Author: Allirra Selkirk
In January 2015 I set off on a series of flights that would ultimately land me in the Northern Tanzanian town of Moshi– best known for sitting at the foot of Africa’s tallest mountain, Mt Kilimanjaro. Moshi is also home to the Kilimanjaro Christian Medical Centre, a 450+ bed referral
hospital for 11 million people. KCMC runs a local medical teaching program as well as accepting international students from around the world for elective placements.
Moshi has one of Tanzania’s lowest rates of HIV at approximately 3%, however, HIV accounts for a high proportion of admissions and I encountered a mix of newly diagnosed adults and children and patients presenting with AIDS-defining illnesses. I also saw cases of TB, advanced lymphomas, advanced CNS tumours and malaria, including a pregnant woman with cerebral malaria, something I had only ever read about in text books. I was also surprised at the rate of lifestyle diseases including heart disease, hypertension and diabetes, with diabetic complications a common feature during ward rounds. KCMC receives its blood supply from local university students, and in holiday times (including January), KCMC experiences a critical shortage of blood and consequently patients were dying from blood loss, severe anaemia or being denied surgery.
I spent much of my time with the local medical students, attending their lectures, hand-over, ward rounds and tutorials. The lecturers were engaging and friendly and it was refreshing to see blackboards used instead of computers! I also learnt how the local doctors rely on clinical judgment over pathology tests and imaging and how they develop management strategies without the supporting evidence that we rely on. This was particularly useful as KCMC’s CT machine has been broken for many months now.
I met Tanzanians from a range of tribes including Chagga, Masai and Iraqw. These people are proud of their heritage and are proud to tell you about their background and family. Extended families play a vital role in caring for patients in and out of hospital including providing food, money and support. We were privileged to be invited for a traditional Tanzanian meal by one of our drivers and his family. These personal encounters made the whole experience richer and more rewarding.
My time in Tanzania featured a packed social calendar, which greatly enriched the experience. We lived in on-campus houses with other students from Aus, NZ, Germany, USA, Austria and Switzerland. Every night dinner was either at home with my housemates or the students would
eat at one of several cheap local restaurants. Everyone had advice about places to visit, food to eat, and what to do with your time off (to climb Kili or not to climb Kili?), which meant we visited plenty of local sites you won’t read about in the Lonely Planet and had new friends to share the experiences with. We used these recommendations to book a fantastic safari company for our end-of-trip safari –definitely a high-note to end our elective on. We also took some time to relax on the amazing beaches of Zanzibar, while other people took the time to climb Kilimanjaro.
Unsurprisingly, I learnt a little about myself including 1) my ability to tolerate long flights and cold showers, 2) I prefer to admire Kilimanjaro from the base than set foot on it and 3) I am definitely “that” person who always gets bitten by mosquitos!
I highly enjoyed my time in Tanzania in terms of both my professional and personal education. I learnt a great deal about medicine in a developing nation as well as about the people and places of Northern Tanzania. I saw this experience as a small peek into an area of medicine that I
may wish to explore in the future and I hope to return one day in the not-so-distant future.