Outsider looking in

I am often told of tourists who get to go on safari and visit game parks in Kenya such as Amboseli National Park, where they are so dazzled by the array of wildlife, combination of swamps, arid areas and in the home of the Maasai warrior downed in their bright red shukas or shawls. The experience takes them to an almost medieval time, where man was still in tune with nature, that they almost forget that the tour van taking them around is well conditioned and equipped with modern facilities. It doesn't get any more basic than that especially in a park that's famous for being the best place in Africa to get close to a free ranging elephant.

But for a local, such experiences aren't anything to write home about. It's not that you encounter an elephant or lion at every other corner, but such destinations never really stick out as exotic destinations as it would for a tourist. Therefore, it often takes the perspective of an outsider looking in for the realization to sink in. For it is the same way that coming to the Institute of Tropical Medicine, I was dazzled. Dazzled because nothing I had seen in my life, could have prepared me.

The Institute of Tropical Medicine, Antwerp is one of the world's leading institutes for training, research and assistance in tropical medicine and health care in developing countries. It houses three scientific departments including public health, biomedical services, and clinical services. In addition, there is a specialised outpatient clinic that deals with imported tropical illnesses and provides medical assistance to travellers returning to the tropics. Simply put, ITM is the place to go if you are travelling to the tropics and the learning institution of choice when it comes to tropical medicine; biomedical, clinical and public health research.

The courses offered at ITM are advanced study programmes and these include doctoral and master’s programmes, postgraduate courses, and short specialization courses with some of the programmes being offered via the Internet as distance learning.

ITM offers Master of Science courses in Public Health and Tropical Animal Health as well as a range of short courses on topics including Health Policy, Planning and Management of Reproductive Health Programmes, Clinical Research and Evidence Based Medicine and International Health. In addition, PhD programmes including a sandwich programme in which researchers from developing countries divide their time between field work in their home institutions and Antwerp. ITM is also part of the Erasmus Mundus Transglobal Health Joint Doctorate.

Therefore, the students range from medical doctors to epidemiologists and from biologists to veterinarians. The pool of students coming mainly from Africa, Latin America, and Asia as well as European students with an interest in pursuing an international career in public health.

It is under a specialised programme that I was able to do my medical school elective period, an opportunity to both learn and work at ITM. The pilot programme presented the unique opportunity to both follow some of the ongoing classes and to interact with the researchers and different professionals and thereafter write about my experiences and feature stories in media platforms based in Kenya and in India. As a medical student from Kenya and budding journalist, the programme could be described nothing short of amazing, mind blowing even.

Arriving at the ITM student service building where the entrance is a large monastery door which gives the impression that this is simply no ordinary place. But what really struck me was just how massive and complex, the structure of the main building was. Not to mention, you get to appreciate the receptionist who in those moments where you could neither pronounce the name of the researcher you wanted to see or figure out where their office was, she patiently listened, figured out what you meant and pointed you in the right direction or simply called their office.

The kindness of the people, willingness to help and share is another aspect that did surprise me. For you see, I had been given to understand that Europeans are a bit more aloof and with a mind my own business mentality. But that's not what I found.

But what really stands out is the level of research on varied medical and public health issues ranging from the well known to the neglected. After years of growing up, only reading about discoveries or medical advancement in books or hearing about it on programmes on TV. You can't help but amaze when you realize that the same professor you were once reading about, is the same one teaching you or that you get to interact with them; from Prof. Jean Claude Dujardin on Leishmaniasis, Prof Lut Lynen on antiretroviral therapy, Prof Anne Buvé on HIV projects, Prof Pol de Vos on non communicable diseases and Prof. Leen Rigouts on TB.

Knowing that the viral condition everyone is talking about, Ebola, was discovered right in this very institute. That ITM researchers in the eighties were among the first to address the mysterious disease which got known as HIV/AIDS. Or that a whole genome sequence of a tsetse fly salivary gland was mapped out right in these very same laboratories. There is simply so much to absorb and learn that simply one article isn't enough.

Naturally, it is not all a haze of mind-blowing experience after another and speaking to some of the other students from developing countries, you could tell it's a large adjustment for most of them who were probably leaving their own countries for the first time and if it wasn't for the scholarship provided would not be able to get such an opportunity.

There are moments of missing home. Joshi Bishnu, a microbiologist from Nepal pursuing a Master in Tropical Animal Health, remembers those first few weeks, "I would spend a whole day happy, then get back to the room and the depression will set in. It's not that I was sad, if anything I was excited to be here. But I missed home, and it took a while before I could form any real connection with anyone. We were all strangers from different background and different cultures" He adds that the trips and interaction activities organized by the ITM student service made the process easier and faster.

There are overwhelming moments. "There is a lot of work to be done and as it's a different learning environment it becomes challenging, "Olivier Kablan, a surgeon from Cote D'Ivoire who for the past few years has been working with humanitarian organisations in his country with a  particular interest in HIV/AIDS before deciding to pursue a Master in Public Health in Health Systems Management and Policy, "The schedule didn't look as hectic when you go through it at first. But once you begin, you realize it's a marathon, you are either in class, in a study group preparing for a presentation or DOING an exam which was after every other week. I'm not sure if it's just me. And perhaps another factor is that being here on a scholarship, the last thing you want to do is be disrespectful to your host and make them feel that you wasted their time and money."

Another Health Systems and Management Policy student from Cameroon, Kevine, says that leaving her children behind was her biggest challenge. But she views it as a worthy sacrifice as it's not just a personal development milestone. What you must understand is that for most of the students, especially the Africans, they are not only here to learn for their own sake but for the society at large. For some the evening before they leave, there is a celebration in their village cause the members feel they are celebrating not only someone who got a great opportunity, but someone who will come back after that and aid the community.

And on prompting what was the greatest cultural shock, she said, "The fact that people live according to schedules is probably the biggest difference. Back home, people aren't so keen on following programmes or keeping time. You only need to call up a friend or show up at her doorstep to chat. You say that you will meet at 3pm and anywhere between 3 and 4pm is acceptable. I was surprised to find that you send out an email and within an hour you get a response. It was strange that two people living or working in the same area, had to plan weeks in advance to have lunch or talk." But it's expected and slowly you adjust.

In the end, none of them would even consider foregoing the opportunity for as Billy Bongoso Ifeka from DR Congo, having acquired an MSc in Public Health from ITM, said "I never had such a rich intellectual experience in such a short time span, with people from all over the world." That summarizes it perfectly.

But I was left wondering, how come I hadn't heard of the institute before? Didn't ITM see that they would be right in blowing their own horns? What about the locals? Did they see what we see or to them is it just another learning and training institution? Did anyone see ITM as we did?

But perhaps the biggest question of all, what did the locals think of having a tropical medicine institute in a non tropical country? A country where diseases such as Malaria or Leishmaniasis had to be imported and were not just another disease. A country where the temperature as I write this was at two degrees and for you to experience such a temperature in Kenya, you had to be climbing a mountain and a snow capped one at that, for that was what it meant being in a tropical country.

I would say that having a tropical institute such as ITM in a non tropical country, provides great reference centres and in a world were travelling whether for work or leisure is increasingly more common, all bases ought to be covered. But more importantly it allows for collaborations that would not have been possible without a common goal. But what were the locals’ thoughts or was I just an outsider looking in?

Author: Diana Wangari Gitau from Kenya, ITM's 2014 journalist-in-residence