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Mombasa, Kenya, Africa Jaimee Lobley, 4th year, Nursing/Paramedic student In January 2011 I travelled to Kenya, Africa to participate in a volunteer nursing elective with a program called Elective Africa. I was offered the opportunity to work in a third world country public hospital, in the ward of my choice, for 4 weeks. I was placed at Coast Provincial General Hospital in Mombasa on the east coast of Kenya. During my time at the hospital I rotated through obstetric, paediatric and medical wards while spending the majority of my time in the emergency department, as this was of particular interest to me. One of my key objectives upon travelling to Kenya was to compare not only the procedures and equipment, but also the attitudes and values to those here in Australia. As expected the equipment was less than desirable which in turn affected the ability to perform procedures safely. “Hakuna gloves” (no gloves) was a daily expression around 12pm, some wards had a secrete box hidden for the afternoon, others did not, resulting in you wearing the same pair of gloves for the rest of your shift. What came as a greater surprise to me were the vastly different attitudes and values expressed by the staff, towards patients. Nurses didn’t have a patient allocation as they do here in Australia; they were responsible for the completion of one task on that day, eg. Medications were completed by one nurse, wounds by another and notes by another. This meant it was easy for patient deterioration to go unnoticed. One particular case that highlights an attitude difference between Australia and Kenya; a man presented to the emergency department with a police escort after he was caught stealing and subsequently beaten by members of the community. He had multiple gashes to his head which requiring stitching. Another student and I enquired to his wellbeing and asked to clean his bleeding wounds and prepare him for minor theatre (an adjoining area where he would be stitched); the nurse’s response was “no, he is a thief.” We attended to the man. I learnt to communicate across the language barrier and build a rapport with the Swahili speaking Kenyans, some of which had never seen a mzungu (white person) before. I gained experience in tropical diseases such as tuberculosis and malaria, not often seen in Australia. There is also a higher rate of HIV AIDS in Africa than in Australia. 60% of the patients treated at the hospital were HIV positive, many suffering from secondary infections due to their AIDS. There were occasions when I was given additional authority and times when I was required to express my knowledge and understanding to aid the medical staff in acting in the best interests of the patients. I reflect on these times and appreciate them, knowing that I have the confidence to speak up for my patients. Finally I’d like to say Asante sana (Thankyou very much) to the school of nursing for their support, while my trip to Kenya was challenging it was a life changing experience that was beneficial in my growth and skill development as a nurse and paramedic. Photo’s from top to bottom: Hospital entrance sign; emergency ward; an ambulance; myself and an orphan in the paediatric ward.