Daniel Mutonga from Kenya

01.12.2012 I first heard of IPPNW
in 2010 when a colleague, Charles, was collecting signatures at the School of Medicine, University of Nairobi for a petition against nuclear weapons. Two years later Charles introduced me to Dr. Hellen, the coordinator of IPPNW in Kenya. Coincidentally, IPPNW had an elective opportunity in Germany. The only requirement was  to win an essay competition. I initially hesitated since I had not written anything in a long time. However, after doing some research on the essay topic, I put down my thoughts. Three of us got shortlisted for an interview where we also learnt more about the history of IPPNW in Kenya. I received the “good news” in late September while at my friend’s house in Nairobi. I was so excited that I hardly slept that night.

Gwendolin, a German exchange student whom I had met earlier, invited me to her farewell party the following week. We shared on her experiences in Kenya and what I was to expect in Germany. Later on Ulla, the IPPNW-Berlin coordinator, sent me an introductory email. We began planning. Compared to my earlier travels, this was a piece of cake. It was well organised and fully sponsored. All I had to worry about was getting my schengen visa.

Clinical elective in Hannover
Due to unavoidable circumstances, I arrived in Hamburg on the 10th November, 2012 instead of late October. Gesa, an IPPNW volunteer,  received me at the airport with a placard bearing my name. Since I would spend more time in Hamburg during the last week of my visit, we headed straight to the Hauptbahnhof. Gesa bought me a ticket, some burgers and water for my ride to Hannover. Svea, IPPNW-Hannover student leader met me at the main station. I spent the night at her apartment. While she prepared dinner, we talked alot about our countries. The following morning, Hellen, Svea’s colleague and volunteer at IPPNW joined us for breakfast. We had great converstaions about the nuclear weapons and medical school. That afternoon, Svea and I toured the city before we headed to a local church for the evening service. Afterwards, Maribelle Mayo (another IPPNW volunteer) and her husband, Michael picked me up and we drove to their parents’ home for dinner. The Mayos had moved to Germany from the Phillipines in the late seventies in search of greener pastures. Theirs was a success story. Monday morning, Maribelle took me to the Deutsches Rotes Kreuz (DRK) Krankenhaus by bus and metro. Sophia, an internist and a founder of IPPNW-Hannover, introduced me to the Chief of Surgery at the hospital and my work began.  For the next two weeks, I woke up very early so as to make it for the morning rounds from 7:20hr. I shadowed the attendings (Ingor, Takripan, and Besong) at the Notaufnahme (ER). Since “Isch spreche keine Deutch”, they tried to explain all the cases we saw in English. I observed many gastroenterology and orthopaedic procedures. My best moments were to assist in a four-hour laparascopic colon resection plus anastomsis and to observe a cystectomy that was being transmitted to Berlin as part of a training for surgeons. I also attended an IPPNW-Hannover meeting where Svea and her colleagues were organising lectures, conferences, skype meetings, movies and other activities to promote the war against nuclear energy. I took down lots of notes. Perhaps we would conduct similar campaigns in Nairobi. On the weekends, Svea and the Mayos took me out. I got to see the aquirium, museum, the man-made lake, several churches and the night-life in Hannover.

The seven towers of Luebeck
Judith arrived at the train station in Luebeck with her bike. She was covered up in winter clothes such that I could hardly see her face. Because of the cold weather, my huge luggage and the long wait till the next bus, we decided that I take the taxi to her apartment while she followed us on her bike. That was funny! We then took a quick tour on foot round the narrow streets of Luebeck and had dinner at a local restaurant. I was fascinated by the old buildings, some as old as the 15th century, the ganghaus, the Rathaus, the church with a little devil statue and the Martzipan shops. The following day, we woke up at 6:45hr and cycled to the Luebeck University Klinikum. I shadowed Judith at the Paediatric Surgery Department. We examined patients who were due for operations, attended ward rounds, and clerked new patients at the Notaufnahme. We came across syndromes such as VACTERL association, Crohn’s disease, fractures, and burns among other surgical conditions. Occasionally, I joined medical students for University Lectures and lunch. We also performed many abdominal ultrasounds. Judith was such a good cook. During dinner, we talked about her IPPNW experience and her time in Kenya. She showed me a Medical Peace Work website where I could be equipped on human rights issues and use the materials to start a local group back in Nairobi. Courtesy of her neighbor, a young pianist, I was lucky to attend the Opera at Theater Luebeck. I was totally blown away by the actors and orchestra of “Das Land des Lachelns”. I also met Marius, an IPPNNW volunteer and passionate doctor training in trauma medicine. He showed me around the city over the weekend. We saw the seven towers of Luebeck which were mainly old churches, some remains of an old whale, many bridges and the Holsten Tor. After lunch at an Italian restaurant, Marius bought me a ticket to Kiel where I would meet my next host. Worried that I would not find many English speakers in rural Germany, he got me a travel guide. On the morning of my departure, I was so excited to see snow for the first time in the streets that I almost missed my train.

Family Medicine in rural Germany
Gisela was speaking at an international medical students’ meeting in Kiel. She had her own practice in Otterndorf and was acively involved in political work. From Kiel we drove out of the city through the autobahn and back to the highway towards Otterndorf. It was a new experience been driven so fast for so long.  As we crossed the Elbe-fähre, I enjoyed the birds and the cold breeze. I saw two nuclear plants along the river banks. Gisela told me that one was functional while other was closed down. We talked alot about the alternative energy sources in rural Germany, the available jobs, the politics, and life in general. Despite Otterndorf being a rural part of northern Germany, the roads were quite good and the houses did not look as old as I had imagined. While shopping in the small town, we stopped to watch an old tradition. About forty firemen swam in the cold Elbe river every 1st December. They wore scary costumes and carried torches.  The rural folk cheered on while taking glue wine at the banks of the river. On Sunday, we toured the town. It had many old brick houses with small windows. Most of these were formerly store houses which were renovated to modern housing facilities. Andrea, Gisela’s daughter, drove us to the Christmas market in the afternoon. It was wonderful seeing people dance, bands perform, children play and kiosks open in such cold weather. We later went to an old painter’s house for a lithography exhibition. The technique was quite complicated but it was like making a stamp on a stone and printing it onto the cloth. The painter’s wife, originally from Paraguay, played her guitar to some tunes about some of her husbands work. On Monday, we started work at 7:45hr.  I took my coffee, cheese and bread in the car as we drove to Hemmoor where Dr. Gisela worked. Every morning, we saw patients from 9:00hr to 12:00hr. After some tea and snacks, we conducted home visits in the afternoons. We saw elderly patients who couldn’t make it to the clinic. Most lived in old people’s homes, others preferred to stay at their homes while those who could afford bought smaller one-bedroomed apartments where nurses regularly made visits twice daily. The family practice was a totally new experience for me because I had never seen doctors make home visits in Kenya. Although Dr. Gisela said that it was a dying profession, I somewhat enjoyed the relaxed atmosphere compared to working in a busy hospital. Spending time at her office was nostalgic. It was my own personal visits to the family doctor at an early age that attracted me to the profession. I only got to visit a big hospital once I started my clinical years in medical school. I was also impressed on Dr. Gisela’s good rapport with her patients. She understood their social, financial and psychological problems unlike doctors in the big hospitals. She even helped refugees who made frequent visits to her clinic. It snowed again. That weekend, I prepared a Kenyan cuisine for my host family; ugali, spinach and fish with whatever ingredients we found at the supermarket.

The social project that never was!
I arrived at Hamburg at about 19:00hr on 9th December, 2012. Kaja, an IPPNW volunteer, met me at the Hauptbahnhof. We went to Bettina’s house where I would stay for the week. Gianni, Bettina’s husband, had prepared some special soup and rice. The next morning I met Doris, Caritas Organization, near the St Pauli harbour. On the way I had seen homeless people sleeping under a railway bridge in the cold. I later learnt from Doris that European immigrants who lacked work permits, health insurance and proper housing received free health care from Caritas. The elderly mainly had septic wounds, diabetes or hypertension while the younger ones had hygiene-related diseases such as lice or scabies. Most homeless people in Hamburg were men. I wondered about the gender disparities of street families back home in Nairobi. After a brief tour of the shelter, we made an appointment for Friday when I would practically engage in some social work. However, I never got to participate in any social project per se. I arrived at the bureau a couple of minutes late and missed the ambulance. My efforts to catch the metro and meet the team at their next stop in Mönckebergstrasse did not bear any fruits either. I headed back home disappointed that I had not yet learnt on German punctuality. That week, Franzi, a final year medical student was very helpful in showing me her university. She even translated for me the lectures we attended. I again met Gesa who had received me on my first day in Germany. She was a family doctor in Hamburg. Over coffee at Messehallen near the television tower, we talked about my German experience, family medicine and my future plans. Having been to Kenya previously, she was interested in Kenyan politics and the upcoming elections. Despite the snow that week, I found my way through Reeperbahn, Altona, Jungfernstieg and other wonderful places. The metro, underground, subway and bus system became very familiar! I got to understand why cars were not a priority for most Germans, even doctors. The transport system was very efficient. Kaja, who had also hosted Bettina and me for dinner that week, took me round Hamburg. We attended a music concert organized by immigrants living in Hamburg. We brought along some souvenirs from the free market and bought drumsticks for my music practice back in Nairobi. I was also invited to a party of an IPPNW student who was travelling to Vietnam for her internship. I met other young people involved in social and political work. Early the next morning, Bettina took me to the train station. I had mixed feelings. Sad to leave my new friends but happy to return back to Kenya with wealth of experience.  

In summary, my IPPNW experience was a short-term student exchange project in rural and urban centres in northern Germany. I visited hospitals, private clinics, medical schools, homes, and projects while living with IPPNW volunteers and their families. It really made me rethink my career options and my future goals. I recommend it to any medical student interested in humanitarian work and willing to explore health care systems of other countries. I cannot wait to host or at the very least interact with other IPPNW exchange students visiting Nairobi. Last but not least, so many people including my family participated in making my German experience a great success.  I thank them all. Danke!