The College of Osteopathic Medicine celebrates ten years of providing healthcare to rural Kenya and international clinical experience to students through SHARE Kenya. Benson Bonyo, DO, '98, started the program as an OU-COM student, fulfilling his childhood pledge.
April 12, 2006
By Anita Martin
Long before she knew she wanted to be a doctor, Sara Snyder played safari with her father in the family's Toronto, Ohio, living room and dreamed about the wild, majestic landscapes of Africa.
Last December, she got to experience the real thing. Snyder, now a fourth-year medical student at Ohio University College of Osteopathic Medicine (OU-COM), was one of 31 volunteers who participated in the tenth anniversary SHARE Kenya trip from November 21 to December 19. Four senior medical students from OU-COM attended, including Snyder, Brian Steinmetz, Kimberly Sudheimer and Rhea Richardson, led by Administrative Director Deborah Meyer, PhD, and Clinical Director Bob Gotfried, D.O.
SHARE (Student Health Assistance Rural Experience) provides volunteer healthcare to Kenyans, as well as clinical and cultural training to Americans. Participants set up and run provisional clinics in areas around the northwest village of Kisumu, receiving a warm welcome every time.
"In November, the people are looking out for SHARE," says program founder Benson Bonyo, DO, '98. "For most of (the patients), these are the only doctors they will see in their lives." With an average annual income of less than $100, many people in this area cannot afford the limited healthcare provided locally by private and provincial clinics.
Bonyo vowed to somehow improve the health conditions of his community after his sister died of dehydration at age nine in their village of Wangaya more than 30 years ago.
"She died from a very preventable disease and from a lack of access to health care," Bonyo says. "We can't solve all the healthcare problems in Kenya. We are just trying to help, to make a difference and to learn. Hopefully our work will have a ripple effect."
To keep his promise, Bonyo attended a Catholic boarding school in Kenya and applied to American universities, eventually receiving a scholarship to a community college in Texas. To raise the $800 for airfare, Bonyo traveled door to door on bicycle for several months collecting small donations.
Bonyo went on to the University of Texas-Arlington and to Ohio University where, as a first-year medical student in 1995, he led a group of OU-COM volunteers to Kenya. The program gained official university sponsorship in 1997.
"There were a lot of willing people at Ohio University," Bonyo says. "It was easier than I thought (to develop the program)."
Ten years later, the annual program includes fourth-year medical students, residents and clinicians from OU-COM, along with Ohio Northern pharmacy students and pharmacists, and medical volunteers from University of North Texas Health Science Center, Des Moines University, Northeastern Ohio Universities College of Medicine, University of North Carolina and The Ohio State University.
In 2005, participants saw more than 4,000 patients, at an average of 300 patients a day. Their next goal: to complete the construction of a permanent SHARE clinic in the village of Masara and provide volunteer healthcare all year round.
Lions and tigers and tropical disease
Before leaving for Kenya, Snyder's childhood dreams of Africa grew precariously real.
"I was extremely nervous," says Snyder, a self-proclaimed medical hypochondriac. "I was like: I'm going to get TB. I'm going to get AIDS. I'm going to get malaria. I was even nervous about the flight because I had never been in a plane before."
Once in Kisumu, Snyder found herself adjusting to a rigorous schedule. After an early breakfast, participants would cram into hot, stuffy pick-up trucks and travel one to two hours on bumpy, dusty dirt roads to construct their own clinics from scratch. Each student, supervised by an attending physician, typically saw about 25 patients a day – far more than they would see as medical residents in the States.
But for all four OU-COM students, the biggest challenge was recognizing and treating tropical diseases.
"We learn bits and pieces about tropical disease (in standard medical school), but most students never really pay attention," says Sudenheimer. "In the States you're like: yeah right, malaria. But there malaria is like the flu is here."
SHARE participants reviewed their knowledge of tropical medicine through supplemental reading and exchanged morning mini-lectures in Kenya.
According to Gotfried, associate professor of family medicine, almost every patient in Kenya has a condition that students would not see in the United States, including parasites, malnutrition, rare cancers and the severity of conditions. Adding to the challenge was the students' reliance on volunteer translators, and the lack of lab tests, x-rays and other diagnostic tools.
Such a situation may be taxing, but Gotfried, who has faced similar constraints while providing healthcare in Latin America and China, calls it an opportunity.
"Your professors and the doctors you work with teach you the science of medicine, but your patients teach you the art of medicine," he says, repeating a pep-talk he gave to students in Kenya. "With these particular patients, you understand that it's a privilege to be able to hone your diagnostic skills, your deductive reasoning and examination skills."
Students say they often consulted attending physicians at first, but grew more autonomous and self-assured as the month progressed.
"The situation forced us to have confidence in what we learned," says Steinmetz. "As a medical student, you're not trained to trust yourself yet."
Snyder admits to volunteering for wound care a couple times as a break from diagnostic stress, but she affirms that her medical examination skills have markedly improved.
"There really are some cases where you would see those conditions here, too," Snyder adds. She treated a patient with sarcoidosis in the United States just weeks after encountering the inflammatory disease in Kenya. "They say: if it sounds like a horse and looks like a horse, it's probably a horse. But you always have to be ready for a zebra."
Through all the heat and hard work, SHARE volunteers found time to relax and connect with each other and with the culture around them.
"This trip is really one that immerses you in tropical medicine and patient care," Steinmetz said, "But also, we got to experience Kenya in a lot of different ways."
Volunteers took day trips to the Kenyan rainforest, Kakamega, and to Masara, a village where Bonyo lived. They ended the trip with a three-day safari.
From Bonyo's point of view, "the best part about the program for the students is that they can learn another culture and understand how much they have in the United States."
Indeed, despite her childhood safari dreams, Snyder says the people of Kenya impressed her more than the natural setting.
"It was actually sad to come back home," Snyder says. "The people there were so friendly, and they seemed so much happier with so much less. It makes you humble."
As departure time neared, Snyder wasn't the only one sad to go. Gotfried says that students often complained that they were helping only temporarily. Many have already expressed interest in returning to SHARE Kenya-Ohio in the future.
"You always felt like you could do more," Steinmetz says. "Having a permanent clinic will help ease the guilt of leaving. They'll have a year-round staff."
Bonyo says the permanent clinic will launch as soon as they have the money needed to complete construction, a sum Bonyo estimates to be about $20,000. He hopes the clinic can open in November 2006.
"The plan is to use our own clinic as the central place to provide care all year round," Bonyo says. He hopes to collaborate with government sources and non-government organizations like the Peace Corps who are typically stationed in one area for at least two years.
With a permanent clinic, SHARE can create laboratories for more accurate and cost-effective diagnostic tests. Also, eliminating the need to travel everyday will free up time and resources for helping more people.
"That's the most important part," Sudheimer says, "to feel like I'm really making an impact on someone. In the States you don't see it, but over there, you make such an immediate difference."
OU-COM accepts financial and in-kind donations for the SHARE Kenya program. Financial donations help to build the permanent SHARE clinic in Masara, and with daily expenses and logistical needs such as travel, medicines and medical supplies. In-kind contributions (over-the-counter and prescription medicines, medical supplies, medical books, clothing, soccer balls and uniforms, ballpoint pens, coloring books and crayons) directly benefit the SHARE clinic, as well as churches, schools, orphanages and agencies.
Ohio University is a tax-exempt institution, so donations to SHARE Kenya may be tax-deductible, as long as proper guidelines are followed. For more information about donating, please contact Cheri Sheets at (740) 593-4694 or by e-mail at firstname.lastname@example.org.
Anita Martin is a writer with University Communications and Marketing.