Working in conjunction with the Center for Constitutional Rights, The Bellevue/NYU Program for Survivors of Torture, and Physicians for Human Rights, NYCAT has been at the forefront of education and advocacy efforts intended to address this issue at the state level. One of the group’s primary goals is to see the passage of the Gottfried-Duane Anti-Torture Bill (S. 4495-A /A. 6665-B), which is pending in the New York State Legislature. This bill is the first of its kind in the nation and explicitly addresses the role of health professionals in the abusive treatment of prisoners.

The bill explicitly states that NY-licensed health professionals’ duty to do no harm applies to their relationships with all patients and employers, and affirms that they are prohibited from any involvement in torture or other abuse of prisoners. This can be a way to help health professionals resist unlawful instructions that may expose them to risk of criminal prosecution and civil damages lawsuits.

“As future doctors, we are committed to restoring trust in our profession and respect for the rule of law. We look forward to garnering additional support for the bill and to raising awareness about this critical ethical and human rights issue,” says Hana Akselrod, medical student and member of PHR’s active student chapter at Mt. Sinai School of Medicine

Today, NYCAT and interested medical students will go to Albany to meet with legislators to advocate for the Gottfried-Duane Anti-Torture Bill. They have been gathering signatures for the petition to demonstrate widespread support for the legislation, including at the PHR National Conference in February, and will present the petition today.

Show your support by sign the petition now.

MEDIA ADVISORY: Medical Students Advocate Against Health Professional Participation in Torture

(Cross-posted from the PHR Student Blog)

PHR made the following video in collaboration with our Kenyan partner group, the Health Rights Advocacy Forum. In this 6-minute video, four health workers at Mbagathi Hospital talk about  the challenges they face every day — and why they stay and practice medicine in their home country. This moving video can be shown on campus or at your workplace to stimulate discussion and urge people to take action.

For more personal stories, check out Africa’s Health Care Worker Crisis: Views from the Ground, a PowerPoint presentation that outlines six main drivers of the health workforce crisis in Africa and explores these challenges through the eyes of four Ugandan medical student leaders. Feel free to use this to make a presentation on campus or in your community, or use facts from it to drive home the need for action.

And watch our slideshows of Dr. Fred Katumba and Clinical Officer Jane Byarugaba following them through a typical day as they provide health care to the rural poor in Southwestern Uganda. Dr. Katumba’s work has propelled Lyantonde District to #2 out of more than 90 districts in terms of health outcomes — a phenomenal accomplishment and testament to Dr. Katumba, his staff, and the millions of hard-working health professionals who help communities realize the right to health every day.

Who should attend the conference?
We hope that the majority of our National PHR chapters will attend, with two to three students and a faculty member or dean representing each school. We also welcome applications from medical students who may not have a PHR student chapter but are committed to furthering human rights education in their curriculum. Students are encouraged to apply online. If you are a Dean or faculty member and are interested in attending, email Sarah Kalloch, PHR Director of Outreach, at skalloch[at]phrusa[dot]org.

What will the conference include?
The National Conference will feature world-renowned speakers, panel discussions, strategy plenary sessions, skill development workshops and action planning sessions to address all aspects of integrating health and human rights into the health education field. The jam-packed day will provide information on the critical need to integrate health and human rights into education, strategies for incorporating quality human rights education in curriculum, as well as tangible skills and solutions to help lead your campus on this issue.

How does this conference differ from previous PHR National Student Conferences?
This year’s conference is the first of its kind. It will focus on empowering students and faculty to change the paradigm of medicine to one which embraces human rights through the incorporation of human rights in health professional education. We will bring together a select group of roughly 150 committed students and faculty members who plan to be the frontrunners of the curriculum change movement on their campuses. This select group will gain vital ideas, strategies, skills, and connections to make health and human rights education a reality for their student bodies.

What will I gain from attending?
The conference will provide an excellent opportunity to network and strategize with dedicated students, faculty members and Deans who strive to bring a greater understanding of human rights to their classrooms, and to meet experts in the human rights field who have dedicated their careers to furthering this cause. You will learn from and engage with student leaders around the country who are passionate about health and human rights in their education. You will also gain new insights on the health and human rights approach, tools to create electives at your school, valuable resources and connections, and tangible ideas for getting your campus involved to shape your own education and that of your peers.

How should I prepare to have the best conference experience?
If you are accepted to represent your chapter and/or campus, you will be called on to prepare a preliminary plan for a tangible educational-change project you would like to see on your campus. As the conference approaches, we will also give you a short reading assignment to help you prepare for some of the conference’s key topics.

Whether you are looking to improve a current project or proposing a new initiative for you school, we recommend you draw on our Health and Human Rights Education Toolkit for guidance and resources for your planning process.

Questions? Email us at conference[at]phrusa[dot]org.

Download a printable version of the National Conference FAQs (pdf).

(Cross-posted on the PHR Student Blog.)

Earlier today, I joined a group of medical students, health professionals and other concerned citizens to rally for increased funding for HIV/AIDS programs in the US and around the world.

1-2-3-4, AIDS funding, we want more

we chanted while marching toward the Massachusetts State Capitol Building.

5-6-7-8, AIDS funding cannot wait.

And that’s when the torrential rain began. The group clustered together, juggling signs and umbrellas while continuing to chant. We only paused the chanting to take out our cell phones for a group call to Congressional leaders.

This week, Congressional appropriators are in the process of setting funding levels for global and domestic HIV/AIDS programs. Levels under consideration are drastically short of what is needed to fulfill US commitments to fight AIDS at home and abroad. We are already hearing about cutbacks from our partners in Uganda and we must act now to ensure that critical programs are fully funded. The Senate Appropriations Committee is schedule to consider global AIDS funding levels tomorrow, Wednesday, July 8.

President Obama’s new global health initiative calls for $63 billion over six years for all global health programs. Physicians for Human Rights estimates that the HIV/AIDS, TB and Malaria programs supported by PEPFAR alone need at least $60 billion over six years. PHR also estimates that a total of at least $95 billion over six years is needed for all of the global health initiatives outlined in President Obama’s plan and to meet all US global health commitments. We have the resources and the responsibility. We don’t have to choose between HIV/AIDS programs and other global health initiatives.

The rally is part of a coordinated effort of dozens of HIV/AIDS advocacy organizations across the country calling on leaders in Congress to strengthen US commitments to HIV/AIDS prevention and treatment programs. From June 30-July 7, activists have called upon Senate Majority Leader Harry Reid (D-NV) and Speaker of the House Nancy Pelosi (D-CA) to increase funding levels. The event today in Boston was co-sponsored by Physicians for Human Rights, the American Medical Student Association, Our Bodies, Ourselves and Health Care for All.

The rally ended with one last round of chanting and a rousing group cheer. As our group began to disperse, the rain stopped and the sun came out.

You can join our efforts today by calling on Congress to fully fund HIV/AIDS programs. Pick up your phone and call Senator Reid, Speaker of the House Pelosi, and members of the Senate Appropriations Committee.

Student leaders, Sandra Kiapi (AGHA) and the Minister of Health of Uganda

Last week, over 80 health professional students from Uganda, Rwanda, Kenya, Burundi and the United States gathered together in Kampala for the first East African Health and Human Rights Student Leadership Institute, sponsored by PHR and our local partner, the Action Group for Health, Human Rights, and HIV/AIDS (AGHA). This three-day event was the culmination of months of planning by student leaders, as well as PHR and AGHA staff. Read the blog posts from US students on their experiences in Uganda.

Eleven different training schools — with delegates from medical schools, nursing schools and paramedical programs — were represented at this workshop, a first of its kind in the region. The delegates came together to build their knowledge of human rights, to enhance their skills in advocacy and to share their ideas for building student organizations focused on protecting human rights.

The three days were packed with distinguished speakers (including keynotes by the Minister of Health of Uganda and Honorable Dr. Elioda Tumwesigye) and focused discussions aimed at helping the students understanding how to use human rights principles as they take on their role as future health professional leaders in the region.

As I reflect on the week, there were many highlights — watching the students present on the main health and human rights challenges in their countries; hearing the experiences of current advocates like Sandra Kiapi of AGHA, Miano Munene of HERAF and Dr. Davis Kasheka of FACT; and participating in interactive skills building workshops, which engaged the students and built their knowledge in crucial areas like leadership development, working with the media, power-mapping for their campaign and online organizing and communications.

On the last day, a group of the students worked together to write a resolution from the Leadership Institute which they will all share with their local media, their institutions and their governments. This resolution, which is included at the end of this post, was read aloud to the closing Guest of Honor, AGHA Board of Directors Chair Dr. Margaret Muganwa, who praised the delegates for their impressive work over the course of the three days.

For me, the Student Leadership Institute was much more than just a three-day workshop. It was a symbol of how far we progressed in the past five years through PHR and AGHA’s work in Uganda.

When Students for Equity in Healthcare (SEHC) — the medical student organization founded by AGHA and a group of medical students who wanted to get involved in advocacy for human rights — was founded just four years ago, we could only imagine a health professional student human rights movement that spanned four countries across the region. Yet last week, as delegates from each University shared the health and human rights activities taking place on their campuses, it was clear that the concepts of advocacy and human rights have taken hold among students at these universities. PHR, AGHA, HERAF, and FACT Rwanda have all contributed their knowledge and expertise, but the students have really taken the information and the skills provided to them and made this movement their own.

Blending advocacy regarding their own rights and the rights of students with advocacy on behalf of the communities they serve, SEHC and the other student organizations represented in Kampala last week are building the next generation of human rights advocacy in East Africa.

All of the delegates left with their work cut out for them, and, as Dr. Muganwa reminded them, their path forward will not always be easy. On the last day, all the delegates started to draft their work plans to bring back to their student organizations on their respective campuses. Although this group of delegates may never meet all together again, the human rights advocacy networks that they are building on their campuses are now linked together through the delegates and through the local human rights organizations that support their work. A true regional student movement was born last week, and all of us from PHR were proud to be a part of it.

East Africa Health and Human Rights Leadership Institute Resolution

Sponsored by: Physicians for Human Rights (PHR-USA), Action Group for Health, Human Rights and HIV/AIDS (AGHA-Uganda), Health Rights Advocacy Forum (HERAF-Kenya), Students for Equity in Health Care (SEHC-Uganda), and Forum of Activists Against Torture (FACT-Rwanda, Burundi)

Preamble

We, health professional students from Burundi, Kenya, Rwanda, and Uganda, convened for the East Africa Health and Human Rights Leadership Institute in Kampala, Uganda on April 2-4, 2009;

Being aware of the need to bring together a group of future health professionals to raise awareness of our role in promoting health and human rights on our campuses and in the wider community;

Building the foundation for a network of East African health professional students in health and human rights advocacy;

Having acquired health and human rights advocacy skills to address critical health rights issues;

Identifying health and human rights concerns that affect the future of our countries, important issues that affect health professional students, health care professionals, and fellow citizens;

Believing it is essential that health professionals and students ensure that governments deliver on internationally agreed upon commitments to protect health and human rights of all people;

Committing ourselves to identifying pressing health professional and student rights and looking forward to working together to protecting these rights.

Resolve to call upon our governments and their partners to work together to ensure that:

1. health professionals and health professional students have freely available vaccinations in order to protect themselves and their patients, including hepatitis B vaccinations, which are cost prohibitive to many health professional students in the East Africa region;
2. essential medicines for diseases including tuberculosis, malaria, and HIV/AIDS are continuously funded and in-stock so that patients can receive timely, accessible, and consistent treatment;
3. health care professional students have access to up-to-date medical guidelines and training as well as reliable access to internet at their institutions for educational purposes;
4. governments upgrade and increase the number of health care facilities, especially in rural and semi-rural areas of our countries;
5. health care professionals have adequate supplies and organized events for frequent, widely available continuing medical education and current standards of good clinical practice;
6. robust short-term and long-term solutions are created and implemented to increase retention of health professionals in our countries, including improved investment in health professional compensation, adequate supplies necessary to good clinical practice, safety protections in the workplace, and continuing education;
7. improved funding and coordination within the health sector, including mechanisms to decrease doctor/nurse to patient ratios and to identify and respond to disease epidemics and the increasing burdens of chronic diseases, such as diabetes mellitus;
8. human rights are included in the curricula for health professional students in all cadres.

This is a country rife with the denial of basic rights. From a lack of educational opportunities for  youth to food insecurity in the rural areas to widespread abductions of children by the Lord’s Resistance Army (LRA) in the north — denial of rights is widespread.

In America, we rarely think about human rights, and most of us don’t really even know what they are. But here, in Uganda, people are acutely aware of them. The lack of rights is so severe that it affects daily life. Access to food may be a human right, but if the soil is too poor to grow anything, then how can that right be assured? If water sources are running dry due to climate change, then how can the right to water be fulfilled? These are basic life necessities that are lacking in parts of Uganda, and the rights-based approach can empower the people to demand that they have access to these things. It is up to the governing powers, however, to build sustainable systems for delivery of basic rights.

As enshrined in the Universal Declaration of Human Rights of 1948, healthcare is one of those basic human rights. In Uganda, there are so few doctors being trained, and even fewer choose to stay on here after their schooling is over. Brain drain to industrialized nations has crippled this country’s ability to effectively respond to the healthcare needs of this country, from basic primary care and obstetrics to a burgeoning HIV/AIDS epidemic. It really falls on the government here to encourage doctors to stay; one way they could do so is by paying them more adequately.

Throwing money at the problem is not the most effective solution in a country that has serious problems with corruption, accountability and rule of law. Uganda has developed a bad reputation for mismanaging aid money, as evidenced by the recent withdrawal of Global Fund for AIDS, TB and Malaria. This has led to increased hesitancy by international donors to give money. As a consequence, there are no drugs left here to treat TB, and this country has the 15 highest disease burden in the world.

Before money can simply be channeled into the system, it must be ensured that an accountable and transparent government exists and is kept in check by the people. Civil society involvement is essential, and that is why all of these human rights groups who we visited on Wednesday exist. People need to know what their rights are and that they must exercise them by voting and holding the government accountable if they want anything to change.

We began by visiting Sandra Kiapi at the office of Action Group for Health, Human Rights, and HIV/AIDS (AGHA). AGHA is a NGO that was founded in 2003. They have several advocacy campaigns and community-based research projects that tackle human rights issues as they relate to health, with a specific focus on HIV/AIDS. One of these is the Stop Stock-Outs Campaign. AGHA also continues to promote accountability and transparency in the spending of PEPFAR and Global Fund monies, which has been difficult since the local culture has been to keep budget information away from the public eye.

Sandra had a lot to say about the HIV/AIDS Bill, which currently is in Parliament. She described loop holes, and she said the bill really needed more compelling language to ensure that states provide drugs. The public already pays 30% taxes, and most of them have no other disposable income to afford private healthcare. 30% of Ugandans receive healthcare through religious NGOs. 2-10% of Ugandans receive private healthcare. The other 60% need state assistance — yet the current bill has no provisions for their health services.

I was really excited to talk to Rose, Patricia and Ruth at the Uganda Human Rights Commission, a quasi-governmental body which was established under the Ugandan constitution in 1995. At the beginning, their biggest focus was bringing justice to victims of torture and upholding the rule of law. UHRC also tries to promote the Right to Health by educating both government officials through seminars and the general public through public radio. AGHA and UHRC have worked together on AGHA’s Stigma and Discrimination Campaign, for which AGHA trains health professionals and health professional students on health and human rights. Some of the students we’ll be meeting in the next few days, leaders in the Students for Equity in Health Care (SEHC), have been active in helping with this work. UHRC and AGHA both work on advocating for health workforce rights on many levels. Currently, there is only 1 health care worker per 22,000 Ugandan people.

UHRC also works on transitional justice and reconciliation, as well as reintegration of LRA child soldiers — all issues that have been incredibly trying for both the Commission and nation in general. I highly recommend watching Uganda Rising and Invisible Children on these issues.

We also met on Wednesday with Julia Spiegel from the ENOUGH Project, a program of the Center for American Progress with a mission to build a permanent constituency to prevent genocide and crimes against humanity. She’s been working directly with victims, military and officials in Northern Uganda and the Congo and has been using insight from her research to advocate for high level policy and holistic action to end the LRA’s crimes against women, children and the region in general. Check out the ENOUGH Project’s Raise Hope for the Congo campaign. For all you Law and Order fans, the Project also helped write a new episode that tells survivors’ stories to educate the public and humanize the issue.

We ended by meeting a physician-advocate who does not wait but acts, even when funds or resources are unavailable. He is one of the world’s most inspirational pioneers in providing HIV/AIDS treatment for all, Peter Mugyenyi, MD. He was the first person to bring ARV treatment to Africa, and he was involved in the initial planning of PEPFAR. He is the director of the Joint Clinical Research Centre (JCRC), one of the largest PEPFAR funded programs in all of Africa.

The JCRC provides HIV care and treatment to over 60,000 patients in both urban and rural Uganda. About twenty percent of these patients are enrolled in the clinical research at the center. JCRC is the smoothest-running, most high-tech clinical, epidemiological and treatment-based research center we had ever seen. It was the first center to test an HIV vaccine in 1998, and the lab continues to study HIV and opportunistic infections in novel ways. Dr. Mugyenyi has about 1,000 patients under his personal care, and he also is Principal Investigator to seven research projects at the institution. He continues to maintain and enroll patients that need care, despite a Uganda PEPFAR mandate to halt the treatment of new patients.

Meeting with activists from these organizations gave me a lot to think about and process. These organizations deal with tremendous obstacles in creating sustainable change and fighting for the rights of people that are often poor and powerless. Yet, they trudge on, knowing that, though change does not come over night, progress does. These are not people that will wait for better conditions to begin fighting for human rights. They just do it.

(Cross-posted on the PHR Student Blog)

Lyantonde is a rural district about three or four hours driving distance southwest from Kampala. Looking out the window, I caught a glimpse of what life for ordinary Africans might be like.

I don’t really know what I expected; all of the imagery that I had conjured up about the continent before I came here were basically clichés from movies. I didn’t expect people talking in clicks, wielding poison-tipped darts or looking like Libyan terrorists boarding our bus.

The Ugandan countryside is plush and green, it is extremely iconic without being strikingly beautiful. Unlike other parts of Africa, the soil here is fertile, and there are thousands of trees sprouting tropical fruits such as bananas and passion fruit. Along the highway are people gathered in little communities, often sitting in front of small shops.

All the shops are painted vivid colors, like bright purple, that don’t mix very well with the surrounding environment and appear this way to advertise for SIM cards companies. If there were a dominant industry here, it would be cell phone credits. It seems like every single person in the city or in the countryside sells airtime. I don’t know if this is a good thing or not, but it sure was evident as we passed by thousands of storefronts doused in neon paint.

After about four hours of contemplating this, and of feeling every speed bump and pothole that the road had to offer, I was ready to jump out of the minivan and meet some of the people we had kept passing by. Lyantonde district is where AIDS was first discovered in Africa — initially called “slim disease” because it made people very skinny and frail before they died.

Now, about 30 years later, the region has made a lot of progress toward diagnosing and treating this disease. Central to those efforts in this region is Fred Katumba, MD, the head of Lyantonde District Hospital. This facility is depressingly bare-bones for the the approximately 250 patiens seen there each day. Yet it offers many services such as obstetrics, gynecology, general medicine, basic surgery, pediatrics, infectious disease and specialized HIV/AIDS patient care.

The hospital is really a collection of a few old buildings with hundreds of people waiting inside and outside, either to receive care or to visit their loved ones. Inside the hospital there is one small ward for each service and patients lie on cast-iron beds often doubling up with others or in very close distance of one another. Family members who are attending to the patients make a bed on the floor below the patient and are responsible for feeding the patient and buying the necessary supplies and medications. Those without caretakers have a difficult time getting the care they need. Though this is barely a hospital and has almost no infrastructure to speak of.

Yet Dr. Katumba has transformed this into one of the best HIV/AIDS treatment facilities in the country. People come from all over to seek care here, because the program inclues a high degree of follow-up and treatment success rate. Dr. Katumba has recruited community health workers who go to patients’ homes and help to ensure their medications are taken regularly. Family members may also assume this role — the idea being that when a patient has a sponsor or partner in their treatment plan, they will be more encouraged to keep with their medication regimen.

Dr. Katumba also has a great patient education program with guidance and counseling to teach patients about their disease and why it is important to remain on ARVs consistently. Another unique program that he has started focuses on commercial sex workers, who frequent Lyantonde because it is a hub of long-distance trucking traffic. He has addressed stigma head-on with this program, by sending healthcare workers into the workplaces of commercial sex workers to test and treat them for HIV and STDs. This program has proven very successful and is actually well-received by the community. Dr. Katumba has made a lot of strides in addressing stigma about HIV/AIDS in his community with the very limited resources that he has to work with.

The countryside is overrun by commercialism, and people are moving out to cities, yet the people I met were friendly and motivated to help change things for the better. It is inspiring to see Dr. Katumba has make postive things happen through being a powerful advocate for his patients — something we can all aspire to!

(For more on the visit to Lyantonde Hospital, see Mona Singh’s post on the PHR Student Blog.)

My name is Neil, and I am a second-year medical student at the Keck School of Medicine. I have been incredibly lucky to have the chance to travel to Uganda with a group of PHR leaders and other students. We’re here to be part of the East African Health and Human Rights Conference, which is going to bring together health professional students from all over East Africa — Uganda, Burundi, Rwanda and Kenya. The issues that students face here are vastly different from the ones we face in the US, but the strategies we can employ to make changes are similar. The goal is to share experiences and make new friends whom we can help and support as we continue in our careers.

We touched down in Kampala on Sunday night. The cab driver took us straight to the guest house we are staying at, and we pretty much just passed out. Getting to Africa is not a short journey by any means!

Monday was a whirlwind tour of the city. We started by walking down to the main road and soliciting a ‘matatu,’ which is basically a minivan which functions as a public bus. There are hundreds of matatus buzzing around the city constantly but each one will try to charge you a different amount. Haggling for prices seems to be part of life here, as I soon found as we entered the main market of the town. Fruits, vegetables, spices, lentils, animals, all squeezed closely together with almost no room to walk, and people everywhere made this market hard to navigate but exciting to explore.

The city is overwhelming, especially for foreigners. The city is dense with people, and the streets are filled with cars, vans, motorcycles and bikes moving in a sort of organized chaos. It is a surprise to me that more people aren’t hurt in the traffic, but I think that being able to navigate the roads as a pedestrian or hail down a matatu is definitely a rite of passage here.

Later that day, we met with a couple medical students from Makerere University, which is one of the largest and most prestigious universities on the continent. The students here have formed a group called Students for Equity in Healthcare (SEHC) (PDF), which is similar to PHR in the US. We got a tour of Mulago Hospital where they do their rotations, as well as their medical school. It was simply amazing to see so many highly motivated medical students who are doing such positive things in their country.

The medical school itself is quite large, but is also very old and not up to standards that we hold as the norm back at home. Can you imagine preparing your own microbiology slides and studying Biochemistry from donated books published in the 1950s? Would you be able to survive in medical school without a laptop or easy access to the internet? Many of us might have shied away had we been required to study in an environment such as this; I know I certainly would have thought twice. But that is where the difference is; I didn’t realize how privileged I am until I came here and saw how hard these students work.

Worse still, graduating students here are not guaranteed good jobs or decent pay. It is not uncommon to find trained health professionals selling vanilla beans in the market because they can make more money that way. Even though I don’t know the SEHC students very well yet, I already have an immense amount of respect for them. They chose this profession out of such genuine commitment to health as a human right and out of desire to protect that right no matter how difficult it might be.

The rest of our week promises to be quite eventful. On Tuesday we are going out to the rural Lyantonde district to visit a healthcare facility that uses a community-based approach. On Wednesday we will meet with officials from the Ministry of Health as well as some NGOs that are working on health equity and justice in Uganda. Thursday through Saturday will be the conference, which is what I am most excited for!

Though I have spent time on the African continent before, this is my first time in Uganda. I arrived a few days early with three national PHR leaders, Neil Chawla, a second year medical student at USC, and Justin List, a med student from Loyola currently living and researching TB in Kampala. We wanted to visit some rural and urban sites in Uganda and gain a better sense of the unique health and sociopolitical issues that affect the region. Seventy-five other medical and paramedical student leaders from schools in Uganda, Burundi, Rwanda and Kenya will join us later this week for the conference. The Institute will serve to strengthen a community of health professional student advocates both regionally and internationally.

On Monday, Justin spoke to the rest of us about his work in Uganda over lunch. I gained a deeper understanding of the TB-drug shortage and inadequate media and public attention to the critical lack of available therapy.

After lunch, Nixon, a fifth year medical student and one of the founding members of the Students for Equity in Health Care (SEHC), and Herbert, a fourth year medical student and current president of SEHC, gave us a tour of Mulago Hospital, Uganda’s largest hospital. Based in Kampala, it is the main National Referral Hospital. It has 1500 beds, and the emergency department sees about 100,000 patients a year.

Nixon took us to the maternity ward. Although the maternity ward has provisions for delivering ten babies a day, a startling 60 babies are delivered on an average day. There are also twenty private rooms available for mothers that can afford the 40,000 shillings per night rate, a hefty sum for a nation with 9.5 million people living on less than a dollar a day. On a given day, there are usually five to ten empty private rooms, but when beds have not been available in the public rooms, some mothers have given birth on the floor.

Nixon and Herbert also took us on a tour of the medical school. The visit was a particularly sobering experience. The medical students lack some of the most basic supplies that my peers and I take for granted in the US. Their curriculum is 100% problem-based learning, and they do not receive syllabi. The students are expected to research and learn the material on their own. Textbooks are too expensive to buy, and the vast majority of students do not own a computer. The students do not have access to PubMed or journal articles. They study at the library, learning from the few, mostly donated books that are available on reserve. Most of the books at the library are drastically outdated, gathering dust from the early 20th century.

I walk away from the day with a lot of perspective and gratitude for my medical education system. I am in awe of these students. I also hope to learn more about ways in which students in the US and East Africa can work together to address the needs of these students. Since the medical class of 100 has a ratio of about 2 males to 1 female, I’m also hoping to meet some of the female medical student leaders at the conference to gain a better understanding of the unique challenges women in medicine face in East Africa and how they compare to issues we face in the US.

I know that a week here will not be enough time to fully understand health, human rights, and the medical education system in East Africa, but my time here will provide invaluable insight on health care justice and advocacy locally and globally. I’m excited for the upcoming week.