening to him and help where I can. I was also motivated by a young lady: a medical doctor who was in her second year of residency in Neurosurgery. That made me believe young ladies can also excel in the field of medicine. I excelled in my final high school examination and got admitted to study medicine.

Unfortunately, my dad passed away while I was in my first year of study before I could barely understand what made him unwell. Later on, I understood and this fueled my passion to fight Non-communicable diseases(NCDs) by creating awareness on healthy lifestyle practices for prevention of Non-communicable diseases. I write articles concerning NCDs on my blog mercyokovaonncds.wordpress.com

I learned of the GEMx electives through my classmate and we met the coordinator in my school who guided me in applying for an elective at University of KwaZulu-Natal, South Africa and got accepted to rotate in the Department of Family Medicine. I am glad to have met a very pleasant team lead by Professor Mergan Naidoo. The program is quite busy already learning a lot in the first week. I hope to share more experiences as the elective goes on.

The 4 Amazing Weeks in Nairobi, Kenya

Filed under: GEMx Regional Exchanges GEMx Student Reflections

Joachim Nsubuga Kikoyo

Post by Joachim Nsubuga Kikoyo, final year medical student from Makerere University Medical School.

I wake up, time check 7:46 AM, I know it’s a different morning, one that is starting the day that I am going to have the longest and funniest journey of my life. Deep into my heart, I sing, “I am going to have the most amazing time for the next month.” My name is Joachim Nsubuga Kikoyo, a final year medical student from Makerere University Medical School and this is my four-week experience in Nairobi.

 

TRAVELS

Well anticipated, me and my colleagues including; Bitira Lyness, Wassajja John Bosco, Akanyijuka Abel, Mayindi Frank and Ebele Isaac Gift had already paid our bus tickets two days prior; so we are already at the bus station at 6:25 PM. Our luggage is packed and there we are, setting off at 7:09 PM.

Taking selfies on the bus

4 hours later, we are at the Uganda-Kenya border, cleared everything normally, but then one thing is messed up. Our bus has broken down. We are stuck for almost one and a half hours until we get back to the road. One good thing was that we got to have a wonderful view en route including the Naivasha Game Park, and Savanna Vegetation! It was some sort of a blessing. We however arrived and settled in Solomon plaza, in Kahawa Wendani in Nairobi.

FIRST DAY

I can’t completely describe the feeling, the wonderful environment, friendly people, the food, the glamorous weather, etc. To make this interesting, I will split this into parts.

a) Food

The food is not so much different from our food.  Just what we eat at home as snacks are what they actually eat as lunch, and supper. For example one can have a Chapatti (Chapo) with any sauce, beans, meat, etc. well they have lots of new foods I’ve never eaten, seen or even heard before, say for example; Ndegu, Mutura, and Mukimo

Ndengu;

I always call these ‘tiny peas’. They almost have the same taste. They are greatly delicious especially when served with rice.

Ndengu “Tiny Peas”

Mutura:

Mutura dish

My favorite; I almost ate it every day. It consists of offal’s packed with minced meat and usually some fats. It is either fried or grilled and then served with salad or chili. The taste is confusing between offal’s and meat if you have ever tasted both separately.

 

 

Mukimo:

Mukimo dish

A mixture of Irish potatoes, maize and pumpkin leaves that gives it the green color, all mashed together to form one solid chunk. The taste too is combinational, though the Irish potato taste is prevailing.

 

b) The people and the language

I can possibly say, Kenyans are the friendliest people I’ve ever met. Not that I haven’t met all of them, but it gave me that ill feeling that I don’t usually act in the same way when other visiting international students come at Makerere. I mean, who stops and asks if you are lost; and then after directs you, where you desired to go.

One only challenge though is the language. Kenyans speak, mostly Swahili, English and some speak some Kikuyu and other native languages. It’s funny that I don’t speak Swahili yet I come from the great East African region that is thought to be speaking Swahili as a joint language. But anyway I labored to learn how to speak some including: How you would inquire about a price, Ordering some food, Asking for directions and of course How to greet I still got many friends though, including; Punam Raval Ajay, Brian M Mbogo, Vugutsa Magada, Daudi E Musokyi, Dennis Mukabati, Juliet Wanjiri N .

Joachim taking pictures with his colleagues

An interesting thing though is that people who speak English are often thought to have more money, “a rich kid.” When you are negotiating prices you will always be charged extra despite your resemblance to the natives if you can speak English.

On Sundays, I took off some morning hours to attend mass. The mass was amazing attending one in a new community. Everything was however normal since it’s the same procedure like one at home, just the language though.

 

c) Transportation

Well if you are from Kampala and you are used to the boda-boda guys; in Nairobi they are rare, if you are to get one, which is possible, they are a bit high at cost and usually not allowed in the city center. So you will probably enjoy their great matatus (taxis). One funny thing with them is that, if you are to board one of them (that is if you are lucky) it will feel like you are entering a club. The matatus have loud booming music, flickering lights, and a large TV set in the front. The ride is inexpensive as a 2 km distance can cost you as low as 10KSHS.

d) Prices

The standards of living in Nairobi are kind of higher than that in Kampala. It’s worse if you don’t know where to buy the cheaper stuff if you can’t speak Swahili and worse if you are bargaining in English. So if you have a Kenyan friend, stick to that one, he/she will probably save you.

e) The Weather and Climate.

Not so much from the one in Kampala, its rainy season in June and so in Nairobi. It’s too cold, you will probably consider coming with winter clothes to be on a safe side.

f) Sports and Leisure.

A lot of sports activities exist at Kenyatta University; Soccer, Hockey, Basketball, Handball, etc. The sport I am interested in is soccer. It is fun to play around with my Kenyan brothers, even when communication skills are poor. At least you can use sign language or even struggle to shout Swahili words, but anyway, the major thing is I enjoyed playing soccer.

HOSPITAL WORK

Kenya organizes their health system in a stepwise manner so as complicated cases are referred to a higher level i.e. from level 1 (Community Level) to level 6 (National Referral Hospital).

I was stationed at Kiambu Hospital, a level 5 facility, with almost all facilities to manage most of the conditions in Kiambu County of Kenya. I was rotating in Pediatrics and it consisted of three wards; Newborn unit (NBU), Ward, 1 and Out-patient Department. I decided to rotate in each of these wards weekly.

a) NBU

NBU Facilities

Not so much different from the one in Mulago, with nearly all facilities, with a good sense of organization and yeah the crying cute little ones who I loved to be around with. One other thing though, it’s kind of too hot in there, so it was usually my safe haven for the freezing cold weather during that week. At NBU, that’s where I got to be taught by Dr. Mugane a neonatologist, who took me through the common conditions managed at their unit and how and they are handled.

 

 

b) Ward 1

Doctors from Ward 1

The ward consists of the resuscitation area, the acute respiratory emergency management, and others. One specific thing, however, is that I was lucky to be taught by the pediatrician, Dr. Grace Akech Ochieng, a consultant pediatric cardiologist, who took me through the echocardiography. I learned how it is taken, read, and interpreted. It was my first time seeing one be done.

 The Medical Camp

This involved boarding buses to Isinya in Kijiado County, South of Kenya at a children’s center (Brydges center). It involved examining the kids, providing them with prophylactic treatment and distributing hygienic supplies. It was fun to hang around small kids even when I know we can barely communicate.

THE TOUR OF THE NAIROBI SAFARI WALK

My colleagues and I got to visit the only game park in the capital of the nation.  This involved sight and sound of different animals, trees, the river and the people. Though it is not my first time to see animals like the ostrich, hippopotamus, hyena, buffalo, crocodiles, and many others, it was however too long since I last saw any of them. I guess my last time was when I was 8 or 9 years old. The best part of all of the tour was being able to hang out with the newly acquired friends and enjoying every moment of it.

THE LAST DAY

I hate goodbyes, but unfortunately, that’s life! Everything has a beginning and an end. It was the end of the four weeks; I knew this would be hurting to leave. So I had to say the hard words. Even though I know I will see them again.

The picture with the GEMx team

 

Get to know: Imelda Namatovu

Filed under: GEMx Regional Exchanges GEMx Student Reflections

Imelda standing in front of the airplane.

Post by Imelda Namatovu, a student from Makerere University College of Health Sciences [NEPI]  on an elective exchange to Lusaka School of Nursing and Midwifery [NEPI] 

The cyclical patterns of audacious curiosity and dogged determination have constituted the last two decades of this maze, I call my life. For an African girl who has been raised in deprivation of opportunities to dream big as well as bring her dreams to life, it is my pleasure to confidently say it is never about society but arduous nature of the person in you. This get-up-and-go has further driven me to ends many never thought I could stretch. Pursuing the Nursing profession has unbolted all doors to my career goals. My interest in Nursing research and teaching is growing untamable as well.  I enjoy watching soccer, teaching and singing is my most treasured hobby. Coming from a relatively smaller highly populated country (Uganda), my experience in Lusaka (Zambia) has been a totally different one. Being a large country with a relatively smaller population, I have met a number of very warm and welcoming people who are willing to spare time to teach us as well as make us feel at home. Despite the comparatively cold weather, Lusaka has been a wonderful discovery in my life. It has been wonderful experiencing a different culture while learning from another health care system as well as expanding my career network and professional aptitude.

Imelda standing with her colleagues

GEOFFREY MPHATSO KWABENA WIAFE

Filed under: GEMx Regional Exchanges GEMx Student Reflections

Post including excerpts of a report by Geoffrey Mphatso Kwabena Wiafe, who recently completed an Ophthalmology elective at the University of Nairobi, Nairobi, Kenya –a GEMx facilitated College of Ophthalmology of Eastern Central and Southern Africa  (COECSA) Regional Exchange. 

The University of Nairobi is located in Nairobi, the capital and largest city of Kenya. The University of Nairobi started postgraduate training in Ophthalmology in 1978 under the Department of Surgery. Ophthalmology became an independent department in 1990. The department has trained over 159 Ophthalmologists from 1978 to date. The teaching eye clinic is housed by Kenyatta National Hospital and there are various sub specialties including Glaucoma, Oculoplastics, Vitreo-retinal and Anterior Segment which I benefited from during my one month elective period.

Geoffrey examining a patient using an indirect ophthalmoscope

I am very fortunate to be one of the students from my University to be involved in the GEMx Elective program. Being a part of the exchange has further boosted my interest in sub specialties like Oculoplastics and Vitreo-retinal surgery.

The first half of my elective period was primarily spent at the sub specialty clinics, where I had the opportunity to see a wide variety of interesting cases including Aponeurotic Ptosis, Congenital Glaucoma, Choroidal Detachments and Central Serous Chorioretinopathy (CSC). I was also given the opportunity to take patient’s history, examination, and work up. Then, I presented some of the cases to the consultants and they gave me a better understanding of the diagnosis and how to manage those conditions.

I also had the privilege of learning and participating in the screening of Retinopathy of Prematurity, which made me more confident in not only the use of an indirect ophthalmoscope but examining neonates.

The last week of the elective took place in the clinic and operating theatre. Spending time in the operating theatre, I was able to observe for the first time the surgical repair of a retinal detachment. I also observed Laser surgery (photocoagulation) and vitrectomy surgery.

During my elective period I was also fortunate enough to have attended a few lectures on approach to management of Glaucoma and Glaucoma surgery and complications by Professor Damji. I also gained more insight on interpretation of visual fields and optic coherence tomography findings.

Dr Teddy, Dr Muchai (VR Surgeon) and Geoffrey

In general, the elective as a whole was a great experience. Both the consultants and residents were always ready to assist in whatever way possible to make our stay in Nairobi a memorable one. Towards the end of the elective I was certainly more confident and had a much better understanding of the management of several conditions.

Ophthalmology is an extremely rewarding and dynamic field of medicine. This elective gave me the opportunity to acquire more theoretical and practical examination skills. I look forward to using these skills during the rest of my training and career as an ophthalmologist.

 

 

 

ACKNOWLEDGEMENTS

Global Educational Exchange in Medicine and Health Professions for the elective opportunity.

College of Ophthalmology of Eastern, central and Southern Africa for funding and organizing.

Ophthalmology Department, University of Nairobi for providing multiple learning opportunities.

Kenyatta National Hospital for providing multiple learning opportunities.

Ophthalmology Department, Mbarara University of Science and Technology for allowing me to undertake this elective.

An Ophthalmology Post-Graduate Exchange Experience in Kenya

Filed under: GEMx Post-Graduate Exchanges GEMx Regional Exchanges GEMx Student Reflections Uncategorized

Post by Dr. Vrunaben Patel, a 3rd year MMed Ophthalmology resident from University of Zambia, who recently completed a GEMx Regional Exchange at the COECSA Institution,  Lighthouse for Christ Eye Centre, Mombasa Island, Kenya

doctor in front of care center

In front of Lighthouse for Christ  Eye Centre, Mombasa Island, Kenya

After all the pre-trip emails and detail fixing I finally sat on my flight to Mombasa, the full moon shining bright right outside my seat window. I was received at the airport by a friendly Lighthouse member of staff (got to read my name off a placard). Clean, convenient and safe housing was provided within the eye centre grounds.

THE EYE CENTRE EXPERIENCE

Day one at Lighthouse I met both the consultant ophthalmologists based there. I was shown around the whole centre by the medical director and introduced to all the staff. First word I learnt in Swahili was ‘karibu’=’welcome’ as I was greeted warmly by everyone, including patients I was introduced to. During my elective, I spent most of my time seeing patients in the general clinic as well as the cornea and paediatric clinic. Interesting cases I got to discuss with the consultants included persistent diabetic clinically significant macular oedema, neovasular age related macular degeneration, high myopia in toddler, solar macular burns, branch/central retinal vein occlusions, ocular toxoplasmosis, amblyopia, recurrent corneal erosions, corneal graft complications and viral illness related uveitis.

 

Doctor performing and eye examination on an adult patient

Examining a patient in general clinic

Doctor in scrubs performing surgery

Performing eyelid graft surgery

Had a few clinical meetings as well, some cases discussed were central serous chorioretinopathy, retinitis pigmentosa, oculocardiac reflex, and driver examination. My elective period included two weeks of screening patients and surgeries with visiting paediatric and corneal specialists. I got a chance to observe some penetrating keratoplasty surgeries, Descemets Stripping Endothelial keratoplasty and phacoemulsification; a totally new experience for me. Surgeries I did included 7 small incision cataract surgeries, 2 conjunctival growth excision biopsies, 1 pterygium excision and auto graft, 1 intravitreal injection, eyelid full thickness skin graft, anterior vitrectomy, examination under anaesthesia, and suturing corneal laceration/graft. I also did some dry and cycloplegic refraction using a phoropter for the first time.

plate with local cuisine

Local meal- ugaali and leafy vegetable

THE MOMBASA EXPERIENCE

Within walking distance of the eye centre lays the town centre of Mombasa Island. Stalls, supermarkets, places of worship all accessed easily nearby. Mostly I would be accompanied by a colleague from the eye centre while sometimes I was able to take walks around the town by myself and went to some local attractions like Fort Jesus. I also got to visit the public beaches on the mainland Mombasa and shopping malls. I was able to appreciate some similarities with Zambian culture- the matatus (mini buses) used for longer distances; ugaali (Nshima) and muchicha (leafy vegetable) as the staple meal. Other foods commonly found were cassava chips, dates, cashew nuts, mabuyu, and fresh coconut water.

OVERALL EXPERIENCE

Practice at Lighthouse was just like an extension of the work environment from Zambia though I missed having fellow registrars to interact with most of the time. The staff had different levels and exposure to ophthalmology training and so I had a good learning and teaching exchange. It was a minimum-stress environment on most days. I am sincerely grateful to the staff at Lighthouse for an enlightening and happy experience during my elective. I am also thankful to the GEMx team and my school for making this trip possible. Experience, be it that of oneself or of another, is definitely the best teacher and that is what this elective was for me.

A Regional Exchange at the University of Malawi College of Medicine

Filed under: GEMx Regional Exchanges GEMx Student Reflections

a smiling student

Post by John Baptist Ssenyondwa
GEMx exchange student from Makerere University School of Medicine 

John standing outside of the Queen Elizabeth Hostipal

My first day at Queen Elizabeth
Hospital

Medical school without a clinical rotation outside the teaching hospital environment of one’s training is not comprehensive enough. Through elective rotations, medics are exposed to the different experiences that come with working in a different setting from one’s training facility. I was one of the students that got the opportunity to take part in the GEMx Electives program this year. It was last semester for me and not only was I looking forward to completing medical school but also engaging in a clinical rotation for the weary holiday prior to internship. I had tried to apply for several programs that I could enroll in before I started internship but in all in vain.

As I walked through the busy schedules of school, the call for applications by GEMx Electives came to my notice and so came the interest to apply to take part. I had always wanted to travel as a student to a different medical school for an exchange program that would contribute to building my future career as a doctor. I immediately logged into my new GEMx account to find out the available universities for elective applications. I also found out that I was under the GEMx- South to South program which included University of Witwatersrand in South Africa;  College Medicine in Malawi, Makerere University and University of Rwanda. The days passed by and three weeks later on, I received the good news that my application had been accepted for the elective rotation at Malawi University College of Medicine. Filled with joy, I shared my good news with friends who were happy for me.

Malawi is divided into the central, northern and southern regions with 28 districts. The college of medicine is located in Blantyre, which is found in the southern region of Malawi. Having been established in 1992, it is the only medical school in the country with four undergraduate courses offered which include the five-year-long Bachelor of Medicine and Surgery (MBBS), and the four-year-long programs of Bachelor of Medical Laboratory Sciences (BMLS), Bachelor of Physiotherapy (Hon) and Bachelor of Pharmacy (Hon). For a greater portion most of my rotation, the College was on holiday and therefore I had appropriate contact time with the senior lecturers however limited interaction with the other students.

surgery being performed

Assisting surgical theater at Mercy James Centre for Paediatric Surgery and Intensive Care

The first official day of my elective found me at Queen Elizabeth Central Hospital in the Surgical Annex for the handover meeting held daily. Queen Elizabeth Central Hospital is the largest government tertiary unit and main teaching hospital for the College of Medicine. The hospital handles the referrals from the districts surrounding Blantyre. I was oriented through the facility ends and corners so that I could get my bearings well thereafter. I was introduced to the head of department, Surgery and each individual on the team I was joining in paediatric surgery. I rotated through paediatric surgery for first three weeks and one week at Beit Cure International Hospital.

Cure Malawi is a 58 bed teaching specialized in treating orthopedic needs of children and adults opened in 2002. The hospital also has special expertise in total hip and knee replacement surgery, making it one of the few places where this surgery is available in Sub-Saharan Africa. The hospital treats a wide range of orthopedic conditions including clubfoot, burn contractures, osteomyelitis, and other acquired or congenital conditions. In addition, CURE Malawi also provides physiotherapy and chiropractic services.

Table of Metrics

Table I. The cases observed and assisted in Paediatric Surgery rotation at the MJC theatre

 

Table of Metrics

Table II. The different surgeries participated in at Beit Cure International Hospital

While at Queen Elizabeth Central Hospital, I attended the handover meeting first before heading out for the day’s work each day. At these sessions, a 24 hour recap of the cases handled by the department was held and these cases discussed by the resident doctors together with the respective surgical teams of General Surgery, paediatric and orthopedic surgery.

Ward rounds were conducted daily by a senior consultant and residents on the different wards. The wards included: Paediatric Surgical Ward at the Mercy James Center; Chatinkha Neonatal Unit; Paediatric Nursery Ward; Paediatric Oncology Ward.  At the ward rounds, I was able to see several of the common conditions in paediatric surgery most of which I hadn’t seen during my school rotation. Additionally, we were able to discuss the conditions with the consultants and learn the approach to managing the ailments.

While in paediatric surgery, I was able to attend 3 ward rounds in a week. At the ward rounds, I was able to see several of the common conditions in paediatric surgery most of which I hadn’t seen during my school rotation. Additionally, we were able to discuss the conditions with the consultants and learn the approach to managing the ailments.

The OPD [Out Patient Department] ran every Monday afternoon after the rounds. While at the clinic I participated in eliciting history from the patients, examining and discussing with the consultants the different cases. This was a special learning experience as we saw several patients with a variety of conditions and therefore I always had various conditions to study. I had assignments to do every clinic and this facilitated my learning throughout the rotation. It was exciting to be in theatre and take part in the management of patients. I worked in theatre on Tuesday till Thursday for about seven hours each day.

surgery being performed

Assisting through the operations at Beit Cure Hospital

The rotation at Cure hospital was one week during which I rotated through the OPD clinic, theater and the wards. The OPD clinic also ran on Monday the entire day. I attended one clinic day of which we saw 30 patients with various orthopedic conditions. I was well facilitated by Dr. Lubega Nicholas, an orthopedic surgeon at cure who always discussed and ensured I followed through the activities at the facility.

I also attended teaching seminars at Cure hospital with the resident orthopedic students. Much as the cases discussed at these seminars were beyond my scope, I was able to learn the basic concepts on how to diagnose and know who to refer to. I learned the basic surgical skills employed generally in the field of surgery. I also took part in the general surgical management of the patients admitted at Cure, assisting in the various operations at the facility.

natural waterfall and pools

At Dziwe Lankhalamba Waterfall

While in Blantyre, I toured several beautiful places around the town during the weekends which also rejuvenated me throughout the rotation. I hiked Mulanje Mountain the highest peak in Malawi and visited several other sites like Mandala historical site among others. I met so many people and made quite a number of friends both within the medical field and other fields.

During my stay in Blantyre, I was able to work in a different environment with warm people eager and committed to improving the health of their patients. Despite the fact that the setting was much similar to my training hospital, I was able to achieve the objectives of my rotation.

I was able to develop and build my confidence in proper approach to pediatric surgical cases. My diagnostic acumen depending on history taking from the patients without need to depend on newer imaging diagnostic modalities was greatly improved. I was trained by highly qualified surgeons in the basic surgical skills and technique employed in the operation theatre which is a lifelong skill obtained.

group of young people

With new friends

The rotation greatly supplemented my prior curricular clinical rotation in which some concepts and topics had been unsatisfactorily taught. I was able to deeply appreciate and understand some of the topics clearly through the ward round discussions with my supervisors and mentors. Throughout the rotation, I had ample time to read up the cases I saw on the ward and in theater. I was also able to identify the deficiencies associated with our African health systems and how these impact on the health of our patients. I met different individuals practicing in the medical field and made friends throughout my rotation and stay in Blantyre. It was great interacting and socializing with people from all over the world but with similar goals and interests. I was able to share several ideas and experiences with my new friends and establish career building relationships.

 

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