University of Leeds 2020

Medical, Tanzania Dar es Salaam

Hanton, AliceWhen deciding where to do my elective I was overwhelmed by the choice; I could go pretty much anywhere in the world! 

I ended up choosing Dar es Salaam, Tanzania because I wanted to visit Africa, and it had the combination of beautiful beaches, a big city, the opportunity to go on safari and healthcare that would be different to what I’d seen in the UK. 

My fourth year of medicine was a busy and difficult year of the course, so I chose to go with Work the World to take a lot of the planning for my elective off of my hands. This meant I could focus on studying throughout the year and just look forward to my big six week trip in the summer!

I went on elective on my own but upon arriving in Dar es Salaam I almost immediately spotted other people in Work the World t-shirts at the airport. 

We were met by a member of the Work the World team who was really friendly. He gave us a comprehensive and enjoyable orientation of the city, the house and the hospital the next day. 

The Work the World house was great! More luxurious than I had expected – lots of my friends at home were jealous that I had a pool to relax by. 

The team at the house were all fantastic and very friendly.

We had breakfast and dinner prepared for us and had a great communal area complete with TV and Netflix. The team at the house were all fantastic and very friendly.

Hanton, AliceMy hospital placement was really well organised and made things a lot easier than if I’d arranged the elective myself. The Work the World team took me into the hospital on my first day and introduced me to the head of the anaesthetics department where I would be spending my first three weeks. 

At first, I was a bit overwhelmed, but the staff at the hospital were friendly and I soon found an anaesthetist who was happy for me to join him. 

On my first day, I watched a skin graft. This was for a wound infection on a woman’s foot that had progressed much further than I think it would have done in the UK. 

I found it really interesting to see the similarities and differences between Tanzanian and British healthcare. 

In many ways it is similar – the physiology obviously doesn’t change and neither do the technicalities of an anaesthetic. But there were subtle differences such as mosquitos buzzing around the theatre, crowds of Tanzanian students standing in theatre (as opposed to the one or two that would be allowed at home) and a relative lack of resources (the scrubs, for example, were pretty worn out). 

Within the first week of my anaesthetics rotation, I met a lovely Cuban doctor who was on a two-year post at the hospital. He took me under his wing and was fantastic – teaching me how to intubate and asking me how to properly pronounce English words! 

Hanton, Alice

I got lots of opportunities to assist with intubation, including on children, and always felt within my comfort zone because the doctor was supervising me. 

I was struck by how different communication and the attitudes towards patients was between Tanzania and the UK. 

During anaesthetics I’ve seen at home, the patient is always given a lot of reassurance, whereas at the hospital in Dar the attitude was a lot more paternalistic with little being explained to the patient – in fact, they were hardly spoken to. However, this was the accepted culture of the place and patients didn’t seem to expect anything different.

Medical school in Tanzania is taught in English, so I was able to easily communicate with all of the doctors I came across and understood the notes which were also written in English. 

Hanton, Alice

I really enjoyed chatting with the local students who I met on my second rotation on the infectious disease ward. 

They were really friendly and we shared a mutual interest in each other’s cultures and experiences of medical school. They were surprised to learn that we give analgesia in childbirth, responding with, “but it’s natural?!” 

On the infectious diseases ward the pattern of presentations was very different to the UK. There were numerous cases of HIV and its sequelae, tuberculosis infections and one possible case of rabies. 

My time on this ward was spent on consultant-led ward rounds. The consultants were happy for me to tag along with the other students and were keen to explain things to us.

Hanton, Alice

My time on placement was really interesting, and there was an excellent balance between placement and relaxation!

During my time off I relaxed by the pool or walked down to Slipway – the local shopping and restaurant area on the seafront. I even found a gym down the road to go to a few times a week – it was pretty run down and definitely a locals’ gym, but it was functional and nice getting to know the owners! 

I play ultimate frisbee at home and managed to seek out a Dar es Salaam team made up of locals and expats who I went to play with a couple of times. 

We had Swahili lessons at the house twice a week which were really useful, as well as fun! It’s a fairly easy language to pick up and by the end of my stay, I had lots of useful phrases up my sleeve. 

Hanton, Alice

One afternoon a group of us from the house went to a big football match at the city stadium which was quite an experience! The entire crowd supported the local team Simba, and we were apparently the only foreigners in the stadium as a TV crew came to interview us! 

In the evenings we had barbeques at the house, went out to local bars and had a weekly karaoke night at the local beach.

We went on an excellent safari and went on day trips to the nearby islands.

On the weekends I went out on trips with new friends from the house (who were doing a variety of courses - midwifery, physiotherapy, nursing and dentistry, as well as medicine - and were from all over the world). 

Hanton, Alice

We went on an excellent safari and went on day trips to the nearby islands. Four of us also went on a safari to the Serengeti and Ngorogoro Crater in the North which was an amazing experience! 

My highlight, though, was spending a weekend in Zanzibar! It’s easy to get a ferry across from Dar es Salaam, and there’s a guide that everyone from the house recommended who was brilliant. 

The beaches were absolutely stunning with crystal clear waters and Stonetown (the city) has a lovely, relaxed atmosphere. Seeing the giant tortoises on Prison Island was amazing, as was the ‘blue safari’ where we sailed around islands (complete with a constant supply of fresh tropical fruit on the boat!) and did lots of snorkelling.

Village Healthcare Week

My final week in Tanzania was spent on the Village Healthcare Week. Which was fantastic and ended up being my favourite week! 

Hanton, AliceThe village is a long coach ride away, which is an experience in itself, and we even spotted giraffes, warthogs and zebras as we drove through a national park. 

During the week, every morning was spent at the health centre either in the mother and baby clinic, shadowing technicians in the on-site lab, or sat in with the GP. 

I found sitting in with the doctors really interesting. Their attitude was a lot more paternalistic than in the UK, and although I found myself questioning their management decisions, at the same time I realised that I was far less experienced than them and did not know the local population. 

The GPs were really friendly and happy to have us sit in, and got us involved by dictating the notes to us.

Many of the patients had malaria (it was often the first differential to be ruled out), and the lab had rapid finger-prick testing for malaria, syphilis and HIV. 

Afternoons were spent doing a different activity each day: we went on a bike ride through the sugar cane plantations, walked up to a nearby waterfall where we could swim, went on a hike where we saw baboons, visited a witch doctor, and had a personal performance from a local dancing troupe. 

I would genuinely really recommend the Village Healthcare Week to anyone considering it.

Hanton, AliceI had a brilliant time in Tanzania and writing this review has brought back so many good memories! 

I’d highly recommend Work the World. They made organising an elective so easy and the team both in-country and at the head office in the UK have all been fantastic. 

The customer service is exceptional and any queries before the trip were responded to quickly and effectively. 

At the house in Dar, the team were invariably fantastic and became friends to us while we were there. 

My elective was such a good experience; I made some great friends who I’m still in touch with, I saw interesting and different medicine to what I’d see at home and I got to experience and enjoy a new country and culture.

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