UCSF School of Medicine, 4th Year,
Kisumu, January 19th-February 28th
I’m a UCSF 4th year medical student who came to Kisumu for a clinical elective hoping to learn more about medical care in Kenya and sharpen some of my own skills before starting residency. I spent 6 weeks at Lumumba Health Center in Kisumu, working with clinicians to provide care for patients with HIV.
I started by spending time learning about the flow of the clinic. In reception, I watched how patients were checked in and files were sorted. I then went to the vitals bench, where I helped nurses manage clinic flow and reassured patients that they would be seen. I spent time in pharmacy where I saw all the different drug regimens lining the walls up to the ceiling, and learned about the side effects of medications and the barriers that affect adherence. I was able to spend a day in nutrition, eating fortified uji (porridge) and trying to understand how food insecurity can become a major factor in HIV treatment.
During my time in clinic, I was able to work with some amazing physicians and see some cases that I will never forget. I still think about the woman, who at the age of 30 was already on her 3rd regimen of ARVs and presented with skeletal TB and disseminated Kaposi’s Sarcoma. One of my most rewarding cases included a 25-year-old man who presented unable to walk due to a complete loss of sensation in his feet. I saw him over the next 3 weeks walking more and more under his own power as sensation returned to his feet after starting to take ARVs regularly. I learned about the stresses of school fees and how most patients don’t have enough money to be able to get a blood test or an X-ray, and tried to do my best work as a clinician to recognize and navigate through those challenges.
Outside of clinic, I was able to spend time exploring Kisumu and traveling to Kakamega National Forest, Ruma National Park, Lake Nakuru National Park, and Hell’s Gate National Park, all of which were amazing. I rode in my first ever matatu, desperately trying to make sure I had enough space to sit. I ate my weight in ugali and mandazi, and got to spend time with an amazing group of people here at FACES who were kind, welcoming, and always laughing.
Some of my recommendations for people coming here for a clinical rotation in the future is to try and spend time at the emergency bench, which is where the most interesting cases come in, as well as in Room 12 with the defaulters, where you hear stories about the challenges that patients have in trying to take their medications. Be willing to take initiative and ask for what you want to do, and everyone is really accommodating. Try to do a field experience just to see how the clinics in the district differ (Lumumba is definitely bigger than some of the others!) If you want to spend time at KDH (the district hospital), try to arrange that before you go, because it is difficult to try and arrange time there once you’ve arrived. Most of all, go with the flow and have fun! You’ll learn a lot and have a great experience as you go.