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Titilayo Mabogunje, MED'26, clinical elective experience with the University Teaching Hospital of Kigali in Rwanda<\/span><\/p>\n <\/p>\n <\/p>\n <\/p>\n I didn\u2019t expect to be startled by an avocado. But during my first week at the Centre Hospitalier Universitaire de Kigali (CHUK), a loud bang on the metal roof made me stiffen instinctively. \u201cIt\u2019s just an avocado,\u201d my colleagues laughed. Earlier that day, they had been equally surprised by something I carried around without thinking: a hospital badge listing emergency codes\u2014Code black for bomb threats, code amber for infant abductions, and so on. \u201cPeople come with bombs to the hospital?\u201d a Rwandan medical student asked. Their confusion forced me to confront something uncomfortable\u2014how routine these situations had become in my experiences. That moment set the tone for my month in Rwanda: a steady unraveling of assumptions I didn\u2019t realize I had.<\/p>\n As a medical student rotating through pediatrics and gastroenterology, I quickly learned that practicing medicine in a resource-limited setting demands a different kind of intentionality. In the U.S., it\u2019s easy to order tests reflexively\u2014sometimes to confirm a diagnosis, sometimes to protect against uncertainty. At CHUK, that reflex is checked by reality: patients often must pay out of pocket before labs or imaging are performed, and delays in payment often delay care. I still remember a physician pushing back when I proposed we get a chest X-ray: \u201cWhat will it add?\u201d he nudged. It was a simple question, but one that exposed a deeper truth\u2014investigations should serve the patient, not the provider\u2019s comfort. And yet, I couldn\u2019t ignore the tension: in a different setting, with different resources, I might have ordered the imaging test.<\/p>\n Beyond the clinical decisions, I was struck by the human dynamics of care. In the pediatric high-dependency unit, mothers stayed at their children\u2019s bedsides around the clock\u2014sleeping beside them, feeding them, holding vigil. Many had other responsibilities waiting at home, yet they remained. Over time, I watched them form a quiet community: sharing food, comforting each other\u2019s children, stepping in during Clinically, the differences extended to the very patterns of disease and how they\u2019re My time in Rwanda challenged me in ways I expected\u2014navigating language barriers, adapting to new workflows\u2014but also in ways I didn\u2019t. It pushed me to reflect on what I take for granted, from access to diagnostics to the culture of medical training itself. I don\u2019t yet know exactly where my career will take me, but I know this experience will stay with me. It reshaped how I think about responsibility in medicine\u2014not just to provide care, but to question how and why we provide it the way we do. I\u2019m so grateful for the kindness and patience of the medical students (shout out to Robert and Gloria!), attendings, nurses, residents, and the patients I had the privilege of interacting with during this experience! Murakoze cyane!<\/p>\n Titilayo Mabogunje, MED’26, clinical elective experience with the University Teaching Hospital of Kigali in Rwanda A Month at CHUK: Rethinking What Feels Routine by Titilayo I. Mabogunje, MED’26 I didn\u2019t expect to be startled by an avocado. But during my first week at the Centre Hospitalier Universitaire [\u2026] <\/p>\nA Month at CHUK: Rethinking What Feels Routine<\/span><\/strong><\/h2>\n
by Titilayo I. Mabogunje, MED'26<\/span><\/h3>\n
Bridging the Resource Gap<\/strong><\/h3>\n
Transnational Care<\/strong><\/h3>\n
\ndifficult moments. In a space with limited privacy and tightly packed beds, they created a deeply supportive community for one another. It made me wonder about the trade-offs in more resourced systems, where private rooms offer comfort but can also isolate families from one another during some of their hardest moments.<\/p>\n![\"\"](\"https:\/\/geiselmed.dartmouth.edu\/cghe\/wp-content\/uploads\/sites\/39\/2026\/06\/medical-students-300x226.jpg\")
\nmanaged. Frequently diagnosed conditions in the U.S., like pediatric inflammatory
\nbowel disease, were rare here, while others\u2014like H. pylori<\/em> infections\u2014were so common
\nthat treatment was often initiated based on clinical patterns rather than confirmatory testing.
\nProcedures like colonoscopies weren\u2019t used for routine screening but reserved for patients with clear symptoms, reflecting the realities of limited specialists and equipment. These weren\u2019t just differences in practice\u2014they were reflections of broader systems, where resource availability shapes not only what is possible, but what becomes standard.<\/p>\nFeelings<\/span><\/h3>\n