Tuesday, June 16, 2015
I am currently doing a global health non-credit summer elective (MEDS1050) at Muhimbili Hospital in Dar Es Salaam, Tanzania. The majority of my time will be spent in the emergency department and I will be completing a clinical teaching unit in trauma management in resource-limited settings. I will also be rotating through the infectious diseases unit through the department of internal medicine. I am completing this elective with four Schulich Medicine colleagues, all of us finishing our first year in medical school.
After more than 30 hours of travelling from London to Toronto, Amsterdam, Frankfurt, Doha and finally into Dar Es Salaam, we were quite relieved and exhausted when we arrived at our apartment in the centre of the sprawling city. Our landlord stopped by and took us for a tour of the city and brought us out for a classic Tanzanian meal – street-side barbecue.
On the morning of June 8, we met with the international exchange coordinator at the Muhimbili University of Health and Allied Sciences (MUHAS) and received our badges for the next month. The staff at the office showed us around the campus and took us for lunch at the staff cafeteria. My four colleagues and I went our separate ways to introduce ourselves to our prospective preceptors.
I completed the first unit of my trauma management block on Tuesday morning. Topics included poly-trauma management, head trauma and paediatric/geriatric medicine. The class included medical student, residents, interns and attending physicians. Interestingly, medical students in Tanzania go straight into medical school from high school, spend five years in school and then go into a residency system very similar to that found in the United States.
As part of that training, I was invited to attend a symposium on Wednesday morning on CPAP (Continuous Positive Airway Pressure) – a setting on ventilator machines in emergency situations, specifically in Tanzania. The instructor noted interestingly that Muhimbili hospital has 1,500 beds, however only four beds in the intensive care unit (ICU). According to the instructor, the standard is that a hospital should have 10 per cent of its beds devoted to ICU which would translate to 150 beds. I was more surprised to learn, however, that the emergency department and the ICU only have two ventilators to share between them. There are no paediatric CPAP masks and this is the most technically advanced hospital in Tanzania. It is eye-opening to see how medicine is practised in a resource-limited setting like Dar Es Salaam.
Check out Matt's Twitter feed from his first few days at Muhimbili Hospital.