TCOM student preparing for a pediatric global residency
A passion for medicine, a love of children and a desire for global health led Texas College of Osteopathic Medicine student Natali Borrego on a once-in-a-lifetime rotation to Africa for two weeks in February. Borrego spent two weeks in Maai Mahiu, Kenya, with a non-profit organization called Ubuntu Life Foundation, helping with a team to run a neurology clinic for children with very complex conditions.
Her interest in medicine grew from a volunteer trip she took to Haiti in high school, where she saw the plight of a nation and its people with limited resources struggle with access to health care. Combined with her love of children, the two-week international rotation has given her a foretaste of her upcoming residency, of which Borrego landed one of the most unique specialties in the nation with the Baylor College of Medicine in Global Child Health Pediatrics.
“It’s a pretty unique program and Baylor has an amazing global health network that has multiple countries throughout the world they have partnerships with,” Borrego said.
While her residency program will start in July, this was the kind of trip Borrego had pined for, even before starting medical school at TCOM and her time at The University of North Texas Health Science Center at Fort Worth as a graduate of the Medical Science Program with the College of Biomedical and Translational Sciences.
“Even before starting at TCOM, during interviews, I asked about global health opportunities because I always wanted to do an international rotation,” Borrego said.
It was early in 2024, through a mutual friend who had also done global health in Haiti, that Borrego met Dr. Ric Bonnell, a pediatric emergency medicine physician. Bonnell has extensive experience in indigent care in the United States at free clinics and in global health in Haiti, East Africa and Central America and has previously served as the Director of Global Health for Dell Medical School and Dell Children’s Medical Center. Bonnell liked what he heard from Borrego when they met, but he wanted to see her work ethic.
“One day we had lunch and she’s telling me what she wants to do, and so I decided that I’m going to test her,” Bonnell said. “I had a project with elementary school students later that day, and she came along and spent the day with me, even helping to recruit TCOM students to help with the project. She proved to me how dedicated and hard working she was, so I mentioned that there might be a chance to go to Kenya early next year.”
In late 2024, as fate would have it, a spot opened up for his next trip to Kenya. The first person he thought of was Borrego.
“Dr. Bonnell has always been involved with global health and he reached out and said he had a team going to Kenya with a spot for me if I wanted it,” Borrego said. “It just fell into my lap all so quickly, but TCOM made the process very smooth.”
The team flew into Nairobi and headed to Maai Mahiu to meet up with the Ubuntu Life Foundation, which provides access to essential care for individuals throughout the region, with volunteer doctors from the United States coming in quarterly to hold clinics. The clinic was founded to take care of poor Kenyan children with complex neurological conditions, cerebral palsy, multiple sclerosis and other very rare neurological conditions.
Borrego got to see not only the impact the team was making but how much they mattered to the local population.
“It was very eye-opening as we saw parents that were traveling on foot for miles and miles while carrying their children in their arms to come see us,” Borrego said. “Like so many global health trips, it gave me such a new perspective on the world, our life here, and motivated me even more to go into global health and medicine.”
Impressed by not only the natural beauty of the country but also the resiliency of its people, Borrego recounted one of the more intimate encounters they had with a child. It was while the team was making house visits in the countryside, they followed up with a patient who had been having severe seizures, up to 20 a day. The treatment the team had given him on previous visits was working, but Borrego noted it’s not always just the medication that makes the difference.
“In a lot of ways, this trip has made me more sensitive to knowing what cultural and social factors that patients will be coming to us with,” Borrego said. “We can’t just prescribe a medication to someone and think that’s the thing they need to get better. We have to understand the patient in their whole context, and a big theme that came up on the trip was ‘do no harm,’ which we learn from the beginning and is in the osteopathic oath. Sometimes, we don’t think about that enough during our time in medical school, but in that setting in Africa, we thought about it with every patient and talked about that with every patient.”
“The purpose of her going to Kenya wasn’t to build her career but to give her a perspective on medicine in other countries,” Bonnell said. “She was able to learn how to hone her skills when there is no access to medicine around. Medical students (and other trainees) aren’t going on these trips to save lives. They frequently get more personal benefit than they are able to give back. I’m hoping it stokes the flames of their passion to take care of disadvantaged people back in the United States. Many people I have taken don’t do this as a career, but it has changed the perspective on every single one of them on the care back home, their cultural perspectives, and it just makes them a better physician, that’s my goal.”
The trip in Kenya lasted two weeks, so Bonnell had one last challenge for Borrego when they got back home. Bonnell is teaching classes on health sciences to students at Tolar High School now, so he brought Borrego down to work with him for the rest of the month in the classroom with the high school students and at Ruth’s Place, a free clinic in Granbury that Bonnell and his wife founded in 2009.
“She spent the rest of the month with me at Ruth’s Place and teaching,” Bonnell said. “She’s fortunate that she has a lot of experience in other countries, so she’s not going into this program blind. I think there’s a very high chance she will be involved in developing countries and the disadvantaged patient populations there. She will do great wherever she ends up.”
Borrego’s residency program is a four-year program that offers a unique approach to pediatric global health training by having three years of on-site work done in Houston with an additional year of clinical immersion at a global health site in Africa or Latin America. In other words, after her first year of residency, at some point, Borrego is going to spend a year living abroad.
“I do speak Spanish, so South America would be nice, but I would be happy to go back to Africa for a full year,” Borrego said. “I’m very open at this point, I went into medicine to improve health outcomes for kids in resource-limited settings where there is a much bigger and urgent need, and part of that will mean living abroad.”
Following her residency, Borrego wants to do an endocrine pediatric fellowship and continue her growth in the profession.
“This was an incredibly enriching experience, and I’m very grateful I was able to do this,” Borrego said. “It was one of the most unique and best rotations of my medical school career. I would love for all of my classmates to experience something like this because it is worth it.”
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