Coventry University 2010

Physiotherapy, Tanzania Dar es Salaam

Before leaving for Dar on my physiotherapy elective I felt well prepared. The team in Brighton were happy to answer my questions and, give me any advice and support I needed. Flying on my own was the scariest thing I have even done! When I collected my bag and walked through arrivals, I saw a very smiley Baptista in his blue shirt. This instantly filled me with so much relief!

The house is beautiful, the pool being its highlight!  It's in a really good location close to shops, Internet cafĂ© and cash machine. 

Rooms are spacious, with bunk beds based on 4-6 sharing.  The house has 24 hour security, which made me feel really safe.  There were a lot of students there when I arrived and again being on my own was daunting, but everyone was friendly and welcoming.  There were 6 of us that had arrived that weekend, so with the introduction, tour of the surrounding area and of the hospital, it meant that we had time to get to know each other and bonded quickly being in the same boat!

To get to work you take the Daladala or public minibus.  It takes half an hour but can take longer in the mornings with traffic, and costs about 25p a day.  My placement was in the biggest hospital in the country.  I was based in the orthopaedic institute for 5 weeks.  Lucas is the head of the department, along with 10 other physiotherapists.  All are really friendly and are happy to have students around.  Communication posed the biggest barrier that I found challenging to overcome.  However the teams English is excellent, and patience for translating is endless, so I made some advancement with my ever improving Kiswahili!  The physios are very knowledgeable and keen to exchange ideas and techniques. 

At work I wore scrub bottoms and my uni polo top.  It was the coolest and most appropriate thing I could wear.  I took my own gloves (they don't have powder or latex free) and hand gel.
 

A typical working day for the Physio department is officially 8 - 4, with an evening clinic until 7.  From 8-11 each physio visits the wards of their specialist area.  Lucas developed a roster for me so that I was distributed amongst the staff and could therefore experience many areas of the hospital.  This included ICU, burns and plastics, trauma and elective orthopaedic wards, both public and private.  After wards I returned to the outpatient department to observe, treat or assess with supervision, a mix of patients.  These included orthopaedic, chronic back and neck pain, and neurological patients.  My day usually finished around 3pm.  On request Lucas organised for us to observe a total hip replacement surgery, and also for me to spend a week in the paediatric department of the main hospital.  Here I was given the opportunity to experience children with cerebral palsy, with a fantastic team of physios.

The department's gym has an exercise bike, parallel bars, steps and some walking aids. Physiotheraputic approach is mostly manual, which gave me the opportunity to develop my hands on techniques. Some treatment methods seem very outdated, for example they use a lot of interferential and traction to manage fractures.  It is hard not to compare African healthcare to what were used to back home. The environment is very different; with wards so busy that patient's sleep on floors or sometimes share two to a mattress.  Staff are stretched with limited or no resources and at times I found things shocking and frustrating.

During the week we spent our evenings playing card games, boa - an African board game, pictionary, reading, watching football at Q Bar, baking cookies, going to the cinema at Mlimani City, or just sat by the pool with a cold bottle of Kilimanjaro beer chatting and listening to music.  Thursdays were especially fun as it was BBQ night and usually ends in Sweet and Easy, a club where Banana Zoro perform!  Weekends are best used for exploring.  Zanzibar offers the full moon party at Kendwa, swimming with dolphins in the south, red colobus Monkeys in Jozani forest, tortoises on Prison Island and the spice tours in Stone Town.  Bongoyo island, Kipepeo beach, Sea Cliff and Slip Way I would also recommend to visit.

Myself and 5 of my housemates went on safari to the Serengeti for 2 days, and the Ngorongoro crater for a day.  This was the single best experience of my life. 

We caught the bus to Arusha, (which be warned takes 10 hours!) and stayed in the backpacker hostel, we were then picked up by SOKO for our amazing safari adventure.  We were lucky enough to see the big 5 and some beautiful landscape.  Our guide was fun and informative and we were well fed!  It was more expansive than I had planned before going to Dar, but I felt it was a once in a lifetime experience and not to be missed.  SOKO deal with Work the World students a lot and so usually offer a good deal.  My biggest tip would be dress warm!!  At night temperatures drop and in a tent you need a jumper and joggers!

All of the Work the World house staff were amazing.  While I was at the house Alpha joined the team, so we had the opportunity to get to know him.  Alpha, Baptista and Rashid are all very approachable.  They are a wealth of knowledge for whatever you want to do and they don't mind you asking.  Reheema and Akiba do a beautiful job in the kitchen!  Reheema took me to have my hair braided - again something I would recommend for safari, and to explore the local market.  Johnson holds Swahili lessons on the porch a few times a week to teach us greetings, numbers, body parts etc, which really helped us to get by day to day.

I thoroughly enjoyed my placement and time in Dar.  I met the most amazing people, learnt new things about myself and experienced things that have changed my outlook on life.  I would recommend WorktheWorld and the Dar physio placement to anyone who wants to travel, develop your clinical skills within a challenging yet rewarding environment and meet new people.

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