GEMx Blog

Post by Wasukira Bugosera Sulaiman, Bachelor of Medicine and Bachelor of Surgery student at Makerere University CHS (Uganda), who went on a GEMx regional exchange to Kenyatta University School Of Health Sciences (Kenya)

The first clinical year at Makerere University College of Health Sciences is always climaxed by doing a clinical placement in a field that a student is interested in and done from places of their own choice. Well, this was my opportune moment to hunt and grab a site and an opportunity to do my placement in a very resourceful fun and skill- impacting environment for one month (4th July – 4th August).

In just the same time, a rare and perhaps a first time opportunity presented itself in which a call for students interested in undertaking exchange electives through the GEMx exchange system was put up.

Application and Vetting

Having been an ambitious highly motivated and open-minded medical student ever looking around for opportunities and trying out on each of them, I went ahead to initiate the application for the GEMx elective exchanges through the GEMx web based system. Application was through the international office and was consequently followed by an interview, which I presume to have just excelled in and followed by being successfully nominated to undertake an exchange elective at Kenyatta University School of Health Sciences, through the GEMx- MEPI partnership. This was with two other classmates: Namingira Simon Peter and Barigye Aston.

The rest of the process involved obtaining a couple of documents as required by the host University. I was amazed by the way the GEMx web system eased the whole process of document submission and with the fact that I could actually store these documents for another application in the future. At the end of the whole process, all documents were submitted through the web system! By this moment, I just had to hold on for the host institution to review and accept my application which came in through on the 9th June 2017.

Preparations before travel

Just as the Luganda saying goes “Okutambula kulaba, Okudda kunyumya” literally meaning that “to travel is to experience and returning home is to tell stories”, the preparations were quite filled with a lot of expectations and excitement; new experience, a lot to learn, first time in Nairobi and so much more. As all preparations were under way, I am sincerely grateful the support given to us (me and the other two colleagues) both from the home institution (Ms. Phiona Ashaba and Dr. Isaac Ssinabulya) and Host institution (Dr. Kahiga Titus and Mr. Vincent) plus the GEMx staff (Ms. Faith Nawagi). As a team, they ensured that the funds to facilitate our electives were processed in time, bookings for accommodation made, bus station pickups arranged, plus guiding on what we need to carry for daily living in Nairobi. At this moment, the GEMx checklist was important since it acted as a measure of the progress in the preparation process. The GEMx web system also played a big role in the preparation process as it provided the emergency contacts from both the host and home institution. This greatly eased communication towards and during our travel.

Travel to Nairobi

Right after securing our fund facilitation for electives, we booked the bus to Nairobi on the eve of our travel with travel date of 3rd  July 2017, and opting for the 7am bus because we wanted to experience the epic scenery as we go sight-seeing the way to Nairobi as long as no one interrupted my peace in my window seat.

Our journey was a fine one with a lot scenery along the way and with most of the attention after crossing the border. The stops in Kisumu and Nakuru, made the journey was less tiresome and awesome.

I should say my eyes are wiseacres as they immediately identify and report to me the good and unique things they see. The same thing happened upon entry in Nairobi, it was the beaming street lights and the skyscrapers that welcomed me then I knew this is the capital of the famous Kenyatta land!!!  The great hospitality we received made me feel like actually we sometimes have 2 hearts- one that pumps blood and the other one for caring. Our arrival time in Nairobi was 9:30 pm and we were picked up by Mr. Vincent, one of the administrative staff members at Kenyatta University. Off we went to Kahawa-Wendani, where our accommodation had been booked in a Destiny Park Hostel, a student hostel approximately 500metres from Kenyatta University.

Stay in Nairobi, Kenyatta University and the elective site

HABARI!!!! Our Kenyan life begun with a visit to Kenyatta University where we were given a tour around the university by a medical Student (Kiema Lucky) and later on met the GEMx coordinator, Dr. Kahiga, Mr. Vincent and Dr. Francesca Ogencha. The three were to be in charge of our stay in Kenyatta University.

The lecturers strike and Nurses strike.

I thought we had left the habit of lecturers’, non-teaching staffs’ and other government workers’ strikes in Uganda. But little did we know that this would be our big welcome in Kenya. By the time period we arrived at Kenyatta University for our electives, the lecturers in all public universities had gone on strike and so was the case with the nurses in Kiambu hospital, which is the teaching hospital for Kenyatta university school of Health Sciences.

These happenings put our rotation on the clinics and wards on a halt for a full week as the staff at Kenyatta University tirelessly worked around to get us a nearby hospital to undertake our elective at. By the second week, Dr. Francesca had managed to secure us a place at the Mater Misericordiae Hospital, where I and Barigye Aston were to do Pediatrics and Child Health and our colleague Namingira Simon Peter was to do Obstetrics and gynecology. The group in pediatrics and child health were to be supervised by Dr. David Duro Galgallo and the colleague in Obstetrics and gynecology was to be supervised by Dr. Irungo.

The Mater Hospital: The clinical experience

Mater Misericordiae hospital is a catholic founded missionary hospital, a multispecialty hospital with many branches worldwide, and the Nairobi branch being one of them. Located in Nairobi South B, having our clinical rotations in Mater Hospital meant that we had to travel an approximate distance of 20km to reach hospital from our residence in Kahawa, which is north of Nairobi city. A tiring but rather good opportunity for me and my colleagues to learn how to go around Nairobi by ourselves.

At the Mater Hospital, we were given a great hospitality with all the staff mindful to teach us whatever they could.

Outpatient clinics

The outpatient clinics in The Mater hospital are conducted by consultant pediatricians and during the clinics, I was involved in clerking the patients to take history and also do clinical examination under the guidance of the attending consultant for the clinic. This was followed by forming a diagnosis and a management plan. Subsequently, we discussed the patient’s condition with the consultant and participated in patient education about their conditions including informing them about what the diagnosis is, helping them form decisions about treatment course of action and preventive measures for recurrence of certain conditions.

The outpatient clinics are mainly for follow up and review of review of patients who were discharged from the inpatient care.

At the outpatient clinic, patients who had symptoms that pointed to a diagnosis for which a patient needed inpatient care were admitted on the pediatric ward.

At the outpatient clinic, I also participated in the immunization of children and the consultant taught me about the recommended immunization schedule as per the ministry of health in Kenya.

Pediatric ward (Lourdel Ward) and Special Care Unit

On the pediatric ward and the special care unit, I was involved in clerking the patients to obtain history and also did clinical examination then later presented the patients to the consultants. After the patient presentations, we were engaged in the patient condition discussion and later patient education. I also participated in the request for the required patient investigations and follow up on the patients’ progress on the wards. The whole process was incorporated with bedside teachings about the common conditions experienced on the ward.

Obstetrics theatre

During the caesarean section theatre sessions, I would occasionally attend with the pediatrician and participated in receiving the babies.

Postnatal ward

In the postnatal ward, we participated in review of the wellbeing of the newborn babies who were always kept at the hospital for up to a maximum of 4 days. During this period, all those who developed any complications like hemolytic disease of the newborn and neonatal sepsis, were isolated and taken to general nursery or special care unit for the necessary care to be given.

Continuing Medical Education (CME) Sessions

The Mater hospital holds continuous medical education sessions for its clinical staff, aimed at updating the clinical staff members about the latest advances in management and care of patients with certain disease conditions.

During my electives period at Mater hospital, I attended CMEs about management of Asthma, Ateriovenous malformations and Cholera. During these sessions I learnt in detail about the etiology, epidemiology, pathophysiology and management options of the above conditions

Nairobi city and Culture

Learning on job has never been among my hobbies but as it’s said “a drowning man even holds on a straw to survive”, I was made to reproduce the spoonful Kiswahili that I had learnt ages ago as I needed to get along with some “rafiki” and also navigate my way through the city. However, this in most times never worked and my thick accented English made in Uganda had to come and bail me out. But save for the fact that I did not know a lot of Kiswahili which is the national language in Kenya, the rest of the cultural experiences were just amazing and since most of the ward round and clinic activities ended by lunch time, we used to utilize most of our afternoons to explore the beauty of the city of Nairobi and trying out the local delicacies.  Tours to the Uhuru Park, Central park, Kenyatta International Convention Centre and many more other places enabled us view Nairobi from a variety of angles.

Most notable are the Matatus and the matatu culture. Matatus is the commonest public means of transport within Nairobi and the design plus the music in the matatus made using them to move around Nairobi a thrilling experience.

Kenyatta University: Involvement in student activities and Interaction with student community

While at Kenyatta University, even when we did not get chance to rotate on the wards with other clinical students due to the ongoing strikes, we were able to get time to meet with them in other activities. Important to mention is the Medical camp at Huruma Children’s home, which was organized by Kenyatta University Pharmacy Students Association (KUPhSA), where I was able to meet with many Kenyatta University medical students plus students from University of Science Philadelphia who were also visiting students to the Kenyatta University School of Health Sciences. During the camp, I was paired with a pharmacy student at the consulting desk, an experience which gave me a new touch of the importance of involving pharmacists in the day to day patient care. 

As we were coming to the end of our electives, we were privileged to be hosted by Dr. Kahiga Titus for a luncheon at his home in Kitengela-Kajiado. Here I was able to meet a lot more students from Kenyatta University, meet the Students from Philadelphia again and still meet many officials from the Kenya Pharmacy and Poisons Board. This was a moment to grow social and professional circles.

Lessons learnt

As the medical discipline is known to be a monkey see monkey do business, for the knowledge we can read and acquire but skills have to be passed on through apprenticeship. With a very good mentor assigned to me as my supervisor, my rotation in Pediatrics and Child health at The Mater Hospital made the love for the discipline glow more and more. Being in Mater Hospital, a state of art hospital, I learnt a lot about comprehensive patient care and the practice of medicine in the concept of family care. I also got a deeper understanding of the importance of team practice in patient care. These two aspects of which I believe will enable me grow into a better healthcare provider. With the disease patterns slightly differing in Nairobi as compared to Kampala, I was able to experience child health in a new environment and learn of management of common childhood diseases in Kenya as compared to Uganda. This enabled widen my scope of thinking as a clinical student which is an important aspect in patient care. This coupled with the many differences in health policies made me better appreciate some of the concepts of global health.

Future commitments

The name may be called GEMx exchanges but personally I customized it as GAME CHANGER for the experience, knowledge and skills acquired. I can undoubtedly say it has been a cornerstone in my medical education and I believe it has already shaped my path as a future health worker. Talent may be everywhere but opportunity isn’t, thus I am committed to pass on information about GEMx exchanges to other students within and outside my university so as they may be able to gain the same experience or even better.