PROFILE: Med Students Discover Contrasts in Kenya

Before they got married, Elizabeth and Jeff Schlaudecker were known in their families as the ones who least liked to travel. In recent years, that has been changing.

So far, one of the most adventurous destinations for this once travel-reluctant couple has been Kenya. In January and February 2003, the two completed an elective family medicine rotation at Tenwek Hospital, about 150 miles from the Kenyan capital of Nairobi. Located in the Bomet District of Kenya's Rift Valley Province, the hospital has only 300 beds, but has a busier emergency room than University Hospital in Cincinnati. Tenwek serves a population of 600,000 people, mostly Kipsigis farming families, in the surrounding villages.

As fourth-year UC medical students, the Schlaudeckers believe their newly-found wanderlust will help make them better physicians. Most of the couple’s recent trips have taken them outside the boundaries of the United States to put their medical skills to work in developing countries.

“We’ve always said we’re going into medicine because we want to help people. In medical school, that can get a lot more confusing. People lose sight of that goal, because it’s so expensive, the hours are so long and the work is so hard. You begin to think I need to get out of here and make money,” explains Elizabeth, a native of Lexington who now resides in East Hyde Park with her husband. The Schlaudeckers’ decision to work overseas is something of a countermeasure to that tendency, as well as a way for the couple to put their Christian faith in action.

At Tenwek Hospital in Kenya, the medical students found that the facility got so busy that frequently two or more patients often had to share the same bed. According to Elizabeth, who has been accepted for a pediatric residency at Cincinnati’s Children’s Hospital this fall, the Bomet area didn’t even have a nurse until the 1930s. Its first doctor came in 1963. Under his guidance the hospital grew from a single hut to its present complex with an emergency room, three operating rooms, laboratory services and radiology lab.
 

“About 90 percent of the women still deliver at home,” says Jeff, a native of Toledo who plans a residency in family medicine beginning this fall at UC. “But the hospital has about 4,000 births a year. That’s more than University and not as many as Good Sam.”

Despite the growth and the facilities, the Schlaudeckers say that poverty and lack of resources definitely place Tenwek Hospital in contrast to typical American health care.

For example, one villager with a sick, 11-month-old boy biked across rough terrain carrying his infant for about two days to reach the hospital. In addition, many Tenwek patients wait years before getting treatment while Americans would see a doctor within months, if not days. Family involvement at the hospital also is different - a lot of the patients at Tenwek received daily care from family members, who stayed with them throughout their stays.

One contrast between here and there that Elizabeth will never forget is the death among children.

“At Children’s Hospital in Cincinnati, there’s not really a lot of dying that takes place every day. In the hospital in Kenya, many children died every day. It was horrifying.

That was so hard for me. It was almost surreal. I felt so hopeless most of the time.”

Many of the children’s deaths that Elizabeth witnessed during her eight-week rotation were caused by an epidemic of cerebral malaria. “They use the older treatments, because they can’t afford the strongest medicines like we would have here. Here, there are very good anti-malarial drugs available. There, the most common treatment was quinine. Sometimes it works, other times it doesn’t.”

“We loved the people,” says Elizabeth. “It’s such a different place. There are so many things we take for granted here in the United States. There is so much they don’t have over there, but the little that they have, they are so willing to share.”

Her husband Jeff looked no farther than people’s mouths to find a discouraging contrast between health care at home and around Tenwek. “One big question I had during our first month there was: ‘Why did so many adults and children not have their bottom front teeth anymore?’

He learned that the answer was tetanus, something nearly every American takes care of with a simple injection. In the Bomet region, tetanus, along with its resultant lock-jaw, is such an accepted part of life that it’s customary to knock out the lower teeth as soon as the permanent teeth grow in.

“That way if they get lock-jaw, they can still get food through their mouths. That was very mind-blowing to me. We would never see that here.”

Now that the Schlaudeckers have gained more experience with world travel, they work to get other medical students interested in similar field experience. For example at a recent afternoon meeting at the UC Medical Center, they addressed the Christian Medical Association.

The list of nations in which the Schlaudeckers are gaining their own medical experience keeps growing. Earlier in her medical school studies, Elizabeth worked in the Dominican Republic. The couple also has joined Jeff Heck’s Shoulder to Shoulder team in a medical outreach to Honduras. Many of their travels have been financially supported with study abroad grants from the university’s Institute for Global Studies and Affairs (IGSA).

Most recently the husband and wife, both graduates of Northwestern University, joined Heck in another Honduran outreach program from April 14 to 26. There, they joined faculty and students from UC’s medical and nursing schools to provide health and dental care to Hondurans in a project that began 12 years ago. Three times a year, a UC-Shoulder to Shoulder  team provides health care, dental and nutrition services to an area with 20,000 people living in one of the poorest and most remote areas of Honduras.

“Traveling the world can really broaden your horizons and make your world so much larger. Usually I try not to say those kinds of stereotypical things, but it really is true,” says Elizabeth, with her husband nodding in agreement. That’s quite a statement from a couple who once found the thought of international excursions frightening.