The Value of Learning Abroad: HIV and TB in Kenya

Samuel De l'Étoile-Morel

As I was completing my residency in internal medicine at the McGill University Health Centre, I was fortunate to have access to an almost unlimited pool of resources to offer the latest and most up to date treatments to the patients I was caring for. Unfortunately, this is not the case everywhere in the world and there is a massive disparity between how diseases are treated in Canada and in low resources countries. To learn on multiple aspects of global health and the practice of clinical medicine in a low resource setting, I decided to organize a clinical elective in Kenya with Family AIDS Care & Education Services (FACES), an organization that provides direct care to HIV infected Kenyans in the city of Kisumu.

I did not know what to expect when I took off from Pierre-Elliott-Trudeau airport.  I am fascinated by the field of infectious diseases and very curious about global health but had never set foot so far from home. The first thing that struck me when I left the plane that brought me to Nairobi, was the warm breeze as I was contemplating Kenya for the first time.  I made it to Kisumu shortly after, where I was greeted by the beautiful Lake Victoria quietly guarding the city.

I was ready for my first day at one of FACES’ busiest location: Kisumu County Hospital (KCH). As I walked away from my tuk-tuk (rickshaw) that brought me to KCH, I saw the busy waiting room of the clinic and made my way through. My anxiety quickly faded as I was welcomed by FACES’ personnel and the clinic’s staff.

For the upcoming weeks, this clinic felt like a second home. I met dedicated and experienced clinicians engaged in a battle against HIV and tuberculosis. I felt welcomed and a part of the team; everyone at the clinic was kind and helpful. I quickly found my way, relying on my physical examination skills and on my colleagues’ vast knowledge of HIV in the tropics.

Patients were numerous and the high number of them presenting with an undetectable viral load speaks for the good quality of care that the clinic provides to them. I was fortunate enough to join the clinic’s consultation team for HIV and TB related care at KCH inpatient medical wards. I could see new suspected cases of HIV with various opportunistic infections or complications related to the treatment of HIV or tuberculosis.

My favourite rotation and I believe, one of the most important sections of the clinic was the Prevention of Mother-to-Child Transmission of HIV (PMTCT) where HIV-positive pregnant women and babies were cared for and efforts were made to eliminate vertical transmission of HIV.

Every day was an opportunity to explore what Kisumu had to offer.  The city felt safe despite some political tensions affecting the country regarding the National Super Alliance (NASA) swearing-in. I became friends with incredible people during my stay that helped me to discover a lot about Kenyan culture and local hidden gems. I will not forget the incredible sunset on Lake Victoria, freshly baked chapaties (a local delicacy that you must try if you visit Kenya!) and more importantly, how Kenyans influenced my experience very positively with their kindness and omnipresent smile.

I highly recommend to residents in training to get off the beaten track and to go abroad. The learning opportunities are numerous, and the experience will make you become a better physician.

Samuel De l'Étoile-Morel is a fourth year infectious disease and medical microbiology fellow at the McGill University Health Centre and at the Jewish General Hospital. Prior to beginning his fellowship in infectious disease, he completed his residency in Internal Medicine at McGill. Fascinated by the field of infectious diseases, he has a special interest in the treatment of HIV and its related complications.