Rishi Kaipa and Euan Chand, third year medical students at Barts and The London, share their experience volunteering in Nairobi recently. 

Before beginning our third year of medical school at Barts and The London, we embarked on a medical volunteering experience in Nairobi, Kenya. Our journey allowed us to develop our clinical skills, alongside witnessing healthcare in a new context. 

The initial shock when walking into a government hospital in Kenya was unfathomable. We saw patients standing waiting for the operating theatre due to a lack of beds; fresh blood from the previous delivery that remained uncleaned, yet constantly patients flooded in and there was no urge to maintain sanitary conditions, risking the spread of potentially very serious infections. Yet, there were smiles, laughter, families standing strong during hardship and a network of relatives surrounding their loved ones. Despite the awful situation these patients were in, they found a way to be happy, putting into perspective varying aspects of healthcare. 

A contrast to the UK

This is a sharp contrast to the UK, where hospitals sometimes value efficiency over patient interaction. Hospitals are filled with a sense of impending doom, despite having resources that are plentiful relative to what we witnessed in Nairobi. This isn’t the fault of doctors, but a result of the pressure they are put under by seniors or the system. A professor referred to doctors as ‘healers’. Therefore, sticking true to this definition, does the system really allow doctors to heal patients fully, emotionally and physically? 

On the other hand, the lack of resources in Nairobi puts into context our supposedly ‘failing’ NHS system. In Nairobi, healthcare staff operate under intense pressure, facing unreliable electricity, incomplete stocks of medication, and no constant access to water. When available, these resources are deeply valued and appreciated, perhaps suggesting a need for a deeper sense of gratitude amongst the public and staff for the NHS. 

Emotional intelligence as vital as clinical knowledge

In Kenya, volunteering at a private and public hospital allowed a holistic understanding of healthcare. Our private hospital, Mikulinzi Community Hospital, was filled with ward rounds, admissions, and opportunities to practise basic skills such as cannulation and wound care. Assisting in caesarean sections were high-stake emotional and technical moments, showing emotional intelligence is just as vital as clinical knowledge, the difference being, bedside manners cannot be learned from a textbook. 

Shadowing doctors from private and public hospitals revealed another reality: the emotional, as well as financial toll of healthcare inequality. One case that stood out involved a patient that was distressed with the decision to refuse post-exposure prophylaxis, due to finances, showing the socioeconomic interplay of healthcare. Societal pressure coupled with the inability of accessing medications, means this diagnosis will remain hidden, and be passed on to another patient, until the supposedly small act starts affecting millions of people, adding to both their medical and psychological burden. This experience reinforced a doctor’s role is to advocate for a fairer system in which patients are protected to the best of our abilities. This suggests empathy and communication can be applied beyond law and policy for true medical protection. 

The reassurance of Medical Protection membership

As Medical Protection members, we felt reassured knowing that support was there if we needed it. Fortunately, we did not encounter any medico-legal issues, however having that safety net ensured we could fully focus on learning and the service we provide. For students considering an elective or volunteering abroad, such peace of mind is invaluable. 

Our experience in Nairobi shaped the kind of doctor we hope to be and illustrated the complexities of global healthcare systems. Despite hearing about junior doctor strikes and an under resourced NHS, Nairobi deepened our commitment to patient-centred care. Amongst treating physical illnesses, it is vital to understand the empathy and communication that is required when treating patients. 

Find out more about how we support you with your medical elective and how to plan yours here: Medical elective planning resources, elective protection and indemnity