Derek Zipkin spent his first day of clinical shadowing in Africa facing a mother who had just learned that her 6-year-old daughter contracted HIV through a blood transfusion.
"I can see their faces clearly,” says Zipkin, a second-year medical student in the UC College of Medicine. "The mother crying hysterically and the child, not knowing why her mom is crying, going over to comfort her mother when her mother found out she has HIV,” says Zipkin.
Zipkin, 24, a Cincinnati native, spent two weeks in Tanzania in June with the Village Life Outreach Project, a Cincinnati-based nonprofit organization that makes trips to the Rorya district of Tanzania each June and October to provide supplies and medical assistance to villagers in the area. Zipkin signed on to this year’s "June Brigade” following the end of the academic year.
Many Americans venture to Africa and return with tales of the continent’s scenic landscapes, rampant destitution, surreal wildlife, fledgling health care systems and surprisingly comfortable temperatures. Zipkin’s African excursion offered fair shares of all of the above, but he didn’t return to the States with simple stories. His experiences brought a changed mind, broadened perspective and a resolve to call Americans to action.
As Zipkin had only just finished his first year of medical school, he was unable to directly administer care to patients. Instead, he shadowed Esther Kawira, MD, a U.S.-trained physician who moved to Tanzania to work full time at a number of clinics. One such clinic, Village Life’s Roche Health Center, was completed last April and constructed by Village Life, its partners and volunteers and the local villagers.
Zipkin was exposed to many types of cases during his shadowing and gained a wealth of knowledge from Kawira and other medical officials in the area. "I got to scrub in on a surgery on my last day,” he says. "That was a very cool and unique experience—definitely something I wouldn’t get in the States for another year.”
The surgery, which took place at Shirati Hospital, was easily one of the highlights of the trip for Zipkin. "It was on a 7-year-old boy who had a hernia,” says Zipkin. "It was an uplifting thing because they were able to completely fix the issue.”
While that case was surely memorable, other, more harrowing experiences had more of a lasting effect for Zipkin.
"The cases that stick out to me are the ones that tend to be very, very sad,” he says. "Those cases are not only memorable, but also change your mind.”
On the last day Zipkin shadowed Kawira, before going to Shirati Hospital, he met a 16-year-old boy with a large tumor-like mass on his right side. The mass felt as if it was connected to the teen’s liver. "We immediately thought hepatic cancer. The mass took up most of his abdomen,” says Zipkin.
With no access to magnetic resonance imaging, Kawira had to employ ultrasound to confirm the extent of the damage. The mass was,indeed contiguous with the liver.
"Hepatic cancer at that stage, even in the U.S., is untreatable,” Zipkin says. "The mass was too large and took up too much of the liver. Dr. Kawira told us he had maybe a month to live. We’ve been back for about a month now.” Given the lack of supplies and equipment, Kawira had to refer the teen to another doctor.
In the U.S., with the advent of annual general screening, complications such as hepatic cancer can be caught relatively early. "It’s easier to detect tumors in children and, when caught early, hepatic cancer has a fairly high chance of being cured,” says Zipkin. Unfortunately, this is rarely the case in Africa. "We’re fortunate just to be born in the U.S.,” he says. "It’s just chance.”
Zipkin’s trip showed him just how far African medicine has to come. Americans have little to fear in operations like blood transfusions. HIV, while certainly a large issue in the States, is not the rampant scourge it is in African countries. Even with government policies in place to test all blood before an operation, contaminated blood still makes it into patients’ systems. Such was the case with the 6-year-old girl on Zipkin’s first day.
A year before arriving at Roche Health Center covered in swollen lymph nodes, the girl was waiting for a blood transfusion in a Kenyan hospital. "The hospital was out of blood, and needed to go out and buy some from off the street,” says Zipkin. "It’s hard because these governments try really hard, but because this blood slipped through the cracks a 6-year-old has HIV.”
Tragic as they are, cases like that of the young girl and teenage boy have inspired Zipkin to help streamline health care in Africa. "I remember seeing the Great Rift Valley on our way to Tanzania and thinking, ‘There’s so much potential here,’” says Zipkin.
He believes many Americans want to see improved conditions in African countries, but do not know of any ways to help other than throwing money at the issues. "A lot of medical students in particular want to get involved in international health care, but don’t know how to do it,” says Zipkin.
To that end, Zipkin is working to create a Village Life interest group based under the Medical Student Association at the College of Medicine with the goal of connecting more students to Village Life. Through fundraisers, Zipkin hopes to help provide medical equipment and supplies to Kawira and other health care providers in the area.
Zipkin also plans to use fundraisers to help pay for trips to Tanzania for other medical students. "Even if it’s just a couple of hundred bucks, students will see that somebody wants them to go on this trip and make a difference,” says Zipkin. "I think that’s a big mentality shift. Even though the financial gain isn’t huge, the mentality of a lot of students will change.”
"I think the important thing is bringing awareness to people, both here and over in Africa. Trips like these change minds and the more people that share the experience, the better the chance of making a difference.”
Learn more about Village Life and its Tanzania brigades here
* This story was written by Perry Simpson, an intern in the AHC Public Relations and Communications Office.