The Frist Global Health Leaders (FGHL) program affords young health professional students, residents, and fellows the opportunity to serve and train abroad in underserved communities for up to one semester. In doing so, they will bolster capacity in clinics in need of support as well as offer training to community health workers to promote sustainability upon their departure from these communities. As part of the program, they blog about their experiences here. For more information, visit our program page.  

“Where’s your team?” the man asked.  He was a surprising figure to see on this gray rainy day in Kijabe, standing about my height casually just off the middle of the road, looking onwards at the soccer, or as the rest of the world calls it, football game a few yards away. He was dressed well to be out in such weather, a formal black suit, collared shirt, and tie, eyes lighting up as the orange and yellow teams chased the football from one side of the field to another amidst the big juicy rain pellets.

"Where’s your team” is a question that put words to a feeling I’ve struggled with the last few weeks. Two weeks ago my husband and I began work in Kijabe, Kenya. Though he has traveled once in Kenya, this is my first time to this incredibly beautiful place and taking care of these incredible patients. Traveling to another hospital, even within the US, can be difficult. As a surgery resident, my life is built around teams. Our resident team. Our nursing team. Our OR team. Our ED team. Our attending team. These teams are what provide care for a patient, education for us the residents, and, if we are doing it right, improvements in both, at our respective homes and beyond. You spend months, sometimes years proving yourself to this team, earning your right to play, to come off the bench. The same traits that allow athletes to excel, hard work, focus, commitment, all translate well to the work we are called to do as physicians in training, with long hours and often long periods as the “junior varsity” team. Yet with time, effort, and love of what we do you earn the right from your colleagues, the nurses, the attendings, to play.

When I started at Kijabe a few weeks ago, it was not long into my first few moments when I realized I not only did not know the team, the game was a bit different. As I wandered around the wards in search of a folder for a patient to look through their paper chart, I can only imagine I looked more lost than I felt. As the past few weeks have unfolded, I have stumbled more than I have stood. I have fumbled through the pages of paper charts, in search of elusive vital signs or medication lists. I have misunderstood my patients who pronounced a Swahili word meaning “yes” (ndiyo) that I took as “no” in response to their pain or their eating. I have been so excited to ask a postop patient if they are in “uchungu”, a word I had learned that particular day, meaning “pain”, only to get a 2-minute response in Swahili and realize speaking and listening in a language are two very different things. But I have stood for two reasons – the patients and the people.

My first night on service I was on call, and I was saved by my patient. The junior resident called me to casualty to see a middle aged woman with abdominal pain. It has been a long time since I have been nervous to walk into an emergency room on consult call, but in a new place with new rules, I found myself feeling not dissimilar to the first day of my internship. She was seated in a plastic lawn chair in the middle of the room, turned towards the entrance as if she had been awaiting my arrival. As I knelt down next to her we began talking about her pain, and a refocus, or perhaps a less self-focus, occurred. In this place that in some ways feels so different from home, so much is the same. People in pain seeking treatment will tell you a story, and as physicians, our challenge is to listen, whether they speak Swahili or English or Kikuyu. As I left her chair and went to greet the other resident on call, I felt grounded. The resident and I talked and taught each other. She had a presentation I was concerned was appendicitis, a well-known and nightly occurrence in our ED but a relative rarity here. I had an opportunity to share knowledge and experience of a common medical problem from home while beginning to learn the language, rhythm, and culture of the hospital. That patient will likely not remember me, but she re-centered me in this place as I moved forward in my time at Kijabe.

The people I work with have also saved me. A few days following my start at Kijabe, I stood staring at the OR board. It was 7 at night and I had a patient I needed to take to the operating room. I had talked to a variety of people, but got the sense I had made little progress, and felt unsteady in a sea of empty OR rooms, unsure how to move my patient’s care forward. Around the corner came a young woman with a big smile, a fellow resident I would soon learn, and with a big handshake and an introduction she motioned towards the board – “that your case?” I nodded. She laughed, “well, let me show you how things work around here.” She was not on call, nor on my team, but in that moment she made herself my ally when she needed not, and I remain grateful for her kindness. I am surrounded by that kindness in the residents here – as someone who will only be in their lives for a few weeks, and often feel clunkily unhelpful, with my lack of Swahili, lack of knowledge of where patients are, supplies are kept, or charts are filed, their patience and compassion gives me strength in this place and renews my determination to attempt to give back even half of what they have gifted to me, here and at home.

I turned towards the suited stranger – “I’m sorry?” I asked, lost in thought, and not expecting an English conversation, clutching my warm chapatis and American coffee filters to my chest to protect them from the warm afternoon drizzle rain. “Where’s your team?” the man repeated. “Oh, I’m walking alone today.” We exchanged a few pleasantries and then, nodding towards the football game, I asked: “Who’s winning?” He smiled, broadly, and returning his gaze towards the field - “Oh, I’m just enjoying the game.” I returned his smile and wave, and headed down the hill towards my home and then, the hospital.