Dr. Christine Ngaruiya, One of the First Kenyan Women to Teach Medicine at Yale And Ranked Among The Top 100 Emergency Medicine Researchers in America
By Mukurima Muriuki
People like Dr. Christine Ngaruiya are the game-changers of the world! Driven and motivated, they make our world a better place for all of humanity, regardless of their nationality and careers. When amazing feats or discoveries occur in the field of medicine and healthcare, we owe our gratitude to Dr.Ngaruiya and others like her. Many of these heroes remain faceless and nameless to the general public, but we at African Warrior Magazine are here to celebrate our sister and give her a standing ovation for her ongoing work both in America and in Kenya. It is a pleasure to learn about her journey from Nebraska to Nairobi and on to Yale University. She has risen to great heights because of her determination, support and God-given talent.
Dr. Christine Ngaruiya, born in the U.S. and raised in Kenya, is an Assistant Professor in the Department of Emergency Medicine (DEM) at Yale University, the DEM Wellness Officer, and the Director of Global Health Research. She completed the Global Health and International Emergency Medicine fellowship in the DEM in 2015, while also matriculating for a Master of Science and Diploma in Tropical Medicine and International Health from the London School of Hygiene and Tropical Medicine. Her research interests center on: Non- communicable Diseases, barriers to care, and community-based interventions with a particular focus on Africa. She joined the faculty at the Yale DEM as an Assistant professor in the Fall of 2016. Her past professional work has focused on health disparities among minority populations in the U.S. and Community-Based Participatory Research (CBPR).
Dr. Ngaruiya’s resume is quite impressive as she has reached pinnacles of which many can only dream. However, she asserts that her focus isn’t about the academic degrees or accolades she has received.
“The awards are nice. I work hard to achieve equity and change. I don’t pine over them. I am mindful of the prove-it-again syndrome that affects women more than men. I suppose I think of awards as milestones of hours and hours of hard work. I’m thankful that someone out there noticed it and added punctuation to that work. That doesn't drive me, but it doesn’t hurt to get those rewards. And, I am thankful for the recognition,” she explained.
Her story began when her father traveled from Nairobi to the USA to attend a conference where he met and became fast friends with an Anglican bishop — who is now her godfather. Her father continued his studies in the US and eventually landed a position at Mutual of Omaha as the first black (and first African) employee of the company. When Christine and her sister were born, their parents chose to return to Nairobi to raise their girls.
Many sacrifices were made by her parents, and Ngaruiya remembers how difficult it was to reside in two different countries. Initially, she and her sister lived with her Mom in Kenya, while their Dad stayed in America where he had to sell their home and pack up their belongings. This move would take him two to three years to accomplish.
“There was always a period of time when we had one parent with us while the other parent was closing up shop in another country.It speaks to the sacrifice and dedication of parents when they value what is best for their children.” She explained
Because of these experiences, she believes her view of the world is more fluid and not as conventional as the view of those who haven’t lived in more than one country.
Dr.Ngaruiya with her parents and sister
Relocating to Kenya and rediscovering her roots was a thrilling experience, but, at the same time, a double-edged sword. “It was exciting to discover that my extended family consisted of many cousins, etc.!” she exclaimed.
Dr. Ngaruiya was in the second grade when she and her sister, a third-grader at that time, enrolled in St. Christopher’s Primary School, which had a very strict Christian-centric focus. They had to attend weekly assemblies, participate in daily prayer, and adhere to a strict dress code. “I was raised with a lot of structure, discipline, and Christian focus in both primary and high school,” she commented.
Her excitement soon turned to frustration as she and her sister encountered bullying from the other children.
“They bullied us a lot when we moved back to Kenya. I remember they made fun of our accent, weight (we were a bit chubby), and our clothing. My parents were strict about our clothing. I was smart and always had that one friend who was at the top of the class and I suppose we were nerds together! She is also probably doing well today. And the bullying probably made me stronger. You know there is the trop that driven people have probably all been bullied in the past.”
Dr. Ngaruiya views Kenya as a gift in regard to an overall appraisal and comparison to other places she has lived. She praises its friendly and welcoming communal nature.
“It is like being raised by a village — one giant community,” she said. “I distinctly remember growing up with my cousins. Here in America, families can be distant, but not in Kenya. Cousins call each other ‘brother.’ I’m still very close to them today.”
She feels that friendships are very different in Kenya when compared to friendships in America. “A person comes first. This is reflected sometimes in our respect for time,” she said laughing. “You treasure time with that person above all else. Spending time developing and nurturing relationships is of primary importance. My best friends are those from my high school in Kenya. In America, I don’t have close friendships like those in Kenya.”
At fifteen years old, Dr. Ngaruiya graduated high school and traveled to America for her post secondary education. Excited to experience greener pastures, she naively thought that college in America would resemble the examples she had seen on television. She attended the University of Nebraska - Lincoln and, after settling in, she began to realize that America was distinctly more individualistic than Kenya. It was difficult for her to make friends. She felt excluded, and had her first encounter with racism. Since the Nebraska population is predominantly white, she was obviously in the minority both at school and in the city. She remembers being ill-prepared for the culture-shock. Coming from a communal environment, she assumed that her classmates would be her friends inside and outside of class. Unfortunately, that was not the case, and she recounts feeling sad when recalling an encounter where she waved at a classmate in public who treated her like a stranger. “I didn’t understand at the time, but later I figured out that the individualistic part is that you are part of school life, but not actually my friend,” she explained.
Encountering racism in America can be a very eye-opening experience for a young Kenyan. Dr.Ngaruiya recalls when an African-American student in her dorm took her aside to educate her about racism in America. “She alluded to the fact that it was like ‘them or us’. She let me know who could be my friend, and who couldn’t. This student also told me horror stories of when she would sit at her grandmother’s feet and hear about white people calling her relatives “boy” and “girl” instead of using their given names. Her grandmother taught her the history of segregation, while my grandmother taught me anecdotes and funny stories about my parents when they were younger. I remember being dumbfounded and not knowing what to say. ”
Ngaruiya’s next early experience with racism in America occurred at the popular retail store, Forever 21. She recalled,
“I had my bag checked in the mall at a Forever 21 store. The cashier called the police and wouldn’t let us leave the shop until they checked our bags. I called my dad and was crying because of humiliation, frustration and anger. I continued to cry these hot tears, trying to control myself. I asked the cashier why she had called the police. She was defensive and didn’t apologize. This experience was important in shaping who I am today. I want to mentor other diasporans — to teach them to be able to stand up and speak up when things aren't right. I asked the cashier why she didn’t ask or check the others in the store? There is a feeling when you know there is something wrong, but you can’t put your finger on it. Those examples stick with you decades later. That particular employee was fired weeks later.”
Although those were difficult experiences for a young girl, looking back she is thankful for them. She feels that they made her a better, stronger, and more mature individual.
A college graduate at nineteen years old, Ngaruiya headed to the University of Nebraska Medical Center as one of the youngest in her class. Not only had she recently learned about racism and how to live in an individualistic culture, she was about to experience ageism. Because of her young age, she couldn’t “hang out” with her fellow classmates and attend their social gatherings. Her response, “Such is life.” Her attitude developed into one of looking at others based on their ability to complete projects which had nothing to do with their culture or age. “I see myself as on par with my peers regardless of our ages. I started school early and was fast-tracked, so I ended up several years younger than the average age. I see it as I have the same challenges that my fellow professor or academic has, and how I am taking the necessary steps to advance,” she remarked.
When asked what motivated her to choose medicine as a career she replied, “I have characteristically Kenyan parents who encouraged us to go into medicine, law or engineering. I liked the idea of medicine. I found it interesting. I always really liked biology. I really like animals, and I thought I wanted to be a zoologist. My Mom had my cousin explain to me that it wouldn’t be a lucrative career (she laughs recounting this). I always found science, math, and physics interesting. And, I happen to be good at them.”
Dr. Ngaruiya also has an affinity for foreign languages. She studied French throughout her primary and secondary school years. She then took German for two years and went on to enroll in German elective classes for two more years. “Teachers were concerned that I might get confused if I knew more than two languages. I got the highest scores for both languages. I liked learning about the cultures too. I also thought I wanted to be a translator, but I was discouraged about doing that as well.”
Currently, she is an academic physician at Yale University. She explains her job as being “three pieces to one pie.” She specializes in emergency medicine, teaching, and research.
“The largest slice of my pie is research. I do public health research in the U.S. and other parts of the world. I work with medical students and trainees and give lectures. It’s busy. Academics is a labor of love - I don't have a 9 to 5. I set the level of busy-ness on my schedule as to how many papers or grants I am going to write. There are benchmarks, but I have to push forward the mission in the field of academia and in the greater picture of science. I would do the same thing even if I wasn’t getting paid. I love my job! Silent killers is my area of research. So diseases like heart attacks, diabetes, and cancer have the highest death rates in countries like Kenya,” she explained.
When asked if she was the first Kenyan on faculty at Yale she replied, “I am quite certain that I am probably not the first but one of the first Kenyans at Yale on faculty. It is a privilege and one we take seriously representing Kenya and the continent of Africa the best way we know how. It is an opportunity to be a bridge between the US and Kenya.” She is always delighted to meet a fellow Kenyan or African here in America. She senses an immediate “shared understanding and connection.” She went on to explain, “It is more exciting to see other Kenyans who are in the same field as I - academics or physicians. I started an organization called Kenyan Doctors USA for diaspora Kenyans born or who had moved here alongside a handful of others like me, that wanted to see change and connection established. I am passionate about Kenya and want to act as a collective or vehicle to leverage our desires to affect change back home in order to move the needle forward there. Even while I am here in America, there are ways to do it strategically. I am overjoyed that Kenyans are here!”
In addition to her position at Yale, she is dedicated to the Global Non Communicable initiatives: “It involves working with various teams and partners to get the work done. This is what has allowed me to be able to engage back with Kenya. I started a fellowship here and now do a spectrum of research on NCDs back home in Kenya on how to reduce the burden there. As a start, I emailed all of the organizations that I could remember back when I was growing up there, and the rest is history! I have ended up working with a variety of organizations in Kenya-the Ministry of Health, as well as faculty and colleagues at The University of Nairobi, etc. I do a lot of mentorship in Kenya and in Africa, and I have ten mentees at any given time. The majority of them are based in Kenya. Seeing mentees achieve and even pass me in accomplishments such as publishing their first paper, getting their first grant, or completing a research paper is what makes it all worth it,” Ngaruiya explained.
As far as medical disparities between Kenya and the USA, she notes that that the US has one of the worst health outcomes among Western countries overall. She states healthcare also isn’t equitable for all citizens because of socio-economic status and racial categorizations.
“As far as Kenyan, most Kenyans have very poor access to healthcare etc. There is a lack of the overall number of physicians, a lack of specialists, and lack of access to advanced treatments such as for cancer. For example, there may be first or second-line therapy, but additional therapies, certain procedures and surgeries may not available,” she said.
She believes that Africa could benefit from having more collaboration across the continent to ensure that entire regions as a whole are coming together. She proposed, as one solution prefer to have Centers of Excellence located in the different regions, so that the continent can have a means to an end in realizing progress.
Reflecting on the most emotional moments of her life up to this point, she recounted three of them: graduating medical school, matching for her residency at the University of North Carolina Chapel Hill, and receiving her first Federally funded grant for research in Kenya. “I think the amount of work and challenges that I had to rise above with the help of many people and many shoulders I have stood on to get to those accomplishments, made me cry tears of joy. I broke down in each of those situations with full-on sobs. It was a mixture of relief, joy and shock. I am the first doctor in my entire family. I got my top choice for residency and then finally left Nebraska, which was bittersweet for me. Lastly, it was so hard to get the grant, not having footsteps to follow in, however, I figured it out myself over several years and hundreds of hours,” she said.
“I’m not much of a crier. I’m pretty emotive, and fairly empathic, but not much of a crier. I will try to act around it,” Dr. Ngaruiya answered when asked if she gets emotional. She likes to refer to them as “happy tears.” Her most emotional day was when she found out her match for her residency program. She compared it to a lottery system in that it is like the luck-of-the-draw. However, they perform a ceremony where you walk up on a stage and the name of the program is in a sealed letter that they hand to you. She described the ceremony like this, “You open it in front of hundreds of people. I opened it, and I can still see the small print that matched my first program of choice - University of North Carolina at Chapel Hill. Overwhelmed with sobs, I walked into my friend's arms and continued sobbing. I don’t even know where those tears came from.” She does admit that about once a month she will cry about something in frustration when she is unable to accomplish a task in the way she intended. “As you mature, you realize everything really does work out in the end. Things get done that are meant to get done, and it's okay when they don’t. There are a million ways to skin a cat. The next bus will be coming”.
Words that describe Dr. Ngaruiya are: hardworking, trustworthy, and reliable. She tries to keep her word and holds to the saying, “If I say I will do it, I will do it!” It is important to her to be kind to others because “one never knows what someone else may be going through.” She also remembers being bullied and having to deal with difficult people. Those experiences taught her to be kind and patient with others.
Her virtues are balance and wellness. She has learned how important it is to take care of oneself, and is constantly working to improve in that area. At the core of everything that she does lies her faith. It is her primary foundation. Knowing that she has a higher purpose and that God is her strength, gives her the knowledge and wherewithal to accomplish anything she sets her mind to do.
While in Medical School, Dr. Ngaruiya took an elective class on working with disadvantaged populations." I was determined to see my class project through instead of just completing the class. I had become involved with the refugee community at my church with the French service there, so I volunteered to help with the evening service,” she said. “One day, a very happy and vibrant young woman came to the meeting, however, her infant was fussy and inconsolable. I wondered, where is the mom going to take the child? Is she going to know how to navigate the process?”
Dr. Ngaruiya couldn’t stop thinking about ways to help the woman with the crying child, who attended the evening service, and those thoughts propelled her to form a program called Bridge to Care. This program targets the largest number of refugees per capita in Nebraska. When the program first began, it was a two-hour long exchange of writing about basic health knowledge, ie. the flu season etc. Later, it encompassed lectures by experts on basic healthcare topics. Time was allotted to provide for meaningful exchange between the refugees and the lecturers. It wasn’t easy getting grants and vouchers for the refugees, but she never gave up. She successfully obtained a small grant which enabled the Health Department to get onboard with her vision. She put together a successful solid team which is still in existence today. The program hosts many events, one of which is an annual fair. It helps the community to be more aware of the refugees and to be involved and engaged in their healthcare. The program was sustainable and is now fifteen years old.
Most of us are intrigued about the procedures that are executed daily in the hospital Emergency Room, and Dr. Ngaruiya graciously provided us with a bird’s eye view into the daily demands of an ER physician. She explained,
“It is busy, unpredictable and exciting; approaching apprehension and trepidation. Trainees, as they are coming up in Med School, either love it or hate it. You never know what you are getting each day. Sometimes there are very, very, sick patients. The level of uncertainty and urgency is not something everyone can deal with. Some physicians can’t juggle that volume and feel comfortable with it. ER people are a certain breed. They are people that get bored easily or like a thrill and adventure. They don’t mind being pushed out of their comfort level. You have to be quick on your feet, being able to address whatever comes in. You also have to know when your boundaries have been met and consult another physician. You also must be good at customer service —- meeting patients for the first time: meeting, diagnosing, and discharging. You must be a special type of individual to do that. You don’t have the leisure like a primary care physician. Anyway, I love it! I like watching students' eyes come to life when they encounter the patients in the ER. I like the team spirit!”
Dr. Ngaruiya with her mentees from UON
Life inevitably has highs and lows and although Ngaruiya is obviously a glass-half-full type of person, she has had her share of disappointments. Admittedly, she feels that most of them have revolved around the fracturing of relationships, friendships, and partnerships with colleagues. She has been devastated when people for whom she cares and respects were disappointed in her. She doesn’t like to let others down. Because of these inherited traits, she enjoys relationship building, lifting people up, and valuing others’ opinions. When she has experienced broken relationships, she ponders these events in order to figure out how she could have had a better outcome. She has learned that boundaries are the key to having successful relationships. The popular book Boundaries, by Cloud and Townsend, has been helpful to her in this area. Her belief is that it is healthy to set boundaries in terms of what you will and won't do in different areas of your life. “It helps people in navigating relationships with you. Make boundaries clear early on, and have direct consequences for crossing them. Not having them can be more detrimental to you. My regret is that I didn’t understand them or set them early on. It hurt my relationships in the end,” she said.
When she isn’t working, reading is her favorite pastime. How Women Rise, A World Without Email, and How to Think Like a Monk are the books on her current reading list. She is slowly reading and meditating on Jay Sheddy’s book because she feels it is more of a meditation process than just reading through it. There are two new books that she also wants to read: Influence is Your Super Power and The 1619 Project.
At this time, Dr. Ngaruiya isn’t married or in a relationship. She has had wonderful dating experiences and is looking forward to God answering her prayers regarding a future life partner. There is no rush for her to be married, but she does want someone who shares her same beliefs, is culturally sensitive, and loves (or is willing to love) Africa and Kenya!
Her advice to young girls in Kenya is to always remember that “the sky's the limit” and that everything is possible with God. “Don’t be afraid to ask, keep pushing and don’t be shy about asking questions,” she said.
Lastly, her inspiration to continue to push for growth and change comes from an understanding of how Africa, along with many other parts of the world, isn’t treated equally. She envisions a panacea of equity for women and all races of people. Ngaruiya’s vision is to tear down the superficial boundaries that have been in existence for far too long. She stated, “I think about how I can elevate the next “me”, or someone like me. I think about how to give Kenya and Africa its best light and opportunity for it to shine. It is an incredibly resource rich country and its people are approachable, funny and smart. Also, the food is amazing!”
As we celebrate Black History Month, we are reminded of leaders, like Dr. James McCune Smith, the first black doctor to practice in America, who paved the way for other African American and African doctors to succeed here. Ngaruiya is a giant standing on the shoulders of giants, like the American Civil Rights leader Dr. Martin Luther King and the famous African American poet Langston Hughes, who told us to keep dreaming.
We are thankful for Dr. Christine Ngaruiya, the young Kenyan girl who never let go of her dream of being a doctor! In looking at her life and her accomplishments, we can’t wait to see what’s coming next!
Honors and Awards
The Emergency Medicine Residents Association (EMRA) Augustine D’Orta Award for outstanding community and grassroots involvement, Harambe Entrepreneur Alliance Associate and the 2014 Harambe Pfizer Fellow Award for social entrepreneurship, the 2016 University of Nebraska Outstanding International Alumnus award, the 2018 Society for Academic Emergency Medicine Global Emergency Medicine Academy Young Physician award, and the 2019 Yale School of Medicine Leonard Tow Humanism award. In 2020, she was selected as 1 of 24 women nationally as part of the Stanford-affiliated, Gates Foundation funded WomenLift Health Leadership Cohort.
She has held several national and international leadership positions including with: the American Medical Students’ Association (AMSA), the Emergency Medicine Residents’ Association (EMRA), the Society of Academic Emergency Medicine’s (SAEM) Global Emergency Medicine Academy, the Consortium of Universities for Global Health (CUGH)-Global Health Education Consortium (GHEC)-Canadian Society for International Health (CSIH) Trainee Conference and Advisory Committee, and the Women Leaders in Global Health (WLGH) conference committee. She was a member and regular contributor to the Young People’s Chronic Disease Network (YP-CDN). She is also a founding member of the Yale Network for Global Noncommunicable Disease (NGN) with an inaugural cross-campus symposium in 2016, which continues to play a role as a hub for global NCD work involving the Yale community. Additionally, she served on the research pre-symposium committee for the African Conference on Emergency Medicine in 2014, on the Scientific Committee in 2016, and as the chair for the research pre-symposium committee in 2020. She has sat on a number of NIH panels related to global NCD topics, and has lectured both nationally and internationally on the same
She was a senior contributor to the first ever national study on NCDs in Kenya using the WHO STEPs tool in collaboration with Kenya Ministry of Health, was awarded one of five 2017 Yale Global Health Leadership Institute Hecht-Albert junior faculty pilot awards to do an ED-based study on NCDs in Kenya, was one of two 2019 Yale Institute for Global Health faculty network awardees to assess the role of Natural Language Process in heart attack patients in Pakistan, and an NHLBI (NIH) awardee in 2021 to conduct an assessment on capacity of emergency care centers in Kenya to manage NCDs.
She was selected as one of twenty Yale Public Voice Fellows for 2015-2016 from across campus with around 30 publications in outlets such as Time, Huffington Post, Medium, and The Hill since that time. She continues to teach on the topic as the faculty advisor for the Yale OpEd and Advocacy course, a 4-year old program that is co-led by an interdisciplinary team of residents, and which has trained or mentored more than 150 trainees (residents and fellows) at YSM to date
In addition to joining faculty in the DEM in 2015, she was also selected as one of twenty Yale Public Voice Fellows for 2015-2016 from across campus with publications in a variety of outlets such as Time, Huffington Post, The Hill, among others.
Finally, she is the creator and co-founder of Kenyan Doctors USA (KEDU), a non-profit organization with a mission to provide an opportunity for discourse among diaspora physicians working across the U.S., and to engage with medical or health-related organizations and programs in Kenya.
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