People of AMPATH: Grace Wandia, MD
Each year, AMPATH’s North American partners welcome approximately 16 Kenyan students and 2-5 registrars for rotations. Approximately 25 North American students and 25 residents visit Kenya for two-month rotations as well.
If you ask Grace Wandia, MD, what impressed her most about her two-month rotation at Eskenazi Hospital in Indianapolis, she will tell you about the environment. She was impressed by the environment inside the hospital which she found collegial, transparent and supportive. She was also impressed by the environment outside the hospital, which she found really, really cold.
Wandia, a registrar (resident) at Moi Teaching and Referral Hospital (MTRH) in Eldoret, experienced one of the coldest days in Indiana history while completing her pulmonary and intensive care rotations in January and February. The combination of temperature and wind on January 30 made it feel like -40 degrees (F or C). It was so cold that the campus surrounding the hospital cancelled classes, but of course, the hospital was still operational. “That was an experience. What I hate about the cold weather is that I can’t walk around. I totally understand why people get depressed in the winter,” she said.
While the record cold weather may have given Wandia a good story to tell her friends and family in Kenya, it was the warm environment inside the hospital that she will remember most. “For me, the interactions between the faculty (IU School of Medicine) and residents was a highlight. I think the faculty provides really good mentorship across their practice including seeing patients and doing procedures. It is a really good team environment where everyone gives their input and at the end of the day you come up with a solution as a team. The faculty are very approachable. It was an amazing experience,” she said.
“The doctors also go to great length to explain everything to patients,” she continued. “They break it down to the basics and talk to the patients in a way that they will understand. It’s the real definition of team work, because everyone who needs to be on board, such as therapists and social workers, are on board. I think the patients are more willing to know all of the details than they are in Kenya,” Wandia said.
Wandia also enjoyed participating in morning teaching sessions and having academic discussions with the fellows on her team. She was inspired by the focus on continuous learning and appreciative of the warm welcome she received. “My resident colleagues were really helpful in helping me find my way around, telling me where to go and where to see patients,” Wandia said. Efficiency and attention to detail were also traits that Wandia saw on frequent display.
From a clinical standpoint, Wandia found the regular use of ultrasound as a notable difference between care in Eldoret and Indianapolis. “Almost everything at Eskenazi is ultrasound guided. At MTRH there are no ultrasounds on the wards. Most of the procedures in Kenya are based on physical examination and in Indianapolis one of the fellows even has a portable ultrasound probe that can be used to confirm examination findings,” she said. She also noted that patients in Indianapolis often had multiple diseases or conditions for which they were receiving treatment which has not typically been the case in Kenya, though the diagnosis of cancer and chronic diseases such as diabetes and hypertension have been increasing in Kenya as well.
Outside of the hospital, Wandia enjoyed trying new food and meeting new people. A variety of salads and bourbon chicken were some of her favorite new finds, but she also thinks that the American diet is too sweet and too salty. Wandia had the opportunity to visit friends and family in Atlanta and Baltimore and noted the wide variety of people, houses and things that she saw. In total, Wandia calls her time in the U.S. “interesting, eye-opening and mind-opening.”
Wandia is scheduled to complete her registrar training in Eldoret in March 2020 and will then practice for at least three years in Kerugoya, Kenya. She is still determining a career specialty and is currently favoring either endocrinology or pulmonary.
If she were giving advice to other Kenyan registrars about completing an elective at one of AMPATH’s North American partners, Wandia would definitely tell them to do it, just maybe not in the winter.