STEP Story: Ali Khaki

Internal Medicine Resident, University of California, San Francisco (UCSF)
Rongo, March 2016

Dr. KhakiThe FACES clinic site in Rongo was based in the district hospital grounds making for a unique experience including both outpatient HIV care and exposure to inpatient hospital ward rounds. I also had an opportunity to do some field work with the FACES staff visiting some remote clinic sites in the villages of Osogo and Ongito as well as attending World TB Day festivities in Rongo. I enjoyed my time in the outpatient HIV clinic working side-by-side with the clinical officers (COs) to check-in with patients and refill their medications. I learned some basic Kiswahili to use while screening patients thanks to the tutelage of the fantastic COs by my side: “Una shida gani leo” (What problems have you today). “chupa ya dawa” (Pill bottles).With this elementary Kiswahili, I was able to connect with patients and participate in the process of routine symptom screening and refilling medications.

At least once a week, I would join the hospital staff for their Medical Ward Rounds. The rounds were a multidisciplinary event with doctors, clinical officers, nurses, pharmacists and rehabilitation therapists as we rounded on all the admitted patients in the hospital. This was a memorable experience on medicine in resource poor settings and exposure to tropical medicine not seen in the USA. For example, I saw numerous patients with malaria – a diagnosis I had never seen in the USA. I was impressed by the diagnostic skills of clinicians limited to very few diagnostic tests and how this changed their clinical practice. Absent microbiological diagnostics and even basic hematology and chemistry labs, providers are left treating patients empirically (with more liberal use of antibiotics) based on presenting symptoms, exam and epidemiology.

During my field visits to rural villages amid sugar cane plantations, I was impressed by the extensive infrastructure of HIV care that has been developed by the Kenyan government in partnership with NGOs like FACES. Even in remote villages, difficult to access by car, FACES had a clinic present working to diagnose and treat patients with HIV. I was also impressed by the numerous local community workers who have committed their lives to HIV screening and education. This same infrastructure will be a valuable asset, if preserved, to expand relevant healthcare screening and treatment even in a future Kenya without HIV!

Finally, on a personal note, I have a particular interest in East Africa due to family roots in this region. My parents were both born in Tanzania so, as a child, we made frequent trips there to visit family. Since that time, I have always been looking for ways to return to the region to visit and to serve the local community. The partnership between UCSF and FACES made this return possible.

Despite multiple trips to Tanzania as a child, this was my first time visiting Kenya. One thing that struck me about my experience was some of the differences in the culture and people between the two countries. For example, I was struck by how well the people of Kenya spoke English compared to what I recall of people in Tanzania (with the caveat that my last visit to Tanzania was back in 2002). I was also struck by the educated, motivated Kenyan middle class that I interacted with both through the FACES staff and my exploration of Kisumu and Nairobi.

For more information about my experience – check out my blog documenting my experiences and reflections from my time in Kenya at