Josh’s Experience

Hi, my name is Josh McNaught and I’m a fourth-year medical student at the University of Manchester although originally, I am from Liverpool. In June I had the privilege of travelling out to Kenya to do a 4-week medical elective in Kijabe Hospital with Matt, a good friend of mine from church back in Manchester. It was for me a really valuable experience and one which I am very grateful to have been given the opportunity to have had. I am especially thankful for the support Medical Mission Network provided, both financial and through prayer.

Kijabe is a relatively small town about an hour north of Nairobi which houses one of the countries most renowned hospitals. The town is a missionary-dense area with the local Christian boarding school, Rift Valley Academy, housing over 500 students, and a good number of missionaries serving in the hospital and in the local bible college. We were really fortunate that many of these missionary families were so welcoming, making it easy for us to settle in. We were spoilt by invites to dinner and various social events, my favourite being Thursday night football!

I spent my time in the hospital based on Casualty (what Brits would call A&E and Americans would call ER). This was my first experience of emergency medicine with my emergency placement in the UK not until next year, so I was really thrown into the deep end! It is by nature a very unpredictable field of medicine and so we saw a huge variety of presentations – strokes, trauma, infections, pregnancy complications, you name it. One of the most common things we saw was road traffic accidents, which is unfortunately a far too common occurrence in Kenya. It could sometimes be challenging taking histories from patients with the language barrier, but between the help of family members translating and some Swahili I learnt along the way we usually got there! The placement was a valuable learning experience for me, helping develop my clinical problem-solving skills and for sure my communication skills. Often the consultants would lead teaching sessions on various topics, which was something I found beneficial.

The placement wasn’t without its challenges though. It was eye-opening to see the difference in working conditions and resources to what I am used to. Obviously, this is something that I expected but it is difficult to appreciate the impact this has on patients without seeing it first-hand. The placement could be frustrating at times, with existing differences in ways of doing things, likely stemming from cultural differences, but overall, it was amazing to see how doctors from different cultures worked together and were open to learn from each other. One of the biggest difficulties I found was to do with the financial burden treatment was to so many patients. In the UK we are so fortunate to have free healthcare and so considering the financial aspect of care and dealing with insurance companies was totally foreign to me. However, in Kenya it was often a key consideration when deciding management of patients and sometimes this could be extremely difficult. For those without insurance, often there was a choice between huge financial burdens of treatment or compromising the best quality care. And even for those with insurance, often there were difficulties in getting the correct paperwork which could sometimes delay management of patients.

When choosing where I wanted to do my medical elective, I decided early on that I wanted to be in a faith-based hospital. One of my motivations for this was that I was keen to experience what this was like and to develop my understanding of how to live for Jesus in the medical workplace. Every morning the team would have a short devotional time led by the consultant for the day – a great way to start the day and commit it to God. On ward round, we would pray with every patient – it was encouraging to see how most patients were so receptive to this. We were also able to attend the chapel services held every Wednesday for the staff to come together and worship before the start of the day. It was amazing to see how spiritual care was valued in the hospital. I had the opportunity to hear first-hand from two of the hospital chaplains over a coffee about the work they do and it was great to learn of how fruitful their ministry was.

Whilst in Kijabe, we were also able to spend some time up at Rift Valley Academy and get to know some of the students and families there. We particularly enjoyed attending some of the school sports games and Matt even dressed up as Buffalo to be the mascot at the rugby semi-final! We were fortunate that whilst we were there, two baptism services were taking place where we witnessed around 15 students get baptised and heard their testimonies. It was really challenging to hear about some of the difficulties of growing up on the mission field and yet it was so encouraging to hear that despite these challenges, so many had decided, independently to what their parents believe, to put their trust in Christ. Towards the end of our placement, we were able to have lunch with some of the lads who will be graduating and leaving Kijabe for universities and colleges. It was great to be able to share with them our experiences of university and the challenges Christians can face in such a secular culture.

What I’m sure will be one of our most lasting memories of our time in Kijabe actually comes from outside our time in the hospital. Through connections we had made in Kijabe, we got to know some of the staff at a local orphanage called Naomi’s village and were blessed with the opportunity to spend a few days there. We quickly became very invested in the work that was happening there and were desperate to visit whenever we could. To hear the tragedies of so many children’s stories and yet see an overflowing of joy and hope in those same children had a real impact on us. We were greatly encouraged to see God’s work at hand in developing them into young men and women of God. I’d massively encourage anyone to check out for themselves the work that is happening at Naomi’s village and to even consider contributing to the life-changing work there by sponsoring a child! (www.naomisvillage.org)

Matt’s Experience

Hi, I’m Matt Gastinger and I’m a new physiotherapy graduate from the University of Salford. I too have recently returned from AIC Kijabe hospital in Kenya where I spent 3 weeks working alongside the physiotherapy team in partnership with Serving In Mission (SIM). This was my last placement before starting my first job this September!

Upon arrival in Nairobi, both Josh and I were met by a local SIM Kenya worker who provided our orientation which included getting a local SIM card and trying some Kenyan food! After a day in Nairobi we travelled to Kijabe. On our first day we received an induction, a brief tour of the hospital and a complementary meal.

During the first week, I spent time observing the different specialities the Physiotherapy team covered in the hospital. This incorporated a wide range of conditions, including neurological, respiratory and medically unwell as well as seeing patients after a variety of surgical procedures. I also visited neighbouring private wards with similar patients. This was a good introduction into how the Physiotherapy team managed their workload. Each day there would be a morning devotional and prayer time led by one of the team. This would be followed by either a more extensive bible study in Joshua, or meetings depending on the day. I concluded my first week observing an occupational therapist who worked in paediatrics. There were no speech and language therapists at Kijabe hospital and so part of the Occupational therapist’s role would be to cover some of their usual responsibilities. This involved feeding patients and assessing a patient’s swallow. Furthermore, the occupational therapy department led a developmental clinic every Monday. This included assessing and providing treatment to patients with developmental delays due to various conditions. This, at points, was quite emotionally challenging but was also a joy to work with children, knowing you were trying to help them in their development.

For the rest of my time at Kijabe hospital, I was involved with paediatric Physiotherapy seeing patients suffering more commonly with Cerebral palsy, respiratory complications and post-operative procedures, including spina bifida to various fractures of the lower limb. Other less common conditions I observed were Guillain-Barré syndrome and post-op cleft lip. I was also involved in casting to create splints for a patient, which is not part of a Physiotherapists role in the UK. The main aim with the CP patients was to help them in their motor skills as they were often behind on the development milestones for their age. Some also presented with respiratory complications including high amounts of sputum on the chest. As a result, Chest Physiotherapy was needed which involved providing percussion, vibrations, shakes and postural drainage where necessary. This was often uncomfortable for the patient and so as a team we resorted to any means necessary in using toys or anything with noise to distract them and make the session more enjoyable! During one of my first sessions with a patient, they were distressed and agitated as we attempted to assess them. However, the mother started to play some worship music in the background which calmed the patient and helped them to feel at peace while we carried out our assessment and exercises. I was also able to pray with the patient afterwards which is unique to Kijabe hospital, as a Mission Hospital. This encouraged me to continue to pray with patients either upon discharge or at a distressing time in their recovery. This is obviously something that is more restricted for us as professionals in the UK.

I grew in my relationships with many of the staff at the hospital, mainly in the Physiotherapy team. Each day at around 11am all the staff would have their break for chai time which often involved chapati. During this time, I chatted more to some of the staff and got to know them better, often talking about football but also learning about Physiotherapy in Kenya. Many of them were not from Kijabe as the hospital had students and healthcare professionals from tribes throughout Kenya. This was also the time when I would learn some Swahili phrases each day. However, the Swahili dialects differed depending on the area of Kenya, which was an added challenge when learning! Finally, Josh and I had the opportunity to attend a birthday party for one of the local Kenyan Physiotherapists. It differed slightly to any other birthday gathering we had been to with Swahili songs and dancing (in a living room) alongside sharing a word of encouragement and affirmation to the person whose birthday it was.

Finally, we both attended the local AIC church in Kijabe, which was more similar than expected with a couple of English worship songs. However, in Kenya along with many countries in Africa there is a struggle against the prosperity gospel. The local church varied in what was taught and was mild in its’ approach to the prosperity gospel compared to other churches, but it was still present. Please pray for the church in Kenya and throughout Africa that the truths about God would be preached from His Word and that people would know the freedom and life that the gospel brings - with no attachments! Overall, it was a thoroughly enjoyable placement for both of us and great to see brothers and sisters in Christ doing gospel work in Kenya which may not have been possible without the support of Medical Missionary News, so thank you very much!