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Going Global: Four Weeks in Tanzania - Week Three

Monday, July 6, 2015

My third week at Muhimbili Hospital in Tanzania began with week three of the trauma management clinical teaching units. The day's topics included acute care in the emergency department, introduction to clinical reasoning, seizure management, shock and sepsis - a real smorgasbord of topics.

It is interesting to note the emphasis that is placed on the family in Tanzanian health care. Oftentimes, the family plays the role of nurse and caregiver, even in the hospital setting. There is an expectation that the family will get food, water and medications for the patients in the hospital. The families also often assist with some of the more basic procedures, like holding a child still while placing an IV line. This emphasis on the family is also seen in the lectures delivered to medical students. The family is considered an important and indispensable resource for both the physicians and the patients.

I was also fortunate enough to be able to spend some more time in the infectious diseases unit this past week. Again, it is interesting to compare both the burden of disease and delivery of care between Canada and Tanzania. In Canada, our most burdensome comorbid conditions are things like coronary artery disease, diabetes, cancer, obesity etc. - all disease closely linked to lifestyle and diet. In Tanzania, however, the most prevalent comorbid conditions are almost entirely infectious in nature - malaria, tuberculosis, HIV, fungal infection. These conditions are closely linked to living conditions and poverty experienced by the people in Tanzania. In fact, 70 per cent of people living in Dar Es Salaam, the largest city in Tanzania, live in slums and non-permanent structures.

On Thursday, I scrubbed into my first surgery. Myself and two other Meds 2018 classmates (Rob Soegtrop and Taylor Bechamp) were able to see our first C-section. It was a healthy baby boy, weighing in at 2.3 kg.

Since we first landed in Tanzania, everyone has been insisting that we "go see the animals" so this past weekend we took off on a safari. We flew into Arusha (a city in northern Tanzania) and toured around Lake Manayara, the Serengeti and the Ngorongoro crater (the world largest unfilled volcanic crater). We can now proudly say that we have seen "The Big 5"- the African elephant, the leopard, the buffalo, the lion and the rhinoceros. We also spotted a cheetah perched in a tree, stalking its prey.

Check out Matt's Twitter feed from his third week at Muhimbili Hospital.