STUDENT INTERNSHIP & EXTERNSHIP REFLECTIONS
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that access to food, water, and shelter is never a certainty. With the
standard of living so heartbreakingly poor, sickness is inevitable.
Learning about, and assisting with, public health concerns was a
large part of our trip. For every day we spent in the clinics, we spent
another day doing some kind of public health outreach. Truth be
told, at first many of us, myself included, were pretty disappointed.
After all, we’re medical students. We should be spending our time in
the clinic learning about the presentation and treatment of a variety
of tropical diseases, right? Instead, we taught a remote village an
easy way to make a bulk supply of porridge, taught families how to
attend to sustainable agriculture, educated families on the utility
of raising rabbits, and so on.
The most impactful thing we did for the long-term health of
many members of the Kabale community came as a result of one
of our public health outreaches. Access to clean water is likely the
biggest barrier to health in Kabale. Most of the families live in one-
room huts high in the hills where they care for their small plot of
land. In terms of accessing clean water, the best-case scenario for
these families is to send someone down the mountain with a couple
large jugs. This person would then have to wait in line with everyone
and eventually fill up the heavy water jugs at a well before making
the grueling climb back up the mountain. One older man showed
us an open gash he suffered three years prior after getting hit by a
motorcycle as he made the climb up the mountain after collecting
water. The wells would often run down to a trickle during the
dry season. Many kids were often sent at dawn on this tiring and
dangerous trek. Unable to make it back in time, kids got behind
in school. Other families didn’t live close to any well and collected
water instead from highly contaminated ponds.
In order to combat this problem, KIHEFO began building huge
rain water harvesting tanks. Built for the communities struggling to
access enough clean water, these tanks were built into the ground,
walled off and supplied by a series of gutters that would direct water
from roofs of huts down into the tank. They had several simple and
innovative ways to filter the water before it entered the tank. Inspired
by what we saw, we raised $600 of our own money to sponsor and
build a new tank. Construction began the next week. We dug a
6-by-9-by-5-foot hole, built walls out of eucalyptus and papyrus, and
sealed it shut with a tin roof. The tank would hold over 5,000 liters
of clean water. Although we had to leave before the final product
was complete, our contribution would give an entire community
in the mountain access to clean water for the next decade. While
we were initially a little upset about the trip’s emphasis on public
health, as I reflect on my experience, I am thankful. We have our
whole careers to learn about recognizing and treating a variety of
disease processes. Helping with the various public health projects
gave us insight into the trials and tribulations the people of Uganda
must overcome for basic necessities.
Watching this community suffer such depths of poverty was
humbling. The clinical officers, despite being some of the most
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LOUISVILLE MEDICINE
educated people in Kabale and often working upwards of 12 hours
a day, made only the equivalent of $82 a month. They could save
every cent they made for 30 years and not afford a house. They lived
in one-room apartments with communal bathrooms. Running water
and electricity were luxuries reserved for the few. Dishwashers and
washing machines were non-existent. Despite the financial short-
comings, all the clinical officers were incredibly happy people. They
are called to medicine for the same basic reasons we are.
Most are not as fortunate as the clinical officers. One Sunday
morning we delivered a few dozen kilograms of food we bought for
children in the local orphanage. Even though it was a weekend, the
children at Little Angels Orphanage were in the midst of a social
studies lesson in school. (I was taken aback by the strange irony
that the 320 children packed into the handful of small classrooms
were learning about population density.) The children and teachers
could not have been more grateful. After their lesson, they sang,
danced and played with us before wishing us goodbye. Every one
of them was smiling. The children undoubtedly knew all too well
that when they turn 18, they must leave this home to fend for them-
selves. Almost all of the KIHEFO workers at our apartments were
once orphans. Dr. Geofrey sponsored their continued education.
Now they either work on the various projects in the community
or as maids or chefs for students like us in the KIHEFO program.
They are the lucky ones, and they will be the first to tell you such.
One thing that I will never forget about Uganda is that over
the course of the month we spent there, I did not hear one man,
woman or child complain about one thing, ever. Not one person
ever complained in our hearing. In fact, I met some of the happiest
and most carefree people in my life during my time in Uganda. On
the contrary, I became increasingly aware of how ingrained com-
plaining is in our communication. One day we were complaining
about having to go to yet another public health outreach. Another
day we complained about how few patients we saw in the clinic that
morning. The glaring differences in our upbringing compared to
so many of the people in Kabale was literally right in front of us,
and too often we turned a blind eye to it. Access to medicine, food,
water and shelter are all scarce. That is the hand that the people of
Kabale have been dealt. They are taught at a young age that com-
plaining about their scarcities will not solve anything. Instead, they
accept their situation and work hard to improve it so that the next
generation can be a little better off than the last. This relentless
pursuit of positivity in the face of adversity left me humbled, and
inspired to do better.
Carter Richardson is a second-year medical student at the University of Louisville
School of Medicine.