By: Hannah West
Post-Enrichment Reflection
When I was preparing to go to Kenya, it was easy to open Google and search “health disparities in Kenya”. It was easy to discover that HIV/AIDS, malnutrition, malaria and respiratory infections were common. It was easy to comprehend why these illnesses and sicknesses occurred. However when I arrived in Kenya and began to work in clinics, it was impossible to understand that gruesome infections and burns were left untreated, citizens were intentionally denied information about their health by local doctors, and children were visibly starved and malnourished.
I had no idea what to expect during the first morning of clinic. Half of our team was delayed the night before in Audis Ababa, including our team leader Amy. I felt safe since we still had experienced alumni and local support, but I definitely felt like I had more responsibilities since we were short staffed. After boarding the bus, we drove to a rural village an hour outside of
Kitale. Once we got into the village, the community members stared at our bus. People were waving, smiling, tearing up; children ran along-side our bus smiling and laughing, attempting to keep up. I was shocked—I did not know that the presence of Americans was so accepted and supported in Kenya, but every encounter I had while in Kenya assured me that it was. Once our

team got off the bus, the children swarmed us. We taught them how to high-five and fist bump, and they stayed by our sides for as long as possible. The children loved having their pictures taken, and also enjoyed playing with hand sanitizer. Once we began clinic, I took my position at the check in station. I recorded patients’ main complaint and assisted in taking vitals. I enjoyed working at check in because I was able to see every single patient who came through clinic.
After a few hours, I began to notice patterns within peoples’ complaints. Common trends within children included itchy skin, respiratory issues and yellowing eyes. After fist bumping children for an hour earlier in the morning, I learned that many children had itchy skin because many children had scabies, a highly contagious skin infection (I began to wear gloves and a mask after learning this). The respiratory issues were caused because people in Kenya typically cook with an open fire inside of their homes. The children had visibly yellow eyes within the sclera, a condition caused by Vitamin A deficiency. Many adults had open wounds, inquiries about HIV testing and vaginal infections, and Jiggers. Jiggers are round parasitic bugs that burry inside of peoples’ finger and toe nails and lead to infections.
They looked as nasty as they sound.
The public health issues in Kenya primarily stemmed from unhygienic practices and lack of nutrition. Though I realize that the majority of the health issues present in Kenya could be addressed with proper nutrition and hygiene, I have no idea how these issues should be addressed. I wish there was a simple solution to addresses these issues on a large scale in Kenya, but I understand that there are cultural, economic and systematic barriers to doing so. Anyways, I thought it was both interesting and shocking to compare the health disparities we face in the
United States to those that occur in Kenya. I realized that around 60% of the patients we saw required the expertise of our dermatology team or our wound care team. I was able to see a case of leprosy, several benign tumors, and more fungal infections than anyone should see in their entire life. I also met a handful of patients in every village who were infected with malaria, and even met a young boy who had both sickle cell disease and malaria. I was constantly shocked when children told me their age. Some children were so malnourished, I often assumed they were half their actual age. At one point during the trip, our ER doctor had to perform CPR on a baby while transporting the baby to the hospital. What was most difficult for me to understand was the detached relationship between the mother and the baby—the mother portrayed little emotion in light of this catastrophic event. Despite this, International Medical Relief paid the medical costs of the baby’s hospital stay, and the baby was released soon after our team returned to the United States. It was heartbreaking for me to understand the reality of Africa.
I never could have imagined how poor the communities in Africa truly are. I know that there are poor communities within the U.S. and I don’t want to discredit the living conditions that may exist within our own country, but I do not believe that anywhere in America is nearly as undeveloped as the communities we visited in Kenya. While driving through Kibera, a slum populated by 2.5 million Kenyans, I noticed that there were rivers of urine running through the slum. There was trash covering the ground, and old make-shift houses were packed within inches of each other. Every village we went into had maggots covering the floor of the latrine, dirty livestock brushing up against fruit stands and children, and feces covering the dirt floors in the

classrooms. The citizens that did wear shoes typically wore flip flops, but the majority of the citizens simply walked around barefoot. Regardless, no one was well-protected from tropical and parasitic infections. I remember talking to our group leader Amy midway through the trip and she said, “When people come to visit us in clinic, they come wearing their nicest outfits. They may worn out, they may be too big, and they may be filthy, but that is the nicest outfit they have.
That is the only outfit they have.” I began to tear up, reflection upon the shredded, baggy children that I had seen the children wearing previously. I also realized that our clinic was usually set up for eight hours, and I never saw any of the citizens drink food or eat water.
Though it was winter and the temperatures remained moderate, I can’t imagine what it would be like to be in Kenya during the summer without water. I never realized how poor areas in Africa really are.
Traveling to Kenya taught me about public health, the Kenyan culture, Kenyans perspective of the American culture, and even some Swahili. One goal I established for this trip was to gain a deeper understanding of the Kenyan culture. I discovered that in Kenya, people talk extremely quietly when compared to the volume people utilize in the U.S. I also learned that it is customary to hold both hands of a person when engaging in conversation. I was surprised to discover that
Christianity is the predominant religion in Kenya, and that many people talk openly about religion. Another goal I established was to learn more about why health disparities exist in
Kenya. This is the goal I feel I learned the most about and yet still have so many questions about.
I feel that I have an understanding about the trends of health issues in Kenya as well as their primary causes, but there is still so much more I am wondering about. I definitely want to continue to do research about public health in developing countries. My third goal was to connect with members of the local community. I feel as though I was constantly connecting with individuals. The citizens of Kenya were incredibly welcoming and were very curious about what the U.S. was like. People asked me questions about our education system, President Obama, traditional foods, New York City…you name it! I had the opportunity to work with two medical students attending universities in Kenya, and I believe I will be reunited with both of them at some point in my life. I connected extremely well with several translators, hotel staff, and parents who visited the clinic, but I enjoyed connecting with the children the most. I was talking to an adorable young girl, and she asked me if we were taught Swahili in school. She looked relatively sad when I told her we weren’t, so I asked her to teach me some Swahili. She would say a common phrase such as, “what are you doing?” and then precede to laugh at me when I tried to repeat it. She asked me so many questions about what the seasons were like in the U.S., what I liked learning about, and what I thought of Kenya. At another village, I taught the children how to fist-bump and play duck-duck-goose, and in turn the children sang “head, shoulders, knees, and toes” for me. My final goal was to learn about professions in the medical field. I was able to rotate throughout clinic, shadowing various areas and assisting where I could.
This allowed me to undergo professional development through networking and engaging in conversations with knowledgeable professionals in the healthcare field.
I had the opportunity to connect with some outstanding individuals who are extremely passionate about their careers. I connected really well with an E.N.T. (ear, nose and throat) doctor from Wyoming…he is easily the most interested person in the nose that I will probably meet in my entire life. I also had the opportunity to shadow a dentist, an acupuncturist and a pharmacist. I decided three things: I never want to be a dentist, I want to visit an acupuncturist,

and I want to receive study tips from a pharmacist because they definitely know a lot! I also worked with two Physician Assistants who have careers in emergency medicine and pediatrics. I enjoyed discussing the future of the PA profession as well as the benefits and drawbacks of being a PA with them.
Traveling to Kenya has given me a deeper sense of purpose and drive to enter the field of healthcare. Sometimes there is so much emphasis put negative things when discussing healthcare in America that it is easy to forget the positive aspects of healthcare. The moment when the baby’s heart stopped beating and the doctor had to perform CPR, I felt like the world was spinning away in slow motion. I felt so personally connected and intertwined with that child’s life. Though I was not the one performing CPR, I felt as though I was meant to be in that moment. Even if we had not had an impact on anyone else’s life while in Kenya, the entire trip would have been worth it because we saved one child’s life. In the healthcare industry, people save others every single day. I can’t imagine a more rewarding career than saving peoples’ lives.
Traveling to Kenya opened my eyes and my heart, and changed my global perspective in ways that I could not have anticipated, and I for that I am incredibly thankful.