My Elective - Tanzania 2013

Elective: Tanzania, East Africa
Member Name: Garth Douglas
Destination: The Swahili coast, Tanzania, East Africa
Hospitals: Mnazi Mmoja Hospital, Zanzibar and Shree Hindu Mandal Hospital, Dar es Salaam
Length of placement: two months total (a month in each hospital)

During my stay I also took some time to appreciate the stunning beauty of the country, its rich cultural history, abundant wildlife and diverse landscapes.

My colleagues and I decided on Tanzania well in advance. Tanzania's reputation of being a country of peace amongst relatively volatile and politically unstable neighbours made it an ideal choice. After undertaking some online research – sifting through medical student blogs, past elective reports and utilising our free subscription to The Electives Network as part of our Membership with MDA National – we shortlisted hospitals in different locations within Tanzania, and finally settled on two.

The preparations

As the preparations were underway, exciting new plans began to take shape and I was intrigued by the idea of documenting the whole experience in the form of a video exposé. The goal was to share my experiences and provide an insight into developing world health care. I also considered the project a good candidate for attracting charity support to the areas we visited.

After gaining support from key stakeholders, we raised enough money for medical supplies – 300 birthing kits and 100 first aid kits – which we delivered to a regional mission clinic South of Dar es Salaam and a missionary nurse living in a remote and isolated coastal village.

The elective experience

We spent the first four weeks at the Mnazi Mmoja Hospital located in Stone Town, on the west coast of Zanzibar. This 400-bed hospital had every major department, and with around 8-10 international medical students at any one time, it's a popular destination for medical students from around the globe. I spent three weeks in pediatrics and a week on the ENT team. Due to the language barriers, working autonomously was not possible but most handovers and ward rounds were conducted in English and there were opportunities to assist with procedures and contribute to patient management. Mnazi Mmoja has reciprocal partnerships with hospitals from Norway and China where medical and surgical teams integrate with the local medical staff and help to treat patients and improve hospital protocols. It was great to see these lasting partnerships making in-roads into sustainable health care improvement.

The next four weeks were spent in ED at Shree Hindu Mandal hospital where I saw some very exotic infectious pathologies. The medical team was very welcoming and happy to teach me about the abundance of malaria, tuberculosis, and end stage HIV comorbidities such as cerebral cryptococcus, toxoplasmosis and PCP. This clinical experience was a highlight of the elective. There were difficult days and but I learnt lessons that couldn't be taught without the experience.

Something that gradually dawned on me was that the healthcare system in Tanzania had to be prepared to deal with pathology from both the developing and the developed world. Tropical disease formed the majority of illnesses; however the prevalence of lifestyle disease such as diabetes, hypertension, and ischemic heart disease was also alarmingly high.

Down time

Armed with a fully loaded additional holiday week allocated to travel, it was difficult to know where to start. Tanzania boasts the largest freestanding mountain in the world at 5895M above sea level. It's also a stage to some of the largest game reserves in Africa and is home to none other than Simba, Timone and Pumbaa who are now enjoying their retirement in the Serengeti! The Zanzibar archipelago also has some stunning reef diving, friendly dolphins and an array of marine life unique to the area. You're probably thinking it's not possible to do all of this in one week. You're probably not wrong!

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In summary I had an unforgettable experience among the people of Tanzania and would recommend this placement to any dedicated global health enthusiast. From international hospital collaborations to rural mobile health clinics, Tanzania is a developing country with an evolving healthcare sector. I count myself lucky to have witnessed a few projects focused on doing just that.

We will feature Garth's video exposé in a future issue of Student eNews.