One moment, I’m staring groggily out the window of our Toyota RAV4 as my husband and I travel cross-country from Arizona to his new home in Ohio. I’ve just finished my fourth year of neurology residency and I have conflicting emotions about leaving the place I’ve called home for the last four years. The next moment, I’m staring out of an airplane window, peering into thick clouds as I head toward Lusaka, the capital of Zambia. I’m in disbelief. Did I really just set out on a solo journey around the world?

First of Its Kind

For years, I’ve wanted to pursue my passion for global health, but I was unsure how to make this dream become a reality. My prayers were answered in November of 2019, as I read a headline on the American Academy of Neurology (AAN) website announcing that Johns Hopkins was establishing a global health neurology fellowship — the first of its kind.

As I look out the airplane window, I recollect the utter joy I experienced the day I received the email from Dr. Saylor offering me the position. Has it really been over a year? In true Dominique fashion, I let a flurry of thoughts race through my mind as I try to get comfortable in my seat. My thoughts are my only company during this day’s worth of travel. “Am I ready for this?” “Dominique, please don’t disappoint anyone.” “Will I be able to recognize the disease processes in Lusaka? It’s a totally different climate and demographic than Tucson.” My emotions fluctuate as quickly as my thoughts race — I transition from fear to excitement to anxiety to gratitude. “This is normal,” I tell myself. “How else should I behave? I’m moving to a foreign country with limited resources. This is not going to be a piece of cake. But let’s try to appreciate and embrace each emotion for what it is. When will I ever get to do this again? This is going to be such a life-changing adventure!”

Indeed, it sure has been. The past three weeks spent in Zambia have been a whirlwind. Each moment shifts promptly into the next as I try to adjust to the culture, the environment and the hospital. The Zambian people make this an easy task, as they’ve all been so warm and welcoming.

Unique Experiences

The hospital setting is unlike anything I’ve ever been exposed to. I marvel at the care the patients’ families provide at the bedside. They act as couriers when patients’ labs need to be transported. They provide the detailed histories. They help feed the patients, frequently using a nasogastric (NG) tube because many of the patients are too altered to safely swallow on their own. The family members are the patients’ best advocates.

Each day, I try to soak in my surroundings. I feel a sense of despair around the hospital. Lusaka has been ravaged by COVID-19 and the hospital has felt the impact. I have become familiar with each of our patients’ stories, and I am overcome by sadness. I see just how influential of a factor poverty plays in their overall outcome. I leave the hospital each day with the same unanswered question: How can I make a difference?


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