- Abraham Gachunji - Tumutumu School of Nursing
- Allison Foley - UMass Boston
- Amanda French - UMass Boston
- Amanda Hurley - UMass Boston
- Anne Ngare - Tumutumu School of Nursing
- Anne Ng’ang’a - Kijabe School of Nursing
- Anne Wanjiku - University of Nairobi
- Annya Volkova - UMass Boston
- Anthony Kimanzi - University of Nairobi
- Beth Kamau - Kijabe School of Nursing
- Bridie Curran - UMass Boston
- Brooke McGrath - UMass Boston
- Christine Bertoni - UMass Boston
- Collins Muchoki - University of Nairobi
2013 Student Reflections
Abraham Gachunji - Tumutumu School of Nursing
I am privileged to have participated in this year's Kenya Heart and Sole project. This is helped me both socially and academically. Through Kenya Heart and Sole I have been able to reach and help people in need of health support deep in the community. I've also been able to learn a lot of skills through interacting with students from other learning institutions and also able to come across some cardiovascular conditions I've never come across. This project has enabled me to gain courage and confidence of working in and with the community in order to help improve their health status. In addition, Kenya Heart and Sole has helped me interact with people of different culture and learn from them new ways of living and many of the things. Sometimes there were issues with time management or delays, however this was generally caused by unavoidable circumstances which we could all understand. In conclusion I would most sincerely thank people from UMass for their sacrifice and willingness to help and also to those who participated for cooperation throughout the project.
Allison Foley - UMass Boston
My experience with Kenya Heart and Sole has been an incredible, eye-opening journey. I think back to when I first found out I would be going on the trip and the immediate nervous jitters that followed. I had no clue what to expect and my imagination went wild with visions of what I might see and experience as part of the Boston team. Looking back now, I laugh at my wide-range expectations and realize in Kenya one has to expect the unexpected. Our journey had some bumps in the road (and not just the ones on the ride to Nyanduma), but whether it be the bus breaking down or literal ants in our pants, I wouldn’t change a thing.
One of the most important parts of the trip for me, was the ongoing partnership we maintained with the Kenyan nursing students. Not only did I meet some amazing people and gain friends through the partnership, but I learned a lot from each partner I had. I enjoyed working together with them as both sides provided a different perspective towards how to approach each clinical experience. Without the Kenyan nursing students dedication, the trip could not be a success as their translations and explanations of cultural differences helped increase the quality of care towards the patients we encountered. I am forever grateful to all of the Kenyan students and the amazing work we were able to accomplish as a team.
This trip has not only taught me a lot about a culture so different from the one I was raised in, but about my thoughts and feelings regarding my future as a nurse. Hands-on experience in the clinic exposed me to an array of different types of people and experiences that I otherwise never would have been faced with. From the 1 ½ year old baby with a burn who never flinched as we cleansed and dressed it, to the gentleman who opened up to us when asked about stress, and finally to the 101 year old man with a smile on his face- I witnessed and experienced them all. And what I gained from them is that though we may be an entire ocean apart, we are not so different in our basic human nature. Each patient I met during this trip affected me the same as those I have encountered back home, and I will carry them with me as I continue on with my education and future career.
Amanda French - UMass Boston
I could hardly contain my excitement upon learning that I would have the opportunity to return to Kenya. There were so many great candidates from our team the previous year; I couldn’t actually believe that I had been selected. But soon I became so bogged down with these new responsibilities, my regular course work, and accepting a promotion at my job I nearly lost sight of that original excitement. It wasn’t until our second orientation in April that Annya and I locked eyes and realized that it was really happening. We were going back to Kenya.
While I was writing to a friend during our layover in Heathrow that I realized I was going to be working in a completely different role. I wasn’t even sure I was going to like that role. That was when it hit me that this was going to be a completely new and unique experience, and that it would be difficult to compare it to the previous year.
The first few days were spent doing hospital tours, community immersion and visiting local schools to get a feel for the people we were going to be serving. The weather was grey and rainy. Our days were long. We learned a great deal about the health care system in Kenya, and the implications of recent changes enacted by the government, as well as about the educational system for nurses. We met our partners and learned about their experiences and interests. We met community members and were welcomed by them; we learned what life was like for people living in rural villages. All of this was in order to help us make culturally appropriate recommendations for the patients we would soon be screening.
The first clinic at Thaigeni dispensary was massive. There were well over a hundred people waiting for us when we arrived early the next morning. By the end of the day, we would have seen more than 400 patients, almost double what we had seen in any previous clinic. This presented numerous challenges, not least of which was running out of all our paperwork and having to go out and make photocopies midday, and then running out of those. It was difficult for people to take breaks, and we all felt bad that we weren’t able to see everyone. We worked until dusk and there were still people waiting.
Perhaps the best part of being a peer mentor was seeing how involved the community members got. When you’re screening, you’re just going from patient to patient, head down and working through it all. Since we were free to move about, we got to see a lot more of what it takes to run one of these clinics. We had community members working tirelessly to register patients, keep the lines moving and organized, and to assist in various other ways. It was really uplifting to see how people could come together to help out and do whatever needed being done.
For our final clinic we were in Ongata Rongai, on the outskirts of the ghettos of Nairobi, and it was here that we saw some of the most extreme cases of poverty thus far. Malnourished children and adults, victims of abuse, and people sick simply because they could not afford to access health care. It was a sobering lesson that despite everyone’s best efforts, there’s still so much more that could be done. Cardiovascular and metabolic disease screening, health, nutrition and exercise education, pain management… it’s all just the tip of the iceberg.
We had the opportunity to shadow the nurse practitioners during this final clinic. It gave us better insight into their roles, and I was amazed at how much they were able to do with constrained resources. I was given a better idea of what it takes to care for these patients, and what it can take out of you. Seeing such heart-wrenching cases of poverty and knowing you can only do so much to improve their lives, hearing the same stories over and over again.
Overall, this experience was much different than my experience the previous year. This year I learned a lot more about the world and the people in it, I was better able to understand the work that goes into a project like Kenya Heart and Sole, and I was able to experience first-hand many of the challenges that humanitarian and global health workers must face on a daily basis. The challenges we faced were taxing, tiring, and ultimately forced me to grow as a person. I learned a lot about myself, I learned to better express myself and my feelings, and I learned a lot about being in a leadership role. I gained self-confidence, and reflected on my personal experiences in a way that solidified my personal goals for the future.
But perhaps the most rewarding part of the experience was seeing a handful of people I had screened the year before, who remembered me, and thanked us again for what we were doing. They cared enough about their own health, and felt our services were valuable enough to sacrifice another day to waiting in line for us to tell them their blood pressure.
Amanda Hurley - UMass Boston
Experiencing for myself what “global health” really means has been something I have known I wanted to do since I started my college career, and after taking a life-changing course in African politics I knew it was there that I would one day travel. Before going on this trip, I felt that I was well prepared for what I would see in Africa. I had a detailed image in my head of what it would be like, from my coursework on African culture and from the nursing education I’ve gained so far. My first surprise was that there was nothing that could have truly prepared me for my experience. So many people told me before the trip “this will be a life changing experience for you,” and I agreed that I knew it would. But one of the major lessons I learned on this trip was that no matter how much you’ve read up and might think you understand, there is no way to truly understand a place, or a person, or an experience until you are there.
I arrived expecting to love everything about my experience. What I found was that the experience was not that simple, despite the fact that overall I really enjoyed and appreciated the trip and the work we did. There were experiences that were touching and inspiring, like the joyful cheering from the school children we visited who were cheering just because we came to see them, and the generous, hospitable, and often very humorous spirit of the Kenyans we met everywhere. The people we met were open and eager to learn, and most of all I was inspired by the sense of contentedness I saw in even the people who had the least. But I also found myself frustrated by the limitations of our treatment, and having to face patients with serious ailments that we could not treat. I was alarmed and disquieted by the seriousness of the chronic diseases we saw, and the health and economic disparities that were prevalent in the area. Even still, I felt and feel very positive about our work. I have seen that Kenya Heart and Sole is making a big difference in Kenya, and know that this summer we did a great deal to further that distance.
The biggest surprise I’ve had though, I would have to say, has been since returning. When I arrived home I had a lot to think about, but didn’t know yet how much the whole experience meant to me. When people started asking about my experience, I really had to learn to articulate what it was like, which is when I really learned the most about what I had gained from all of it. When people ask me, “So what was the BEST part?” I still have trouble describing just one thing, or anything at all. Sometimes I just come up blank. But that’s because for me, though it’s hard to explain, even that parts that were troubling or difficult, every part was the best part. For a nursing student, I think there is no better way to see what nursing really is, and why we do this, and for who. I’m profoundly grateful for the experience and the more I look back on it, the more I wish I could go back for more. We were half a world away, but I felt more connected to my patients and my team, both American and Kenyan, than I ever have and it was also moving and encouraging to feel like such a vital part of the medical process. The best part, if I had to pick one, is seeing that nurses and patients share something important and very much the same from Boston to Tumutumu. And that partnership, both nurse-patient and American-Kenyan, is one I wouldn’t miss for the world.
Anne Ngare - Tumutumu School of Nursing
The 2013 screening was a very good experience. First of all we went to give health education to children of various schools in Thageini. I learned that most of the children have little knowledge of things that are associated with health, and therefore was very proud to have been part of the team that made a difference in those children's lives by providing them with knowledge. The other two days we went to screen patients at a dispensary. They came in large numbers which made the team very tired. At the end of the day I was very happy because I knew in a way we change the lives of every client they came there just by the kindness and care we showed them. From that experience I learned that the best things in the world are not seen or even touched but felt with the heart.
The debriefing was a good event. I learned many things that I did not know in the group discussions and also the speeches given by various leaders. Our achievement as a team made me feel proud and inspired do better next time and also be a better person than I was. I realize a part of nursing that I never knew. This has made me love the profession more. It was nice working with my partner Sasha and the whole and UMass team. I hope to be part of this as long as I have the ability to do so. God bless you.
Anne Ng’ang’a - Kijabe School of Nursing
To my most loving, admired, cherished and blessed team, UMass Boston. Having been newly chosen to work with the UMass team I felt such an honor to work with the team and eager to learn as like meeting new people and learning from them, sharing experiences also finding out about what they feel about nursing. I am grateful to have worked with your team through the medical camps. I salute you; my people and may the grace of god never depart from you. I worked with the whole team, especially my partner
Darlene whom I admired all through the procedures of history taking, treatment, and she was so kind and nice to me. She gave me gifts and made me feel appreciated in the team as we worked hand in hand and also involved me in decision-making. I am really proud of the UMass Boston team because you have made me love nursing as I used to be in denial. From working with you I feel motivated t continue with nursing through a PhD level if given the chance. You really made me like nursing. Thank God for Darlene and all of you. Professor Eileen, I loved how you took charge of the team, I love how you handled the team with respect, being kind, showing love to them, handling them well even when they seemed very un-kept to touch their body. I like the way you asked for consent. Your concerns and also assuring them good health and also giving them good health and offering medications and sweets. This is a way of showing care and love to according to me. I am sure the image you have left to these people will forever bless you in their prayers.
I also admired the way people respect each other, working as a team and also according to me I felt you appreciated each other. They would ask each other for help if they were too busy. I like the fact that all of you are madly in love with nursing and every one of you are in school for further education.
Anne Wanjiku - University of Nairobi
The project has really enriched me especially in the field of the nursing profession. It has shown a lot of light in the mostly ignored medical field of NCD’s. It has brought out clearly the importance of patient oriented practices that foster prevention of these diseases, and health education especially on proper nutrition. The cross-cultural experience really taught me a lot and I learned much from the UMass Boston students and nurse practitioners. Their motivation and passion in nursing really inspired me to pursue greater heights in the nursing profession and always work for the benefit of the patient.
My resolution: To give health education to everyone I interact with on any grounds- including friends and family.
My dream: To start a web page o a program that will host campaigns on diabetes and HTN prevention.
Thank you and lord bless the founders and sponsors of this wonderful project. May it rise to greater heights.
Annya Volkova - UMass Boston
This year was my second year with the Kenya Heart and Sole program, where I came back as a peer mentor rather than an undergraduate screener. I was excited to see familiar places and people, both of which I did not have high hopes of revisiting this time last year. Naturally, I had expected this trip to be different from the first, yet, I was surprised nonetheless as to how different the two trips ended up being.
Coming back a second time allowed me to understand how much I was in awe of everything around me the first time I visited Kenya. I felt like a sponge that was simply trying to soak everything in, in order to attempt to understand and analyze it later. This year, however, I already had that base knowledge. I already knew what the trip entailed, the people we would see, and the conditions we would have to live under. Due to that, I had more of an opportunity to look deeper into things. To try to understand the cause and effects of the issues we were encountering rather than just familiarizing myself with the issues themselves.
This made me both full of hope for the future, but also filling me with despair because I realized that so much more could, and should be done. By going just twice, I could already see that certain progress was being made. A lot of the patients seemed more educated on non-communicable diseases, and the nurses employed at the clinics seemed to be more welcoming with each trip. I also met several Kenyan undergraduate nursing students who said that due to this program they were filled with a desire to help treat diabetes in their communities. This, among other things, showed that a ripple effect was truly in action and that non communicable diseases were no longer a foreign concept in the central region of Kenya.
I do, however, think that this ripple effect will take too long of a time to attain a large enough magnitude where it will be felt nationwide. This trip made me realize how you cannot attempt to fix just one aspect of a person’s life without having to change the others. And that in this case, a systematic change has to be made in order to help the general public lead healthier lifestyles.
Something else that I appreciated a lot more the second time around was working with the Kenyan students. Last year I think that the culture differences seemed more of a barrier to me than they did this year, and this year I already had relationships with some of the people we worked with. But this year I somehow came to understand the huge importance of working with students from a different country. Not only do we get to learn from each other, but I believe that no-one, neither Kenyan nor American, left the trip without somehow changing their perspective on things. This partnership truly showed that non communicable diseases are a global issue and that it will have to be tackled as such. The students from both the U.S. and Kenya all have malleable minds, and I think that partnerships such as these will only benefit our future by increasing our awareness while simultaneously providing us with tools for change.
Anthony Kimanzi - University of Nairobi
My own personal perspective about nursing has changed a great deal. I have learned that being a nurse is the most noble this I did when I decided to take the course. This is because I have realized a nurse can ultimately save or prolong a patient’s life more than a doctor would do and I can now passionately take nursing to it’s highest level. This experience has helped me realize that most of the people are dying do to diseases that can be prevented. Health education is a very important aspect if we are to reduce the rate of deaths due to non-communicable diseases.
Beth Kamau - Kijabe School of Nursing
As we were screening for DM and HTM it was so obvious that the patients would complain of general malaise, dizziness, diaphoresis, headaches, back pain or any other form of normal presentation or signs and symptoms of many diseases like anemia or respiratory tract infection or other diseases but this was so different as we took the vital observations only to find them either diabetic or hypertensive.
KHAS is an important angel who has come at the right time when many people, especially geriatrics in our communities are suffering back in the villages. I also appreciate how they ensure that the students or all the protocols in it are diversity distributed and this helps to boost each other’s way of thinking and giving good interventions. It is so disappointing that many people who are suffering really don’t know the extent of the complications of the NCD.
As we were doing the medical screening I was very impressed how by how the community members could pay attention to the health messages that we were impacting on them especially for the modifiable risk factors of cardiovascular and NCD. A certain middle aged man presented in the center with diaphoresis and hyperventilation but had already been diagnosed with DM. He had tested his blood sugar and confirmed it greater than 15mmol/l almost all the time whereas he was on oral hypoglycemic like metformin. I gave appropriate health message on dietary intake after confirming what he has been taking and it was having increased glucose in it like rice and maize meal, which is already packed. He was afraid that the doctor would start him on insulin but I with my partner encouraged him and impacted knowledge on him on the management of diabetes as pharmacologic, regular exercise, nutrition, and prevention of complications. He was grateful and we gave a return date to his nearby clinic for further management. Thanks for the opportunity to participate in KHS because I learned a lot.
Bridie Curran - UMass Boston
Summarizing my experience with the KHAS into a reflection essay has not been an easy task – it has required revision after revision to try to encapsulate such an amazing experience into a few paragraphs… I’m not even certain this final essay does justice to this experience. Over the course of two weeks we delved into a project that was very intensive, encompassed many goals, settings, miles and people. Between days of setting up clinics, this opportunity brought us into tours of government hospitals, local schools, universities, rural communities and homes. We saw so many places and settings that provided us the chance to not only learn how medical care is provided and obtained – but allowed us the privilege of asking questions, consider implications of care, compare and critique the different ways that learning and care are provided and to build relationships with our global neighbors in Kenya. Our days were very busy and thought provoking.
We were given an opportunity to meet and work alongside Kenyan nursing peers who we built a reciprocal learning and caring relationship with. We were welcomed into a space of reciprocal curiosity, sharing questions and answers of different cultures, experiences, education, technique and skills. Through these exchanges we would find common themes and characteristics: we all have committed concerns of health, of security, of education. We shared inquisitiveness of culture, of lifestyles, geography, foods and communities. As nursing students, we all share the desire to provide the best care that we can, learn the best techniques, use the best technology and tools available… ultimately, we want to make a difference… we want to care.
Learning about the roles of nursing in Kenya was eye opening. These nurses undertake a great amount of responsibility and even prior to graduating, they have spent a great number hours working in their hospitals and have performed things that we in the US have not. For example, almost each of the students I had spoken to had a lot of experience delivering children. Their experience and dedication to nursing was awe-inspiring and put into perspective the many ways that nursing care may differ between nations. It also provoked thought into the nursing education of the US and ways in which it too could be expanded.
One of the many beautiful experiences of working on this project spurred from a shift… a shift from a sense familiarity to a sense of curiosity, not only of culture, but of attitudes and perspective. Although Kenya presents with clear differences of housing, access to food, health care, education – Kenya also presents with a great deal of optimism, community strength and fortitude that appears different from the US of today. While Kenyans may lack some of the things that we in the US take for granted, they are rich with many of these elements which continue to appear in decline in the US. Versus an American ideal of rugged individualism, the Kenya familial and community bonds are tightly tied, there is a sense of common goals and common good. In fact, many of our clinics were spread through word of mouth, neighbors not only knew each other but supported and helped to care for each other… some of the people seen at the clinics came only at the insistence of the concern from their neighbor. Not a day went by where smiles, laughter and pleasantries were not in abundance. Such an outlook and expression of life is nothing short of contagious, and it was beyond a pleasure every day.
This trip presented with the anticipated, unexpected stresses and challenges – yet there was learning even from these moments. The need for resiliency, cooperation and pragmatism under changing circumstances and trying moments strengthened personal fortitude and relationships while challenging adaptation and pushing forward to a committed outcome. This trip was absolutely amazing and the gratitude held for being part of it is something that will stay with me forever. The people that I have created relationships with from the US and Kenya, are some of the most amazing, hard-working, dedicated, caring people I have ever had the fortune to meet. This is a project that I highly encourage any interested person to participate in, given the opportunity. The personal and experiential growth that has come from participating in this project is something that I am not certain could be gained by any other means; the relationships formed, could not have been without this experience.
Brooke McGrath - UMass Boston
The Kenya Heart & Sole trip was an amazing experience for me, yes there were some ups and downs (literally on the bus), but at the end of each night there, I would reflect upon the day and I felt enlightened and enriched by the Kenyan communities we visited, screened, and worked with. I remember when we first arrived in Kenya getting off the plane I felt anxious, excited, and nervous for what the next two weeks had in store for me and now looking back I can say that the KHS experience was very eye-opening for me not only in the way that the culture is so different from ours, but in the way I practice and learn nursing, as well as how I now think of my future in nursing. I enjoyed very much working with my Kenyan nursing partners from TumuTumu, Kijabe, and Kenyatta not just because they were all so kind, but because they all were so intelligent, bright, and full of life and enthusiasm.
I learned so much from each and every one of them not only things about themselves but also about their feelings towards becoming a nurse and what they would like to change about the future for nursing in Kenya to make it a better profession. I loved learning about how nursing is practiced in Kenya and comparing the similarities and differences from the way we practice nursing in the U.S. Listening to the similarities/differences between both our nursing practices really helped me view nursing from a different perspective. I also want to reflect upon the clinics they all were so busy, each and every one of them that I didn’t really have a chance to catch my breath and reflect upon them until we were on the bus driving home either on the very bumpy back roads, or during 2 hour Nairobi traffic!
The clinics were my favorite part of the Kenya Heart& Sole journey because that is where I felt the collaboration between the Kenyan nursing students and the UMass students, we were all there for a common goal to offer our services, knowledge, and our hearts to the many people who came and waited in a very long line to get screened by us. It made me think that although we are from different parts of the world and have very different cultures and upbringings we both share a common passion for helping people.
It felt good to work as a team, and utilize each other’s knowledge and skills to help these people because working as a team is a very big part of what nursing is. It truly touched me to see how much the communities we screened valued our services, it really felt like we had made a difference even if it was just a few days. I loved how I had emerged myself in the culture of Kenya and was able to offer my services to communities that don’t have much healthcare resources, or education, communities that were so appreciative to just have their blood pressure and blood sugar checked, communities that were so appreciative and thankful to just have someone care and want to help make a change and a difference in their lives. This is the type of nursing that I love, this is the type of nursing that requires passion and that is what I remember feeling on my last night in Kenya.
I think that is the most profound learning/growth experience that has had an impact on me, because it really confirmed my love for nursing and my passion to help people. I hope to continue to learn more about nursing in different cultures and become more involved with global health nursing as I continue on in my nursing career. I hope to be able to continue to share my knowledge with other nurses from other communities here in the U.S. and beyond its borders and be a part of promoting excellent healthcare in all communities. I will never forget my trip to Kenya and the experiences I had with my UMass team and with the Kenyan nursing students and the knowledge that I gained, but most importantly what I will always remember is to practice nursing with all my heart and sole.
Christine Bertoni - UMass Boston
Traveling to Kenya was an eye opening and life changing experience. During our time spent in different communities we were able to tour local hospitals, villages, farms, primary schools, as well as private homes. We were given the opportunity to provide wellness messages to young students and get to know people see how they live. One thing that I always remember and that stuck out the most was how happy the people of Kenya are. Some of the people we met could not afford shoes or three meals a day, but they walked with their heads high and had smiles on their faces.
When we were not touring communities, we worked. Our medical camps were long and tiring days that I would not change for anything. To have the chance to collaborate with the Kenyan nursing students and clinicians and provide medical care to people across the world was amazing. It is an experience that I wish everyone could have the chance to have because it changed my life for the better. I have never had so much appreciation for the life I have at home but also realize that of everything I have, most of it is not as important as we think it is. People would walk barefoot, all night long and have no food to eat then wait all day for us to see them in clinic. As long and exhausting as their day was, they were so grateful we were there to see them, and they were happy. Their happiness was contagious and it made me happy. The Kenya Heart and Sole project provided me with the opportunity to do what I love for amazing people and for that, I am grateful.
Collins Muchoki - University of Nairobi
Yes, it has been an eye opener to the health status at the grass root level, and I have learned the uniqueness of the health problems in Kenya. This project changed my view from the textbook perspective to a more realistic view of the situation. It was a good experience that stimulated me to think outside the box on non-infectious diseases and realize the magnitude of it from the grass root level. If offered a challenge to me and made me realize that with the knowledge and skills I have, I could change/improve somebody’s life at no extra cost.
I learned more on Cardiovascular disease and diabetes and how to prevent and manage them. It also occurred to me that arthritis was also a major problem and is on the rise. After the community immersions and the disease screenings I learned more about the community around me, their lifestyle, and how all these affected their health. Meeting people from UMass Boston, Tumutumu and Kijabi schools of nursing was a good learning experience as we shared our culture, knowledge and attitudes. The diverse backgrounds brought about more diverse experiences and growth opportunities. I feel that it was a great opportunity and should happen more often over a wider geographical range whereby more nursing students will get an opportunity to participate.