Kleinman, Keith

School of Medicine

Kenya

Ultimately, I will be caring for children who have no other chance of medical care. During my first 2 weeks, I will be working in rural areas providing care to local populations with no access to medical care. Our primary focus will be on treating children; however, we do also care for adults. This time will allow me to further develop an understanding of pathology that we do not see in the United States, how to care for patients in resource-poor settings, and how to manage my emotions in caring for these populations. I will be able to draw on these experiences as I travel the world delivering international aid and develop academic programs in the developing world.

I will then move to Nairobi to work with surgical teams where my primary role will be to perform sedation on the children and help in their post-operative recovery. I am confident that the skills that I refine through this work will continue to serve me both domestically and internationally, during my clinical work in Pediatric Emergency Medicine.

My education in sedation and perioperative care in resource limited settings will be useful throughout residency and fellowship, and anytime that I am called upon to respond to a disaster, domestically and internationally. My residency experience in Baltimore has allowed me to learn about the domestic disparity in health care access and justice, however I think it is important to continually broaden my understanding of the disparity in the developing world.

Johns Hopkins Department of Pediatrics

Karen Schnelder, RSM, MD

Having been to Africa several times in the past, I knew what Africa time was, I knew what chaotic traffic looks and smells like, and I knew that there would be obviously penetrable redundant security measures randomly placed along the journey.  However, what I learned in Kenya is that you never really know what expect when you take a group of six American physicians and drop them in the middle of the Rift Valley.

The most memorable time I spent in Kenya, over the 4 weeks, was in Samburu County, specifically in Barsaloi.  To get there, we had a 12-hour drive in the back of a 1980’s Toyota Land Cruiser, which was for some reason was dubbed to be an “Ambulance”.  The roads were long, unpaved, and dangerously close to cliff edges.  The back of this “Ambulance” was crammed with six residents, a person that needed a ride to a nearby town, a village elder from Barsaloi who needed a ride, and a seminarian.  Let’s not forget the 2 sacks of potatoes, 10 heads of cabbage, bags for all these people, 100 plus liters of water, and 8 medical bags that were all crammed back there with us.  It was a hot, uncomfortable, somewhat malodorous, but it was also beautiful, exciting, and completely memorable.  This was one of the those “this is Africa” moments.  After you get over the initial shock, and get used to the numbness of your bottom, you see the bigger picture of it all.  You are heading to a remote part of the world that has zero access to physicians, to provide them the best medical care that you can in the resource-limited setting and to gain everlasting memories.  The bumps in the road are worth it!

  

After this drive and having this realization, we arrived at the Yarmusal Medical Mission in Barsaloi, Kenya.  We settled in to our rooms and tried to beat the jet lag and fall asleep.  Shortly after falling asleep that first night, my roommate and I were awoken by the priest who asked for our assistance with an emergency.  We sprang out of bed, grabbed flash lights, sprayed bug spray everywhere and we were off in the complete darkness, amongst the stray barking dogs and howling hyenas walking to the closest dispensary.  When we arrived, we found a lethargic dehydrated 3-year-old boy who was carried 15 miles on his mom’s back in the middle of the night.  When six American doctors come to Barsaloi, every surrounding Samburu village knows, and this mother knew that her son needed help.  Her son had been febrile with a diarrheal illness for several days, but that evening he was difficult to arouse and could not drink without vomiting.  His heart rate was fast, and his blood pressure was low; this child needed emergent treatment with fluids, antibiotics, steroids, and antipyretic medications.  We sprang into action and were able to normalize his vital signs and work towards hydrating him.  The next morning, Tommy and I walked over to the dispensary and found a small boy sitting up in bed playing with his mother.  What was so striking about this experience to me was not how the stars aligned for us to help this child, but what would have been if they didn’t align or what happens when we are not there.  So many questions were flying through my mind: what would have happened if his mom didn’t hear through some amazing word of mouth way that doctors were coming; what if Tommy and I weren’t there; what if it was 16 miles, instead of 15, that mom had to walked instead?  At the end of the day it is humbling to think about these situations and recognize how many people in resource-poor settings overcome such incredible odds.  As a nice twist, we randomly saw this mom and son 1 week later at a mobile clinic in a village closer to her.  He was doing great and nearly all better (picture attached).  These realizations were plentiful during my time in Kenya.

The Lietman Grant supported me in gaining unique experiences and broadened my cultural competency in a way that will allow me to practice medicine anywhere in the world more holistically.  I will forever remember these and many other experiences and hope to return to Kenya.

People

Robert Bollinger Jr., MD MPH

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

Noreen Hynes, MD MPH

Director, Geographic Medicine Center of the Division of Infectious Diseases

Caitlin Kennedy, PhD MPH,BA

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

Joanne Katz, ScD MS,BSc

Associate Chair, Director of Academic Programs

Yukari C. Manabe, MD

Associate Director of Global Health Research and Innovation

Stefan Baral, MD MPH,MBA,MSc

Director, Key Populations Program
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Mpilonhle

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