Understanding AMPATH - Slemenda Scholar Journeys

Sitting on the plane flying from Istanbul to Nairobi, I made sure to document some of the thoughts I had about what this experience—of being a Slemenda Scholar, of living in Sub-Saharan Africa for a summer, of understanding AMPATH would be like. Having never been to Africa, I didn’t really have any expectations or preconceptions that I could think of at the time because I wanted to engage in this experience with an open mind and an open heart. However, I did ask myself a few questions that I hoped to answer throughout my time in Kenya. Who will I meet? What will I learn? How will I change and develop as a person? How will I be pushed to my limits? And of course, will the babies on the plane stop crying so I can sleep? (The answer to this is no.)

 The three Slemenda Scholars at our first meal in Kenya.

The three Slemenda Scholars at our first meal in Kenya.

In hindsight, I can say that I expected Kenya to be warmer. Turns out, I didn’t fully take into account Eldoret’s elevation and how that would translate temperature wise. Sitting at 2100m in elevation, sometimes it’s a cool 55 here in the middle of June. Rainy season is real.

To start off this blog post, I will briefly explain the Slemenda Scholars program and what I’m currently doing here in Eldoret, Kenya. Named after the late IUSM epidemiologist Charles Slemenda, 2-3 first year medical students are chosen to spend a summer in Eldoret, Kenya to see the different aspects of the AMPATH (Academic Model Providing Access to Healthcare) partnership, become ambassadors for the program, and cultivate our interest in global health, all while collaborating on current initiatives and new projects here.

The first couple of weeks here was full of understanding the different facets and aspects of AMPATH. AMPATH started as an educational medical partnership between IUSM and Moi University and Moi Teaching and Referral Hospital but has grown to include 12 major universities/academic health centers and the Kenyan Ministry of Health, working together to continue to build the healthcare system in western Kenya. Through these collaborations, AMPATH continues to reach more individuals, families and communities. Specifically, AMPATH has been pivotal in tackling the HIV epidemic in Kenya in the early 2000s through its holistic approach of counseling, management/control, and HIV testing/treatment which now has become more widely available to the community. The care provided is not only comprehensive but also effective because it takes into consideration the entire person and their circumstances rather than treating patients solely on the basis of their disease. From maternal-child health to financial education and youth empowerment, AMPATH has become a trusted partner and force in Kenya region. Professionals and researchers from different universities come here to contribute to key initiatives, making Eldoret a hub for sustained collaboration with our Kenyan partners. 

 First day on the wards at the Moi Teaching and Referral Hospital/AMPATH Centre

First day on the wards at the Moi Teaching and Referral Hospital/AMPATH Centre

AMPATH’s integration with local partners can be seen at the Moi Teaching and Referral Hospital, where there is committed presence by institutional partners in the wards. For example, there are Medicine, Surgery, Pediatrics, and OBGYN team leaders that lead medical teams at the hospital and round on patients while also educating the medical students, registrars (residents), nurses, and other essential team members on how to approach each case. Having the opportunity to round in the different wards gave me the opportunity to see the Kenyan healthcare system up close and begin to understand why the system is the way it is.   

Walking into the wards for the first time, I looked to see how each and every bed in the adult ward was filled, 2 to each bed, with 8-10 beds in each room­­– a stark difference from the hospital rooms back in the U.S. where TB patients are isolated rather than in the same room as all the other patients. It was eye-opening to see some of the diseases we, as first year medical students, learned about but probably would not see if it weren’t for this experience. From the child with Xeroderma Pigmentosum to the patients with Pneumocystis pneumonia or hydatid cysts, it has not only been a learning experience being on the wards but also a reminder of why many of us chose to go into the medical profession. As I scrub into surgeries, round on the wards and interact with patients and medical professionals, I feel even more motivated and invigorated to work harder so that one day I can become a bigger part of global efforts like AMPATH and alleviate the suffering that so many individuals endure because they don’t have a choice.

 The villagers helping us dig our car out.

The villagers helping us dig our car out.

Outside of the wards, we’ve had various unique opportunities that have allowed us to learn so much about AMPATH and the Kenyan community.  For example, we had the opportunity to drive to a village 2 hours away. At this village, we interacted with a ‘chamas’ group that is a part of the Chama Cha Mama Toto initiative which are community-led peer support groups that bring women together in pregnancy and while their children are in infants. On our way to this village, our car got stuck in the mud (as it is rainy season and paved roads in rural areas are a rarity). Thinking that this was where I would have to jump out and push the car, I saw how the local villagers came out of nowhere to help get the car free by digging, pushing and pulling the car. The sense of community is strong here, where if a person is sick, the entire village will help out in any way that they can. When we arrived at the Chamas facility, the mamas (mothers) and their totos (babies) came out dancing and singing in unison and in harmony to welcome us to their meeting. What is amazing about this initiative is that there is a full integration of health, social and financial literary through these groups, allowing mothers to save money, loan money and gain interest through their savings. Having the opportunity to see how these meetings worked was a great glimpse into how maternal-child health has been improved in Kenya through such initiatives and how you truly can go far when you work together.

 Me within arms reach of wildlife at Mt. Elgon National Park

Me within arms reach of wildlife at Mt. Elgon National Park

Of course, you may be wondering at this point whether we have seen the stereotypical safari animals you think of when you think ‘Africa’ (or perhaps when you hear the song Africa by Toto) during our time here. The answer to this question is yes, we have. Now there aren’t baboons swinging on trees in my backyard here at IU house but there are definitely what seems to be an endless number of cows and goats, doing their work as nature’s lawnmowers here. We’ve also learned that baboons are really good at working in teams to break into cottages to steal food. With Eldoret being the fourth largest city in Kenya, if you want to see giraffes, zebras, bushbucks, waterbucks, buffalo, and other animals you have to go to a national park or a less urban area, which sometimes is just a short drive away. From the culture to the people and the unique nature experiences, Kenya has so much to offer and I am excited to have the opportunity to learn and explore more during my time here!  

 

Diane Choi is a second year medical student at the IU School of Medicine and a 2018 Slemenda Scholar spending two months in Eldoret, Kenya with AMPATH. Her global health experience stems from collaborating extensively with researchers around the world including Belize and Thailand on spatial repellent research and vector control as a whole. She is excited to learn more about AMPATH and the Kenyan culture during her time in Eldoret.