STUDENT INTERNSHIP & EXTERNSHIP REFLECTIONS
der and social stigma in seeking medical care, especially for HIV,
and it makes me wonder if there would be the same or drastically
different results if we compared to data in the US. Within the US,
each city, neighborhood or small town has its own culture. It would
be very interesting to see how initial CD4 counts within each of
these compare to those of Kabale. A possible good branch out of
KIHEFO could be running public forums with a panel of medical
staff who would answer questions from the local communities and
have an open discussion about HIV/AIDs education and preven-
tion. We could try to get to the root of what leads men to come in
later than the women for HIV diagnoses. Through education, more
patients, especially men, might feel more inclined to seek medical
attention sooner and therefore receive a better prognosis. Public
health and medicine always intertwine. Could it be the same here
in Louisville, too?
As a first-year medical student, I constantly fought off self-doubt
and thoughts like “Am I capable of doing this?” or “Am I good
enough to be in medical school?” I can definitely say through my
month in Uganda, from my first timid approach to the patient, to
running my own patient station in an outreach clinic was a sea-
change. Uganda helped me feel truly like a strong and confident
medical student. Now a sophomore, I am excited, and not as scared
of uncharted medical territories. I think more and more about
how I can help my communities through blending public health
and medicine. The best expression of my deep gratitude for these
unforgettable four weeks would be to say “Wabale” - thank you
from the bottom of my heart.
Sravya Veligandla is a second-year medical student at the University of Louisville
School of Medicine.
MEDICINE AND PRIVILEGE: A GLOBAL HEALTH
PERSONAL REFLECTION
K
AUTHOR Alexandra M. Pflum
abale, Uganda is a high-altitude town
with rolling hills, a cool climate, and
vast agriculture. Its people are kind
and welcoming. Kabale is not what
you’d expect if you’ve never been to
Africa. In America, there’s a miscon-
ception that Africa is a swelteringly
hot and hostile place with minimal modern
technology. Many people refer to this as “third-world” not really
understanding this is an insulting over-generalization. My assump-
tions were tainted by this viewpoint. I expected to be miserably hot
and packed four bottles of sunscreen I didn’t use.
I expected to feel uncomfortable because of my distinct for-
eignness. I quickly learned that these assumptions were best left
in Kentucky, because all of Africa cannot be generalized. Did I
feel uncomfortable for being the only person in the room who was
clearly different? Yes, but that’s a mere taste of what some people feel
every day in America. Did I miss my Wi-Fi and social media? Yes,
totally, I’m embarrassed to admit. The reality: the people we met in
Uganda were welcoming, kind and community driven. The culture
is lively, proud and just as interesting to learn about as the medicine.
Every day was different in Kabale; some we spent in the clinics
learning how local healing techniques were used in practice. Some
days we commuted to community outreaches focusing on nutrition,
water access or agriculture. There were even a few days where we
built a well for a family in a rural village with poor water access.
Somehow, we managed to survive without boasting about it all
over Instagram in typical white savior fashion. While I learned a
lot throughout, the health outreaches made me reflect the most on
medicine and privilege.
Medical students learn differently in Uganda; students apply
directly to medical school and go through a five-year program. At
the outreach, two US first-year medical students were paired with
a Ugandan medical student, who was much further ahead of us in
school. We were expected to interview the patients, then report to
the doctors and clinical officers our findings. It was a lot like what I
imagine third-year is like in the US. I learned best this way, because
not only were we trying to work through the dynamics of language
and culture discordance, we were also working with a vulnerable
patient population. The complexity of the situation ensured that I
was double checking my reference guides and taking meticulous
notes. Our patients are people who could not afford to be seen in
traditional health settings and had to depend on our free outreach
clinic. As a result, a lot of patients were dealing with ailments that
should have been handled years earlier.
Of the countless patients I was able to interact with in Uganda,
one sticks out to me in particular: his case required me to reflect
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