After (foolishly) deciding to summit Mount Kilimanjaro, my friend Nick and I decided we should make the most of our time in Tanzania, and squeeze in a quick clinical placement.
Our original plan was a placement in Uganda, but it fell through with only three months to go!
Work the World saved us. They created a placement for us in Tanzania, even closer to Kilimanjaro than we would have originally been.
The team were professional and proficient in sorting out the details for us. We simply couldn’t have done it without them.
When the day finally arrived, I was expecting a shock and Tanzania certainly delivered.
Arriving at the international airport was a lesson in chaos navigation. There was very little structure to the process, and no one was in a hurry.
The Work the World team on the ground in Tanzania were phenomenal.
On to the placement. I must admit I was nervous walking through the doors to the ED. I out of my depth clinically, and my Swahili was fairly basic.
I quickly cast my apprehension aside when a trauma case arrived literally five minutes after my arrival. Before I knew it, I was in resus supporting a humerus that had been snapped clean in half.
The staff all spoke excellent English and were receptive to my ideas and suggestions.
The fracture was sorted. Well, splinted at least. The doctors then handed the patient their bill!
Patients having to pay for treatment part way through treatment was one of the most confronting aspects of the placement.
But this was the reality of life in a busy, under-resourced hospital here. There was little funding, and the scarce disposable equipment disappeared days after it came in.
By day three I’d had plenty of opportunity to practice Swahili on my new colleagues. They were overjoyed that a ‘Mzungu’ (foreigner) was trying to speak their language.
Making the effort to speak Swahili was a huge contributor to earning the trust of local staff. They entrusted us with an array of responsibilities, the highlights of which included full cardiorespiratory assessments, neurological assessments, cannulation, venepuncture, ECGs, interpretation of ECGs, X-rays and CT scans.
I also helped diagnose my first ever malaria case!
On our last day, we even corrected a misdiagnosis. We were told that a patient had a brain tumour, but the CT scan showed a subdural haematoma.
We then helped intubate the patient, after which the oxygen ran out. This left us hand ventilating the patient on room air for 20 minutes.
If you’re thinking of travelling to Tanzania with Work the World:
Attempt Swahili — you will make mistakes but everyone will appreciate your effort.
Don’t be afraid to jump in — it often takes a while to get obs done on a new patient, so make life easier and do a set of obs yourself.
Be patient — everyone in Tanzania is relaxed, and there is nothing you can do to make the urgent head CT scan take less than several hours. I learnt the Swahili word for slowly — pole pole — on day one, but I still don’t know how to say quickly!
Bring your own PPE — gloves and hand sanitizer was scarce.
To leave the comfort zone far behind and gain experiences you will draw from for the rest of your life, look no further than a placement in Dar es Salaam.