from the window of the plane i saw a mish mash of cramped together huts and houses passing below as we landed. we stepped off the plane and made our way through immigration, toughing out the humidity. my elective in tanzania - my first trip abroad - had begun. i come from the uk — a small island with an advanced healthcare system. tanzania is at the other end of both scales.
Mornings in my placement hospital’s A&E were relatively quiet. But when the clock struck one, referrals from around the country came flooding in. Patients with malaria, hypokalaemia (potassium deficiency), victims of domestic abuse, stabbings; I saw a wide variety of cases.
The A&E staff were welcoming and the majority of them spoke English. However, it was learning a bit of Swahili that allowed me to develop friendships with them. Local staff gave us plenty of encouragement and we exchanged knowledge on current cases in the A&E department. These friendships also resulted in some amazing learning opportunities.
local doctors and nurses encouraged me to get involved from day one. i even assisted in securing a broken humerus with nothing but torn up cardboard boxes and bandages. cases involving road traffic accidents were particularly confronting. car accidents were common - the roads were packed, and there were more than a few drunk drivers. this caused a number of serious accidents.
the domestic abuse cases were incredibly challenging. i saw several women and children who had been attacked with both blunt and sharp objects, causing major injuries. domestic abuse does occur in the uk, but i don’t think it’s on this scale. i remember one woman who was covered in multiple, deep lacerations. her composure awed me, especially after enduring what must have been a horrifying event. i found out that women in tanzania can’t divorce their husbands even when faced with domestic abuse. i also found out that outside of the city, if women and children didn’t fulfil their ‘duties’, domestic abuse was the norm. cases like these were confronting, but staff and my housemates were always there when i needed to offload my thoughts. this was one of the best parts of living in a house with other people.
after a hard day’s work, we explored dar es salaam itself. there was plenty to do. some evenings involved staying at home with a pizza. but most of the time we went out to shop for clothes and food, or to see some of the amazing street art found around the city. in the evenings, we went down to coco beach for karaoke, or for drinks at one of the local bars. we filled our weekends too. we took trips to zanzibar (a white-sand paradise island), went on safari in mikumi national park and explored the further reaches of the city.
i spent the last week of my trip in a rural village. our official tour guide picked us up from our accommodation and we set off. it was an experience i’ll never forget. we spent our mornings seeing what it was like to practice nursing at a rural clinic. considering the size of the local population, the clinic was small. further to that, the only clinics available were maternity, one female ward, hiv treatment, family planning, and a gp. they had a lab that did investigations for hiv, malaria, and syphilis. they also had a pharmacy that provided the drugs.
we spent some time listening in on gp appointments. most patients were simply prescribed antibiotics, regardless of the diagnosis. there was very little investigation into their condition or medical history. after our morning shifts, our guide picked us up and we made our way back to our host family for lunch. this normally involved serious portions of food — we never went hungry on this trip. after lunch, we explored the village and did activities like hikes, bike rides, visited the local ‘witch doctor’ and got involved in some traditional dancing!
when we got back to our accommodation in the city after our time in the village, we went on one last night out with our housemates. this brought our month-long trip in tanzania to an amazing end.
i’ll never forget the experiences and friends i made on this once-in-a-lifetime adventure.