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Students give medical care in Kenya

by UofL Today last modified Sep 13, 2010 08:33 AM

Amanda Jo Lott believes that education is a tool to help people serve others.

Students give medical care in Kenya

Amanda Jo Lott in Kenya

The second-year medical student put together a group of other medical students that this summer went to Kenya on a medical mission. UofL Hospital donated medical supplies. The group worked with Mercy and Truth Medical Missions, and did such things as provide medical education and give basic acute care and vaccinations.

Cardinal Cam sent a camera Lott and talked with her when she returned. The short video tells the story of the trip, but Lott told Cardinal Cam interviewers much more that would not fit within the video's timeframe.

Here's the text of that interview:

The trip idea

My name is Amanda Jo Lott and I am a second-year medical student at the University of Louisville School of Medicine.

I started a program for rising second-year medical students called the Kenya Medical Mission program. I'm currently the program director. We went to Kenya for 2.5 weeks this summer, and I'm already implementing, along with my fabulous team, the trip for next year so more rising second-year students can continue to go and help out in Kenya.

We have a break between first and second years of medical school, and I really wanted to do something meaningful with my break. I've always wanted to do a mission trip to Africa and I wanted to wait until I'd actually gained some medical knowledge. In the first year of medical school, we all learned a lot, so I viewed it as my chance to get out there and do something with what I was learning and to come up with a productive way to use that knowledge and to spend my summer.

The medical needs of Africa are absolutely incredible. I know that we call what's happening in the United States a health care crisis, but we don't know the meaning of a health care crisis until you've been someplace like Kenya and seen the way that they live every day.

They don't have access to anything. They have nothing. They don't have simple things like antibiotics or Ibuprofen or children's vitamins. So a lot of what we see there are preventable diseases, such as spina bifida, which is 70 percent preventable with folic acid supplementation. They don't know that. They don't have access. They don't have Web MD or Google to look up those things. Some of their health care needs are very simple, are easily met when a team goes over there and tries to help out like we did.

Finding an organization

It was really important to me to choose an organization that had been to the area before and was kind of established because organizations are really the best way to get your foot in the door and help the most people. I did a lot of research and I went to the Southeast Christian Church's Global Medical Mission conference last fall. It's the largest medical mission conference in the world, and that's where I met the organization, Mercy and Truth Medical Missions. They're based out of Kansas City, Kan. I really liked their approach — liked their 'let His light shine before men' approach to medicine and going to Third World countries. They've been going to Africa for over 15 years, so they knew what they were doing, they knew where to stay and they knew the areas where people would need the most help. That's definitely the benefit of choosing to work with an organization like Mercy and Truth. They can set up things well so you don't have to go over there and not know where you're going, not have the proper transportation or get sick because you eat the wrong food.

We're blessed that none of us got sick or anything like that because Mercy and Truth knew exactly where to take us. They were very organized. It was wonderful.

Arriving in Mtwapa

It takes two full days to actually get to where we were. We stayed in Mtwapa, Kenya, which is right on the Indian Ocean. It's just a beautiful, beautiful area. Mtwapa is right outside of Mombasa. Mombasa and Nairobi are the two largest cities in Kenya. So we had the benefit of seeing what city life was like, but we were also very close to the sparse countryside.

I think the thing that surprised me the most was goats, absolutely everywhere. Everywhere you go there are goats along the side of the road. They're very smart goats. They don't try to cross the road; they don't try to get in traffic. They stay out of the way and they just feed in the massive piles of trash that are on the side of the road because they don't have organized garbage collection there. People throw their trash in little piles and they let the goats feed on it a while. After a few days, they'll burn it.

It's very common there that you see people's eyes look jaundiced, yellowing, like a liver condition. When I first arrived in the country, I thought all of my patients had jaundice. When actually I pulled the eye down and looked, their eyes were still white, and the yellowish appearance was just from the harsh conditions they live in with all of the dirt and the smoke from the side of the road. They cook (using fire) inside their houses, so we get a lot of smoke inhalation issues. They breathe it in. They have a lot of coughing problems. They have a lot of eye problems, as well.

At the clinic

We pulled into the gate, and there was this massive group of people waiting for us. I guess that they had heard that we were coming. We took a quick tour of the facility and then we started to see patients. Before I knew it, I checked with my team that was working registration, and we had 300 people that were signed in and were waiting to be seen. We actually saw 600 patients in our first two days.

We were astounded just by the things that we saw. The things that people had lived with without being treated for months and months, it was very humbling. It really just made us appreciate what we have here in the U.S., and the health care situation that we do have here. If you need antibiotics or you have a sore throat or a cough, you go to the doctor and get what you need.

They don't have Q-Tips there or cotton swabs, so it's really common for them to get ear infections. They get dirt or dust stuck in their ears and they don't know any other way to deal with it, so it's very common for them to stick a pen in their ear and kind of thrash.

One particular female patient had done that, and the very tip of this ballpoint pen was stuck in there for months. It was causing her a great deal of pain. We had to go in and extract it. She felt immediately better, which was gratifying and satisfying … to be able to see that, but just the fact that she had lived with that in there for months and it was such a simple procedure to get it out. It was really kind of shocking.

I was doing some wound care when the staff of the Wema Clinic brought up a 9-year-old boy who had been outside playing soccer. I think one of the things that surprised me the most about Kenya was that there are no shoes. All they wear are flip flops. … despite the fact that there are piles of trash that they walk through every day.

So this young, 9-year-old boy had been playing soccer outside and not wearing shoes. And he had cut his pinky toe on something and it was just kind of hanging on by a thread. It would not have been beneficial for the patient for us to stitch it … so we just had to cut off the end of his toe and do some wound care. I remember he needed to come back to Wema Clinic. He was what they call a street boy there and that's actually the term that they use. … His story was that he had been abused by his parents and run away from his parents' home and was just kind of living on the streets, sleeping on the streets at night. Stealing food where he could. … There was a whole group of that type of children.

I had to actually beg him to come back to the Wema Center in a week to get his foot cleaned again. It was a significant wound, and he was at a high risk for infection — especially with his lifestyle. So I actually had to grab a translator and beg him to come back to get the care that he needed. That was very difficult.

After we helped these people and got to know several families really well for a few weeks, and they helped us a lot, too, just showing us all that we have in our life. We learned as much from them as they did from us.

Our clinic settings were really informal compared to American standards. They have a whole different view of "sterile" in Kenya. It's a whole different method, a whole different thing. But our clinics were really informal, so a lot of times we'd just have little picnic tables and we'd sit down and see a family. There you don't see one patient at a time, you see a whole family at a time. Sometimes you'd be seeing seven patients at a time. There's no structure, so you play the role of their doctor, their nurse, their pharmacy technician, their pharmacist and count pills for them. Sometimes we even played the role of translator while we're writing out prescriptions in Swahili, so the clinic setting was very different from what we're used to, but I think we all adjusted well.

I think one of the hardest things is that half of the people there speak English and Swahili, and half the people there just speak Swahili. So sometimes we didn't have as many translators as we needed just because of the incredibly large volume of patients we saw. So sometimes your best translator option really was a 7-year-old. I was really surprised by how quickly they adjusted to the medical questions we were asking and just at how good they really were at translating for us even though we were talking about some difficult topics sometimes.

Leaving

It was very difficult to leave. People there are so friendly and they're so joyful and they're so glad that you're there. You build these relationships with them. It's really easy to form relationships with them. A lot of people there are just fascinated by Americans. They want to know what our life is like. They've got a really glamorized picture of what American life is like, but they really do just want to talk to you and see what your life is like as badly as we want to talk to them and see what their life is like.

I remember we got in a big bus and loaded up our luggage. A big group of Kenyans stood around and they held the American flag and they held the Kenyan flag and they were waiving it for us, saying, 'Please come back. We really appreciate what you did."

It was just so moving and so hard to leave them, but at the same we were ready to leave them because we knew that we were going back to America and we're going to continue our medical educations.

I know that we helped a lot of people, but we could do more the more we are educated. If anything else, it was more inspiration to come back and return to med school and study harder and work harder because people's needs are greater than even what we could get them. I think you just have to realize your place when you get there, and that's something that's really hard to do. You can't solve the country's health care crisis. You can't save every patient. And you can't provide long-term care. You can only help for a little bit while you're there. For now I guess that's all they need. Luckily Mercy and Trust will be sending out more teams throughout the year — the always do — and the University of Louisville School of Medicine will be sending a team next year.

This isn't the end of them getting medical care, thank goodness, but it certainly was inspiring.

Advice to other students

That they get involved and do something and realize that you're not just getting an education for yourself, you're getting an education to benefit other people. You can do things with that education, aside from earning money — everyone has to earn money — but your education's important because you can go out in the world and do things with it that benefit other people.

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