(ATHENS, Ohio – Jan. 28, 2015) For years there has been a decline
nationally in the number of medical students choosing to practice
primary care, which has contributed to a physician shortage in rural
and underserved areas. However, interest in primary care among Ohio
University Heritage College of Osteopathic Medicine students has
remained strong. The reasons vary.
The decision to go into primary
care could be influenced by growing up in an underserved medical
area, a poignant moment in a student’s own health history, a
positive encounter with a doctor they’ve known, or a life-changing
experience halfway around the world. That was the case for Heritage
College graduates Sarah Simpson, D.O., and Amy Simpson, D.O., who
spent time in a remote, dusty village in Kenya where people walked
miles to see a doctor and silently endured painful procedures
without anesthesia. What the Simpsons saw in Africa changed the
course of their lives.
Early on, Sarah and Amy Simpson rejected medicine as a career,
although their parents were doctors and faculty members at the
Heritage College. Dinner table conversations focused on health care
and science. But Sarah and Amy wanted something different.
Sarah pursued a degree in political science, intending to go to
law school. Amy majored in French. Late in their undergraduate
education, the sisters, who are two years apart, started to question
their career choices. Struggling for direction, the two agreed to
tag along with their dad, Christopher Simpson, D.O., Ph.D., on a
Heritage College-sponsored medical rotation in Kenya.
For years, Ohio University students and faculty traveled to Kenya
with the goal of improving health conditions. More than 75 percent
of Kenya’s population lives in rural areas; more than half of them
subsist on less than $1 USD a day. Medical equipment and personnel
are in short supply, and illnesses like dysentery, malaria,
tuberculosis and malnutrition kill more than 7 million children
under five years of age each year.
Having grown up in Kenya, Heritage College graduate Benson S.
Bonyo, D.O. (’98) knew firsthand the public health crisis facing the
country. His mother died from malaria and his sister died from
dehydration. So, in 1995 he started the SHARE (Student Health
Assistance Rural Experience) Kenya program, which the university
officially began sponsoring in 1997. The university stopped sending
students to Kenya after a surge of violence caused safety concerns,
and in 2006, SHARE Kenya became
Bonyo’s Kenya Mission,
a nonprofit organization. Bonyo recruits medical professionals who
would like to volunteer their services in Kenya.
Other opportunities exist for medical students seeking a global
healthcare experience. Ohio University sponsors several summer
programs in other countries, such as Botswana and Ecuador. The
application deadline for most of those programs is Feb. 1 (click
here for more details).
When the Simpson sisters were Ohio University undergraduates,
SHARE Kenya was still sending teams of doctors and medical students
during winter break to a small farming village in Kenya. The sisters
accompanied their father and were introduced to medicine at its most
basic level, where limited supplies and unusual ailments challenged
even the most experienced doctors.
Their days began with breakfast and an educational lecture. Then
Amy, Sarah and the rest of the group were loaded sardine-tight into
the back of a truck, a canvas top protecting them from the hot sun
and dusty road. For an hour or more, the truck lurched through giant
potholes and herds of cattle, stopping every so often to let the
radiator cool. Amy thought it was the most dangerous road she’d ever
seen. But Sarah enjoyed the adventure inherent in the daily trek.
Sometimes they’d travel to Masara, a village where crowds of
children ran up to the sides of the truck clamoring for candy or to
have their pictures taken. Other times, they were taken to a remote
location and set up the clinic under a tree. No matter where they
went, hundreds of people would be waiting, often having walked
miles, sometimes through the night, to be seen by a doctor.
At the clinic, medical students rotated with different doctors.
There was a triage station where vitals were taken, a wound care
area where physicians often pulled teeth or gave injections, a
pharmacy, and an eyeglass station for people who needed glasses.
People of all ages with a range of health issues, many of which
are rarely seen in the United States, visited the clinic. The
medical team saw patients with malaria, malnutrition, cholera and
parasitic diseases. They also dealt with dental abscesses,
miscarriages and births. But it wasn’t the medical complications Amy
and Sarah remember most; it was the people.
A young girl, gored by the horns of a cow, bicycled to the clinic
with a stream of blood running down her leg. She remained calm as a
doctor cleaned and sutured the giant gash in the back of her thigh.
A man walked into the clinic with a hand so infected it had
swollen to four times the size of his other hand. With no numbing
agent, the physician cut into the man’s flesh to drain the
infection. He didn’t make a sound.
“Having teeth pulled, stitches without anesthetic … they didn’t
cry or moan. They let us do our work and were so thankful,” said
“I was amazed at how tough all the people were,” said Amy.
The Kenyans may have endured pain stoically, but the Simpsons
witnessed many instances of raw emotion, especially involving the
eyeglasses station. Sarah saw a woman cry when she received glasses
that allowed her to see clearly for the first time in her life. She
also saw an older man, who had walked miles to reach the clinic,
break down in tears after learning they’d already given away the
last pair of glasses.
In the United States, eyeglasses are fairly easy to come by, but
that’s not the case in rural Kenya. A 2009 study found that the
ophthalmologist-to-person ratio in sub-Saharan Africa is one to 1
million. Most causes of blindness in Kenya are preventable, but the
lack of resources makes eye health a significant problem.
“It’s amazing what a simple pair of eyeglasses can do,” said Amy.
“One of the most rewarding parts of the trip was the eyeglasses
It was these and other experiences that solidified Sarah’s and
Amy’s decision to become osteopathic physicians and to practice
“I realized I can be doing more in my life to help people,” said
“Being there and seeing medicine at a raw level, it was amazing,”
said Sarah. “It helped me realize that I wanted to be a doctor to
help people, which is the most fundamental reason people should
become physicians. To help people and understand what that feels
like, it’s gratifying.”
Although Chris Simpson, D.O., Ph.D., and Martha Simpson, D.O.,
M.B.A., who have since retired from the Heritage College, never
pressured their daughters to become physicians, they are proud that
Sarah and Amy have chosen to follow in their footsteps. They call
the trip to Africa the “big event” that changed the course of their
“They were on the front line,” said Martha. “It was an impressive
cultural and medical experience for them.”
According to Global Health Initiative Director Gillian Ice,
Ph.D., M.P.H., associate professor of social medicine at the
Heritage College, numerous studies have shown that global health
experiences (GHE) often influence students to become primary care
“Data from the Heritage College show that students who
participated in GHE are more likely to work in underserved
communities in the US. It is hard to know why they are associated,
but if students get to experience the importance of primary care in
low-resource settings, that may inspire them to provide such
services at home,” said Ice. “As the Simpsons note, GHE allows
students to see how very basic health care services make a dramatic
difference in people’s lives. Additionally, GHE helps students
improve clinical skills, including communication skills required for
the delivery of culturally competent care.”
The passion to help others and meet the health care needs of
people in underserved communities are goals Executive Dean Kenneth
Johnson, D.O., hopes to continue fostering among Heritage College
students through programs like the Global Health Initiative, a joint
program of the Heritage College and the College of Health Sciences
As a doctor, Johnson understands how the experiences students
have with patients can shape the kind of physician they will become
in the future.
“Our many programs, including the global health experience, give
our students a unique skillset, which makes them highly sought-after
at clinical sites. They learn how to build bridges to patients and
become more confident during patient interactions. The end result is
that our graduates are exceptional physicians who focus on providing
comprehensive, patient-centered care,” said Johnson.
In May 2014, Amy and Sarah graduated from the Heritage College in
the same class. Of that class, 58 percent entered a primary care
residency of family medicine, internal medicine, pediatrics or
traditional internship. The high rate of students choosing primary
care is not unusual for the college, which has long been a leader at
the state and national levels in promoting the value of primary
Sarah is serving a residency in emergency medicine at Grandview
Hospital and Medical Center in Dayton. Amy was accepted into a
family medicine residency program at Ohio State University Medical
Center. On the Kenya trip, Amy realized that she enjoyed seeing
people of all ages and with different conditions. It’s one of the
reasons she chose family medicine. “It fits who I am,” she said.
But Amy also remembers being discouraged about halfway through
the Africa trip. She wondered if they were making a difference since
many of the health conditions were caused by other systemic
problems. Then, a young mother about 19-years-old came in with a
baby who was lethargic, had a puffy face and didn’t interact with
others. With extremely limited testing and treatment options, Amy
feared the baby would not live. However, days later, at a Sunday
church service in the village, she turned around and saw the mother.
In her arms, the baby was smiling and laughing.
Amy had her answers. She thought to herself, “We helped people