2024-06-28 GCH Travel Scholarship Reflection - Victoria Chi

The week that I arrived in Kenya for my global health rotation, the health care system was buffeted by a nationwide health care worker strike that lasted the duration of my rotation. Medical doctors and other health care staff were largely gone from clinics and hospitals. The fight for better protections for health care workers who give so much of themselves in the service of patients is a universal one that we see in the United States as well, and health care workers in Kenya were striving to create a better system for providers and patients alike. Yet the strike also had profound effects on health care access.

Amidst all this, I was deeply inspired by the health care professionals I met throughout my time in Kenya. I worked with an incredible pediatrician, Dr. Sharon, who was the only one on call for the pediatric inpatient wards and newborn units at the referral hospital where I rotated. Years of covering high patient censuses and an impressively broad range of medical conditions had honed her sharp clinical acumen and leadership. Despite the strike, she regularly came to the hospital to round and provide teaching to make sure medical care continued to progress in her absence, and she rushed to the hospital whenever emergencies arose. When our severely ill patients faced barriers in accessing care—such as no specialists being available to place a dialysis line for a child with kidney failure, or a child being admitted with life-threatening anemia amidst challenges obtaining blood transfusions—she engaged in fierce advocacy. She rallied specialists to get dialysis and spurred the laboratory to prepare a transfusion. In these instances and more, it was relentless advocacy that protected the lives and health of children.  

I was also inspired by many non-physician health care staff who create such a difference for patients. When I visited an outpatient clinic in rural Kenya, I learned about the Mentor Mothers program, in which mothers living with HIV are trained to become community health workers who provide education and guidance to other mothers who are HIV positive during the pregnancy and early infancy of their children. One of the Mentor Mothers described how she shares her personal experiences with other mothers and builds deep trusting relationships. Many mothers are hesitant to take their antiretroviral therapies because of social stigma; for these patients, the Mentor Mother discreetly brings antiretrovirals with her when she pays home visits to the mothers before and after work, ensuring that they take their medications consistently. The Mentor Mother has been working in this role for many years, and every single mother she has cared for has successfully raised children who are HIV negative. Mothers in this region with such a high prevalence of HIV are raising a generation of children who are HIV negative because of the dedication of countless health care workers—creating real intergenerational change.

Throughout my time in Kenya, I witnessed many challenges. Yet, I also saw many opportunities for the creation of lasting change, and I saw heroes stepping up to seize these opportunities. I saw fierce advocates who are creating a better future for generations of children. I became more inspired than ever before to continue being part of this fight, to help create systemic and structural change for children across the globe and to be a lifelong advocate for those who are more vulnerable. 

Dr. Victoria Chi is a second-year pediatric resident in the global health scholarly concentration. Her rotation in Kenya was supported by a Stanford Global Child Health Travel Scholarship.