My trip to Mwanza Tanzania
Charlotte Brown (Medicine)

When it became apparent that focussing on oncology was going to be extremely difficult to achieve in Tanzania, I thought I would have to change either my specialist area or choice of destination. I was thrilled when Work the World managed to arrange a way for me to work in several other departments that gave me the flexibility to discover the oncology side of things once I was on site.  This arrangement worked perfectly, and after my first week at Bugando I was able to get in touch with the resident oncologist, who was more than happy to help me.

During the three weeks that I was at Bugando, I split my time between the obs&gynae department, theatres, and the oncology department.  In terms of obs&gynae there was a lot of time spent on ward rounds, which were usually full and hectic.  There were a LOT of Tanzanian students also there at the same time, and I found myself fighting to get involved at times.  However, there was good opportunity to spend time on the busy labour ward, as well as in theatre.  Tanzanian medical students are not allowed to attend clinics, and so I was able to observe one of the morning clinics, which was extremely interesting.  I also spent quite a bit of time in theatre, observing everything from the removal of massive tumours, to the removal of eyes!  I found that if I just turned up in theatre and had a look at the morning list, staff were more than happy for me to get involved in whatever was going on.  A word of warning though; try and take your own scrubs and masks!  With the oncologist I was able to attend ward rounds, which were quiet (no other students) and full to the brim with weird and wonderful signs.  There were also clinics running daily, which were a really good opportunity to see exactly the facilities available to the local people with regard to cancer care.

Overall, I had a fantastic three weeks at Bugando.  There were a lot of other students, and not too much opportunity to get my hands dirty clinically, but I had the chance to see some truly incredible things that I will probably never see again in my medical career!  Aside from the medical aspect, it was a really great opportunity to meet students from all over the World, and see how different life as a medical student is for them.  Do not be surprised/disheartened to be finished for the day at 11 or 12 o'clock, the doctors in Tanzania do not believe in working in the afternoon!!!

 My final week of placement was spent doing the village experience at Bukumbi.  This is what I wrote having just returned:  "Village Experience" sums the last week up perfectly! Certainly not for the faint hearted, but the absolute experience of a lifetime!! The hospital experience aside, getting the chance to immerse myself entirely in village life is something that will stay with me for many years to come.

Bukumbi hospital is private hospital (receiving no government funding), run by nuns living at the local convent. There are four main wards; a paediatric ward, a female ward, a male ward and an antenatal/postnatal/gynaecology ward. There is also a theatre and a sizeable outpatient department. There are a number of doctors and nurses who all live locally, and a large group of nursing students who live in a residential school just opposite the hospital. The in-patient portion of the hospital is relatively quiet, but the overflowing outpatient department more than makes up the workload of the Bukumbi staff!

Each day started with a ward round in one of the inpatient wards. In stark contrast to Bugando Medical Centre, we were heavily involved in the ward rounds; examining the patients and giving our opinion regarding patient care where possible. Following the ward round we headed to the out-patient department which was always heaving with patients waiting for their chance to see the team of the medical staff. The outpatient clinics were a perfect opportunity for us to observe conditions from a vast range of specialities, and following the patients up on the ward-round the following day gave us a real chance to observe the patient journey through Bukumbi hospital.

Every afternoon was spent experiencing a different aspect of the village culture. We hiked, took a ferry across the lake to a neighbouring village to do some shopping with the locals, met the traditional healer and had the chance to observe the local Sukuma tribe performing a traditional dance. It truly was a once-in-a-lifetime opportunity, and the welcoming nature of each and every member of the village made me feel honoured to have the chance to meet these incredible people.

To sum up I would thoroughly 200% recommend the village experience at Bukumbi to anyone considering it. The hospital was a perfect contrast to Bugando, and the clinical experience I gained has been invaluable. After a week of using a squat, and washing out of a bucket, I was definitely ready to return to the civilization of Mwanza.  However, the kindness of the people of Bukumbi, the strength of the patients and the picturesque scenery are fond memories that I will take with me as I continue in my medical career.

Having completed four weeks of placement, I was well and truly ready for a break!  We (myself and six friends) took a safari from Mwanza all the way to Arusha, passing through both the Serengeti and Ngorogoro National Parks.  This took four days to complete, and was absolutely out of this World.  I would highly recommend doing a safari, especially a four-day one if you have the time and money!  Four of us were then collected by a partner company from Arusha, and headed straight to Moshi, where we began our Kilimanjaro climb two days later!  It took us seven days to conquer the highest walkable summit in the World (5895m), and afterwards we were in desperate need of some serious r&r.  We caught a bus all the way to Dar, where we took the ferry to Zanzibar, which is where we stayed for the remaining two weeks of our trip.  We did very little other than RELAX in a big way on Zanzibar, but it was the perfect end to the trip.

All-in-all it was an absolutely incredible eight weeks of my life!  I would thoroughly recommend Work The World to anybody considering an elective in a developing country.  The guidance and support that I received both before and during the placement was exemplary, and it definitely made for a (relatively) stress-free trip!!!