Hrdy, Michael

Medicine

Residency

Kenya

Due to the generosity of the Lietman Global Health Scholars Program I was fortunate enough to be able to travel to Kenya during the third and final year of my pediatric residency. This month-long journey around Kenya provided invaluable opportunities to serve, to teach and to learn.

My time in Kenya was unique among my travels to Africa due to the degree of medical autonomy and authority we experienced. While in the United States we were merely the most experienced trainees who still required supervision in our care of patients, in rural northern Kenya, we were the pediatric experts. Additionally the sheer volume of patients requiring our attention precluded the degree of oversight we were used to. This was challenging but also very rewarding. At each village concerned mothers and fathers would bring their children for evaluation. With the essential help of our local translators we were able to understand the concerns of the parents and what symptoms their child had. From this conversation we were able to develop treatment plans, albeit limited by what medications we could bring in the suitcase in the back of our mobile clinic. Despite these challenges, I believe that patients were helped by our mobile clinic outreach program as well as by the other experiences we had in Kenya such as providing free hernia and undescended testicle surgeries and screening several thousand children for congenital heart disease.

       

Left: Our modified land cruiser served as transport for medical staff, a private area to examine patients and storage for all our supplies and medication. Right: A picture showing the ambulance in action during one of our mobile clinics. Pictured is Dr Thorn

Beyond service we were also able to share our knowledge with the providers working in Kenya. While weight-based dosing is one of the hallmarks of pediatrics, the providers we worked with in rural Kenya were deciding dosing based on whether the child was “large” or “small” –potentially leading to dangerous dosing errors. They had the capacity to measure the weight of each patient and we were able to build on this by leaving them a reference book including dosing guidelines as well as medication measuring devices to assist in accurate dosing. Furthermore, during our time working at a heart disease screening fair in southeast Kenya, we were able to review the essentials of the cardiac exam with the Kenyan medical students and junior residents we were working alongside. These opportunities to teach provide a chance to make an impact on the care of children in Kenya that lasts beyond our brief four week visit.

The transfer of knowledge was not just in one direction, however. The care of patients in a tropical environment is not merely a resource-limited version of the care we are used to providing in the United States. Rather, the patients and the diseases they were possibly afflicted with were different from those we were familiar with and this stretched our clinical skills to their limit. Fortunately we had the help of experienced nurses, doctors, medical students and community health workers who provided essential instruction and insight into working with a population that was foreign to us but familiar to them. This exchange of knowledge and expertise enriched the ability of both groups of providers to care for patients and I know that there are children in Kenya living healthier, happier lives as a result of the support of the Lietman Global Health Scholars Program.

Walking around the village in northern Kenya were were welcomed by the locals who were so friendly and gracious in sharing their home with us. Pictured is Vanessa Ozomaro, MD. 

People

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Robert Bollinger Jr., MD MPH

Director, Johns Hopkins Center for Clinical Global Health Education (CCGHE); Associate Director, Johns Hopkins Center for Global...

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs

Caitlin Kennedy, PhD MPH,BA

Co-Director, MPH concentration in Social and Behavioral Sciences in Public Health; Associate Director, Center for Qualitative...

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation
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September 2018

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