Frannie Weiland: Care in Kenya

“Hello everyone! My name is Frannie Weiland, and I am a junior nursing student in Lander University's Honors College, located in Greenwood, South Carolina. For the Honors College to produce competitive, global scholars, it is a requirement for students to have at least one study abroad experience. For my experience, I was presented with the AMAZING opportunity to study nursing among healthcare professionals in Nunyuki, Kenya, about 200 kilometers north of Nairobi. This program would allow me to travel between departments of the local hospital (maternity, general medicine, surgery, pediatrics, or in the laboratory), specialize in a department, work with mental health patients, and perform skills that a nursing student in North America would not have the opportunity to do.”

These are the words I eagerly typed on October 1^st, 2017 to kickstart my GoFundMe page. Thrilled and enthusiastic over the possibility of an adventure, I had no honest idea if I was actually going to raise enough money to pull off a breakaway trip to Africa. I only knew I had to at least try; after all, I wanted (and still want) to graduate with Honors.

Fast forward to the next July. Thanks to numerous donors, the Honors College, and my number one fan (thanks Mom), I was tearfully waving goodbye to my family in the Charlotte International Airport. I was officially beginning my month-long nursing internship. Most juniors in nursing school land an internship before the start of their senior year to get comfortable with their hands-on skills and abilities. I was no different; I just happened to be interning in Africa. I knew the language, dress, punctuality, and traditions would be different, and it would be wrong to say I was expecting a healthcare system like that found in the United States. After all, the whole point of the breakaway/study abroad experience is to get outside your comfort zone and blossom into a more competent, global student. Regardless, I was in no way prepared for the vast degree of difference presented to me in Africa.

Likii Primary School in Nanyuki, Kenya

Everything. Was. Different.

I was assigned to work in a teaching hospital owned and operated by the Kenyan government, so I was expecting something akin to America’s bare minimum hospital. That was mistake number one. There were no easily-accessible health records, crash carts, AED machines, IV pumps, safety needles, alcohol swabs, pediatric-sized materials, face masks, appropriate pain medications, or tourniquets. There was no electricity or emphasis of sanitizing one’s hands. Sterility was broken during every procedure I observed. Women happily breastfed anywhere they pleased, clean or dirty. An American hospital in these conditions would have been shut down. While excited to try my hand at providing adequate patient care without the items I believed were essential, I was truthfully shocked and slightly terrified. To say I was confident during my first few days would be a FAT lie. I went to Africa with one semester of actual clinical experience under my belt, and now I was being expected to handle the lives of tiny humans in a pediatric ward without appropriate materials?? Was I really prepared for this?

The answer was simple: no. Recent nursing graduates will be the first to tell you that even after you get your degree and enter a hospital full time, you are going to feel lost for the first six months while you learn to adjust and get in the swing of things. For me to feel totally overwhelmed in a foreign country without basic supplies was, in hindsight, completely expected. However, the thrill of independently being in a foreign country initially clouded my judgment and expectations.

I was one of the fortunate volunteers. By the end of my first week in the ward, I was comfortable with the tools I was given. I learned how much liquid to pour into a plastic spoon to equate one ounce in a measuring cup, to use gloves as tourniquets, and how to brace a toddler’s arm with recycled cardboard. It all seemed second nature by the end of July. I didn’t fully realize I was adapting and improvising until the last community outreach I went on.

Ol Pejeta Conservancy

During these rural outreaches, the volunteers were responsible for recording basic patient information, performing HIV screening tests and analyzing the results, among other tasks. The test was simple: select a finger, wipe it clean with an alcohol swab (this was the only time I saw alcohol swabs in Africa), stick the fingertip with a disposable needle, collect a blood sample, transfer the blood to the testing strip, and wait fifteen minutes for the strip to develop. All the necessary materials were supplied from various organizations and donors. For the most part, there were enough swabs and needles for every patient who visited the clinic. During one outreach, we ran out of alcohol swabs. The whole excursion came to a screeching halt. Performing HIV screening tests and potentially exposing ourselves to HIV positive blood meant alcohol swabs were an absolute necessity. I remember thinking, “alcohol swabs are just alcohol-impregnated cloths.” In that moment, I knew we could potentially create our own swabs on the spot. I shared my idea with the clinic coordinator, and she retrieved cotton and gauze pads from her first-aid kit. I soaked them all in hand sanitizer from my pocket-sized bottle I always carried with me. In a matter of minutes, we’d produced homemade alcohol swabs, and we were up and running again.

The relevance of what I’d done didn’t hit me until I called my mom later that day and told her about my last outreach. She said, “Wow! So, you pretty much saved the day!” And while I don’t think I’m a hero for making some makeshift alcohol swabs, I did subconsciously adapt to a situation when resources were depleted—yet again. My only expectation for my experience in Kenya was learning as much as possible in the short time I was there, but it did infinitely more than that.

When I revisit my original statement on GoFundMe, I feel like I did exactly what the Honors College expected of me. I became a competitive, global scholar. I noticed that transitioning back to the hospital setting for the fall semester was easier for me than my peers. They blew up the class’s group chat with their anxieties over going to clinicals, assessing patients, performing medication administration, and correctly documenting. I, however, was so excited to get back out there. I didn’t experience the same nervous butterflies as everyone else. I went to our first clinical with a big smile and an excitement to share my new skillsets.

Kenya made me confident. It ignited an eagerness in me to lead others in a way I didn’t know I possessed. It taught me that with or without supplies, I am fully competent and capable.

Nanyuki Teaching and Referral Hospital

Frannie Weiland is a senior nursing major from Charleston, South Carolina. She did a month-long internship in Nanyuki, Kenya and plans to graduate in December 2019. After graduation, she hopes to work as a pediatric nurse at the MUSC Children’s Hospital in Charleston.