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on June 23, 2013 on 6/23/13 from

Classes at a Tanzanian medical school

It’s been a hectic and tiring few days of conducting interviews, talking to stakeholders and getting frustrated at the internet speed at the college (my e-mail has been trying to load for the past fifteen minutes). My group decided to write a policy case study specifically on reducing patient waiting time in the medical outpatient department at KCMC (Kilimanjaro Christian Medical Centre). I was initially disappointed because I really wanted to focus on maternal health – watching a documentary on maternal mortality and the lack of obstetric care is what inspired me to pursue global health. However, my Tanzanian group members – who are fourth year medical students and have had plenty of clinical experience were really convinced that this topic needs to be studied further. We also hope to make real headway on giving feasible suggestions to reduce the patient waiting time at Kilimanjaro Christian Medical Centre (the local hospital) given the time limitation (three weeks).

My favorite portion was visiting the Manjengo Health Center – a local health facility in Moshi. We entered a modest concrete building where several patients were crammed into wooden benches. The assistant medical officer (a clinician who does not have a medical doctorate but can diagnose patients) informed us that it was HIV/AIDS clinic day. Seeing the hoards of men, women and children at the center with HIV/AIDS was overwhelming – all those classes learning about ART and mother-to-child transmission failed to prepare me to face a room full of people living with HIV/AIDS. No power point slides or brightly colored pie charts can really capture the human lives affected by disease – for this, I am extremely grateful to be able to learn about these health issues on a first hand basis. This experience has definitely confirmed my desire to pursue health – whether it is through public health or through a more clinical route by being a doctor. It was great to get a first hand perspective from the clinician, who said that she has been observing an increase in the rate of adolescents contracting HIV/AIDS as a generation who contracted AIDS due to mother to child transmission and survived due to access to treatment is beginning to experiment sexually.

We also conducted interviews with patients in the medical out-patient department and with staff members ranging from registration personnel to the director of hospital services (it was intimidating). I’m incredibly grateful to have this opportunity to delve into studying the health infrastructure of Tanzania and to work with my KCMC colleagues – Anzbert, Mselle and Happy (future doctors of Tanzania!). Exploring the hospital and talking to doctors, administrators and other staff has really clarified the limitations of effectively treating patients in this setting. I know for certain that I want to work on improving health in such settings in the future.

Also, while working on writing the case study yesterday, I was able to watch a bit of the football game between Tanzania and the Ivory Coast. The game was broadcast using a projector in a big auditorium. People wore Tanzania jerseys and stomped, cheered and banged on the desks in response to every ball pass. The crowd went absolutely crazy when Tanzania scored a goal – it felt like the whole building was shaking. It was so much fun to watch and cheer on with an auditorium full of Tanzanians – infinitely better than any sports bar. Though I was slightly intimated being a muzungu (foreigner) and all, I also found myself wishing I was part Tanzanian.

We also did a day hike of Mount Kilimanjaro this weekend. The mountain started out like a rain-forest-it was humid and the thick vegetation barely allowed any sunlight. Moss and other small plants covered all the trees and vines. We even spotted these black monkeys with really long and flouncy white tails. I also got to chat with some of our guides – David, one of our guides, is a really cool guy who lives near KCMC, likes to watch Prison Break and has climbed Mount Kili hundreds of times. The terrain got significantly drier as we made our way up until we reached a section that resembled dry grassland with these weird overgrown stumps of grass-like plants that reminded me of mandrakes from Harry Potter. I had a weird mefloquine-induced nightmare later that night that I pulled on the stumps of grass and discovered that it was the hair of people buried underground. Mefloquine is the malaria prophylaxis I’m taking – it can produce hallucinations and weird dreams. Anyway, we also saw this giant crater created by a meteor that hit the mountain. Another thing that amazed me is passing by all the porters carrying gas cylinders (firewood is prohibited) and knapsacks that look heavier than me all the way to the top of the mountain. It struck me that for some, climbing Mount Kilimanjaro is an accomplishment to boast about (the office in the base of the mountain even provides certificates) but for others, it is a daily routine of back-breaking labor. I made a pact with some friends that someday we’ll come back to the mountain and climb to the top – I hope we keep up to it!