Experts: Pharmacists Can "Travel With a Purpose"

In an interview with Pharmacy Times, Amina Abubakar, PharmD, AAHIVP, CEO and owner of both Avant Pharmacy and Wellness Center as well as Roho Voyage, discussed her work throughout Africa and particularly in Kenya. Christina Madison, PharmD, FCCP, AAHIVP, founder and CEO of The Public Health Pharmacist, PLLC, discussed her recent trip with Abubakar and how she believes pharmacists can travel with purpose.

Aislinn Antrim, Assistant Managing Editor: Wonderful. Well, hello, I'm Aislinn Antrim. I'm assistant managing editor on Pharmacy Times and I'm here with the wonderful Christina Madison, founder of The Public Health Pharmacist, and Amina Abubakar, CEO of Avant Pharmacy and Wellness Center and CEO of Roho Voyage, both of which we'll get to discuss today a little bit, especially Roho Voyage I'm excited to hear about. So, you both just went on a really exciting trip, you both just got back from Kenya—or, I know, Christina, you just got back. I mean, you might still be there, I don't even know.

Christina Madison, PharmD, FCCP, AAHIVP: I'm back. We came home at the same time.

Aislinn Antrim, Assistant Managing Editor: Wonderful. The magic of technology, you never know where someone is when you're talking to them. So, can you both give some background on how you became interested in international health care and aid work and kind of what you've both been doing?

Amina Abubakar, PharmD, AAHIVP: Sure. So, I have always been interested in global health before I knew it was global health. So, I was born and raised in Kenya, and I've had the privilege of just firsthand experiencing the diversity of health care needs in our communities, and always had people coming from overseas to help us to give us knowledge. So, I kind of knew that existed. When you learn, you travel, and you disseminate your information, you bring resources where they're less available, so that has always just been a conscious effort for me. Knowing that that existed, I always wanted to also give back. My father is from a very, very rural community, and we call them marginalized communities where they do not have health care at all. One of my cousins called me one day, she wanted to leave her corporate job in New York, she said she didn't have fulfillment, and she wanted to go back home. And she's not a health care provider, but she knew health care was so important. And so, she founded what we call Safari Doctors because I told her, “Yes, go ahead and do it. You'll be on the ground, and I'll be on this side, and we can put our heads together.” So, she founded Safari Doctors and since then I have used that as a platform for my outreach in global health.

Christina Madison, PharmD, FCCP, AAHIVP: And as for me, I think public health and global health are really intertwined, and so when I had my role as a faculty member, one of the things that we offered to our students was going on a medical mission, so they could go to on a medical mission to Guatemala as well as to Ghana. And so that's kind of where my love of global health came from, was really the public health aspect of it and helping get my students ready to travel. Helping them with, you know, vaccinations not just for themselves, but being able to get vaccinated and provide vaccine services when they got to their final destination. And then also HIV and sexual health, because a lot of the places that they were visiting lacked a lot of just general sex education—talking about how to use condoms properly, talking about what their risk for things like HIV and STIs is. And then really just that gender-based health and maternal child health, and how that really is something that, as pharmacists, we can make a big impact on. So that's where my love of it came from. And then always love to travel, so one of my colleagues that I worked with very closely at the university, she was my faculty when I was in pharmacy school, then she became a colleague when I started working for the pharmacy school that I graduated from, and then we became very close friends. And so, she was my travel buddy and we went all over the world together.

Aislinn Antrim, Assistant Managing Editor: Yeah, that's incredible. I had the chance to go to Kenya, oh, probably like, 8, 9 years ago now. My fiancé is from there as well, so I hopefully get back soon.

Amina Abubakar, PharmD, AAHIVP: You know, we can help with that, right?

Aislinn Antrim, Assistant Managing Editor: I'm going to call you about that and be like, “What can I do?” And my fiancé is a nurse, so we'll do all that health care while we're there. When we were planning this episode, both of you have used the phrase “travel with a purpose,” and that's such a great phrase. So, what does that really mean to each of you?

Amina Abubakar, PharmD, AAHIVP: So, I love to travel and as I was traveling, I always had questions around where I was staying, how the workers are treated. How are they paid? Because I would go to a resort and then I would pay attention to what's around it, and I always wondered, you know, will this community ever evolve? Would they ever change, will the people ever come out of poverty? So, I just had all these questions, and I would ask some of those workers, and they barely had money to get their kids to go to school. They are working at these remote lodges that are beautiful, and they barely can survive. And so, I thought to myself, what if this lodge could be a change agent for this community? This would be incredible, because they're having tourists come in, they're having visitors; surely they have income, but why aren't they reaching out to the community? So, with that question, I found that people already existed who were doing that. I just didn't know. My journey led me to find companies that have a social responsibility and so now I find myself just aligning myself with those places that are like, hey, it's not just about us, it's about transforming this community. And so, my job now is to link travelers like me, who are like, yes, I want to have a good time, but it will be great if my travel actually made a difference. So that's how I look at the travel with purpose.

Christina Madison, PharmD, FCCP, AAHIVP: And from my perspective, I think, you know, it really is like a tale of 2 cities, right? You go to these places and there's these people that are, you know, really at the edge of the poverty line and maybe don't have access to health care, don't have access to education. And then in contrast, you have these giant resorts that are offering all of these, like, luxury services—butlers, all these things. So, to me, I was like, okay, there's a disconnect here. There's got to be a way that we can impact the community as well as provide that that fun aspect. And so, I have a lot of colleagues that do backpacking trips and go to remote villages and countries and things like that. But when they do go with those places, they make sure that, like Amina said, there's that social consciousness and social responsibility, where the organization or the place that they go to gives a portion of the proceeds back to the community or directly employs people from the community.

I think that was one of the things that I really saw as eye opening. When we went to this resort in Amboseli and that particular resort is owned by another company, and they have another, you know, lodge in another area of the country. But the difference is that they hired from the people that own the land. And so, their children are now being employed, which is a huge gamble on their part, because hospitality is a skill set. It's something that you learn, it's something that you have to hone. And they really took a chance on these people who had zero experience in hospitality, but because of their commitment to giving back to those families, because they allowed them to build on their land, I think it was just extraordinary.

Amina Abubakar, PharmD, AAHIVP: Yes, and I love the phrase they used: “We have an exciting challenge,” meaning they are a very high-end property and people are expecting a high level of hospitality. But they made a promise to over 800 families, that if we come to this community and we lease this land from you to build our lodge, that we will employ your children. So, from the guards to the servers to the butlers to the cooks, people who have never cooked, people who've never served. And it was really amazing. I was so amazed that their leadership took on a huge challenge where 70% of the employees had zero experience in hospitality.

Christina Madison, PharmD, FCCP, AAHIVP: Yeah, and I was just so shocked. Like, one of the people they said, before they started working there, was selling cell phones, like right before they got there.

Amina Abubakar, PharmD, AAHIVP: [He was] just peddling them on the streets and, you know, just trying to make a living, and now he is like part of this hospitality group. So that's kind of why I feel like when travelers demand this, then we are forcing these hotels or where travelers would stay to raise their consciousness and having them transform that community. So, I think travelers have power.

Christina Madison, PharmD, FCCP, AAHIVP: We absolutely do. I mean, I think about when we visited the giraffe center, and even just the fact that Roho purchases and plants trees to offset the carbon footprint from the travel that it took to get people from the US to the continent. I mean, even just that alone, I was like, “Oh, my gosh, that's amazing.” Because, again, we have a huge carbon footprint and a huge environmental impact. And obviously, we are all subject to the challenges around human-driven climate change. And I just think it's wonderful that we're trying to be so responsible with the fact that we want to travel. We have a responsibility to give back to the community and also to make sure that we're leaving it better than we found it.

Amina Abubakar, PharmD, AAHIVP: Yep. So, when you travel with us there are trees around the country with your name that are growing to overcome the carbon footprint that it took you to visit us.

Aislinn Antrim, Assistant Managing Editor: That's so incredible, and that's such a piece of it that I think doesn't always occur, at least to me. Of course, I know the carbon footprint, but to actually be able to do something that offsets that is so incredible. Well, you've mentioned Roho Voyage. Can you talk more about that and what you do with that?

Amina Abubakar, PharmD, AAHIVP: Yes, so I have been booking travel since I was in pharmacy school. When everyone learned I was from Kenya, they would say, “Oh, my God, whenever you go home, can I go with you?” So, I would, I love planning, I love traveling. It excites me, so I've been doing that for a long time. And then they would bring their families and their friends, so I was, I would say, an undercover travel agent for a long time. And then during COVID-19, as I told you, I'm part of the Safari Doctors and we rely so much on donations to get those clinics going—the mobile clinics that we do around the marginalized communities. And no one was traveling to go there, and a lot of some of the businesses that would support Safari Doctors, they didn't have financial means to support. So, on one of the board meetings, I thought to myself, you know what, what can I do to increase opportunities to fund this project? So, I decided to just officially make it a travel company, raising consciousness and connecting people who are especially in health care that would like to come and volunteer with us and serve. But also knowing an average American may only have 2 weeks, you know, to spend [each year]. So how do I make it fun for them to travel, have their vacation, and at the same time give back or be part of something that makes them feel good? So that's how Roho Voyage was formed. Roho means soul, and voyage is the journey. And so, I just wanted it to be on not just a travel agent, booking travel for the sake of it, because I am taking time from a very busy schedule running a pharmacy, multiple pharmacies. But I just saw the power of the travelers, connecting them, bringing them to places with purpose. And we use the commissions that we get from these hotels to fund the projects on the ground.

Christina Madison, PharmD, FCCP, AAHIVP: And as far as my connection to Roho, Amina and I, we actually met for the first time in person less than a year ago. So, it was March of 2023. We met at APhA’s annual meeting, and it happened to be her birthday the day that I met her, and I was like flabbergasted that she had no plans to celebrate. And I was like, well, we're going to have to change that. So, I took her out and wined and dined her, and we just really got to know each other better. And then she opened up about this other venture that she had, because before that I only knew her in relation to the pharmacy space. And so, because we have so many similar interests and experiences—you know, helping marginalized communities, public and population health, HIV, those kinds of things were like bread and butter to us. We'd been on multiple panels together, but never had met in person. And so, when we sat down and chatted last year and she asked me, you know, what I thought about all these ideas she had, I was like, “Oh, you really have something here. Like, you really need to think about ways that you can market this, get this out on social media.” You know, content creation, all of the things that I absolutely love and adore and have sort of fallen into now that I am doing full time entrepreneurship post my academic pharmacy career. So, we've had conversations over the past, you know, 6 to 9 months, and ultimately, I had stepped down from my academic position and had the time. And so, we talked over the Christmas break in between Christmas and New Year’s, and she was like, are you ready to go? And I was like, okay, and she's like, alright, we leave in a month. So, everything was fast.

But I will tell you, it was such an eye-opening experience on many levels. You know, not to get too, like, deep, but as somebody who is the descendant of enslaved Africans, it was incredibly moving to be on the continent and to have people who look like me tell me “Welcome home.” I cried multiple times, I told Amina like, “I'm so sorry, I'm like a bat.” Like, I'm like, tearing up, bawling, the staff is like, hugging me. They're like, “What's wrong with her?” You know, but it's something I can't describe to you in words that would do it justice. And also, the fact that not only were we there and I was coming home, but I can actually make a meaningful impact by bringing awareness about these villages and about these organizations and foundations.

Amina Abubakar, PharmD, AAHIVP: And, you know, something that I've noticed over the years that I've done this, Africa is such a homecoming for many people. You know, I've seen people, and they'll travel, they've been to Europe, and they've come back and said, “Oh, my trip was great. I enjoyed the food, I enjoyed this.” But then they go to Africa, and they come back and say, “Amina, that trip changed my life.” So, that's kind of why I really call it raw, because there's kind of like a soul movement, or a search that many people land and just find either clarity, find the genuine hospitality that's kind of genuine love that just kind of moves people. So that's why I was even more excited to connect people to Africa.

Christina Madison, PharmD, FCCP, AAHIVP: Yeah, and I was just going to say, for me, because I was seeing this from the perspective of someone watching the journeys and not having experienced the journeys because I was referring people to Amina, before I had gone on this trip myself. And I think I have a very different perspective now than before. And really, like understanding just the vastness of the country, the fact that there's so many different tribes, the culture of the Maasai people, you know, the fact that they support themselves through things like beading and weaving and all of these skills that you really don't think about as being so vital to someone's survival. And, you know, you see these beautiful pieces of art, but you don't realize what it took to get to that.

I'm not wearing it right now, but I created a bracelet with the Maasai ladies. I started it and it was quite challenging, so they finished it for me because I wasn't quite as good at it as they were. But the story I wanted to tell was the fact that on our way to the air strip, as we were leaving, we remembered that we had forgotten the bracelets with the ladies, and they called back to see if they could find them. And so they rushed to bring these pieces to us before we got on the plane, and I'm like, this is just like some incredible customer service. Like, they got there almost, you know, right as we were getting there, and they called. I didn't even realize that our driver had called and told them that we had forgotten that, so that's a piece that I really cherish because those women, they're just so skilled and so talented, and just really that connection to the land and to the people.

Aislinn Antrim, Assistant Managing Editor: Yeah, definitely. I know, obviously, as a White woman, I can never fully understand that kind of homecoming piece, but even when I was there, just everyone was so caring and just genuinely cared about everyone around them. It was so wonderful.

Amina Abubakar, PharmD, AAHIVP: Actually, I've had most of my Caucasian friends say, “I just felt at home, you know?” And that's why I said Africa is like, maybe we’re all from Africa.

Aislinn Antrim, Assistant Managing Editor: That kind of welcoming feeling just felt like it was everywhere.

Christina Madison, PharmD, FCCP, AAHIVP: And so collaborative. That's the one thing that I didn't expect, is like, a lot of the different lodges, they host each other. Because if you say you have dates that you want to go and they're not available, they'll refer you to another lodge that has nothing to do with them. They're so collaborative, it's amazing. While we were there, one of the lodges that we were about to go to, their manager was staying at the same resort with us, and so then we ended up getting to know them, we're on our way to that resort and then we got to talking. And then that just like led to a whole bunch of other things. Yeah, it was incredible.

Aislinn Antrim, Assistant Managing Editor: So incredible, and that that would never happen in the US.

Christina Madison, PharmD, FCCP, AAHIVP: They would never be like, ‘Oh, let me give you some business.” Like, no, they'd be like, “I'm going to keep that business for myself.”

Aislinn Antrim, Assistant Managing Editor: Well, speaking of your recent trip, what was the core goal of that and what did you do while you were there?

Amina Abubakar, PharmD, AAHIVP: So, the core goal for me—one, I really wanted Christina to be very familiar and experience firsthand the work we do on the ground. You know, there are so many people who collect money or just raise money and say that they are helping. But I needed her to see it, to see the people and see how Roho Voyage really works. Because, as she said, she was referring me to people that I booked trips for them, and they went, and so I just wanted her to be there. And also,I'm from there so I go see my family. But then I keep checking on those projects, you know, and I keep looking for new partners. So, I keep experiencing and familiarizing myself with more like-minded hotels or lodges or camps. So that way together we can make a difference.

Christina Madison, PharmD, FCCP, AAHIVP: Yeah, and I feel like my goal was to learn and to listen, but then also to look at ways that I could help amplify their messaging. And so, as somebody who understands the power of social media and the power of storytelling, I really wanted to find out how I can help get the story out about Roho. And so, we did tons of content creation, lots of social media posts. It's really interesting, when I came back, I had so many people that didn't comment on my posts, mind you, but when I saw them in person, they were like, “Oh my god, I was like, living vicariously through you. Your trip looks so amazing, your photos and your videos were so incredible.” Like, “What an amazing opportunity.” And so, I feel like people need to see that and then they can imagine themselves there. And then also knowing someone personally makes it that much more of a potential reality. And so I think just having me as a firsthand account, you know, that allows me to be able to, you know, tell people, “Hey, if you want to talk to somebody who's gone, it's not, you know, too far off.” You can chat with [me] or you can go to our Instagram or Facebook or TikTok, and you can see all these different journeys because Kenya isn't the only place that you can visit with Roho; you can go to Egypt, you can go to Tanzania, you can go to Dubai. Really, you know, if you can think it up and you tell Amina what your dream is, she can make that dream come true.

I literally think that she's kind of a bit of a wizard in that way because I think that there are other places that will quote you a price, and it's very shallow, right? So, it's like, they tell you how much it is and that's it. Versus with this, it's a very much a personal curated experience and I think that's really what sets Roho apart from a lot of these other agencies that say that they book travel. Not just that, but the fact that they are actively putting in the work to help these communities and to give back as much as possible through a health care lens, as well as through the foundations for a lot of these places that, you know, she's connected with.

So, one of them is Finch Hattons, they have a foundation that we found out about that we're going to be working with, and they're super excited to collaborate with us. We went down to a village at Tsavo West, and [it was] just really, super eye opening, you know. [There are] 2 health care workers for a village of 6000 people, and they are just doing so much with so little. And then, you know, for them to say, “Oh, you know, it would be really helpful if we had a few wheelchairs, and it'd be really helpful if we had some more antibiotics.” And we're like, “Done, like, we can do this.” You know, they do so much with so little, but then also they only want very little, and that little that we can give would be such a huge improvement. I mean, there's half a building that was supposed to be built and it's taken them 10 years, like we need to get this building finished. We can get it done.

Amina Abubakar, PharmD, AAHIVP: So, what was exciting about this trip, as I said, the purpose on the surface was, again, Christina getting exposed, being there, and me continuing to evaluate these partners on the ground. So, the first 2 places, I knew of them, I work with them, I understand their foundation, they have clinics, they do education. So, one of the ones that she's mentioned in the chat, it was my first time. Many of them think we are going for the glamour and the luxury—and I'll tell you, they spoil you. It's amazing, it's so easy to get lost in all the lux. So, then I went to the manager, and I said, “I want to see your community. I want to see who's around you.” And so, they were surprised that that's where we wanted to go. We're like, “We don't want one more Safari.” And so, he said okay, so he drove us to this community and that's where we saw the health disparities. And you never know the power of that visit because they had not leveraged their foundation to the people within the neighborhood. So, some of these foundations are really focused on conservation of the animals, which is great, I'm not discounting that. So, I'm raising their awareness that we need not only to conserve the animals, but we also need the people. So, it's the people, the wild spaces, and the animals. And so now we have a meeting and they're super excited. So, now I'm helping a foundation put a board together that is going to govern health care.

Christina Madison, PharmD, FCCP, AAHIVP: Yeah, and both of us separately posted about it and I've had people reach out to me and say, “How do we get in-kind donations? How do we get money?” Because that's the thing, you know, both Amina and I have a fairly high profile within the pharmacy space. But I think that it goes beyond pharmacy. It really is just leveraging connections, right? And so, when we put things out there and we want to educate, we want to expand, we want more people to be involved. We want more people to get excited about this work, we want more people to feel like they can make an impact. And even if they can't travel, there's other things that they can do that will make a big difference.

Aislinn Antrim, Assistant Managing Editor: Absolutely, I know donating is always the first thing that comes to mind and even that's overwhelming. It's like, who do I know is going to use this appropriately, and you want to make sure it's the right organization. So having something like Roho is just incredible. You also mentioned Safari Doctors; how have you partnered with them? And how has that shaped some of your recent program developments?

Amina Abubakar, PharmD, AAHIVP: So, with Safari doctors, I have taken many pharmacists with me, and we run the pharmacy at the clinics. So, in Lamu, that's where Safari Doctors is, there are no cars, so it's donkeys or boats. So, we sail around the island, and we go to all these marginalized communities, and we set up clinics. And when we first started, we had very little resources. And then we became part of the CNN Heroes, so that just put us on the map. Now we are getting so many people coming into Lamu, visiting and helping. And so just last September, I had a group that was nurse practitioners, PAs, and pharmacists, and we went in and set up the mobile clinic. So, the pharmacists were able to do education on sexual health.

There was a gentleman who started the conversation of saying no, condoms are not allowed in our religion, you know. And he’s Muslim, and I’m Muslim, so I was able to have a conversation about HIV, about transmission and about all this. And it was so good to see the change of him, understanding what I'm talking about, because sometimes there's a lot of, “Oh, the foreign people are trying to change us.” So, for me, collaborating with the foreign people and bringing them home and being the connector and translator let the work happen. It's been great. So, that's what Safari Doctors does.

We take care of not only the people, but we also have Safari Vet, because it's kind of taking care of the whole community. There was a time where a group of pharmacists went down there, and everyone had a lot of waterborne diseases, and so we looked and said yes, because they're drinking from the water where the animals are also utilizing these water sources, right? So, through our strategic initiatives, Safari Vet was born and now they come together with us, getting all the vaccinations and medications, de-worming to the animals, and that has improved. We have less and less cases. So now we’re focused on the HIV and other diseases or chronic diseases.

And it's so humbling, because I have 4 pharmacies and we’re like, we need this counter space , and we need all these things. And over there me and one of these other pharmacists, we were on the floor. We had like a little rug that we sat on there and we piled on medication. So, as the nurse practitioners and the PAs were seeing the patients, they bring us the prescription. I was like, maybe we're overcomplicating things to set up a pharmacy, because you know, we are just passing on and counseling and it's been incredible. Now Safari Doctors has an actual clinic that is high standards in the community of Lamu. A lot of expatriates that live in Lamu utilize it. They have a lab,a pharmacy, and we have now educated community health workers for sustainability. So, getting the young kids in the system, teaching them and disseminating them in the communities where they live. And they are now agents of good health.

Christina Madison, PharmD, FCCP, AAHIVP: Yeah, and we're able to compensate them, which is also really great as well. So, we've built a sustainable model with a stipend, which is hugely impactful because this means instead of them potentially, you know, doing nefarious things or things that maybe are not as savory, they're more likely to stay with this group and then they can support their families. And then they're also proving the health of their community.

Amina Abubakar, PharmD, AAHIVP: And that's the sustainability piece. So, Roho looks for sustainability in the programs that we sponsor. Yes, it's good to have, you know, a one-time sponsor of something. And I always said that more helps you, the giver, you feel good about yourself. And that's fantastic, and it's great. But it may not change the trajectory of that person or that community. So, with Roho Voyage, part of what we do with donating isn't just the supplies, it's actually committing to salaries of those individuals, those community health workers, so they're not just volunteering. They are part of that DNA of sustainable health care.

Aislinn Antrim, Assistant Managing Editor: That's so, so incredible. I'm over here listening to everything you're saying and just scheming. I'm like, “How can I help without any medical knowledge?”

Christina Madison, PharmD, FCCP, AAHIVP: You're already helping because we're with you today and we're doing this podcast. Like, by definition, you've already helped because you're helping us get the story out.

Aislinn Antrim, Assistant Managing Editor: So, we often think of kind of physician-based international aid. What are the roles or programs or opportunities for pharmacists? Obviously, you've mentioned several, but how can pharmacists get involved?

Amina Abubakar, PharmD, AAHIVP: Pharmacists can get involved in vaccinations, education, sponsoring a young pharmacist in this communities, so you can pass on that opportunity. Because many of them, as I said, are in these marginalized communities but they’re the brightest minds. You know, they may not be able to go to college, but there are pharmacy schools there. And so, I'm looking at ways that people can find whatever is comfortable for them. But also, just being on the ground, we have a pharmacy out there, you can come educate the pharmacists there, give your knowledge, give of your time dispensing the medications, educating the physicians, physician's assistants. And so, because it's team-based care, we work really well with the doctors that are there, the pharmacists. And before, they even said “We’ve never had pharmacists on this mission.” But now it's like, “Oh, are you bringing pharmacists this time?” So, they look forward to it.

Christina Madison, PharmD, FCCP, AAHIVP: Yeah, I would definitely echo that sentiment and say that there are so many ways that we can get involved. As somebody who, you know, came from academic pharmacy, and really helped our students to see the benefits of doing medical mission work and global health, those students got so much out of those experiences, even though it was just 6 weeks. It was really eye opening and changing for them. And I think that, you know, understanding how fortunate and how blessed we are in this country is very humbling. And when you go to another country and you see how much they do with so little, it gives you perspective so that when you come back, you can see ways that you can encourage and improve the quality of care that we have here, given all of the amazing tools and resources that we have.

Amina Abubakar, PharmD, AAHIVP: Yeah, like when someone says, “Amina, can you just help make sure we can get antihistamines?” And you go, antihistamines, Yys. So, they're, they're down to just the fundamentals, like foundational care. You know, no one is looking for drugs of longevity. And it's just like, hey, we would love to have antihistamines. So, I feel like even for pharmacists, it's really good to be part of this because you can help design formulary alternatives that they can use along the way as they're building these resources.

Aislinn Antrim, Assistant Managing Editor: Yeah, definitely. It always seems like the smallest things that are so tangible, and it seems so easy for us to be like, “Yeah, I can get some Benadryl.” Like, that’s easy, but it makes a big difference. What needs are pharmacists particularly well positioned to help address?

Amina Abubakar, PharmD, AAHIVP: Vaccinations, chronic disease management, in terms of education. I feel like a lot of medical providers are mostly being utilized for the acute needs, and so they're seeing one patient after another and, you know, in some of these villages we go to, people have been walking for days to get there. And it's a lot of them, so you want to get through many. So, I feel like the pharmacist played a huge role while people were waiting, just finding out the conditions and pre-educating or post-educating, so that's huge. And also, a lot of the preventative ways, like the preventative care, because in these areas I tell them, “So now you know how hard it is for you to get here and how hard it is for you to get medications. So, let's talk about how we prevent this. How do we, you know, improve your diabetes by the knowledge on what to cook, what to eat.” You know, education is key, and it's not there. These are people who don't even have access to the internet, so they're not finding even Dr. Google, you know. So, people being present, people being there. It's very important.

Aislinn Antrim, Assistant Managing Editor: Definitely, it sounds quite similar in some ways to what pharmacists do here. They are always educating that's always kind of at the core of what they're doing. It's just different challenges and different situations. Well, it's a perfect segue—can you discuss the natural ways that the community is using things like plant life, vegetation, and the concept of food as medicine? I know we had a feature published today, or maybe not today but publishing very soon, about food as medicine. So, what do the communities do for health and wellness in that area?

Amina Abubakar, PharmD, AAHIVP: We had [Christina] experience it from the food side. And so, I asked Christina this question. I said, “Christina, you're in this shamba, which is a farm, and you're seeing all of this plants and all this food that grows. Why do you think Africa still lacks resources? Like what is going on? You know, what are we missing?” Because all these things that people use in supplements and medications, they grow abundantly. So that's, our mission is to empower the people with what they already have, because maybe we are looking for the pill, you know, that comes from a pharmaceutical vehicle. But if we can't get it, I would love to collaborate with pharmacists in the functional medicine side who understand those key ingredients, because I'm not very vast with a lot of those ingredients and what they do, but I know they are key ingredients in wellness, the key ingredient in major pharmaceuticals. So, we took Christina through the farm and then we met a lady who is revolutionizing reproductive health using plant medicine.

Christina Madison, PharmD, FCCP, AAHIVP: Yeah, and so reproductive health, fertility, immunity, respiratory health, it’s incredible. The other thing that was really cool, that we realized when we were chatting—which also, by the way, we found out about this lovely woman because of one of the people that we met at one of the lodges who uses her products, and she's like, “You should talk to this person.” And so, like I always say, a closed mouth don't get fed. Say what you want and say what you need often because you never know who's listening, and you never know who needs to hear what you have to say. And so, I think when Amina talked about, “Oh, I'd like to learn more about ways that we can help the community and people who are doing these things in the community,” of course this person was like, “Oh, you need to meet this person.” And then luckily for us, that person happened to be available on the last day that we were in Kenya. And so, it was kind of like a rush to meet with her. We got to go to her factory. She told us about the community that she gets the plants from—which also, by the way, you have to get permission from the community in order to harvest or take any of these things. And so again, having that community support. And then also that she gives back to the community, and she utilizes a lot of the youth, I think was super important to see. And so, you know, she started off doing her business during 2020 when people were looking for alternatives during the pandemic to regular medications, and she's just exploded and now she's global. She's international, she ships all over the world—Australia, she ships to the US, Europe, France, you name it.

Amina Abubakar, PharmD, AAHIVP: So, I think how we can help this is, I grew up on these alternative medications. You know, when you had a tummy ache, they took something from the tree, they boiled it, you drank it. I think bringing in experts that can tell them dosage, because I always wondered, so I know that this works. But does it work for everyone? How about if it's a child? Is it weight-based? And I know there are so many experts in the pharmacy world and in natural medicine, so maybe part of it is creating education for those community health workers or the pharmacists and health care providers that are there. How can they use those plants, what is the scientific dosage, side effect of things that are naturally available for them. So, I would love if any pharmacist who is listening to this, or a doctor who's listening to this, and really has the knowledge and resources, contact us because we want to get these people help. And if it's already naturally available, then we don't have to worry about always bringing in medications.

Christina Madison, PharmD, FCCP, AAHIVP: And I think it's really important to get this into a place where it's recognized by, you know, the community at large, as well as reputable sources, because we see this a lot with like Eastern medicine. You know, it's very much like in this country, you know, we've got Chinese herbs and teas and things. But we don't hear very much about African remedies, which I think is a missed opportunity. Because again, there's so many things that grow abundantly and can be sourced with, obviously, approval from the communities, that we could be utilizing here in the US and could be helping people that really have exhausted all their other options.

Amina Abubakar, PharmD, AAHIVP: I liked her sustainability plan, because when you take one of these trees, it takes a long time to grow back, so she gets young children to kind of nurture it. So, this becomes their tree that they take care of. And in 10, 15 years, she will buy from them at a higher premium value. I was like wow, that is incredible. So, they now know they're investing, you know, and that one day she would [buy it]. I mean, she told us some of how much she buys it for to help the community, so that way they can grow more and keep them. She's trying to replenish what she's using. So, for pharmacists, I think Africa is a playground for those who are curious about all these medicinal plants.

Aislinn Antrim, Assistant Managing Editor: Definitely. I know one time I was at my in-laws’ home and I asked my mother-in-law if she had like Tylenol or anything because I had a headache. And she was like, “Oh, no, you need this tea.” I have no idea what it was, but it worked. It was great.

Amina Abubakar, PharmD, AAHIVP: I'm telling you; these things work. It just requires some level of governance, and you know, helping them really understand those right doses.

Aislinn Antrim, Assistant Managing Editor: I think I asked her, I was like, “Where do you get this?” And she was like, “Oh, my mother sends it to me.” It was something that she just grew up on.

Amina Abubakar, PharmD, AAHIVP: That’s what I get at home. Like, while I was there, I had really bad respiratory issues, and you know, I was desperate. I was like, I'll take anything, because I need to feel better. And all I did was turmeric and ginger and all that.

Christina Madison, PharmD, FCCP, AAHIVP: And then I had some tummy problems and they're like, “Oh, you need this.” I was like, what? I didn't know what that was. And then of course I took it and they're like, “Okay, now you're real. Now you're truly Kenyan.”

Aislinn Antrim, Assistant Managing Editor: It's wonderful. I know in November, there's an upcoming CE sort of trip for pharmacists. Can you talk about that and where anyone interested might be able to get more information?

Amina Abubakar, PharmD, AAHIVP: So yes, I can tell you about information. The interest was so high that in 2 weeks we sold out, and so we'll have a little bit over 30, about 35 to 38 people attending. And it's so cool that some of the pharmacists are bringing their kids to be part of the travel, although they don't need the CE credits, but it will be good for them to experience Africa with their kids. So, I wanted to promote a few things. One, what it means to take a break. The best place to take a break is where you are totally disconnected, and a safari is one place that you are surrounded by just nature, birds, lions roaring, baboons on your tent, it just takes you away from the things that, you know, you're preoccupied with. And pharmacists, I mean, personally, even my staff, they've just had huge burnout from the pandemic, there was just over exertion. So, I thought, you know what, there is the power of that piece in the wilderness. And then moving our classroom from a lecture hall to an immersive experience. So, we were given a lot of the objectives through the journey, you know, like at the farm, where food and food is medicine will be one of the topics, but you get to pick your own foods. What are they good for? What food groups are they in? And then they prepare it fresh, and you eat it. So, what a way to kind of, you know, do that. And then they have the medicinal plants part of it.

And then learning more about collaboration. I feel like the US could gain so much in learning how to get different people with different skill sets collaborating. And so, health care is a collaborative effort now, so what does that mean? Even just observing the animals and how their collaborative efforts are. Christina said, “Oh my God, there's a soccer field here, and the zebras and giraffes just hanging out.” I said, they're collaborating! You know, they're collaborating against the predators. So, the destination CE, it's truly getting people out of their comfort zone, out of their routine. And because everyone is really always limited to so little time to do both travel and to gain your education, I thought of combining it. So, I call it work-life integration, because it's never possible to balance them. So, how do we integrate it as part of your life? So that's our destination CE. While we sold out for that one, just watch out on our website. We will be coming up with many other opportunities for different timeframes, because the emails have been overwhelming of the waiting list.

Aislinn Antrim, Assistant Managing Editor: Good, that's wonderful. I know Christina and I were talking about it and I was like, “Do you want a journalist on this trip? I could cover it.”

Christina Madison, PharmD, FCCP, AAHIVP: And I said, “You just talk to Amina, I'm sure she can find a way.”

Amina Abubakar, PharmD, AAHIVP: Yes, I think storytelling is powerful.

Aislinn Antrim, Assistant Managing Editor: Well, I'm very curious about this next question. I'm curious how you both think about voluntourism, which can be at the very least not helpful and it can be harmful when it's not done correctly. So how can pharmacists get involved and empower communities rather than kind of reinforcing problematic narratives and issues? How can they be really positively impactful?

Amina Abubakar, PharmD, AAHIVP: So, for me, first of all, you have to understand that when you volunteer, when you travel and you volunteer to do something, that it may benefit you more than it may benefit the individual that you're helping. And it's okay. I think sometimes we want it to make that change, we want to save that community. But remember, sometimes we're saving ourselves. The next thing is, know who you are working with, because you could be contributing to child labor, you could be contributing to so much that you are not aware of. So, vetting organizations, knowing how they really impact the locals. Talk to local people, you know, not some international page that gets you to travel and do this, but you have to do your homework. And your homework is really connecting with the local people, knowing what happens. I also think the transparency of how they do it [is important]. You know, how much of your donation goes to the people? So, I think you know, as you're volunteering, I think it's a good thing if it's done right. And the only way to do it right is to know who you're working with and where you're going, because I have seen the damage of that too. And also, when you do go to help, think about empowering that community. What are the skill sets that they continue to give? As I said, like, sometimes sponsoring that child to go to school is like a huge benefit. And I say this because I was one of those kids, so it's kind of looking at impact in very different layers. And, again, anything is better than nothing. So, as I said, even at the end of the day, if it's something you do and it makes you feel good, that's also great.

Christina Madison, PharmD, FCCP, AAHIVP: I think from my perspective, it's about sustainability. So, if you go somewhere and you are providing an intervention, you need to make sure that that is going to live on after you leave. What is the mechanism in order for them to continue to offer that service after you're no longer there? And I think that's the difference between sort of the, you know, safari tourism and safari volunteerism where you just go and, you know, journey, and you look, and you see things, but you don't actually do anything, versus making a real impact. And so, going and just helping 1 or 2 people, but you bring them something, and then they can't get it again, that's harmful, right? Versus if you go somewhere and then you figure out a mechanism for them to continue to get the thing that you brought, then that's sustainable. And so, I think that's really the difference. And you can go, and you can volunteer, and that's fine. But you don't want to ever get in a situation where it's unfair, where only some people benefit, and not everyone. Just for an example, when we were traveling through the villages, there was a little boy that had his hand out and he was, like, running alongside our truck. And of course, like, we're looking to see if anybody had candy or something to give. And literally, when we stopped, there were like 20 more kids that came out of nowhere. And I was like, Where the heck did these kids come from? Right? And so, it's like, you can't only just give to one, you have to be able to give to all.

Amina Abubakar, PharmD, AAHIVP: And you didn't know if I know where they came from.

Christina Madison, PharmD, FCCP, AAHIVP: I had no clue where these kids came from, but I literally turned around and there were like 20 kids.

Amina Abubakar, PharmD, AAHIVP: And all Christina had was one cough drop.

Christina Madison, PharmD, FCCP, AAHIVP: That’s allI had. So, note to self, when you go make sure you bring sweets. I mean, a lot of times their parents don't have money to get them.

Amina Abubakar, PharmD, AAHIVP: Oh, that is a that is like a luxury, you know. So, I think to summarize what we just said, think of 3 things: intentionality, integrity, and dignity. Whatever you're doing, how do they fit in those 3?

Aislinn Antrim, Assistant Managing Editor: Definitely, that's a great way to sum it up. We've talked about so much. What can people listening do to help if they want to get involved?

Amina Abubakar, PharmD, AAHIVP: One more thing because, again, you being part of the journey is very beneficial for the people that you meet, and yourself. And if you have kids, having them be part of it, it's wonderful. And if you want to be part of Safari Doctors, just reach out to us and we'll be posting a lot more things as we're vetting these organizations, so you can trust Roho that we are vetting. Again, those who want to travel and volunteer, we are happy. I've collected so many resources, but then I run them through several tests and several resources to make sure that we are not contributing to a back end of something that's really terrible.

Christina Madison, PharmD, FCCP, AAHIVP: And I would just say as someone who has met the Roho employees that are on the ground, they are very happy and they are so excited and they fully believe in the mission of the company, and they want to give, and they are so dedicated to making your experience the best it can possibly be. Even from the moment you get off the plane, there's someone there to welcome you, to help you to get through customs, through security. And then even from the time you leave, you have a driver that drops you off and then you have an escort that takes you all the way to the gate when you leave the country. So, I would say, you know, this is a whole new level of curated travel experience. That is something that will leave you wanting more, but also making you feel like your heart is full.

Aislinn Antrim, Assistant Managing Editor: Just hearing that has me wanting more.

Amina Abubakar, PharmD, AAHIVP: And as we speak, [the International Pharmaceutical Federation] is in South Africa, and I am excited that pharmacy colleagues and some of the pharmacy leaders have reached out. And so, I have just had so much joy planning their South Africa excursions and trips and Safari. So, again, it looks like this year pharmacy is definitely going to Africa.

Christina Madison, PharmD, FCCP, AAHIVP: And if you know anyone that wants to do anything in Africa, you need to talk to them, you know?

Aislinn Antrim, Assistant Managing Editor: Definitely. Well, is there anything you’d both like to add? Any closing thoughts or anything that we didn't touch on?

Christina Madison, PharmD, FCCP, AAHIVP: I would say follow us online and also at Roho Voyage. It's on TikTok, Instagram, Facebook, LinkedIn, check out our stories, check out what we have coming up. We'll be posting about new trips that we're planning, so be on the lookout if you want to do one of these curated continuing education excursions where we can do our life-work integration. And, you know, as far as from a public health standpoint, this is a dream come true. And so, I feel so blessed and fortunate to have met Amina and to be able to partner with Roho Voyage. I just know that the marriage that we have between The Public Health Pharmacist and Roho is going to be around for a while, and I so look forward to continuing to support this organization and helping to amplify their message.