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Sharing Experiences That Changed My Life

Filed under: GEMx Global Network GEMx Student Ambassador Network GEMx Student Reflections

Post by Fuensanta Guerrero del Cueto,  Student Ambassador at Universidad Nacional Autónoma de México (UNAM) guest speaker at the Manipal Teaching Hospital in Pokhara,  Nepal.

I believe in the importance of understanding and embracing diversity as a fundamental part of the medical profession.

When I was elected to be a Student Ambassador at UNAM, my main aim was to share my love for medicine, education and cultural exchange with fellow students who would later become my colleagues. If we can see ourselves in our patients, their families, other students, and doctors, no matter how different they may seem at the beginning, empathy will drive us to provide the best care that we can. An international experience is a great element to encourage it, and this is what I tried to transmit at the Leadership in Medicine lecture on 17 November 2016 during CICOM.

I was invited as a guest speaker to share my GEMx exchange experience at Manipal Teaching Hospital in Pokhara, Nepal in 2015. I was very excited until I knew that it would take place at the main auditorium of my school, which has room for 965 people, in front of all the UNAM and visiting students that were present at the contest. This certainly posed a challenge, since as a teaching assistant I had only given lectures to 40 or 50 students maximum. I felt that this great audience deserved to hear not only my story, but those of all UNAM students who had gone to Nepal before me, so I decided to compile pictures and quotes to show them why this elective had changed all our lives.

Embracing traditions: the celebration of Teej women’s festival with nurses from the Hospital

I told them that I had chosen Nepal because there was no place further away from Mexico that I could have traveled to (it is almost our geographical antipode). However, this turned out to be even more challenging because I arrived right after the 2015 earthquake and during a fuel crisis period. What shocked me at first was the difficulty to communicate with patients whose language I did not speak or understand. However, language barriers encouraged my reflection, since they are always present, not only with Nepali but even with Mexican indigenous languages or when caring for people without formal education.

Additionally, the importance of traditions and family structure is shared between my country and Nepal, and this is something that must not be overlooked by the medical professionals. Lastly, the strength of our people to “do more with less,” overcoming hardships and getting the best out of what they have is one of the most admirable qualities that we share with Nepal.

An elderly woman carrying wood during the fuel crisis. In the background, you can see Manipal Teaching Hospital and the Himalayan range

Community Medicine elective allowed me to approach marginalized populations in Tibetan refugee camps or in the mountains, where medical attention is difficult to access. The similarities between this country and my own were very meaningful for me. I became more aware of social and environmental determinants of health, and how patient education and empowerment are fundamental in these settings. This supported my decision to choose Global health and One health pathways for my medical career.

The opportunity to tell my story and try to inspire others was one of the best experiences as a member of the Student Ambassador Network, which I tried to continue during my outreach activities. I believe that medical students who dare to go out of their comfort zone will discover that “the others” are very similar to themselves. We need to become less isolated from one another in an increasingly globalized world where developmental and health challenges transcend national boundaries.

Team for outreach clinic with British nurses and Nepali doctor

 

Get to know Businge Alinaitwe

Filed under: GEMx Student Reflections

Businge Alinaitwe

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

Hello,

Briefly about myself,

I am a Ugandan male, self-driven, motivated and interested in personal growth and development in all aspects of life including social, economic, interpersonal and professional growth. I love my family so much as well as engaging in business. Professionally, I am interested in delivering quality healthcare and I believe in the future I will be able to establish a quality ensuring health facility. I like soccer so much, being a Bayern Munich and German National team fan. I love engaging in athletics as well as adventuring. My Facebook name is Busi Mohbyl and on Twitter, I can be found at @busimohbyl.

As of now, I am really enjoying Lusaka for the people here are hospitable and loving. The weather is cool. The learning is good as the clinical instructors at the University Teaching Hospital (UTH) are so much willing to teach and guide us. I am really so much privileged to have such an opportunity, thank you GEMx.

Businge Alinaitwe.

Smiling with colleagues

 

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

The Beautiful Art that is Medicine

Filed under: GEMx Global Network GEMx Student Ambassador Network GEMx Student Reflections

Josefa Santa Maria

Post by Josefa Santa Maria, a student ambassador from Pontificia Universidad Católica de Chile Escuela de Medicina who has completed an exchange at Universidad Pontificia Bolivariana Facultad de Medicina.

My GEMx Ambassador Experience: Exchange in Medellin

During the period that I worked as an ambassador for GEMx, I had the opportunity to participate in many activities, from virtual meetings to lunch with the dean of the faculty. However, probably the one that I will remember the most will be my Emergency Medicine elective in Medellin, Colombia.

One of the reasons why I applied to be an Ambassador for GEMx, is that I consider the values in medical education as something that transcends the geographical barrier, and the exercise of this in other countries (even in another city) is an enriching experience both academically and humanly speaking.

My personal experience doing the elective of Emergency Medicine at the Pontificia Bolivarian University in Medellin, Colombia, is something that I will definitely turn into one of my most precious memory. It was a great challenge (and I have to admit that I was even a little scared) to leave my comfort zone and to do part of my internship in a foreign country: everything was different: the schedule, the food, the academic requirement, the way of teaching, the responsibilities with patients, the shifts, and even though the language was Spanish all the same there were local words and expressions that took me a long time to understand, but none of that was an obstacle to get to the hospital every day with a big smile and my maximum enthusiasm to learn.

Posing in front of buildings

One of the things that I liked the most was the warm reception I received from my intern colleagues, the doctors and especially the patients, who always asked me where I came from, and how did I feel living in Colombia, on many occasions I had very interesting conversations with them. They were always very happy and grateful for the attention I gave them, that was something that definitely left my heart full. In addition to having theoretical seminars every day and all the learning I got from each clinical case in the emergency service, my elective in Colombia allowed me to experience the diversity of the gastronomic culture of the area, to do tours around the city, in which I learned from the history and tradition of the neighborhoods of Medellin, and visit the nearby towns, where I  could enjoy wonderful landscapes.

Standing next to art mural

All in all, the 4 weeks I spent in Colombia helped me grow in different dimensions, both personally and academically. They helped me to be more independent, to improve my ability to adapt, to relate to different types of patients, and last but not least, to learn more about the beautiful art that is Medicine.

Eric and Aline’s Elective Exchange to Uganda

Filed under: GEMx Regional Exchanges GEMx Student Reflections

NIZEYIMANA Eric and AKAYEZU Aline, 5th Year Medical Student from University of Rwanda. We completed GEMx Exchange on Family Medicine at Makerere University 

INTRODUCTION

Eric and Aline on the way toward Makarere University for Elective

Our hearts were very full the first time we received an email confirming that we were chosen to be a part of this amazing elective. The Family Medicine is not yet initiated in Rwanda health system. This was a golden opportunity to learn more and bring back a package of knowledge to share with our colleagues.

It is the dream of every Medical student to do an exchange outside of their usual setting so that they work in another healthcare system to learn and have a different experience that’s why I can’t hesitate to say this was our turn to realize our own.

 WELCOME TO MAKERERE UNIVERSITY  

Eric, Ms. Phionah and Aline at Makerere University

 

 

 

 

 

 

 

 

Our journey took 718 km2 from Kigali-Rwanda to Tororo-Uganda training center in Uganda, where the training about family medicine took place.  Arriving at MAKERERE University, we met  Ms. Phionah, the international students’ coordinator at this university. With warm welcomes, she gave an explanation about the exchange and introduced us to the rest of the team.

It was a great experience to travel the long distance on a bus. It was the first time, we took the time to observe the Uganda country, environment, and appreciate how well it is.

ACCOMMODATION

During our elective, we stayed at the Crystal Hotel. The hotel was close to the hospital. It was safe, comfortable and calm when you were studying. They had all kind of foods and it was delicious.

 

Eric and Aline at Crystal Hotel

The hotel was close to the hospital. It was safe, comfortable and calm when you were studying. They had all kind of foods and it was delicious.

ORIENTATION AT TORORO DISTRICT HOSPITAL   

Our 2nd day in Uganda was for the introduction to family medicine and orientation at training center, Tororo district hospital. We met with Dr. George Welishe and Dr. Okuuny Vincent, the senior consultants in Family Medicine who greeted us with warm welcomes. We had a  tour of whole hospital, introducing us to all departments of the hospital. We visited patient hospitalization wards, general theater, labor and administration offices &staff, emergency ward, HIV patients department and antenatal and family planning services. Everyone was happy to host us and we were also happy to be among them and excited to be in different healthcare settings. It is a large district hospital, which has many departments.

Eric, Aline, Dr.Okuuny and Dr.Maria (intern from Italy)

The daily schedule was made by morning staff meeting which was followed by ward round, theater, or labor or other department visit in the hospital.

1.Morning staff meeting

Every morning we have presentations on the topics that we were given on schedule. The topics that was chosen by trainers according to two conditions: 1.The most common cases in medical career related to the family medicine in which they think that will be useful to us along our internship and medical career. The second condition is the cases that are mostly found in Uganda healthcare setting especially in Tororo district hospital.  . Under consultant supervision, we had discussions in which they taught us on both our presented topic and presentation skills.

 2. Hospitalization Patients, Internal Medicine wards round

Aline, Eric, with Family Medicine Post-graduates Dr.francais and Dr.Christine on right and word round team on right

We had a daily attendance of ward round with the rest of the team which was made by family medicine consultants, family medicine postgraduates, nurses, and other medical doctors. I gained more experience in patient clerking and presenting during this activity and from this I understood that medicine is the same all over the world because it was very exciting to be able to make a diagnosis for a patient from another setting and participate in patient management by the same knowledge.

This ward round also emphasized on bedside teaching according to the case as long as also that most of the attendants were students. This was occupying a big part of our exchange where we learned much as found more cases that we didn’t see in our healthcare setting. Here I can list sickle cell diseases associated with malaria which is more common in the pediatric setting here, sepsis secondary to septic abortion, HIV and TB were more frequent in general wards especially in young people. We have seen some special cases like Asthma attack, dog bite, and pregnancy on sickle cell disease.

We learned from all the cases and were involved in their management process. We can confirm without hesitation that we are confident in managing patients.

3. Gynecology and obstetrics department

Eric using fetoscope

This was another interesting and productive service that we rotated in. The main objective was to know what services they deliver and get experiences in them as a future clinician and the objective was achieved. The major services that we provided were TORCH screening (toxoplasmosis, other, rubella, cytomegalovirus, herpes simplex/HIV)  and counseling on results, Prevention of Mother to child transmission of HIV, Family planning, Immunization, Examination of pregnant mothers to assess for any complications that might arise during pregnancy.

We experienced also on the procedures done included vaginal examination, head to toe examination focusing on the abdomen for the pregnant mothers to check for the fetal heart rate through the use of the fetoscope. The LEOPOLD Maneuver like palpation of the abdomen to check for the lie, presentation, and engagement of the fetus. Not only this but also in labor they taught us, conducting spontaneous vaginal delivery, neonatal examination, and resuscitation for the newborn with fetal distress and other complications.

We enjoyed the rotation since we could learn more from each other through discussion of patient’s condition and be sharing an idea with the rest of the team which was mostly made by midwives.

4. HIV patients clinic

Eric (left) and Aline *right in HIV clinic consultation

In all the time we work at Tororo district hospital, we rotated also in HIV clinic. The services provided were history taking and physical examination for HIV patients to access drugs adherence, new HIV diagnosed patients counseling, viral load monitoring and shifting of patients from drugs line to another.

Of course, as a referral hospital, the number of attendants was big, At the time we helped around 80 patients and surprisingly the 2/3 was women and reason was that of the polygamy culture in Tororo community which makes the prevalence of  the HIV infection to rise in women than in men

BENEFITS

We met friends and we made friendships, we learned much from each other and we made strong networks. Finally, we had fun.

SKILLS AND KNOWLEDGE GAINED

Together with family Medicine post-graduates having fun

Four weeks at the Tororo district hospital for family medicine was productive beyond our expectations. Along all time, rotating in different departments we gain many skills in Family Medicine, the way it works and the services it provides. As long this specialty is not yet initiated in Rwanda health system, I hope to share with my colleague medical students, and other health professionals this skills or others who will be interested in family medicine. In addition to this, we gained also more about presentation skills.

The knowledge gained includes patient history taking and physical exams to list differential diagnosis, appropriate patients management, conducting a normal lobar and c/section delivery. Antenatal care includes Leopard maneuver and use of fetoscope and management and follows up of HIV patients.

CHALLENGES

All the time we spent in this amazing elective, the main challenge we meet is the languages. After arriving in the Tororo town, we have found that they are more local different languages spoken in the community which account more than 5 which also is related to different tribes with a different culture. This has brought some limitation during patients caring especially in history taking and management, explanation on medication taking and patient diseases education.  So to handle this, we used to organize a team during ward round such that there is one health care provider who speaks both English and one of the local languages so that he/she will translate.

The other challenge we met was to work in low facilities hospital where some materials were not available especially medications and septic environment, which was a barrier in patients treated and also we thought it could be a source of spreading diseases among hospitalized patients. To handle this will need multidisciplinary involvement including Minister of Health in Uganda and other health institutes but we did some advocacy about the problems.

LESSON I LEARNT

Dr. Cecilia and Enrica (left)

Of course, learning is a continuous process, but in this elective, the first thing I learned is that every healthcare professional can deliver the health services to the community according to his or her level.

The 2nd lesson is that working in limited health facilities can be challenging in the medical career while you were delivering health services but it’s good and important to adapt and use the few we have effectively to help the patients

The 3rd lesson, learning from each other and sharing information and respecting each other is most important in terms of both helping patients and teaching during health care services delivered.

The 4th lesson is As a student I got a lot about professionalism at work during this elective at Tororo district Hospitals. The healthcare professionals were having a positive attitude of medics towards students and their work made me enjoy my stay and practice as a student there.

ACKNOWLEDGE

We want to express my sincere gratitude thanks to the executive committee of GEMx represented by Carol Noel Russo, GEMx Regional representative in Africa Faith Nawagi, the host coordinator at MAKERERE UNIVESITY Mrs. Phionah and my university of Rwanda GEMx coordinator, Dr. UWINEZA Annette and everyone who contributed to making this elective happen

It great pleasure to thank all confident you hard toward us and offer this opportunity in which we learned much skills and experience and all your commitment and effort you made to create a way so that the elective on Family Medicine at Makerere university lead to success.

Special are destined to our trainers, senior consultants in Family Medicine at TORORO District hospital, Dr. Welishe George and Dr. Okuuny Vicent with the rest of the team who showed strong commitment to teach us as much they can, we really highly appreciate their motivation and strategies they use during training  health professionals and I wish they could spread that attitude among the rest healthcare professional trainers around the world.

 

 

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.

GEMx Exchange to UKZN

Filed under: GEMx Regional Exchanges GEMx Student Reflections

Post by Nancy Binsari and Tendwa George, 5th year medical students from Kenyatta University who’ve completed an exchange at University of KwaZulu Natal (UKZN).

Tendwa and Nancy smiling

Tendwa and Nancy ready to go on their exchange

Introduction:

This elective is an opportunity to find out more about yourself and what you want to do in the future. The elective allows you to explore a particular area of medicine or something different, such as research or teaching.

The two of us were selected to participate in the elective term through the GEMx program. Our home school, Kenyatta University was enrolled into this program through the regional platform in Africa for the first time in 2017. Being the pilot group, we were privileged to get a chance to participate in our elective at our host school UKZN (University of KwaZulu Natal) at Wentworth Hospital. Two of our other colleagues also participated in the GEMx program, and were sent to Makerere University in Kampala, Uganda to the cardiology centre.

We had 4 weeks of rotation in the department of Family Medicine in Wentworth hospital, one of the hospitals for UKZN clinical rotations. Family medicine, formerly “Family Practice” is a specialty devoted to providing comprehensive health care for patients. Family medicine is a three-dimensional specialty, incorporating knowledge, skill and process.

Dr. Mergan Naidoo, the head of department of family medicine at UKZN was our contact person and took us through the orientation at the hospital as well as our clinical rotations in our various sections. With the aid of a well-put logbook, Dr. Mergan Naidoo took us through our objectives for the clinical rotations and also guided us on a quality improvement project that we undertook during our stay at the hospital.

4 people standing and smiling at the Department of Family Medicine

Tendwa, Nancy, Dr. Naidoo and Kenneth at the Department of Family Medicine

Week 1: Out Patient Department (OPD)

Our first week was in the outpatient department (OPD) which is divided into the chronic and acute sections. In the acute section, we clerked patients and presented to the senior doctor in charge, Dr. Oyebola who guided us and corrected us accordingly. We had an opportunity to familiarize ourselves with the South African guidelines on management of common conditions of patients in the OPD. We were able to experience a variety of conditions and were tasked to identify or at least make out the differential diagnosis of the presenting complaints.

Of the patients seen, a majority suffered respiratory diseases with TB and community acquired pneumonia leading. We also noted that the country had a large burden of HIV and it was therefore not a surprise that it was in the background in most of the TB infections. We were provided with masks to prevent acquisition of TB in patients. Other conditions we encountered in the OPD were hemorrhoids, gastroenteritis just to mention a few.

Week 2: Accident and Emergency  

Nancy and Tendwa standing in front of Accident/Emergency Department

Nancy and Tendwa outside the accident and emergency department.

The second week of our elective term was at the Accident and Emergency department. This was under the supervision of many doctors. Our task here was again to see patients and clerks, suggest investigations and come up with a management plan. We would then present this to the doctor on call as well as the intern doctor for approval of our approach and advice on what we missed out on. This turned out as a very good way of learning as sometimes they pointed out that we have the theoretical knowledge but need to put more practice into applying it to the patient and seeing them as a whole. We were trained to act like investigators and see beyond what the patient is saying. It was quite interesting because no matter how busy the floor got, the doctor’s would never rush us both in clerkship and in presenting to them. We got really good insight on what it means to be part of a health team and experienced what role we had as doctors.

 

Week 3: Acute Admission Ward

During our third week we rotated in the acute admissions ward. This is where all acutely ill patients admitted from Accident and Emergency department are transferred for high care and monitoring till they are stable enough to be discharged or transferred to other medical facility or surgical wards. It is during this rotation that we familiarized ourselves with the protocols and guidelines of South Africa for the management of acutely ill patients during the acute phase.

Week 4: HIV Clinic

We spent our final week in Wentworth hospital was spent in the HIV clinic. Here, we learnt under the supervision of Dr. Ryan, we saw newly diagnosed patients as well as follow ups and got to experience first-hand the countries’ way of combating the high levels of HIV infection in the area.

A thorough examination of the patient was also well covered to examine symptoms the patient brought up as well as anything they would have missed e.g. skin rashes or mouth lesions. The consultation would end with the patient understanding all the information being presented and patients were asked to come back for another visit. We had to update them with a full summary of what was discussed in terms of patient health and progression or regression of HIV.

Tendwa and Nancy have masks on their faces

Tendwa and Nancy at the HIV clinic

Challenges:

One of the challenges was the language barrier. It was difficult to communicate with some patients who could only express themselves fully in Xhosa or Zulu. To combat this challenge, the doctors and nurses went out of their way to translate whenever possible and give us English speaking patients to clerk.

Acknowledgment:

1) We would like to thank Dr. Titus Kahiga for his exemplary role in making our exchange possible. He conducted regular meetings with us, guided us every step of the way, and took great measures to ensure we gain the most out of the experience. He acted as a link between us students, the university and the GEMx program. We are not sure that if we were under anyone else our exchange would have even been possible.

2) We would also like to extend our gratitude to Dr. Faith Nawagi. She was always present to respond to questions and concerns right from the first day we began the journey. She was always efficient in communication channels and would reply to emails within a very short time. This helped us with our planning and preparations. We are positive that the program will see greater heights with her commitment and passion for the students.

3) We extend our hearty gratitude to Professor Mergan Naidoo. The professor provided very good mentorship right from the planning phase to the end of our exchange. He also made time for regular interactions to address any concerns we may have had. We would also like to extend our gratitude to Mr.Ifukho, Mr. Vincent and the projects team in Kenyatta University as well as Ms. Anitha from UKZN. They were quite helpful in the processing of required documents both for visa applications and for exchange purposes.

4) We would like to thank the individuals who stood out in our elective term. These individuals managed to take time for us students and gave us an exceptional learning experience.  The staff’s enthusiasm and warmth remains entrenched in our memories as well as their motivation to providing us with a good amount of knowledge. These people include Dr. Ayubola, Dr. David, Dr. Daniels, Dr. Mbaiza, and Dr. Ryan.

5) Our sincere gratitude to the office of the Dean at Kenyatta University school of Medicine and our Dean Prof. Agina for ensuring we had all we required during our stay at KZN, as well as selecting the two of us to represent the school for the elective program at UKZN, South Africa.

6) Lastly, we thank the nursing staff as well as the interns who helped us settle in each department and allowed us the opportunity to help wherever we could.

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.

Overwhelmed by Good Hearts and Good People

Filed under: GEMx Global Network GEMx Student Ambassador Network GEMx Student Reflections Uncategorized

Post by Syafaf Humaira Binti Aman, global exchange student from Penang Medical College (Malaysia) who recently completed a GEMx Exchange at University of Sharjah in United Arab Emirates.

Who knew, a split-second decision of applying for GEMx Electives, and travelling alone to a country which was 5000km away from home would bring such an impact to my life – especially my medical student life. My name is Syafaf Humaira Aman and I am currently a final year medical student from Penang Medical College, Malaysia.

I’ve always known by my friends as a person who would leap into any great opportunities that comes and this was definitely one of those opportunities that I had decided to venture upon. Despite of that statement making me sound all very brave and courageous, there was still a hint of nervousness and anxiety when I got on the plane, heading to the UAE for my electives. This was the first time I solo-travelled, my first time going to a country that I am very unfamiliar with, and also my first time being a part of a new student community – alone.

Smiling young woman and young man by palm trees shops and restaurants

With Fuad, the student ambassador from University of Sharjah

All the worries and anxiousness slowly started to dissipate away when I was greeted by Fuad, the student ambassador from University of Sharjah (UoS) and his friend Dalia at the airport. Starting from the first meet up, up until the very last day of my stay in UoS, they had definitely helped me a lot – from helping me to settle down in my new dorm, helping the administrative officer to arrange my hospital posting, and introducing me to most of their friends so that I wouldn’t feel very lonely throughout my stay. I truly owe them a lot, as it was so much easier for me to blend in and get used to the new campus life with their help.

One thing I’ve learnt a lot from this experience is actually travelling alone isn’t as bad as I thought it would. It used to be a scary thought back then, but after this elective programme, I’ve came to learn that more opportunities tend to open up when you travel alone. When you’re all alone, you’ll be forced to get out of your comfort zone, and you’ll be ‘pushed’ to make a whole bunch of new friends. Without you even realizing, you’ll find yourself meeting new people, making connections with people that you’ve never intended to meet, and getting inspired by their life stories. This includes meeting a fellow Malaysian occupational therapist who had been working in the UAE for the past 8 years. It was amazing to get to hear her life experiences over there.

As for my clinical posting, I was being posted to Al-Baraha Hospital in Dubai under the Surgical Department. Truth to be told, it was definitely one of the best clinical experience I’ve ever went through my whole life as a medical student!

student posing with group of fellow students and instructors

With surgical team in Al Baraha Hospital, Dubai

The surgical team consisted of this set of surgeons of different nationalities, with years of experiences working at different regions of the world before. One thing I am truly awed was to see how dedicated these surgeons were, in both healing the patients and teaching the students. Despite their tight schedule during the OT days, they would still make time to teach us in the operation theatre, as well as in between the surgeries. Sometimes they would let us hang around at the surgeons’ lounge and they would share their experiences with us students too.

Instructing Surgeon and student in surgery

Me assisting in one of the surgeries done at the hospital while being assisted by the surgeon

During this posting too, I was fortunate enough to be given multiple chances to assist in several surgeries, guided by these aspiring surgeons. Even though the tasks that was given were pretty minor, but it was already more than I bargained for, and come to think of it, it was a fair start for me as a medical student. It was definitely a great exposure for me, one that I would never experience back home. I couldn’t help but to be thankful for these surgeons had never failed to make me feel as part as their team. At times, they would even introduce us students to the patients as the ‘training surgeons’ who had made them (the patients) feel better, and it was definitely one of the best feeling to hear the patients thanking you profusely for treating them. All in all, it was never a day that I wasn’t looking forward to step into the hospital as I knew I would be greeted by them with smiles and the day would then be occupied with bed side teachings, teachings at the outpatient department and multiple case discussions with the whole surgical team.

smiling students outside of hospital

With my groupmates after our daily clinical bedside teachings

My groupmates in Al-Baraha Hospital were truly amazing too. They were all very friendly and my four weeks at the hospital would have never been the same without them. In between the bedside teachings, or after we’ve all clerked patients, we would then be discussing the cases together, sometimes recalling what the surgeons have taught us by the end of each day. Sometimes these so called ‘hangout’ sessions would be filled with us sharing stories about each other’s families, travel stories, and favourite past times. One thing I find interesting in the UAE is that, all of the students there mostly originates from somewhere else outside of the UAE. Some of my groupmates for instance, were originally from Syria, Palestine, Turkey, Egypt and many more. Although they have stayed in the UAE for most of their live, they would still go back there once in a while and they would then share their stories and how their culture are back home. Not just that, they would also be the ones to prepare a long list for me consisting of interesting places I need to visit, and food that I need to try throughout my stay.

smiling girl by waterfront

Me at Madinat Jumeirah, with the Burj Al-Arab in the background

On the weekends, I would then take the opportunity to travel around Dubai, and explore the city as much as possible. The famous Burj Khalifa, Burj Al-Arab, the souqs and the beaches in Dubai were all truly breath-taking. I had even managed to make my way to Abu Dhabi on one of the long weekends during my stay in the UAE. Although it was pretty taxing to travel from UoS to Dubai, it was always be worth it. Taxing, because the transportations were pretty expensive, especially when you’re travelling alone, so sometimes I would need to opt for multiple forms of transportations in order to get to the places that I wanted to go. However, it definitely taught me the value of perseverance, independence and the importance of planning ahead of time.

All in all, not only I had gain ample amount of new knowledge within the medical field, but I had also obtained countless life lessons throughout this elective. It was a whole new level of experience which had definitely built my confidence and I hope that I could emulate all of these invaluable lessons throughout my life as a person, and a medical doctor in the future. I would like to extend my gratitude to GEMx for this once in a lifetime experience, and for encouraging me to step away from my comfort zone, and experience all of this. Not to forget Dr Nabil Sulaiman and Dr Osama Seif for being my supervisors over at University of Sharjah and Hospital Al-Baraha.

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