My final week in Kenya is officially underway, and it's been
great to finally wrap up a few projects that I've working on for
basically 7+ weeks now. And since I haven't talked much about a few
of these projects, it seems like an opportune time to talk about
the smaller projects that I've been tasked with while here: work
with the Kenyan Mengech Scholars and a chance to moderate a
"Fireside Chat" about the past, present, and future of AMPATH.
Over the past 3 weeks, Wyatt (the other Slemenda Scholar) and I
have been teaching a class on "Bedside Manner" to the "Mengech
Scholars" - the 5th-year Kenyan medical students who
will be doing rotations in the US and Canada. The doctor-patient
relationship is markedly different here in Kenyan than in the US,
so to prepare the Kenyan students for their time abroad, the
Slemenda Scholars in the recent past have been tasked with leading
discussions, performing skits, and showing a few funny videos to
demonstrate some of these differences.
Over the course of the 3 weeks, we covered quite a few topics.
The first week we focused largely on defining "patient-centered
care" and discussing proper bedside etiquette. We talked about body
language - in Kenya, doctors will stand with their arms crossed,
and it's considered impolite to have your hands in your pockets;
however, in the US, if your arms are crossed it may appear that you
are putting up a barrier or are uncomfortable.
The second week focused on professionalism and sensitive topics.
Because of the vast differences in US and Kenyan ultures, the
sensitive topics discussion was very important. The issue of sexual
orientation was controversial, which was not surprising as a 2007
survey found that 97% of Kenyans opposed homosexuality. We
explained about the recent push toward legalization of same-sex
marriages in the US, and the topic came up again in the
3rd session as we had to explain that you shouldn't
assume the sex of a spouse during a patient interaction.
The final session focused on taking a sexual history and special
populations. We talked a bit on the elderly, and then we welcomed
two guests to speak to the group: Sarah Ellen Mamlin spoke about
how to talk to children, and Dr. Katherine MacDonald, the new
pediatric team leader, spoke about how to interact with the parents
of pediatric patients. The students asked many questions, and I
also felt like I learned quite a bit. Finally, we wrapped things up
with a discussion about strategies for taking a history from a
patient with a mental illness on initial presentation, if they come
After the final session of the class, and we finished things
with a pizza party. It was great just to sit around with the
students and answer questions they had about the US in general, not
related to what they'd be doing during rotation. They were blown
away that we generally don't have wooden, temporary structures set
up on the sides of roads that sell everything from chai and bread
to phone airtime and phone charging. I was able to relay the good
news to them that generally they can walk safely on sidewalks, as
drivers tend to use the roads and avoid the sidewalks in the US
(which is in stark contrast to here in Eldoret). And finally, I had
to break the bad news to them that it will be hard to find a good
meal for 200 Kenyan shillings (about $2.50).
Last week, Wyatt and I were asked to moderate a panel discussion
about the Past, Present, and Future of AMPATH. Each Thursday,
there's a "Fireside Chat" (although I've yet to see an actual fire)
about a variety of topics, from women's rights to sustainability to
street kids. For this session, Joe Mamlin, Bob Einterz, and Paul
Ayuo agreed to spend about 90 minutes answering questions and
speaking about the history of AMPATH and where they see it going in
the future. Dr. Mamlin and Dr. Einterz are two of the original IU
faculty who help forge the partnership with Moi University, and Dr.
Mamlin and his wife has been living in Kenya "permanently" since
2001. Dr. Ayuo is the current dean of the medical school at Moi
University and has been working with AMPATH since its inception.
Pictured below: Dr. Mamlin, Dr. Ayuo, and Dr. Einterz at the
I wish I could write a synopsis of
what was said during the talk, but I don't feel like I'd do Dr.
Mamlin, Dr. Einterz, or Dr. Ayuo any justice during the process.
The collective institutional knowledge amongst the 3 is astounding,
and it was an honor to share the "stage" with them. So I'll leave
you with this: supposedly the talk was filmed, so keep your eyes
open for this to show up on the AMPATH webpage. We tried to focus
on topics that aren't touched upon in-depth in Walking Together,
Walking Far, so hopefully between reading the book and listening to
the recording, you can get a good feel for what this program is all
about and why it's been an honor for me to spend 7+ weeks here so
Finally, I'd be remiss if I didn't talk a bit about our safari
this past weekend - we made it to Maasai Mara! It was an 8-hour
drive, which was a bit daunting, but overall it was well worth the
trip. We spent about 12 hours in the park, and managed to see 4 of
the "Big Five" - lion, elephant, cape buffalo, and black rhino (we
missed the leopard on this trip). We also were able to spend a
morning in a Maasai village learning about their culture and
shopping in their market. I was able to pick up a few Maasai goods,
which will be a great reminder of the trip. All in all, it was a
great way to spend my last weekend here in Kenya. Pictured below:
The African "Big Five": elphant, lion, rhino and cape buffalo in
Maasai Mara, leopard from Nakuru.