Brighton & Sussex Medical School 2011

Medical, Tanzania Dar es Salaam

I spent my 6 week medical elective in the Regional Hospital of Dar es Salaam. It is hard to describe the experience in a few hundred words but it was honestly everything I wanted from my elective and more.
I spent 4 weeks in the paediatric department and 2 weeks in the internal medicine department but I would recommend anyone going for 6 weeks to split their placement equally as two weeks in one place just wasn’t enough!

The house in Oyster Bay was huge, and it was great meeting students from other parts of the UK (and some from other parts of the world). We loved having a swimming pool for those hot afternoons and evenings after a day in the hospital, and it was perfect for sunbathing around on our days off! The staff at the house were really friendly from day 1 and often ate dinner with us, telling us stories and laughing at our attempts at Swahili after our weekly lessons!

These clinics were a fantastic opportunity to see diseases that are quite rare in the UK, such as sickle cell anaemia, and the doctor was happy to translate so I was able to ask questions and also to carry out examinations.

My first week in the hospital was quite a challenge – whilst the doctors speak fluent English, very few of the patients do, so I found the language barrier a huge problem and resorted mainly to pointing and facial expressions. However, by the second week I was getting into my stride and followed the advice I had been given – make an effort to get involved and the staff will make an effort with you. I spent most of my time on the 53 bed paediatric ward, but I was also able to go to the paediatric clinic, which was a far cry from the ones I have attended in the UK. There is no appointment system and the patients are seen on a “first come, first served” basis, meaning some travel for miles to wait for hours to be seen by a doctor. These clinics were a fantastic opportunity to see diseases that are quite rare in the UK, such as sickle cell anaemia, and the doctor was happy to translate so I was able to ask questions and also to carry out examinations.

Whilst I was on the internal medicine wards I got a lot of experience at making clinical diagnoses, as the doctors in Tanzania have less access to imaging and investigations than we do in the UK, and so rely more heavily on the clinical picture to decide on diagnoses and treatment. I was also encouraged to spend a day in the lab, and the staff were really keen to teach, so I managed to get a crash course in cross matching, microbiology, serology, parasitology and haematology all in one day!

One piece of advice I would give to all students considering an overseas elective is –don’t hold back! If you hide in the corner of the ward and don’t speak to any of the staff or patients, they will ignore you and you won’t get anything from the experience. The majority of the staff are really keen to teach and they love to hear about life in the UK and how we do things in our hospitals.

After working hard during the week we wanted to play hard at the weekends. A highlight for me was the Dar es Salaam goat races – a huge day out attended by loads of locals where the jockeys pushed and cajoled the goats around the track in order to win the big money prizes. A day trip to the idyllic Bongoyo Island was perfect for sunbathing and relaxing, whereas the bike tour round the old town of Bagamoyo was far more energetic, but worth it to see the sights of the old slave town. There are also some amazing markets near to the house that are perfect for buying presents and souvenirs.

My favourite weekend was spent on Safari in Mikumi National Park – one day I was at the hospital on a ward round and the next I was seeing elephants, giraffes and lions in their natural habitat!

Evenings were spent at the house, just relaxing and playing card games, or sampling the various bars in Oyster Bay. From the nearby Hilton hotel with its cheap cocktails, or the local shisha bar, to the more expensive waterfront restaurants with their beautiful views, there were nights out to suit everyone (and every budget.) Thursday evenings started with Rehema’s amazing barbeque, with such delicious food we often had second and third helpings. The food was normally followed by games complete with the infamous Conyagi gin, before persuading the staff at the house to teach us African dancing, and then completing the night with a visit to the nearby “Sweet Easy” club for more drinks and dancing.

A visit to Zanzibar was the perfect way to end our trip. The Work the World staff were great at recommending hotels, day trips and taxi drivers to use whilst on the island. From Stone Town to Paje, I would advise anyone visiting Dar not to miss out on what is now my favourite place in the world!

So would I recommend an elective in Dar es Salaam? Yes – if you want a busy hospital experience in a developing country where you can experience a different culture whilst still being in a busy urban environment, and where English is widely spoken. Dar gives you plenty of opportunities to try new things – we even bought a pet goat for the Work the World House!

Alison Burridge, 2011

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