Trip Background

A bit over 48 hours now remain before I leave for Kenya! If you are like countless others who I have informed about my upcoming trip, you are wondering what I will be doing there. Here's a brief summary.

I will be volunteering at the Ushrika Medical Cinic, located in the slums of Kibera, Nairobi. Ushrika started in the community with a focus on hygiene and sanitation. A 1994 donation by a Médicos Sin Fronteras (Doctors without Borders, Spain) participant supported the formation of the clinic. 


Kibera is located 5 km from Nairobi's center. It is among the poorest slums in the world; most inhabitants lack access to running water and electricity. Some sources also state that it is the largest slum in Africa--with UN population estimates ranging from 350,000 to over 1 million people. "Flying toilets" are used due to the lack of a sewage system, and the slums are thus a breeding ground for disease. There are several construction projects attempting to get off the ground (forgive the pun), but problems include theft of building materials, lack of a solid foundation (much of the ground is refuse), and the geographical topography (few homes have vehicle access, meaning that building supplies must be carried by hand). 


My responsibilities at the clinic will be clinical in nature; there will be copious exposure to patients, facilities, staff, and the overall treatment system. I will assist in the VCT (HIV Voluntary Counseling and Testing) clinic, as the locals refer to them, by providing HIV education and counseling. TB education will also be a focus. 


Within the hospital, I will assist in the maternity ward with deliveries. I will also vaccinate children, provide nutrition/health counseling, and observe surgeries.


I have extensive experience with the healthcare system in the United States at both public and private hospital settings, and it will be useful comparing the level and extent of care given with available resources. There are significantly less legal regulations in Kenya, and I will therefore be able to provide as much medical care as I feel comfortable with (under the supervision of hospital staff, of course). 


While differences in healthcare are bound to astound me, I am also expecting a sort of "medical culture" shock. I am particularly interested in how involved the patient remains while making critical treatment decisions. Occidental values champion autonomy, and the patient therefore communicates directly with the physician in critical decision-making. Many cultures are more family-oriented, and serious news is often told to the eldest member of the family in the room, who is then expected to "break the news" to others. While this would spell lawsuit in the States, it is a cultural norm in many cultures. The Kenyan view of patient autonomy particularly interests me, but I have certainly not discounted other opportunities for cultural self-advancement.