Case Notes:
Matthew Owen
(HIV outreach, Tanzania )

I’m a 4th year medic from Guys, Kings and St Thomas’ Medical School, London. When I was looking for somewhere to go on elective, I knew I didn’t want to go somewhere like Australia (everyone goes there as if it’s a huge achievement!) or America (why try and be like Greys Anatomy when you can watch it on Channel 4?). I knew I wanted to go to Africa, but I also knew that in a developing country it would be so much better to go with an organised company, just for good health standards etc. As well as wanting to get some very good experience in an African hospital, I also wanted to try something different, and when I saw that Work the World were setting up a HIV Outreach Programme, I was all set. I contacted them about going to Tanzania shortly after - it was only 6 weeks before I wanted to go, which wasn’t ideal, but luckily it was still possible!

Until the day I flew (usual chaos at Heathrow) I had plenty of contact from Work the World and everyone there is so friendly you feel like you’ve know each other for years. After 7 hours in the air (good movies, especially Night at the Museum surprisingly) we finally touched down in Nairobi, and then quick change and 1 hour later, Kilimanjaro Airport in Tanzania, which is the closest airport to Arusha where Work the World Tanzania is based. At the airport, the friendliest person on the entire planet, Baptista (the local manager for Work the World) picked me up and there was a taxi waiting to take us to Arusha (exactly what you need when you’re a bit lagged).

The next few days consisted of gaining my bearings and figuring out how everything works in Arusha. The one thing that strikes you when you first walk around (someone from Work the World gives you a tour) is how friendly everyone is. Almost every single person on the street says ‘Jambo!’ (hello) to you with huge smiles and coming from somewhere like London (where, let’s face it, people are more likely to rob you blind or spit on you than say good morning!) it was such an experience!

Right! The HIV Outreach Project! There were 6 of us, including the Kate the Project Co-ordinator, and it has to be said we became like a little family during the 5 weeks the project lasted. The first week we spent devising our education schedule, travelling around Arusha making contacts and meeting the staff from the schools that we were to teach in. For people who don’t know much about the project, it consists of teaching about HIV transmission and its prevention in Arushan schools, followed by an event where we encourage the children and the people of Arusha to be tested and where the schools can celebrate what they have gained from our being there. We decided to call our project KUVA (‘Kupime ukimwi kwa vijana wa Arusha’ (HIV testing the youth of Arusha).

The following weeks we started teaching in the schools, which was definitely one of the highlights of the trip. The children were very fluent in English, extremely enthusiastic to see us and loved the lessons we had devised. It was very rewarding and it brings a smile to your face when they excitedly run into the classroom every lesson. During this time we were also getting ready for the KUVA 2007 event which we held at Arusha’s national football stadium. The event was an incredible success, and as we were all involved and essential to its smooth-running you get such a sense of achievement that you couldn’t get from just watching some Australian doctor take some blood in a Sydney hospital. We were featured in 3 newspapers, some radio shows and there was talk of a television programme in the works! Joining KUVA was one of the best choices I have ever made (incidentally one of the worst was treating myself to a Tanzanian haircut by a barber who spoke no English, hence in all the shots of me I’m in a beenie hat!).

On the hospital side, I was placed at St Elizabeth’s, which is a small private hospital in the centre of Arusha. On my first day one of the staff from Work the World came with me to see I settled in, and although I have to say that there was a language barrier (mainly with patients), I learnt so much whilst there. True there were some sights that shocked me, but it’s Africa, and I had come to see things I would never see in a Western world hospital. The main cases I encountered were HIV (never say ‘HIV’ in hospital though, it’s called ‘immunocomprimised disease’), malaria and a host of other surgical conditions. I was really given the chance to examine patients which is good. The most interesting times I had were in theatre, and it was great as the consultant supervising me always wanted to discuss the cases we were seeing (but not grill me like a quarter pounder as I’m used to on the wards here!). I learnt a lot, especially about HIV, and I’m glad I was placed there. I was at St Elizabeth’s for 3 weeks.

The Work the World house is something you don’t forget – it’s one of the nicest houses I’ve stayed in, UK-inclusive! The rooms are all spacious, and the living room and dining room are always buzzing with activity. One of the biggest concerns for most students’ on their electives is safety and you really couldn’t beat the security that the house has – iron gates, a 24/7 security guard and a beautiful front door even an atomic bomb couldn’t get through. The food in the house and in particular the housekeeping is amazing. The name of the housekeeper is Maryan and she becomes not only your housekeeper (the house was sparkling every night we got back), your cook (more than enough food and so nice I would have brought a suitcase sized doggy-bag had I known) but your friend, and no one will ever match her friendliness and energy. Go to Arusha and you’ll see what I mean.

The Work the World house is walkable from the town centre, but if you can get used to riding the dala-dalas (Arushan minibuses that are definitely a lot more fun than the tube) it’s even better. Nightlife in Arusha is quite good, although it is Africa so I was never expecting to stumble across an undiscovered Soho. The one thing you’ll notice is how different the bars and clubs are – the best bars are Via Via and Masai Camp and there you’re at the bar holding beers and chatting to Maasai people about their tribes etc. Amazing, and they know some good jokes!

After the KUVA Project ended, we took a quick trip to Zanzibar. The island is a 50 minute flight from Kilimanjaro airport, costing about £100 return, and accommodation is very cheap. We stayed at Kendwa (think of the cliche vision of a desert island, hammock with palm trees and that describes Kendwa) which was a total dream, and got to do some scuba diving. Stone Town is the city on Zanzibar and that’s also worth visiting, especially for the haggling which I’ve decided you have to train yourself up in (when you arrive in Tanzania you make do with the price they ask, when you leave you’re dragging them down to 10%).

Going on safari is something you must do. We visited 3 national parks, all not too far from Arusha, and to see the cast of the Lion King in real life was absolutely breath-taking. In Ngorogoro crater (one of the best national parks in the world) all the African animals you can think of are literally 2 minutes away from each other, although it’s when you see the first lion that I think everyone gives out a collective gasp. Climbing Mount Kilimanjaro is something I didn’t do, but was apparently well worth the climb and I wish I had now.

Before I finish I’d like to make mention of the children of Arusha; in particular those from the various orphanages around the town. During the KUVA project, the HIV project leader, Kate, introduced us to the CCF, a home for street children, and these children became locked in our memories (sounds cheesy, but you won’t meet more friendly boys anywhere else). Whilst on my hospital placement, my friend Soma and I visited the home to do some medical check-ups on the children which helped in sorting who needed to see the doctor when he came, and who didn’t. It also helped develop our paediatric examination skills. There was another orphanage closer to the WTW house, and information about that is readily available when you get to the house.

For anyone thinking of going with WTW to Arusha, for hospital placements only or the KUVA project too, I would totally encourage them to go. It was the best summer I’ve ever had and I just wish I had appreciated it more when I was there, as it’s easy to get used to how friendly Tanzanians are and how close a community the WTW house can be. It made it so much nicer than some of my friends’ electives have been, and I’m so glad I did it.