Student Stories

 It broadened my understanding and appreciation of different cultures and helped grow my medical knowledge. We had to serve patients that had never seen health care providers with minimal resources. I went with some classmates and made lifelong friendships. I was able to travel some with even more classmates after my rotation while over in Kenya and Tanzania.

 My time at Macha Mission Hospital in Zambia through INMED was one of the most difficult but most amazing things I have ever done in my life; it is something that I will cherish and remember until the end of my days. The people I met, the patients I cared for, the experiences I had, the travel adventures – I have and will carry them all with me since I left. One of the most difficult situations I experienced while there was caring for a malnourished child. The mother brought the girl in the afternoon on my second day; although this was a 2-year-old, the little girl maybe weighed 15 pounds and barely looked human because her skin was so thin and her bones were practically visible. I can still remember her faint cry as she didn’t have the energy to even moan, let alone lift her head, move her arms, or walk. We knew we needed to get her hydration and nutrition, and the quickest way would be IV. However, the nurses were unable to get an IV in her; I was asked to help, so I placed a large IV as an IO and we started giving her fluids. She died in my arms 15 minutes later. After the news was broken to the mother, her heartbreak became audible through wailing. I had never seen a child die; my heart broke for the mother, but I was also so mad at her for waiting so long. I had such strong and conflicting emotions, I felt completely torn. My wonderful colleagues at Macha Mission Hospital helped carry my sadness and anger. They helped me process the situation and understand why and how this happened; that they likely traveled a long distance to get to us as well as the more global issues of children being weaned from breast milk to porridge that lacked in amino acids. I was blessed to be surrounded by nurses and other providers who were beyond generous with their time, advice, help, and friendship. I assisted in many different surgeries and procedures, grew exponentially in my clinical reasoning and exam skills as well as my procedural abilities. I experienced things that I would never have had the opportunity to experience anywhere else. Looking back on that time and thinking about how special it was really comes down to the amazing people that I met at every stage: the kind woman on the plane with advice about navigating the bus system, the cab driver who took me by the hand and put me on the bus so I wouldn’t get taken advantage of, the nurses and doctors and patient care techs at the hospital, the border guards who were incredibly kind and grateful that I was there working at the hospital, the guy at the hostel reception desk who told me the hostel had hot water and showers after I hadn’t experienced the luxury of hot water for 28 days. All of this, plus much more, has made me who I am and every single day, I hope that what I do makes them proud.

I visited Kijabe, Kenya February 2020 as an INMED learner and volunteer. This facility drastically changed my impression of what is possible as an international volunteer, teacher, learner, and doctor. They were tirelessly dedicated to quality, despite resource limitations. I saw incredible physicians help numerous patients live without suffering. I took the lessons of compassion from this trip with me to my clinical practice in the United States. It caused me to look at my relationships differently and remove some dead-weight aspects of my life (complaining, negative company, and excessive spending on frivolous things). I felt renewed – and rededicated to practicing to the best of my ability.

My service-learning experience in Ghana in 2012 came at a very pivotal time in my career. I was about 6 months post-graduation from NP school and attended during my NP ER orientation.

I was at a time in my life where I had a call to go and make a difference, and a willingness to be used in medical missions.

The most critical skills I learned was the skill to enter into every experience of life as a learner. I learned that I wasn’t the one coming to save the day but that others spent a lot of time and effort making sure I had all I need to be successful. As I completed the INMED graduate certificate, I was changed and transformed by lessons of cultural humility I learned and by the examples of the lives who had sacrificed so much to serve in a place like Nalerigu (both Foreigners and Ghanaians).

It’s led me now, 13 years later, to continue to find ways to serve the least of these and to use my life to make a difference in the life of others, to continue to find opportunities where I can make a difference making disciples and continually positioned me to remember to serve the forgotten.

Working in the center of Kampala Uganda at “The Surgery” covering the ER was yet another of my treasured experiences working around the world. Each unique in their way.

As it was a difficult and lengthy trip each day to get to work on a boda-boda, I immediately witnessed the transportation challenge, for me and especially the staff. Beginning with the almost hour long trip each way on the back of the bike. Experiencing the travel danger due to poor road construction, the dust, rocks, lack of rules of the road, varied weather conditions (in the rain you go when it stops and are late) and the daily expense. Upon arrival to work each day I witnessed the commitment or lack thereof of some staff. Immensely troubling. Emergency cases where people look up from the desk or another room as if this arrival is “a bother” and continuing on with what they were doing, which was to not care for the patient. After a few days of quietly watching, getting to know staff, practices and paying deference to the way the unit functioned I quickly changed my approach to the day. To begin the staff had no idea what a Nurse Practitioner does. No amount of explanation seemed to suffice. My approach became to do my job. Admit all patients, perform an assessment, physical exam, and come up with a plan of care including acting promptly as the emergency required, case dependent.

Upon completion of admitting the patient it was common practice to go to the adjacent clinic, notify the covering doctor and accompany them back to also see the patient. While walking back over to the ER, with the physician, I would present the case, all pertinent information and the plan of care all to the doctor’s utter surprise. After doing this numerous times our collaboration evolved beautifully. Including now being asked to chart in the doctor’s computer, assist on cases and be a part of the conversation, a small success!

Of course this is not uncommon even at times in our country. In this situation it became a rather important evolution. Why? One morning a 5-year-old arrived being carried by a missionary woman I had not yet met. He was having seizures repeatedly and had been for a couple days. She and her organization had to pay for his care. No insurance, no money, are we sounding a bit like our country now too??? We began a workup, now with the physician in attendance. Treatment ensued no resolution of symptoms occurred. He was taken into an emergency bay, the attending called. The team was struggling with how to proceed. My goal was to work with them to figure out the quickest most efficient work up necessary. It was now very important that we all do this together. The most important thing for me was to respectfully guide, offer suggestions, work with and quickly get done what was needed. Very few appeared to have an infectious disease background, mine vast, time was of the essence. The collaboration, without judgement, was the most important outcome. It happened, it grew and we continued to work, teaching one another, with mutual respect. Ultimately achieving the best outcomes for patients, the goal we must always strive for.

Now the good and the bad. The bad, this 5-year-old had TB meningitis and ultimately died a difficult tragedy to witness. The good, through my own network of health care providers, collaborators, in Boston, where I have always worked, I was able to get update critical medical advice. Immediately being connected to the world’s leading MD in India who had recently spoken at Harvard about this subject. The Uganda staff believed no one would help or respond, their frequent experience. Within 12 hours of identifying this need, 3 continents had communicated and shared an up-to-date protocol for the care of this young child. Yes, the good being we all CAN work together, thoughtfully, with patience and respect and helping one another, always.

My volunteer work has been all over the world, now exclusively pro bono, full time, developing self-sustaining health clinics in rural Liberia. Refuge Place International.
Clearly, I am the one being gifted this existence and privilege. My work continues and I am grateful.