As a medical student at VCU, I was able to pursue my interest in global trauma and emergency care through a fantastic summer research opportunity working with faculty from the Division of Acute Care Surgery who have ongoing projects in multiple countries. Under the guidance of Dr. Sudha Jayaraman, we developed a project on cost analysis of treatment delay at the University Teaching Hospital- Kigali, Rwanda (CHUK).
Working at CHUK, was an incredibly rewarding experience both academically and culturally. I learned a lot about orthopedic surgery, while simultaneously immersing myself in Rwanda’s rich culture and history. During my time there I worked with residents, nurses, medical students and attending physicians to track trauma-related lower extremity fractures in patients and evaluate the cost associated with the delay of care. In addition to my research project, I enjoyed having the opportunity to scrub in on the surgeries of the patients I was following and actively work with the team in assessing the treatments for these patients.
Daily Routine and Interactions at the hospital
Each morning I would walk up the dirt path just behind my house and hail a motorcycle taxi. I would jump on, tell the Taxi I’m headed to CHUK (pronounced say-ah-shu-kha), buckle my helmet and hold on for dear life as we zoomed through the “land of a thousand hills” or “mille collines”.
I would arrive at the hospital between 7:00 am and 7:15 am just in time for morning report, located in a small room with rows of crimson red chairs facing a white board. I would watch as the white coats of attending physicians and residents rushed into the room and filled the seats in preparation for a recap by the residents regarding the status of the patients they had been seeing. The morning report was an excellent opportunity to hear the perspectives of doctors and residents coming together from all over the world on the different approaches to treating patients, with the common goal of increasing the quality of healthcare in Rwanda.
Following morning report, I worked alongside the residents to see each of the newly admitted orthopedic patients. Our evaluation with the resident would involve gathering a patient history, analysis of the patient’s injuries, ordering pertinent lab reports and imaging studies, and then preparing an initial treatment plan.
The nurses smiled delightfully as I greeted them each day with “Mura ho” or “Hello,” ecstatic that I was learning the local language. I would ask how my old patients were doing and if there were any new patients who had come in with lower extremity fractures. My French and Kinyarwanda were limited as was often the nurses’ English, but the connections I made with the staff transcended the communication barriers.
I was also able to work closely with a local Rwandan medical student, which created an environment of stimulating exchange of ideas by increasing our mutual understanding of medicine within the context of a different culture. It promoted international cooperation with the goal of improving healthcare while simultaneously allowing us to develop long-lasting friendships.
The patients I met came from all walks of life and backgrounds. Having the opportunity to follow them over the course of my study allowed me to establish long terms relationships with my patients and to appreciate the importance of culturally relevant medicine.
From this exposure to global trauma and emergency care, I have gained an understanding of how care is delivered in resource-constrained settings and how research can be conducted systematically to contribute to improving patient care, despite resource-constraints. This opportunity has created a global network for me to share ideas, explore the different perspectives and work with my peers in a variety of fields. Ultimately, it has given me the chance to gain valuable hands on experience while applying the knowledge that I have gained in the classroom in an attempt to provide better health care.
My involvement in global trauma and emergency care at CHUK was a unique learning opportunity that was personally and professionally transformative. The support from the Dean of the VCU SOM and the VCU Global Health Education Office provided me a fantastic opportunity to conduct medically relevant research, immerse myself in a new culture, while also allowing me to form life-long connections and friendships. It has been an excellent opportunity to reinforce my medical education and to work within the global health community and take the next step in my medical career.
I believe that medical students can benefit from participating in global trauma surgery and emergency care programs as it provides exposure to treating a wider variety of illnesses as well as case presentations. Furthermore, students are able to learn about medicine under different legal healthcare structures and can understand how this impacts clinical decisions and management of care. Ultimately, international experiences will broaden a student’s horizons and provide a unique understanding about different cultures, socioeconomic factors, and communication despite language barriers that positively influences subsequent medical training and patient encounters.