Earlier this year, already the third group of students of the Charles University 1^st Faculty of Medicine headed out to do their internships in Itibo, Kenya, accompanied by Dr. Jarmila Klieščiková from the 1^st Faculty of Medicine's Department of Tropical Medicine, and Dr. Šárka Karlová, a stomatologist from Písek. In the course of the five-week stay, the students examined walk-in patients and took part in surgical procedures, as well as prenatal and postnatal care.

The project was co-founded by the Department of Tropical Medicine and the humanitarian organization ADRA. First students came to Kenya last year, this year's participants were Tomáš Mrvka, Petra Bolehovská, Andrea Gálová, Tomáš Dědič a Michal Beneš.

A small health centre in Southwest Kenya was built and funded by ADRA and allowed students of medicine and physicians to get work experience. Due to spatial limitations, only five students can participate at once. “There is a huge demand, and therefore we prefer more experienced students, who can already work on their own and do not need constant observation. Another requirement is taking a course in tropical medicine, so that they have some idea of what they can encounter in Kenya”, says Jarmila Klieščiková. The option is available to students of all faculties of medicine in Prague, not only the 1^st Faculty of Medicine.

Planning the journey

Part of the costs is funded by the Charles University's mobility fund, about half of it has to be procured by students themselves, because there are no projects supporting this kind of activity, due to the fact that most funding support programmes only apply in EU countries. Before leaving for Kenya, students are administered the required vaccination, including yellow fever, typhoid fever or hepatitis. During the stay, they use antimalarics.

24/7 Service

The Itiba health centre services about 100,000 locals and also offers vaccination. “Patients pay the basic fee as well as the price of the drugs. The fees and prices are, however, lower than in hospitals”, says Dr. František Stejskal from the Department of Tropical Medicine, who participated in the previous round of internships. In the center, a nurse, a medical officer and two lab technicians are available. Sister Elizabeth also works as a midwife. Childbirths were among the most vivid experiences. During the stay, 12 healthy children and one baby girl with cleft spinal cord were delivered.

Students rotated on four different posts. One was assisting the Czech physician or stomatologist, one was in a lab or in the walk-in room and the other two worked at the surgery room, where they treated injuries ranging from burns to acute abdominal pains. No way was this a holiday. The students had to be ready to work almost  24/7. Walk-in hours depended on the local religious traditions. “A catholic would go to a church on Sunday and to see the doctor on Saturday, an adventist would do it the other way round”, Dr. Stejskal says. Most days, the waiting room would only be full after workers were done with their jobs on the field. “Tuesdays are reserved for prevention among young children and Thursdays serve as something like a pregnancy advice hours” notes Dr.  Klieščiková. Unfortunately, only a minority of future mothers comes to the centre.

Safety first

During the whole stay, the interns had to adhere to strict hygienic directions and ensure their own safety. “Each patient is treated as potentially HIV positive”, Petra Bolehovská explains. Students were warned that any contact with needle, for example, has to be reported and post exposure prophylactics have to be applied. HIV is still a great taboo in the region and is not even discussed among relatives. Any results had to be delivered confidentially, so that the information does not spread among the community.

As a reward for a job well done, the students went on a two-day trip to a local national park.

Tomáš Dědič, Petra Bolehovská, MUDr. Jarmila Klieščiková a Tomáš Mrvka (left to right) shared their experiences from Kenya

Why did you decide to participate in the health care project in Kenya?

Tomáš Mrvka, 5^th year

I have been interested in missions to developing countries for a while now and I found it useful to experience this kind of work while studying. To find out what it's like and whether it would be a job for me. I was proved right. As soon as I get some experience after graduating, I want to head out.

Petra Bolehovská, 5^th year

I am interested in tropical medicine in general. I have always dreamed of going to Africa. In the future, I want to join a Médecins Sans Fronti?res mission.

Tomáš Dědič, 6^th year

I wanted to find out for myself, what working for a humanitarian organization is like. We had a unique opportunity to work on unusual diagnoses. I'd also like to go somewhere with Médecins Sans Fronti?res, because I believe it is something that matters.

(Lucie Kettnerová)

Translation: Jaroslav Švelch