Christopher Carlos

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UCSF, Internal Medicine Resident,
Kisumu, April 4th – 29th  2016

Admittedly, prior to my clinical rotation through the FACES clinic at Lumumba Health Centre in Kisumu, my experience in global health was limited. Though I always had an interest in learning about how healthcare was delivered outside of the United States, the opportunity to rotate through a clinic abroad never seemed to materialize. The opportunity to travel to Kisumu through my residency at UCSF was too good to pass up, and the month ended up being one of the most memorable of my life.

On my very first day, I immediately came face to face with proof of the incredibly important role this clinic plays within the community. On a Monday morning, I saw several hundred clients crammed into the waiting room, many of whom arrived before dawn to receive refills of their medications. Over the next week, I rotated through each department and began to piece together the larger system of multidisciplinary work that had come to define the FACES model of HIV care.

In one room, newly diagnosed clients were instructed on the basic tenants of HIV infection. In another room, a man with a cough was providing a sputum sample for GeneXpert testing of tuberculosis. In the neighboring building, a mother was encouraged to stop breastfeeding her HIV exposed infant at exactly one year. Clinical trials were ongoing at every turn. The FACES clinic was constantly abuzz.

With respect to my professional growth, the rotation was very rich with learning opportunities. I honed my clinical skills, having to rely more heavily on my physical exam without the benefit of costly diagnostic testing. I saw many unfortunate consequences of advanced HIV, including pruritic papular eruption, chancroid, zoster opthalmicus and Kaposi sarcoma. I learned about antiretroviral regimens, complications and side effects.

But more than anything, the month was filled with memories that will stay with me long after I return to America. The breathtaking sunsets, the animals of Ruma National Park, the beans and chapatti lunches to name a few. The FACES clinic was truly special and I was very fortunate to learn from the incredible staff and people of Kisumu.

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