Away Rotation

[Thirteen]

Last night, DH asked if I wanted to do an international away rotation (1 month) with him, sometime after this Oct. and before he graduates from the program, next June. His place of choice is Kenya, Africa -- he went in undergrad, and would be returning. He says it's a medical mission site ("very safe"), but to be honest, I have a few reservations.

1. I haven't been keeping up with political status in Kenya, but wasn't it just 1-2 years ago that there were some serious riots?

2. I would be (fingers crossed) somewhere in my 2nd trimester at the time of the trip.


Am I paranoid? Does anyone have any insights?
TIA!

**I suggested possibly some place in Latin America (Nicaragua, Belize, Panama) instead.

[moonlight]

What does your gut say? My gut would say "have fun hon, see when your back" but your gut might say something different!

[NYCHoosier]

Hmm... I know there has been a lot of serious violence and political unrest in Zimbabwe in the past couple years, but I'm not sure about Kenya.

Is this what you're thinking of? http://www.google.com/hostednews/ap/...oaO3AD9EMEC8G0

I wish we got better world news coverage here.

[Deebs]

Personally, I wouldn't go. If you do go, do your research ahead of time. Do you have medical evac covered by your insurance? I'm assuming if he's going to do a medical mission, there's not going to be a ton of OB coverage where you're going. Some of my attitude just comes from being married to an EP, where the approach is very different from the rest of medicine. Think of planning for the very worst case scenario and then see if you're comfortable with going.

[DCJenn]

I'd go in a heartbeat. Contact the American Embassy and see what they say.

Jenn

[scrub-jay]

I don't know much about the political unrest, but concerning the pregnancy - My only thought is regarding the pregnancy - I felt awful through my first trimester AND most of my second trimester. Every woman is different (seems like most of my friends had no M/S and had all of their energy throughout their entire pregnancies). During my second trimester we travelled from CO to CA and that in itself was pretty challenging - I couldn't imagine international travel when my body was demanding so much from me.

But again - everyone is different, but it is worth considering. Also, the access to medical care would have me nervous...I definitely had a few scary calls into my provider during that time period and was very glad to have them so close.

Good luck with what you decide! Sounds like it would be an amazing experience and adventure!

[Auspicious]

My husband did a six-week away rotation at Kikuyu Hospital in Kenya four years ago during MS-4.

Is this arranged through his residency? Do they send people every year? Did they have people there during that massacre two years ago? Were they safe?

Is he sure that spouses can go? What would you be doing all day? Would there be other spouses there?

There were protests over some hospital employment policies going on outside the hospital while he was there, but nothing violent. They went on a side trip to Mombasa without too much worry, even though it had been bombed by terrorists four years earlier. Kenya is more stable than a lot of places in Africa and more friendly to Americans (and that was before we elected one of their own as our president!), but it's definitely not stable like here. Their beef is not with us, though. My husband had an amazing experience* and I would have loved to have gone with him.

BUT, with our combined knowledge of the Kenyan medical system and pregnancy, we would both consider traveling there while pregnant to be absolutely out of the question. Not even maybe, just a big fat NO. Part of what makes it an interesting away rotation is that it's still a developing medical system--I wouldn't want to have to receive any care there. Plus they had different ideas of food safety, etc. . . . just no.

IMHO if you can get satisfactory answers to the questions above, I would go with him and start TTC after you get back.

*This is an oversimplification, as it wasn't all positive and came up at a particularly tumultuous time for him (he had signed up for it nineteen months earlier). I think it's fair to say it was a valuable experience, though.

[Thirteen]

NYCH - it was the 2007 post-election unrest and demonstrations that I was thinking of. Also, as a former NGO employee whose emphasis was in Sub-Saharan/Horn countries, I'm thinking of the existence of extremist-types additionally in places like Somalia and Ethiopia (bordering Kenya). I just looked at the U.S Embassy website to double-check it. (Couldn't really remember...)

Julie, it is arranged through residency and would be on-site at a medical mission, to my knowledge. He's checking to see if I can go. I'm going to find out if I could tutor/teach while there - not sure, really. Although I am EPT certified, so I could do that as well.
I'm so with you though - my top concern was regarding needing medical care, and/or being pregnant at the time.
He actually told me that 80% of blood transfusions have HIV in them, while we were having this conversation. (What was he thinking?!)
It's possible we could go this summer, before we TTC, so that might be more ideal for us.
Or, given what you've suggested (and these are thoughts I had initially as well), try for somewhere "closer to home."

I do really want to go, though. Ack, choices...

[TulipsAndSunscreen]

Let's just say I've done a lot of research. Both on the away rotation thing (we're doing a year in Africa) and the pregnancy while there thing. One word: anti-malarials. You want to think long and hard about taking those in pregnancy. They're not "a reason for termination" but almost all are pregnancy category C which means unstudied in pregnancy and therefore not recommended and certain ones (doxy for sure) are actually teratogenic (i.e. known causes of birth defects).

PM me if you want more info. Sorry to be so definitive, obviously this is an individual decision but it's pretty close to home...

[Tenacious_D]

Malaria is my biggest concern. We have a friend going to Liberia for medical work for a month and they had to hold off TTC because of the medication. I am not sure about the safety of Kenyan but like Jenn said, contact the state department to find out and also contact your doc to see if they can look into what medications you would have to take before the trip and whether you can as a pregnant mom to be.

[Thirteen]

After showing him the Embassy's travel advisory, talking about our plans for TTC, etc., it would seem that he's had a change of heart and would instead like to do an away rotation (stateside) for Wilderness Medicine. I am now looking into National Parks/HPSA sites close to the parks, and getting info on what that would be like for us.
The upside is it's cheaper, no malaria meds needed, and we'd get up close and personal with a park.

Thank you for all your insights and comments ladies - the boards are very helpful in this area, especially

[oceanchild]

I know you've already made up your mind, but in case anybody does a search for this some other time, always check the State Dept before visiting a country:
http://travel.state.gov/travel/cis_p.../cis_1151.html

And then check Foreign Affairs and International Trade Canada: http://www.voyage.gc.ca/countries_pa....asp?id=149000

(I would really want to go, but probably would not want to be pregnant and go... for me that would mean postponing the baby-having.)

(DH is talking about going overseas, but I have no idea how I'd get a month off work.)

[Cumberland]

I was in Kenya recently. There is an enormous Western population there and excellent medical facilities for those that can afford them. You do not need antimalarials in the Nairobi area. I would go while pregnant and I would have a baby there, but it is a personal decision and one I can speak for having already been there.

There are often opportunities in places like Alaska or on a reservation. Alaska in the summer would be amazing.