STUDENT INTERNSHIP & EXTERNSHIP REFLECTIONS
STUDENT INTERNSHIP & EXTERNSHIP REFLECTIONS
The following student essays are reflections on internships and externships taken during their first year as medical
students at the University of Louisville School of Medicine.
REFLECTION ON UGANDA
“L
AUTHOR Sravya Veligandla
adies and gentlemen, the pi-
lot has turned on the fasten
seatbelt sign. We will be ex-
periencing an area of turbu-
lence as we are preparing for
landing. Please return to your
seats and keep your seatbelts
fastened. Thank you.” Little did I know that the
heavy turbulence while landing in Rwanda was a foreshadowing of
the bumpy highs and lows ahead. These led me to new discoveries
and better understanding of both myself and another culture’s
challenges over our four week global health rotation.
Arriving in Kabale, Uganda we were greeted with cool fall tem-
peratures and beautiful lush scenery of rolling mountains and
endless hills. The staff of our living area, locals and even strangers
we’d pass by on the roads all showed us the warmest welcome and
genuine kindness. Being so far from home while feeling pushed to
be independent in a medical environment was utterly new, and so
out of my comfort zone. It was definitely a learning curve for me the
first week. I was homesick, but as we got immersed in classes and
seeing patients, those lows quickly changed into the enriching and
thrilling highs of being a medical student with a singular chance
to volunteer abroad.
The organization we worked with was Kigezi Healthcare Foun-
dation (KIHEFO). It was started from the ground up by a local man
who through hard work, determination and perseverance followed
his dream of pursuing medicine and became one of the first doc-
tors from his village. Dr. Geofrey inspired us all. Instead of leaving
Uganda to go to South Africa after medical training, as so many
tended to do, he stayed back and chose to create a program that
would give back to the communities. Through KIHEFO, there are
many facilities such as a maternal clinic, an HIV clinic, a primary
care clinic, dental services, nutrition clinics and village medical
outreaches as well. It was fascinating to receive daily lectures from
16
LOUISVILLE MEDICINE
Dr. G about the local culture and state of health care in Uganda
and its smallest districts. I was struck by the very clear delineation
of a man’s versus a woman’s role in life, in the family and in the
community—quite the contrast to the US. Most women in Kabale
were wives and mothers, the home their only domain. The male’s
main role was provider and protector for his family. Looking back,
it was vital to understand this difference before our ventures into
the clinics and meeting the locals.
My first rotation was at the HIV/AIDs clinic, which was rather
small with two exam rooms that doubled as office rooms for the
nurses, who had over 300 medical records of current and former
patients. Shadowing the nurse practitioner Margaret was eye-open-
ing. The patients don’t schedule appointments ahead of time, they
come in when they can. Many of the patients were afraid to be seen
because they feared the townspeople would talk about them having
HIV. Some were so apprehensive that they would walk in, then just
as quickly run out. They also feared the stigma of infidelity; HIV
could mean association with prostitutes.
We saw a 46-year-old woman, HIV positive for two years, come
in for a follow up. She was so open and kind and through Margaret’s
translations was eager to help us learn. Her husband left her when
she was diagnosed, she’s just been living on her own since then.
Margaret explained that husbands will leave because the diagnosis
assumes infidelity, which disrespects the husband’s masculinity
and pride. However, if the husband is diagnosed positive, the wife
almost always stays, because it’s expected that the woman should
be a compassionate and nurturing wife. I realized how deep-rooted
and important the gender roles were, with accompanying shame
and responsibilities. All the patients we later saw in the clinic were
women. We wondered if the shame of HIV outweighed the hope
of improvement for the male patients.
After coming home, I found myself missing the food and locals
who became close friends, and the hands-on experiences in Kabale
and its neighboring villages. I am still intrigued by the roles of gen-