Medicine & Healthcare in Tanzania by Jamie Nichols
A Glimpse of Life in East Africa
At my university, students are able to take time off from classes and receive credit for working at a job related to their degree. As a pre-medical student, this presented the perfect opportunity to travel and gain experience in the field of medicine. I researched different volunteer programmes, and it was my school advisor that in the end recommended Projects Abroad.
I have always loved travelling and hiking, and for years I had aspired to climb Mt. Kilimanjaro. For this reason I gravitated towards Tanzania as my placement choice. All it took was an e-mail to Projects Abroad and I was well on my way to a medical placement at West Meru Hospital in Arusha.
Arriving in Tanzania
I arrived at Kilimanjaro International Airport late at night on January 19th, 2011, and began the thrilling ascent up Kilimanjaro the following day. A week later I returned tired and dirty, but with a new sense of confidence and accomplishment. My trip had already been a whirlwind, and I was excited for the months that lay ahead.
After moving in with my host family in Usa River, I enjoyed a delicious home cooked meal and prepared for my first day of work. Truth be told, though, there was no way to prepare for what was in store for me at the hospital.
My medical placement
On my first day I observed an emergency caesarean section in the operating theatre. The second day, I saw three natural births in the maternity ward. Needless to say I was stunned. Overall, the first week at the hospital was nerve-wracking yet mesmerising. I was taking the crowded dala-dala bus every day and struggling with a language barrier, and I felt incompetent because I lacked the knowledge that the doctors and medical volunteers had.
Once I got my bearings, however, things started falling in to place and I quickly learned that a little initiative went a long way. It wasn’t long before I was attending ward rounds, observing surgeries, and assisting in the emergency room. I knew I had come a long way when after a few weeks I was able to discuss with the doctors that one child’s symptoms warranted a malaria test, while another’s was probably just a case of dehydration.
I spent as much time as I could in each ward; and one I always enjoyed visiting was the Dental Unit; the first time I saw a tooth pulled I was hooked! I became good friends with both of the dentists and they were always willing to explain their work to me, from the mechanism of how a lidocaine injection numbs the gums, to the process of making and fitting a row of artificial teeth. The dentists also loved quizzing me on the language, and by the end of my stay I was able to tell patients, in Swahili, to “gargle with warm salt water” and “refrain from touching the wound with their hands or tongue.” Between the instruction I got from my host brothers and the dentists, by the end of my stay I was comfortable speaking conversational Swahili.
Two wards that never lacked in shock value were Minor Theatre (the emergency room) and Major Theatre (the operating room). Thursday mornings at 10am I put on a set of scrubs and rubber boots and assumed my place in the corner of the operating theatre. In the weeks following the caesarean section on my first day, I saw a uterine myomectomy, an appendectomy, a hydrocele surgery, and a hernia surgery. Sometimes music played from a doctor’s cell phone during the operations. Listening to Jim Reeves’ “This World is Not My Home” or Shakira’s “Waka Waka” as a patient lay on the table being cut open only added to the surreal atmosphere during these experiences.
In the emergency room, I was allowed to assist in wound cleaning or holding broken limbs in place as they were wrapped tightly with plaster of paris. Patients with broken bones always arrived with their X-rays from the radiology department, where I also spent a good deal of time. There, I learned how to X-ray patients and set the ray exposure to certain values based on the density of the body part we were imaging.
Most of the patients had broken bones or needed a chest X-ray to diagnose tuberculosis, and I learned how to interpret their films after processing them in the dark room. The radiology department was also home to the ultrasound machine. I learned how to distinguish different organs on the monitor and detect abnormalities, and how to interpret pregnancy information such as gestation age, cephalic presentation, and fetal heart rate.
Travelling and socialising in Tanzania
My three months with Projects Abroad wasn’t solely spent at the hospital. I camped in the Serengeti during a 5-day safari with a group of volunteers, where we saw lions, elephants, zebras, giraffes, a leapard, and more. I spent a week on the exotic island of Zanzibar, relaxing on beautiful beaches, exploring and admiring the architecture, and savoring the varieties of foods and spices.
The Projects Abroad staff were wonderful. They hosted volunteer projects and weekly socials, where all the volunteers gathered in Arusha to go to dinner and, usually afterwards, dancing at Via Via. Some of my experiences in Tanzania took me so far out of my comfort zone that I returned home with a new sense of self and adventure. I also gained the experience I was looking for on an academic level, and am more certain now than ever that I want to pursue a career in medicine.