Thursday, March 8, 2018

Making an Impact 7,899 Miles Away

Patients at Kibogora Hospital – located 7,899 miles away from Mobile, Ala. – often walk up to 20 miles to receive medical care. Hospital beds are positioned less than a foot apart and patients sometimes have to wait until the next day to be seen by a physician.

“If a pediatric patient had difficulty getting food at the hospital, the other mothers would provide food for them,” said Kirasten Brasfield, a fourth-year student at the University of South Alabama College of Medicine. “They watched each other’s children and were a great support to one another, which was a stark contrast to the individualistic society often found here in the United States.”

Brasfield – along with 11 USA medical students and eight USA physicians – recently returned from a month-long medical mission trip to Rwanda, Africa, where they worked alongside Congolese and Rwandan physicians.

The students had the opportunity to assist a 269-bed self-supported facility, which provides surgical, pediatric, maternity, neonatal and general medical services to a population of more than 250,000 people. They also made home visits – examining patients and offering what they could to help.

Brasfield said one of her most memorable days was a home visit with a patient who was wheelchair bound due to neurological complications of HIV. “My classmate and I observed the palliative care nurse ask questions about his health and any social issues that he experienced,” she said. “We also prayed for him. Having the ability to not only serve with friends and classmates, but also to study scriptures and worship with them was a huge blessing.”

Patients at the hospital spoke Kinyarwanda – the national language of Rwanda – and the students had to learn how to overcome the language barrier.

Brasfield said she soon discovered the benefit of learning a handful of basic Kinyarwandan words to help her establish a rapport with patients. “We are taught to communicate as part of good bedside manner, so I think we all felt bad about not being able to speak with the patient to explain what we were thinking about their diagnosis, our plan to treat, or just to provide some reassurance,” she said. “I noticed that patients and their parents appreciated when we found a common thing to laugh about, and we provided some amusement to our Rwandan friends when we butchered the language.”

“It was very difficult for me to express my sympathy toward a patient since I could not speak their language,” said Francie O’Hea, another student at the USA College of Medicine. “I found the easiest way to sympathize with a patient during a time of grievance was to sit and hold their hand or give them a reassuring hug.”

O’Hea said “murakoze,” Kinyarwandan for “thank you”’ was her most used phrase. “I also learned ‘muraho,’ which is ‘hello;’ ‘amakuru,’which is ‘how are you;’ ‘witwande,’ which is ‘what is your name’, and ‘mwiriwe,’ which is ‘good afternoon,’” she said.

O’Hea spent the majority of her time on the labor and delivery service, in the maternity wards and in the obstetrics operating rooms. “I had the opportunity to work with Rwandan obstetricians and gynecologists and family medicine physicians who taught me a great deal about the care of antepartum and postpartum patients in a part of the world where there are very limited resources, access to medications and prenatal care,” she said. “I learned how to think critically and adapt quickly, as there were few labs that could be drawn and very few diagnostic tools.”

“The types of diseases seen in Africa are completely different than what we see in the U.S.,” O’Hea added. “There was definitely a big learning curve, but by the second week I knew how to treat a woman in her second trimester of pregnancy who had just been diagnosed with malaria.”

O’Hea coins the mission trip a success, as the group was able to impact many patients at Kibogora Hospital, often rounding on more than 30 patients each day. “Our group was fantastic,” she said. “We were efficient and worked well together in order to get things done. All of us have ‘go-getter’ mentalities, so in retrospect, I believe we were able to accomplish a great deal.”

As she completes her final year of medical school, O’Hea said she will apply the lessons she learned on the trip throughout her career. “Participating in this trip was the best decision I could have made,” she said. “I learned so much and met really amazing and loving people along the way. It was truly remarkable and reminded me that we have a lot to learn from the grateful, happy and patient people of Rwanda.”

The mission trip is sponsored by the Christian Medical Ministry of South Alabama (CMMSA). To learn more about CMMSA and supporting medical mission trips like these, visit http://cmmsa.org/#/missions.

Click here to view more photos from the trip.