For second-year students Chelsea McGuire and Whitney Smith, the road to a medical career veered east this summer, to Nairobi, Kenya, where they spent five weeks helping a local hospital make critical improvements in its Community-Based Health Care (CBHC) Program. Their journey resulted from a first-ever collaboration between the Little Sisters of St. Francis, the religious order managing the hospital, and Einstein's Global Health Center.
St. Francis Community HospitalThe center, founded in 2007, coordinates Einstein's global health activities in education, research, and service. Its program manager, Jill Raufman – who has traveled to Kenya frequently over the past decade, as part of her work for Kiboko Projects, a not-for-profit organization that implements cultural exchange programs throughout the world – learned of St. Francis on a recent trip to Kenya of her own, where she discussed the St. Francis CBHC program's needs with its coordinator, Sister Esther Wairimu Mwangi.
"The hospital is so well-run; the staff members are so devoted. They're going out to the community, and they know what they're doing," said Ms. Raufman. "I had such a good feeling about St. Francis. And I knew our students could really learn from the program, and that our help would go far there."
Coincidentally, Ms. McGuire approached Ms. Raufman soon after she had returned from Kenya. "When Chelsea expressed an interest in working in Kenya, I knew that St. Francis would provide an ideal opportunity," explained Ms. Raufman. "Chelsea then discussed the idea with Whitney and they made their plans to go."
Whitney Smith (left) and Chelsea McGuire (right) flank Jill Raufman while discussing their Kenya experience.At St. Francis, the Einstein duo helped build a database that now tracks the work of the program's 140 community health workers (CHWs) and captures client enrollment information. The program and the CHWs serve more than 1,000 HIV-positive clients in Nairobi, as well as another 2,000 orphans and children made vulnerable by HIV or poverty.
"Whitney and I aren't database experts by any means, but we brought energy and excitement to get the project rolling," said Ms. McGuire.
In some parts of the world, it's easy to take computerized data such as names and clinical codes for granted. But in the disadvantaged neighborhoods of Nairobi's Kasarani district, the new computerized information will allow St. Francis to better evaluate care, apply for funding, and manage its scarce resources.
"The lack of a database was such a big challenge in our service delivery to the community," said Sister Esther. "We are so excited about the database."
For Ms. McGuire and Ms. Smith, the benefit of working with St. Francis was just as exciting. Besides building the database, the students joined physicians on rounds, observed in the surgical theater, and viewed tuberculosis care along with HIV testing and counseling.
Sister Esther, from St. Francis"I felt like I learned something everyday just walking out of our door," said Ms. Smith. "There was so much to learn about healthcare delivery in Kenya."
But perhaps the biggest lessons were the examples set by the St. Francis staff. "The sisters and staff have a genuine love for their community, and are passionate about their work. And yet they always made time to rest, looking back to really savor the work they're doing and feel good about all they've accomplished," observed Ms. McGuire. "I will be grateful if someday I can be half the clinician that Sister Esther is."
Ms. Smith agreed, "The St. Francis staff members are amazing role models. They know their community and are completely dedicated to their mission. They approach their work with a sense of gratitude, focusing of the resources they have and not on what is lacking."
According to Ms. Raufman, the mutual benefits of the collaboration made the program an ideal partner. "The story of how perfectly our connection with the program fell into place is just the first of many stories about how things seem to ‘work out' at St. Francis," said Ms. McGuire.
Today, the two students say they hope to use the lessons from Nairobi in their future medical careers. At the same time, the program is building on their work, with a CHW overseeing the database, and information continuing to flow into it from the field – information that ultimately will allow the program to better meet the needs of its clients.
"It feels wonderful to have been part of this step forward for the program, and to see it moving forward on its own," said Ms. McGuire.
Perhaps another way to express that feeling is the Swahili words she wrote to friends and family, soon after returning home: "Nilirudi Bronx, lakini Kenya ndani roho yangu." ("I have returned to the Bronx, but Kenya is in my heart.")
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Posted on: Thursday, September 22, 2011