Auslandspraktikum in Accra, Ghana

09.11.2022

In July 2022, I had the amazing opportunity to do a four-week internship in Accra, Ghana. I lived in a student house with other Germans who were working in Ghana, as well as locals who were helping us with everything. My internship took place in Ridge Hospital.

Ridge Hospital, also called Greater Accra Regional Hospital, is a major hospital located in Osu Accra, Ghana. It has a capacity of 420 beds and a staff of 654. The hospital comprises eight departments: gynaecology, labour ward, emergency room, surgery, paediatrics, psychology, intensive care unit and neonatal intensive care unit.

The location is quite far from the student house I lived in. My colleagues and I either took a Trotro or a Bolt. The latter is a cheap taxi company which is unlikely to fleece you. Trotros, in comparison, are privately owned minibuses that travel fixed routes. They are the most popular means of public transportation in Ghana. While there are Trotro stations indicated by a group of people standing next to the road, these vehicles can be boarded anywhere along the route. My first time taking a Trotro was very confusing due to the fact that the conductor isn’t shouting out the destination clearly. Therefore, it took some time to get used to the system and know which one to take.

During my time at the hospital, I saw and learned a lot. I was assigned to different departments and spent one week each in paediatrics, gynaecology, emergency as well as the neonatal intensive care unit. This way I got an insight into in numerous different departments and gained a considerable amount of medical experience.

I began my internship in the paediatric ward where my trainee doctor took his time and explained every patiently to me. I was allowed to accompany the doctors from the respective ward on their daily medical round where they visit every patient and discuss their case. Here, I learned a lot about illnesses such as stroke and malaria and also learned how to identify trisomy 18 by the looks of a new-born child. In addition, I found out about malnutrition and the symptoms coming with it.

In my second week, I had the chance to visit the gynaecological ward. The first day started off great as I got the chance to witness two c-sections. It was my first time in the operating room. Therefore, seeing all the procedures was really interesting. However, the most special and at the same time scariest moment was the time between a child being born and their first cry. This is due to the fact that this first cry shows whether or not the child’s lungs are healthy.

On my second day I was allowed to be present at a natural childbirth. When we first started our shift in the morning, we were determined to watch a natural childbirth. Unfortunately, we had to wait for several hours, which was worth while. The experience was so emotional for me that I had tears in my eyes by the time the child was born.

I spent my third week in the emergency room. The first half of the week, I was at the ward where patients stay for up to 72 hours. I was able accompany the nurse handing out the medication. She showed me how to change infusions, calculate the number of pills to give and measure blood sugar levels. Another task of mine was checking vital signs like blood pressure, temperature, oxygen saturation and pulse. For the other half of the week, I was at the triage where patients are only staying for up to 24 hours. Here, I wasn’t allowed to do as much as in the ward, but I got to see some highly interesting cases. I learned a lot about illnesses such as diabetes and withdrawal syndrome.

In my final week, I visited the neonatal intensive care unit. This unit provides extra care for premature babies or sick new-borns. The illness the majority of the children suffered from was new-born jaundice. This illness can be identified by a yellow discoloration of their skin or eyes. It can be left untreated in most cases, however if the discoloration isn’t disappearing, the child should be treated with phototherapy. This therapy took place in the neonatal intensive care unit where I had the chance to observe it. Additionally, I followed the doctors for their rounds and saw nurses feed the children or lay a feeding tube.

During my internship, I came in contact with the many problems the Ghanaian health system still has to cope with, one being that there is no general health insurance. Therefore, patients need to pay for almost everything themselves, for example drugs, food, water and surgery. This results in doctors paying more attention to the costs of the treatment. For instance, doctors are sending patients home when there is a sign of improvement in their health. They are paying particular notice to their diet and try to avoid unnecessary testing. Another problem I perceived was the lag of sterility. Even though the Ghanaian doctors and nurses did as much as they can, I still had the feeling that generally, awareness for sterility was missing. Therefore, the Ghanaian standards in that regard were not the same as German standards.

This is just one difference of many between Germany and Ghana. Another one that really stood out to me was that people in Ghana in most cases were very welcoming, friendly and always willing to help.  One time I was lost at a bus station and didn’t know which bus was the right one to take. Immediately people came up to me and helped me to find the right bus. I also felt very save in Ghana and never found myself in a situation where I was concerned about my safety. To be fair, I didn’t risk anything and was never out alone at night. For me, this proved the people wrong who told me that Africa was scary and dangerous.

In contrast to these warnings, my internship showed me the beauty of Ghana. After work we were able to explore the city Accra. We visited markets or the beach. At the weekends we went on trips to see more of the country. I visited the Wli waterfalls and did a hike with a local guide who explained everything about the jungle, the animals and the nature there. During this hike I ate the best pineapple of my life, straight from the bush and even walked on the ground of the neighbouring country Togo. I spent my last weekend in Ada Foah, a small village located at the beach. We did boat tours, went swimming in the sea and slept with the sound of the waves. Ada truly felt like paradise. Overall, I had a wonderful time in Ghana. I am unbelievable grateful for the time I was able to spend there and the things I learned, not only about medicine but also about the Ghanaian culture. This internship definitely changed me and put my views and values into perspective.

Eva Gundlach

Praktikumsbericht Medical College of Wisconsin

21.10.2022

I arrived in Chicago on 3rd July and was picked up by my aunt for a two-hour drive to Milwaukee. The Medical College of Wisconsin is located in Milwaukee and this was the location where I would be doing my international internship as a part of the TUMKolleg. My aunt has been working in the Bioengineering Department of the college for several years and gave me the great opportunity to work with this Department for three weeks. I got the chance to be part of the Team in the NRF (Neurosciences Research Facilities) that is responsible for conducting crash tests with dummies and PMHS (short for postmortem human specimens, essentially bodies that have been donated to science for experiments like crash tests). During my three weeks, I was part of three different research projects.

The first project I was involved in used a sled that could be accelerated to 50 km/h within 0.2 seconds to simulate a car crash into a wall with up to 30G. This project has been issued with the background of autonomous driving, where passengers are believed to be positioned more horizontally for added comfort. That position raised the question if current seat belt standards could still meet the required safety level, or if an effect called “submarining” would occur. Submarining essentially means the passenger sliding under the seat belt during the event of a frontal crash, thus resulting in a more dangerous position. For this test, a PMHS had to be fitted with tilt sensors which were directly mounted onto the spine and other bones of the body. I had the chance to watch the body being prepared with the sensors and to assist the team with setting up the sled. After learning about the functionalities of the motion-capturing system they were using, I got the chance to apply this knowledge while preparing the system together with the team. The acquired data, together with the tilt sensors, could be used to calculate the movement and rotation of the spine and other body parts during the crash. High-speed cameras also allowed a slow-motion replay. Additionally, a CMM (coordinates-measurement machine) was used to perform a 3D scan of the body before the test.

The second and longest project of my stay at the Medical College also involved the crash sled, but this time a dummy was used instead of a PMHS. Since we performed multiple test runs in this project, it was easier to use a dummy throughout all the tests than to set up a new body all over again. This meant that we had to dismount the previous test setup and put the dummy set up together. This took a few days of dismantling, cleaning and assembling until we could start with setting up and calibrating everything for a series of tests. This project was issued by a company producing test dummies. Last year, they handed our team their THOR dummy to test how changing the setup of a dummy with different sensors or body parts would alter the response of the dummy during crash tests. This year, a modification of the previously used dummy was given to the Bioengineering Department, which had all cables from the acceleration sensors routed internally. This led to the question of whether the internal routing would affect the response of the dummy compared to the old one. During this project, I got to realize how much effort it takes to run these bigger research projects. Calibrating, documenting and making sure that everything is working correctly and safely, while also meeting required scientific standards took a lot of time and effort. A case in point was the positioning of the body on the test sled. The dummy had built-in tilt sensors, which could tell us at what angle different body parts like the pelvis are positioned. Since the results had to be comparable with other similarly performed tests, we could not just put the dummy on the sled but had to meet the exact required angles. This part alone took us a long time. Apart from setting up slow motion cameras, pressure sensors for the seatbelts and the VICON motion capturing system my part was also to document the test with pre- and post-pictures and create a 3D scan of the dummy.

But I didn’t spend all my time helping the team of the Medical College, and since I had already arrived on 3^rd July, I got the chance to celebrate the American Independence Day on the 4^th July. After a nice afternoon at a nearby lake, my relatives and I celebrated this day together with some friends, while having a great dinner and watching the fireworks.

Another highlight was the kayak tour through the canals in downtown Milwaukee followed by a boat ride on Lake Michigan, which is the fifth-biggest lake in the world and roughly a thousand times larger than Lake Starnberg. There we also witnessed preparations for an air show performed by the US Air Force. Sadly, we were not able to watch the complete Air Show that was set to take place a few days after my flight back to Munich. It was still interesting to see the difference between the US and Germany, since in Germany you rarely see any military planes or air shows, while in the United States they are pretty common. The close distance to Chicago also allowed us to do some sightseeing there. We visited the popular landmark “The Bean” and Navy Pier while also walking along the beautiful Lakefront with the Skyline of Chicago behind us. I also experienced my first ever Korean Barbecue, where we grilled Korean-style meat on a barbecue built into the table.

The popular motorcycle brand Harley-Davidson was founded in Milwaukee and created a Museum displaying the history of the company. We had a great time visiting this museum and walking through all the different generations of Harley-Davidson motorcycles, as well as learning a lot about their racing history.

On the last Friday before my flight back to Munich, the whole Bioengineering Department went to the Milwaukee baseball stadium for a barbecue in the parking lot. Afterwards, we had a fantastic time watching the Milwaukee Brewers team play against the Colorado Rockies.

Thanks to the Medical College of Wisconsin, the great team I worked with as well as my relatives for these interesting and amazing three weeks!

Appendix: Plan your trip early enough so if you encounter any inconveniences or problems you have time to solve them without any pressure. When staying in Milwaukee a boat tour on Lake Michigan and a visit to Chicago are worth it. Watching a game of the popular Milwaukee Baseball and Basketball teams (Brewers and Bucks) is also pretty exciting.

Auslandspraktikum in Utah an der BYU

15.10.2022

Internship at BYU

Just like many former students of the “TUMKolleg”, I took the opportunity to visit an American university with other fellow students for my summer internship.

Brigham Young University (BYU), located in Provo, Utah, is a religious university from the “Church of Jesus Christ of Latter-day Saints” (a.k.a. Mormons). It is named after the influential church leader and first governor of Utah Brigham Young. BYU is just like any secular American university where students commence their undergraduate studies, though with a few exceptions since it requires very modest behavior, and students must follow a rather conservative dress code.

The university has proven its academic success multiple times by several other nominations and was even ranked  the “number one university in the West for student engagement“ by the Wall Street Journal[1]. , BYU offers a broad range of courses to their students, but we only got to see the physics department because Justin Peatross, who organized the whole trip for us, is a physics professor. He is engaged in optics and his specialty lies in high-intensity laser physics.

On our first day at BYU, Professor Peatross had courses to teach that were too advanced for us, so we joined a class for first year college students taught by a senior student. We were doing experiments with magnets and coils, but we had already seen most of the experiments in school before.it was interesting to try everything out by myself nevertheless. After that college class we went to lunch where I was impressed by the number of restaurants in just one cafeteria.  Then Professor Peatross took us to a different lab where he gave us two assignments. The first one was to measure the speed of light mechanically without using electronic devices for our measurements. After running some calculations, we were happy to get to the correct speed. In the second experiment we measured the intensity of polarized light that is reflected by glass. The goal was to findBrewster’s angle and make our data match the corresponding Fresnel coefficients. After some time and plotting the data, we saw how our data matched the values predicted by the theory, which was quite satisfying.

Over the next few days at BYU we worked on electronics with Arya, a teaching senior student. She showed us breadboards and an Arduino chip that was programmable which was not new to everybody in our group, but it was for me. After running through some basic tutorials to get to know the board, we started a bigger project. With the breadboard, several capacitors and a car body, we tried to build a car. The challenge, though, was to optimize for energy efficiency and speed at the same time. We built on the car for several hours and in the end, it could drive the test track with a decent evaluation score. I personally learnt the most while working on the car because I had never dealt with electronics before and I found out how difficult but at the same time satisfying it can be.

American people & culture

As much as I enjoyed the educational part of our stay, the best part of our internship was getting to know Utah and its people. Thanks to our awesome host families we got to see many parts of Utah. I was astonished to see a very rich and diverse nature. The nature we explored was just incredible. It was fascinating to see the Arches National Park, the long canyons in Zion National Park, the bizarre-looking Goblin Valley and so many other fabulous things that would just take too long to list. All our adventurous hiking tours were filled with fun and joyful moments. Sometimes we found ourselves in remote regions with no soul around apart from us. I enjoyed that experience since it is not easy to find such remote spots with only nature around in Europe.

Aside from nature, we also got to in touch with American culture in all its greatness. Generally, European or German culture is quite similar to the American one, but differences are still visible. When we arrived in Utah, the first thing I noticed was the big size of everything: The size of the roads, cars, buildings and even portion sizes of meals were much bigger than I was used to. I did enjoy the food there, but preferred eating at home with my host family. They were growing their own vegetables in their backyard and even had chickens for eggs. Restaurant meals, in comparison, were often too fat- and sugar-rich for my taste.

I was glad to meet incredibly nice and very open-minded people in Utah. It was good to be surrounded by all these kind people on our activities together. I noticed how open everybody was to strangers. People would just have a little chat with strangers they met on a hike. This would be a rather rare occurence in Germany where people are often more reserved. The best talks, though, were with my host family; we could truly get to know each other and talk about all sorts of topics ranging from the Marvel universe to politics. We talked about our cultural differences a few times and found that the most fundamental parts of our cultures were pretty much the same.

I believe this general openness mentioned earlier is deeply integrated in American culture, but in Utah it also stems from their religion. Most people in Utah are members of the „Church of Jesus Christ of latter-day Saints“ (a.k.a. Mormons). They are Christians and mostly differ from other Christian religions through the “Book of Mormon” which could be considered a “third testament”. We went to church with our host families on every Sunday and I saw that the service was not much different from a Protestant one. However, after church service we had Sunday school where we learnt about the Bible, the Book of Mormon or other elements of their belief. I enjoyed being there because everybody was really welcoming and we could have a good time.

Still, Mormonism is not a faith that is very easy to practice: According to their rules members should pray before eating, have daily scripture time and not consume alcohol or high-caffeine drinks like coffee. It might sound very strict, however, I felt that all their good traits such as openness were affirmed by their belief, and it may even be the reason for their kindness. I will always remember our hosts and everybody there I got to meet as very warm, humble and welcoming people, and I am very thankful that they took us into their houses and made our time in Utah incredibly fulfilling.

Advice for future interns

1. You will be traveling with a tourist Visa (ESTA), so don’t mention your internship in the Visa application or when questioned
2. Bring a traditional gift from Germany for your host family
3. Be prepared that you must stay abstinent from alcohol and should not drink coffee or black tea (Coke is okay, though)
4. You will probably go hiking and camping, so bring proper clothes and shoes with a good profile
5. Bring modest clothes in accordance with the university’s dress code
6. In church, boys should wear a tie and girls may wear a dress
7. If you want to use your phone there a lot, you should consider buying a prepaid SIM card in the U.S which is very easy to do.

[1] https://www.byu.edu/academics

[2] https://en.wikipedia.org/wiki/Brewster%27s_angle (in case you are interested)

[3] https://en.wikipedia.org/wiki/Fresnel_equations

[4] https://www.arduino.cc/en/Guide/Introduction

[i] All pictures taken by my travel group or myself