Final week in Kenya

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 alone.

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 Fireside Chat.

Fireside Chat

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 far.

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.

Big Five

 

Posted at 07:13

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