Purdue News

May 22, 2006

Pharmacy students learn medicine, culture in Kenyan program

WEST LAFAYETTE, Ind. — Completing a residency during the last year of Purdue University's doctor of pharmacy program is a requirement, but instead of serving in a local pharmacy or hospital, many students are choosing to fulfill their obligation in Africa.

For the past two years, the Purdue School of Pharmacy has partnered with Indiana University School of Medicine and Moi University School of Medicine in Eldoret, Kenya, to provide care to a community that is markedly different from any that students would see in the United States.

"It gives students a chance to experience not only a different culture but also a different way of practicing medicine altogether," said Julie A. Everett, associate professor of pharmacy practice at Purdue. "Kenya is a country where patients don't have many of the conveniences we're used to, such as electricity and running water, so students are forced to take what they've learned and apply it in a whole new way."

Students choosing the two-month rotation serve alongside medical students from IU, as well as pharmacy and medical personnel at Moi Teaching and Referral Hospital. Students undertake many of the duties that a pharmacist at a United States facility would perform, such as dispensing medicine and counseling patients, but for this group of patients, there are unique challenges.

Ellen M. Schellhase, assistant professor of pharmacy practice, said many of the patients students see are HIV-positive or are gravely ill. Also, they see patients with diseases such as tuberculosis, malaria, typhoid and hepatitis A, which are uncommon in the United States.

"By the time we are seeing them, many of them are really sick and will usually die," she said. "To students, this is just shocking."

Everett and Schellhase, who both have supervised students in Kenya, are part of the Purdue School of Pharmacy but are based at Wishard Health Services in Indianapolis.

Everett said the way Kenyans practice medicine is much different from the way American pharmacy students have been taught. For instance, many of the newer, top-of-the-line drugs students have learned about that are common in the United States are not available in Kenya, so medical personnel must make compromises.

"It's a great lesson in problem solving," she said.

Everett said due to the lack of electricity, things such as refrigerating medicine can be a problem for patients, so the student pharmacists must look for alternative medicines. And because there is a lack of pharmacists and other health-care personnel in the country, sometimes patients are forced to make their own health-care decisions, such as diabetics taking long-acting insulin because they don't have the equipment to monitor their glucose.

Everett said much of the students' time is spent making sure patients understand how to take their prescriptions.

"What we call adherence — making sure patients take their medications and take them correctly — is a big focus for us," she said. "Our goal is to improve adherence by finding out what works and what doesn't and ultimately improving patient care through our research."

Everett said the program has grown steadily in the past two years it has been offered. The first year, 13 pharmacy students went to Kenya; last year, 25 students went there; and this year, 34 students signed up. She said the program can accommodate up to about 40 students.

Students stay in what is referred to as "Purdue House," a facility that has running water and electricity and is near to "IU House," where the Indiana University medical staff stays.

"I always warn the new students who arrive in Kenya that they will be sick when they first come to the country," Everett said. "The elevation — which is about 7,000 feet — combined with the unfamiliar smells and dramatic cultural differences, is often too much for the students to handle at first. It's just sensory overload."

But she said once the students are acclimated after a few days, what they learn in both pharmacy practice and cultural terms, is something they couldn't get anywhere else.

"One of the first things the students notice is the complete reversal of white to black," Everett said. "In Kenya, they are the minority. In fact, some Kenyans have never seen white people and sometimes ask if they can touch our skin."

For all these reasons, before the students go to Kenya, they must complete a class that educates them about the culture and practices of Kenya so their first experience in the country won't be as much of a shock.

Everett said that the benefits students gain from going through the program far outweigh the temporary inconveniences.

"They come out of the program with such a broadened base of knowledge and an openness to experience new things, which will help them in every aspect of both their professional and personal lives," she said.

The first summer rotation of students left for Kenya earlier this month, and another group will be leaving in July. To find out more about the program, contact Everett at (317) 613-2315, ext. 312, jaeveret@iupui.edu; or Schellhase at (317) 613-6315, ext. 305, elschell@iupui.edu.

Writer: Kim Medaris, (765) 494-6998, kmedaris@purdue.edu

Sources: Julie A. Everett, (317) 613-2315, ext. 312, jaeveret@iupui.edu

Ellen Schellhase, (317) 613-6315, ext. 305, elschell@iupui.edu

Purdue News Service: (765) 494-2096; purduenews@purdue.edu

Related Web sites:
IU-Kenya Partnership


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