Hard to Say Goodbye to Kenya

18 07 2011

By Nina Woolley

Rising Senior; Candidate for B.S. in Biology and Certificate in Global Health

The thoughts and opinions expressed in this blog post are my own, and they do not necessarily reflect the views of SOTENI Kenya or SOTENI International.

My last ten days in Kenya went by so quickly that I didn’t have the time to compose a new blog entry, but I wanted to wrap up my experience somehow. Now I am writing this blog entry from my home in the U.S., where I arrived four days ago. I spent the end of my SOTENI internship in Mbakalo, the rural community in Western Province that I described previously. There, I spent about half of every day visiting homes to conduct needs assessments in the SOTENI Dispensary catchment area, and I spent the other half of every day in the dispensary working with staff to gather information for the process and procedures manual.

We conducted the needs assessment with the help of two types of SOTENI community health workers, AIDS Barefoot Doctors (ABDs) and Traditional Birth Attendants (TBAs). The ABDs and TBAs served as excellent guides and translators, and we liked getting to know them better while doing this survey, too. Going from home to home during the needs assessment was both enlightening and unsatisfying. I loved the opportunity to catch a glimpse into the lives of the people I was interviewing, and I hope that the information collected will help prioritize the next stages of development of the dispensary, but the 20-30 minutes spent with each person felt much too brief! I would have loved to be able to spend more time with each person and learn more about their personal narratives. Still, I suppose that in data collection it is neither possible nor advisable to develop a connection with each community member interviewed. By the time I left we had visited 99 homes, and what I’m left with is a blur of faces, homes and stories, punctuated by a few particular faces and stories I’ll remember.

During the afternoons I spent working at the dispensary, I worked with the staff members and a fellow intern Katy, an MPH student at Tulane, to gather as much information about their current process and procedures as possible. As an NGO facility, the dispensary does not have all of the Government of Kenya record-keeping systems put in place or the materials provided like in the Mituntu Health Centre where I had previously spent time. Since I was only in Mbakalo for about 10 days and since Katy was planning to work on the dispensary manual throughout the rest of her month there, I spent most of my time interviewing the dispensary staff about their current operations, shadowing them during their daily activities, recording as much information as possible, briefing Katy on all the government procedures I had learned, and making note of the highest-priority items needed in the dispensary in the eyes of the staff. I felt glad to be able to contribute to this ongoing project, but I definitely would have been happy to stay for a few more weeks to see it through!

Since I intended to comment a little bit about the differences between the health care in Kenya and the U.S., I will add a little bit about that now. There are, of course, monumental differences in facilities, technology and access based on the countries’ different stages of development. However, some of the subtle differences were most interesting to me. For example, one difference I noticed was that medical personnel in Kenya seemed to see their role as teachers more prominently than medical personnel in the U.S. It’s silly for me to generalize two entire countries based on personal experience, so I’ll state this as opinion: Following my shadowing in the U.S. and Kenya, I think that medical personnel in Kenya spend more time teaching their patients about their health than the medical personnel in the U.S. This difference, if it is real, could be based on many factors, such as the importance placed on disease prevention since treatment can be more expensive and harder to access, or the fact that many patients I saw had only a primary school education and didn’t know much about human physiology or medicine, or the lack of access to resources like libraries or the internet to search for health information. As someone interested in both medicine and education, I was interested in this dual role of doctor as healer and teacher.

When we were not working, the other interns and I enjoyed playing with local children. Some of our interactions with them were spontaneous, such as when hoards of children would follow us on our daily walks to and from the dispensary. I liked to call this “The Muzungu Parade,” as the little children would leave their homes in threes or fours to come follow the “muzungus,” imitate our accents, and laugh at our way of walking until we were leading a full-blown parade. Some of interactions with the children were also planned, such as our early evening soccer matches using a new soccer ball we brought from the U.S. Sadly, my middle-school soccer career did not prepare me sufficiently for soccer with Kenyan children, as they were too good! However, we had a lot of fun.

After saying goodbye to everyone in Mbakalo, I returned to Nairobi for a brief two days and then got on a plane to return to the U.S. After working so hard, learning so much, and being busy every day, I struggled to make sense of my entire internship experience – from my first few days in Kuria to my last few days in Mbakalo – and I was grateful for the set-aside debriefing period at the SOTENI International office in Cincinnati as I arrived back in the U.S.  Overall, I think that I’m even more excited and energetic now than when I left for Kenya because this internship confirmed my desire for a career in global health and a career as a physician. I hope I’ll return to Kenya one day, and I’ll certainly strive to keep in touch with the friends I made for years to come. Finally, I hope that this is the beginning of much more global health fieldwork for me!

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2 responses

18 07 2011
lysa mackeen

Congratulations, Nina! It sounds like you’ve had an amazing experience. I’m glad that you were able to see so many aspects of the things that interested you – and learned so much in the process. I hope to hear more about it all in the future.

18 07 2011
Braveen Ragunanthan

You bring up an intriguing point regarding the possible differences in the way medical personnel position their roles in Kenya vs the United States. I can envision your observation similarly applying in varying degrees to other locations around the world. As you suggested, a variety of factors may go into this including the disease prevalence, access to other sources of health information, and even cultural perspectives/approaches to health and well-being. Congratulations as well on completing your exciting internship with SOTENI in Kenya.

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