Fox sisters volunteer medical skills in Kenya

By Todd Adams Challis

The family that practices medicine together stays together. At least, that’s the story for the Fox family of Challis.

Kate and Ciciley Fox’s father, Pat Fox, retired five years ago after 31 years as pharmacist in Challis, the same year their mother, Carrie Boucher Fox, retired from her teaching job of 32 years at Challis Elementary School. The parents keep the family home ready for their daughters’ visits, which are fewer and farther between these days.

Ciciley graduated in May from medical school in the Washington, Wyoming, Alaska, Montana, Idaho program. Earning her M.D. included untold hours of internships, study and classes at the University of Idaho and University of Washington’s School of Medicine.

Ciciley is now doing a yearlong internal medicine residency in Boise that includes stints at the Boise Veterans Administration Hospital and St. Alphonsus and St. Luke’s Boise medical centers. Next comes a residency of several years in anesthesiology in Salt Lake City.

Kate is in the middle of her Pharm.D program at Idaho State University’s Meridian campus. She plans to graduate in May 2021. She’s currently working as a pharmacy intern at St. Al’s.

“I actually told myself I wouldn’t be a pharmacist,” Kate said. “I told myself, ‘I will never do what my parents do.’ I was on the road to medical school and at the time decided I didn’t want it. Ten years ago it (pharmacy) wasn’t right. It took me a while, but I now know why I’m here.”

Kate has experience that puts her a little ahead of her pharmacy classmates. She spent six years as a medical assistant and clinical supervisor in Sandpoint and worked as an electronic medical records technician in Montana.

She enjoys talking medicine with her father and sister. All three Foxes keep up on the medical and pharmaceutical literature and are excited to discuss new techniques and breakthroughs.

Kate hasn’t seen much of Ciciley since they got back from a trip to Kenya that included both women volunteering in a Kenyan HIV clinic, Ciciley observing in a hospital operating room, a stay with Kate’s pharmacy school classmate Davis Nyariki and his parents and a photo safari to see African animals in the wild.

“It’s like Yellowstone on steroids,” said Kate. She and Ciciley toured a national park in an open-topped all-wheel drive van and got very close to big cats. Kate was struck by how one lioness ignored the human visitors and sauntered past their van without even looking at them.

“She kept on her mission to get to the hills. She was the boss and she knew it.”

Their guide said once a cheetah jumped into his van. There wasn’t much protection in the open vans, but the animals are used to humans on photo safaris.

International medicine and volunteerism is a passion for both sisters. Because of Kate’s pharmacy school classmate, the Fox sisters were able to bypass traditional volunteer programs.

“It was just an amazing trip,” said Kate. She’s looking forward to going back after she earns her degree for another volunteer stint in a Kenyan clinic or hospital.

Some things are very different in Kenya and resources are more limited, but the bottom line remains the same: helping patients heal with whatever tools there are in the kit. Kate and Ciciley have both thought about volunteering in underserved areas of the United States, but in Kenya, there’s a greater need. Plus, the Fox sisters get to scratch their itch to travel.

A childhood trip to New Zealand courtesy of the Make-A-Wish Foundation sparked both girls’ interest in international travel and planted the seeds of their passion for medicine. Katie had childhood cancer and her parents were unsure she’d survive chemotherapy and surgeries. She survived and thrived.

“Katie getting sick was probably one of the biggest factors” that motivated Ciciley to become a medical doctor she said. “Being exposed to medicine at that age and not knowing what I could do to help …”

Her father’s career as a pharmacist and her paternal grandfather’s career as a surgeon inspired her. Dr. Robert Fox practiced in Long Beach, California. “I always remember him talking,” Ciciley said. “He has such passion and so much gratitude toward his patients. It didn’t seem to be a job to him. He loved to go to work and taken care of his patients.”

Ciciley has always liked math and science and knew early on that she wanted a medical career. After Ciciley spent several months volunteering at a medical clinic in Haiti, “I decided I wanted to be a care provider. I wanted to make global health care part of my practice.”

At the HIV clinic in Kenya, many of the poorest patients who needed the most help didn’t speak much English, but the sisters’ fellow medical providers spoke Swahili and English fluently and translated for them.

Kenyan patients were different from the average American patient but had similarities to some Challis patients, Kate said. While conditions such as diabetes and kidney disease are common to citizens of both nations, Kenyans tend to wait much longer to see a doctor.

“In Kenya, some people don’t go into the doctor’s office until they’re almost dying,” Kate said. “It kind of reminded me of Challis,” she said. Medical providers like Dr. Richard Paris have often remarked on the high pain threshold the average Round Valley rancher has compared with the patients he sees in Wood River Valley.

“The same thing happens there,” Kate said. “A Kenyan person may present not just with diabetes, but a foot ulceration that might lead to an amputation. Kenyans are more like rural Americans.”

Kenyan doctors see many more patients with infectious diseases such as tuberculosis, the sisters said. Kenyans may have fewer resources but their medical training is rigorous, students are well trained and doctors are competent, Kate said.

The Kenyan trip happened because Davis Nyariki, Kate’s first friend among her pharmacy classmates, invited her to visit and see what the practice of medicine in Kenya is like. His father is a surgeon and his mother was head nurse at a hospital. One of Davis’ sisters is a lawyer and the other is a nutritionist getting her master’s degree. His younger brother is a surgeon.

The sisters’ stay at the Nyariki family home in Eldoret was “probably the best part of the experience,” Kate said. “We were really welcomed into their home. ‘Karibu’ means welcome in Swahili and that’s the one word they made sure we knew and felt.” The sisters taught Davis’ mother how to cook American dishes such as apple pie and macaroni and cheese, and she in turn taught them how to cook Kenyan meals.

The Kenyan welcoming attitude is “an amazing thing,” said Kate. “In America, you have to prove yourself before you’re welcomed. There it’s an unconditional welcome.”

There are about 50 different ways to say, “Hi, how are you?” in Swahili, said Kate, but only one word for welcome.

Kate said yes to Davis’ invitation without looking at her calendar. “I told Ciciley about it,” Kate said, “and she invited herself along.”

“I absolutely invited myself along,” Ciciley said. Ciciley had three weeks between graduation and starting her residency and had another travel itch to scratch.

“It was really an incredible opportunity to stay with a Kenyan family, get a taste of their hospitality and immerse ourselves in their culture,” Ciciley said. “They were so nice and gracious and welcoming.”

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