Health and Human Performance associate professor Sarah Imam, M.D., was so inspired after a 2021 summer experience offering free medical services in the Nairobi slums that she returned home determined to create a similar experience for her students. With the generous help of the Swain family—David, ’80, and his wife Mary, and Chris, ’81, and his wife, Debbie, Imam put together a unique service-learning program. In June, Imam and her daughter Mariam, along with Professor Kimbo Yee and 23 students, traveled to Kenya.
When Staff Sgt. Ben Knight, an active-duty Marine Corps student, signed up for the summer service-learning program in Kenya, he was not sure what to expect. But after a month assisting in a free medical clinic in the slums of Nairobi, Knight and his classmates returned to the comforts of home enlightened and better prepared for their future careers in the healthcare industry. It was the adventure of a lifetime.
Following is an excerpt from Knight’s travel diaries. To read the story in its entirety, visit us at magazine.citadel.edu.
As I boarded the plane, I thought about the enormity of what we were about to do, and I felt like a fish out of water. On the plane, I walked past the spacious and clean first-class seating and settled into my row. Two seats on the left, three in the middle, two on the right. Stuff your carry-on under your seat and buckle up.
I sat next to an African woman wearing a yellow dress, an intricate African head wrap and a big diamond ring. My imagination ran wild—was she coming or going, how had she made her money and where was her family? We made regular small talk and exchanged pleasantries. She had a large bag full of travel necessities and luxuries at her feet, much more fashionable than my ragtag, quickly stuffed backpack holding only my essentials, protein bars and a cell phone charger. She wore white fuzzy slippers and set her feet on the bag, which was now doubling as a footrest. She tore into the complimentary blanket and pillow and began to tuck herself in.
She was so warm and content that her comfort became contagious. My traveling anxiety melted, and I became comfortable as well. My eyelids got heavy, and I drifted in and out of sleep for the rest of the flight.
The final stretch of our travels—Ghana to Kenya—was a bear. I think I looked at the countdown to landing on the onboard flight tracker every two minutes. I sat in the middle row between two other passengers, like a hot dog in a bun, for six hours on Kenya Airways. We disembarked posthaste and began the dance of customs. “E-visa, vaccination status and passport please” was the challenge of the trip thus far. I had become a gunslinger of important documents and pulled them out like Clint Eastwood in an old western. After we satisfied the Kenyan officials, we got our baggage. Well, some of us got our baggage. A few poor souls had to live out of their carry-ons until their wayward belongings washed up. My luck was on point—my baggage arrived in full. We were picked up from the airport in a large passenger van—windows all around with the little curtains haphazardly slung to the sides. The seats were covered in soft, stained 1990s-style fabric. Our driver was friendly and informative. Either wear your safety belts or not, he told us. “This ain’t U.S. driving over here.”
I buckled up.
The streets were basically driving lanes with few rules. We passed numerous motor bikes carrying varying numbers of passengers. As our driver maneuvered through the throng of vehicles, we passed a couple of men carrying a cart of potatoes. When the bags holding the produce ruptured, potatoes tumbled onto the streets like tiny brown balls. Everyone passed carefully around them as the men tried to salvage what they could from the busy roundabout.
Walls and barbed wire helped to break up property lines. There was no shortage of vegetation. Planted in the concrete pillars beneath overpasses were hundreds of little plants, part of a new beautification project created to absorb vehicle emissions.
The Mathare Slum
Looking out of the windows of our van seemed like peeking through a veil into a kind of poverty before I’d never seen before. The people all had curious scars, unique tales of hard times. Their mismatched clothes claimed no discernible brand, color scheme or style. Some slept on the side of the street. Some sold dirty heads of cabbage or corn from a makeshift grill. Some sold old T-shirts displayed like prizes. Many made their way through the crowded streets, chatting and bargaining. And near the road, men and women hawked their goods from wooden boards laid over culverts filled with sewage and garbage.
The equivalent of the population of Boston lives in this three-mile area. People were stacked on each other like awkward Lincoln Logs. Each balcony bore clothes and rugs hanging over the rails. Clothes lines and structural imperfections adorned high-rise buildings. Entire floors had been blown out and left uninhabited. Curious faces watched from the balconies as we drove by, and laughing children smacked the balcony with both hands as they screamed out in a foreign language.
The Pharmacy in Mathare
After the first day, we got our bearings. An assortment of boxes of previously mixed drugs meant to help the needy had now been set in place to enhance efficiency. Our tent clinic was split into eight rooms. Each room was just large enough to be functional. Everything was tight and, like the slums, there were no luxuries. Three of us started our first medical rotations in the pharmacy. Our tent box was outlined with small, unmatched tables to give us quick access to the 100 or so drugs at our disposal—drugs for pain, malaria, diabetes, hypertension and other ailments.
Working in the pharmacy
After a few days in the camp, I started to feel a profound sense of accomplishment. Our team was humble and excited to learn with every patient. After setting up the tables with sectioned-out areas for medications, we stocked them back as far as we could and refilled as needed. We took the paper scribbled on by the doctors and did our best to decipher their scrawls. With the help of a local pharmacist, we packaged up the medication and carefully ensured the patients understood the directions. Most spoke Swahili, and while most anyone in Kenya with a basic education could understand some English, this was rare in Mathare. The pharmacist I worked closest with was originally from the Masai Mare area of Kenya. She was direct and demanding, but a great teacher.
Our patients were the faces of pain, cute babies strapped to their mothers with a cloth and laughing youngsters playing with stones on the dirt floor. They were old people who just wanted to talk, and shy young women, breast feeding mothers and scarred or disfigured characters. They were people with HIV, children with scabies and a man with metal instruments protruding from his calf from a surgery he couldn’t afford to finish. The vast majority said “asante,” which means “thank you” in Swahili.
Just days into our stay, the intelligence and sense of community surrounding us began to open my eyes. On the drive through to the campgrounds, I saw the resolve in the shop owners as they set up what little they had to feed themselves and their families. They swept and unpacked the day’s goods from a large potato sack. The goods were brought in on their backs and laid on a blanket or tarp for the busy street traffic. Motor bikes whooshed by with various cargo and passengers. Vans and cars of all different shapes and sizes hurried by each other in a carefully choreographed dance. At the camp, I noticed a man scrubbing about 30 unmatched shoes, readying them to sell later in the day.
Mothers came and sat all day in the equatorial sun to ensure their children would have this rare opportunity for medical attention. Children and infants clung tightly to their mothers. Their faces as they clutched the medicine and their smiles before they left warmed my heart and reminded me that family ties transcend economic status. Listening to the heavy accents of the doctors and pharmacists who devoted their time to help us learn was humbling. They knew every drug up and down and exactly what to look for. At the end of the day, a woman was flash frying some peanuts with salt and spices in a metal pot over a fire in the corner of the camp. She saw people who were hungry and tired, and she shared her meal with us.
At 0630 we packed ourselves into our 28-passenger limo van and headed out on our first excursion, our first weekend, and our first time venturing outside Nairobi. We drove for two hours on a scarcely regulated highway. Vehicles of various sizes wove in and out of lanes, and on several occasions, oncoming traffic screeched to a halt due to an overzealous driver. Speed bumps on the highway slowed us down. After we got out of the city, we drove past a clearing and saw Mother Africa with new eyes. It felt as if you could see for 1,000 miles. Mt. Longonot, a volcano that was last active in 1860, was the highest mountain range in that landscape. You could make out the greenery all the way to it with painter’s strokes of browns and reds and splashes of deep green.
The bus arrived around 0900. The day was gorgeous, with light cloud cover and a slight breeze. The temperature was around 65 degrees. Some of us rented walking sticks for about two dollars.
After a briefing on the route, we broke off into smaller groups of different effort levels. I was in the middle toward the back and figured I’d take it all in at an easy pace. I wore my military boots and boot socks to protect my ankles and get the best possible tread. At a clearing, I pulled out my binoculars to see zebra and impala grazing in a field below. We all caught up at the halfway point, and I was already visibly out of breath, but as we started for the top, my competitive spirit drove me toward the front. Yousef, the 12-year-old son of our guide and a guide in training, led the way up to the top. I was with a few athletes and Yousef at the front. The pace was steady, and we jogged down the valleys, using the momentum to propel us up the peaks. At the top third, there were no valleys, only peaks. The kind of peaks I had only seen before at various hills in Quantico during Officer Candidate School. The only difference was that we were about 2,000 meters above the highest point in Quantico. Several times I stopped when I didn’t want to stop and gasped for air, but my pride and knowledge that a 12-year-old was out there leading the way made me push harder. I made it up among the top three hikers. We saw the ringed summit surrounding the crater, now filled in with beautiful greenery from the nutrient-rich soil of a previous lava flow eruption.
At the top, we did what any American does at a moment like this—we reached for our phones to take pictures. The others flowed in not long after us, and we took group shots at the summit.
I was proud of us all.
The School in the Kibera Slum
A hand-painted sign above the door of the sheet metal building read “Silver Springs Secondary School.” Our bus was parked across the dirt road next to a large pile of trash where goats foraged for food. Inside, the students in traditional Kenyan fashion sang and danced for us in an open space in the compound. Some of us were pulled into the center and began to dance along with them. I overcame my reluctance and joined in. My partner led the moves, and I copied. My awkward foreign look and enthusiasm made everyone laugh. It warmed my heart to see these young people who have endured the unimaginable smile and dance and laugh.
After the jamboree, we passed out supplies and donations and learned about them as they learned about us. As I glanced through their notebooks, I was stunned to see chemistry notes and equations that I had scarcely just learned about in my college years. These children and young teens were applying high caliber, complex thought while juggling life in a slum. We talked about Drake, Lil Wayne, Tupac, 21 Savage and other artists. They were eager to know about life in the United States. Dr. Imam passed out colas in glass bottles, and we toasted one another. They were victims of hunger, burn, rape, abuse and other evils, enjoying a moment of excitement and laughter.
I was sad to leave that day. Their determination and endurance are seared in my memory. I wish we could have done more for them.
I wasn’t so sure about this. A walk through one of the biggest slums in Africa among what I imagined would be desperate and destitute people. There were six students in our group, males and females, led by a woman who lived in the slum.
We walked through a labyrinth of open street markets and over broken concrete sidewalks. We passed a stern-looking man in his 20s with dreadlocks and another man sprawled out on rocks, eyes closed and chickens pecking and clucking all around him. A one-eyed dog got up and started barking angrily at us. Stumbling down a ledge where stairs should be, we walked the final stretch. In a valley, a small river of trash and waste assaulted our noses. In Kibera, there are no taxes and no government assistance. Any water or use of a toilet comes at a cost. If you can’t pay, you just go, and it smelled like it.
The woman guiding us grabbed her baby from a nearby neighbor as we passed a row of 10 doorways with cloth doors before arriving at her home. She was one of the lucky ones. She had shelter. There were no windows. There was a small end table with two chairs and beyond that, a dresser. A sheet hanging from the ceiling concealed her bed. That was her home, with its cloth door and metal roof. There was no refrigerator, no electricity and no running water. We gave her maize, flour, sugar, soap and paper towels, and some of us gave her cash to help her pay rent. We wished we could do more.
Pharmacy at Kibera
Our bus driver turned right into a hidden lot, just inches from grazing the sides of the narrow passage. The camp was spread out in the heart of Kibera, the second largest slum in Africa. The registration was in one place, triage another and the consulting rooms in yet another area, so there was a lot of walking between the units. My place of duty was the pharmacy, and the storage was in a local mosque that allowed us to use the conference room, so medicine had to be transported from the storage to the pharmacy.
On the horizon as we made our way to the pharmacy, we could see the skyscrapers of downtown Nairobi. The day was overcast, cool with a slight breeze. A woman was hanging wet clothes out to dry on a clothesline with mismatched plastic clothes pins not more than four feet between the walls. A bra, a half dozen tiny shirts, tights and a small blanket were hanging on the line. Children reached out at me, saying “hiiiii” in their best English. One grabbed my hand and tried to lick it as I pulled away, awkwardly laughing.
I continued past the woman and children, past a white and brown kitten, past doors and people and a group of children all happy and laughing. One, a 5-year-old girl in tattered high heels, shuffled around. Past the little fashionista, a mob of people waiting for our medical camp greeted us.
This was our second camp, and we were feeling confident. We set up the drugs and turned on our walkie talkies. I walked back through the maze and encountered a little girl too cute to ignore. She had on a red jumper. On her feet were blue and white tie-dyed Crocs. We played kick the plastic bottle. She scuttled back and whacked the bottle good, stumbling forward from the force. I kicked it back to her, and we had a good, old-fashioned kicking match for five minutes before I headed back to the storage room.
The walkie chirped: “Ben, this is Camille.”
“We need a green box of Metronidazole and Diclofenac gel please.”
“Copy. On my way.”
The Orphaned Elephants
I put on my traditional African shirt. Red, black, yellow and blue interwoven in equal and intricate designs. Next, my bandanna—black base with white designs and red roses—wrapped around my head. I was dressed to meet the stars of Africa, the big babies, the ivory orphans of the Sheldrick Wildlife Trust.
We walked past the gates made of vertical bamboo shoots, down a well-hidden path of stairs to a large opening barricaded off with a yellow rope. Beyond the rope were fresh broken branches with green dewy leaves all about them, a fresh mud bath and a few trashcan-sized water buckets. The handlers had two wheelbarrows full of two-liter baby bottles filled with milk
Soon the orphans with their trotting trunks and giant ears made their way toward us. The elephants knew the routine and quickly headed for the bottle handlers. Some of them held the bottle with their trunks. They were brown and red, almost the exact same color as the dirt, which made sense with all the dirt-flinging they did with their trunks. They used the little articulation in the ends of their trunks to pinch a scoop of red dirt and sling it up behind and on their backs.
After the milk, they made their way to foliage. When they got close enough, we touched them and posed for pictures with our hands on their hides. Their backs were tough and felt almost like concrete, dusty and caked with dirt. Occasionally, they reached out with their trunks to investigate. The trunks were softer and fleshier, with a funny little sniffer at the end. Gosh, they were cute. The handler told their stories, how they were found. Each orphan had a unique story—starved parents, flash floods, violent demise, panicked abandonment.
Safari on the Masai Mara
Our Jurassic Park-style Land Cruiser kicked up dust as we peeled out in a convoy of five vehicles. The smell of dirt, grass and the occasional waft of wild manure filled the air. From our windows we saw a herd of impala in the tall grass of the sprawling planes. Next on the list was the gentle giant of the Masai, the elephant. Pictures don’t do justice to the sheer mass of these amazing animals. Standing in a Land Cruiser and only feet away, I could see the dirty tusks with white ivory dulled by the working dust of the giants’ work. The smallest baby elephant I could ever imagine was being naughty, flopping his baby trunk on a sibling and running between his mother’s front legs and trunk like a toddler trying to get her attention.
Less than a half mile away, we spied two sleeping lions, probably just after a meal judging by their sprawled-out catnap position. A cheetah looking for his next meal posed for us on a large rock next to a canopy tree. As our convoy rushed the scene, he fled across a ridge. We watched through the raised roofs of our vehicles with binoculars as the predator stalked a nearby gazelle. His crouched position in the tall grass signaled the gazelle to run for its life, and the chase ended before it began. As we cruised through the bush, we passed giraffes, hyenas, warthogs, ostriches, rhinos, buffaloes, condors and wild birds.
As I contemplated my last day and the time away from family, friends, Marines and most importantly, my wife, I kept thinking back to the people we helped—desperate people who needed medical care. We saved several lives on this trip. We assisted over 5,000 destitute souls. In the slums of Africa, where food is not guaranteed each day, medical help is unheard of. We worked as a team, triaging, treating, arranging for life-saving surgery at local hospitals and prescribing free medication onsite for weeks. In the end, if we saved one person’s life—which we did many times over—we accomplished our mission and made our sacrifice worthwhile. And to the Swain family for providing this unforgettable opportunity to save so many lives that changed our own lives along the way, I say asante sana. Thank you very much.
What I remember most
I remember the beauty of Kenya—the landscape, the animals, the smiles on the people’s faces, the gratitude in the eyes of our patients and our team members. I remember climbing Mt. Longonot and the pictures we took at the peak. I remember the grassy fields of Masai Mare elevated through rolling hills that looked like a painting, the elephants and the other National Geographic animals. I remember the baby elephants at the orphanage, the survivors of tragedy. I remember the hospitality of the workers at every stop we visited. I remember the people of Mathare and Kibera, dressed in their finest to receive free care. I remember the smiles on their faces and a certain look in the eye when a great burden had been lifted. I remember the words they used most often— “asante sana,” (“thank you very much”) and “jambo” (“hello”). I remember working with my team members and the good people of The Citadel. I remember our weekend excursions to blow off steam and take in the culture and way of life of a new and beautiful country. I remember a hot room in a Kenya winter’s day in the tiny home of a woman and her family of five whose home was smaller than the smallest room in most American houses. I remember the tears in Dr. Imam’s eyes when she couldn’t do enough for a person who was going to die and accepted the fact that we couldn’t save everyone. I remember Dr. Yee roaming the stations and making sure we had all we needed. And most of all, I remember that we did save lives and we worked hard to accomplish our goal of helping the people in the slums of Kenya.
Ben Knight is currently a staff sergeant in the Marine Corps and an exercise science major. Following graduation next May, he plans to commission as a second lieutenant and continue his training at the Basic School in Quantico, Virginia.