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Yearning to Lead: Researching Medicine in Kenya

Written by Kendall Mcevoy

Throughout my four years of high school I had the opportunity to conduct medical research at a hospital in Kijabe, Kenya. Alongside my mentors—students and doctors at Vanderbilt University and Kijabe Hospital—I began a pilot observational study on anesthesia care during cesarean sections focused on emergent and urgent cases. As a medical assistant, my job was to collect and record data, and report it to my superiors for the analysis. I walked into the hospital every morning without a clue what my day would hold. Some days I observed up to eight c-sections, and other days not a single procedure. 

I began each procedure when the need for a c-section was called, and went straight to the operating room to sit in a corner and watch. I had a clipboard with a detailed checklist on it and multiple blanks I had to fill out even before the procedure started. I learned most of the nurse anesthetists’ names and got very familiar with the surgeons as well. They were surprisingly open to my questions and even took the extra time to explain the details of various procedures. Two of my favorite parts of my job were the time from incision to delivery and then the collecting of Apgar scores. The times from incision to delivery were the widest range which was what made it so intriguing for me. I saw some c-sections that took over thirty minutes just from incision to delivery, and others took less than five. Apgar scores—scores given to access the health of a baby within the first few minutes after delivery—are based on the heart rate, respiratory effort, muscle tone, response to stimulation, and skin coloration of an infant. One of the craziest experiences during my time at Kijabe Hospital was a baby that was only 26 weeks along and was delivered in two minutes and had an Apgar score of zero at one and five minutes. All of the doctors told me she would probably die overnight even after they revived her, but this little girl fought and fought until her hearth rate was stable and she was breathing on her own.

After collecting all of this data, uploading it to an electronic database, and analyzing the results, a “Safe C-Section” checklist was created to be placed in operating rooms as a reminder for anesthetists throughout procedures to maximize patient care. From this checklist, and the results of my pilot observational study, I had the opportunity to apply to speak at the International Anesthesia Research Society (IARS) conference in San Francisco in 2016. This experience was incredible from getting to present to real professors and doctors the work I had been a part of, to learning about other research going on in the anesthesia world. As the youngest person to ever present at an IARS conference, the responses I received from my superiors were so encouraging and exciting. I had doctors and professors telling me they were excited to see where my future research would take me and had high hopes for my generation’s advances in medicine. Since this presentation in 2016, my superiors and I have published a paper on our research and continued followup studies in Kenya on the implementation methods of our “Safe C-Section” checklist.

Because of my position as a medical assistant, I was granted permission to view various procedures if a c-section were not taking place. Along with the c-sections I observed, I saw brain surgeries, facial reconstructions, skin grafts, and spina bifida procedures. Spina bifida procedures specifically prompted a second research project I started during my senior year. I researched the effects of regular folic acid supplementation (the B9 vitamin) during the first trimester of a pregnancy. It has actually been proven to greatly decrease the risk of neural tube defects such as spina bifida, hydrocephalus, encephalocele and anencephaly. My goal is to take this initial research and expand it during my time at the University of Tennessee. I would love to continue to research maternal mortality rates and work to decrease that number globally through anesthesia practices and training. Along with this goal, I would like to apply for grant funding for my own research on folic acid supplementation, and hopefully open up doors to further test my goal of decreasing neural tube defects in babies born in third world countries.

 

Research in high school greatly influenced my goals for college and beyond, and I hope to partner with my fellow classmates in the Honors Leadership Program to continue my research during my time at the University of Tennessee. Part of why I chose the Honors Leadership Program was because of the core values of community engagement, experimental learning, personal and social responsibly, and diversity and inclusion. Community engagement is something I never focused on until entering another community—in Kijabe, Kenya—where it was so encouraged, and I was able to take that experience home with me and apply it there. I have learned so much about myself, what I want to do with my career, and how to work well with other scholars through experimental learning in my research Kenya and the United States. Personal and social responsibility along with diversity and inclusion have grown to be major focuses of mine through my time in Kenya and in the way I have learned to relate to my community in Nashville. I hope to grow in all of these areas in my time in Knoxville and learn to lead in different areas of research, travel, and education as a whole.

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