In Kenya, I will travel with a team from the Johns Hopkins Pediatrics Emergency Medicine Department. We will work at multiple clinic and hospital sites in and around Nairobi operating mobile clinics, conducting school physicals, screening for and participating in cardiac surgeries, and providing care to children living in Nairobi slums. On previous visits, the team screened over 1000 children for cardiac disease in one clinic day. The various clinic sites will also expose me to disease processes not normally encountered in the United States such as complicated malaria, typhoid fever, and severe malnutrition.

What I learn about process improvement and optimizing care delivery in the United States will only take me so far in underdeveloped nations. Kenya operates under different political, social, and economic constraints, and it would be detrimental to pediatric care to think that what works here could be retrofitted there. This elective will lay a foundation for understanding new diseases and surgical dilemmas not normally encountered in developed countries. Also, the elective will help me to see how foreign physicians may assist in their healthcare system while maintaining cultural awareness and humility. Learning the tools, processes, and medicines used by patients, technicians, nurses, and physicians will allow me to understand the ground rules under which basic and complex healthcare can be delivered. My hope is that this foundation will be a scaffold on which I can develop ideas with collaborators in Kenya as well as Johns Hopkins for improving pediatric preventative and perioperative healthcare delivery.

Johns Hopkins Department of Pediatrics

Karen Schnelder, RSM, MD