From Elective Reviews - Tanzania - Kilimanjaro Christian Medical Centre, 2006 - Richard Crane, medical elective
I am sat watching BBC's Sport Relief and finally, after six weeks of searching, I have found the inspiration to write this article. I have just seen footage from a hospital in East Africa, the sort of images shown so often on appeals such as this. Except this time, it is different. This time, it doesn't seem such a world away. This time, I could see myself standing there in the bare, ill-equipped, overcrowded ward, because this time two months ago, that's exactly where I was. The television footage brings flooding back the moments of magic, where miracles seem to happen and the moments of sadness and desperation, where everything seems so futile, like a tiny drop in a great big ocean of poverty.
It is strange too, to see well-known celebrities so moved and yet so helpless, knowing that as doctors, God has given us a unique combination of gifts: the skills, the desire and the opportunity to help on a practical level.
KCMC is a 450-bed referral hospital in the foothills of Mount Kilimanjaro, serving the whole of north-eastern Tanzania. The hospital belongs to the Good Samaritan Foundation, an organisation of Anglican and Lutheran churches.
I have been asked many times why I chose to go to KCMC, but it is a question I have struggled to answer. It is not that I had a burning desire to go to Africa, the opportunity simply presented itself and in a moment of what might have turned out to be either inspiration or insanity, I took it. As the months ticked by and my departure drew ever closer, however, the thought of making a difference in one of the world's poorest countries grew more and more important.
I landed in Nairobi, and boarded a shuttle bus that would take me across the border to Moshi in Tanzania. I cannot put into words the profound sense of shock I felt as the shuttle drove just a few miles from the airport into true East Africa. The sight of swarms of people, walking in sandals through the dirt, the sight of mud huts with straw roofs. I felt as though I was in a Comic Relief clip myself, and I felt very overwhelmed! The thought that in just a few hours time, I would be out there walking and living among these people was impossible to imagine. (Incidentally, I would thoroughly recommend this route of arriving at KCMC. Flights are much cheaper and visas and shuttle buses are easily arranged on arrival. Plus, getting a six-hour road tour of rural East Africa is an unforgettable experience.)
I spent the weekend in a hotel in Moshi before arriving at KCMC on the Monday. I remember laying in my tiny, sweltering hotel room on the Sunday, thinking, 'What on earth have I done? I'm not cut out for things like this!' At that moment I felt more alone than I've ever felt. I prayed, and over the days and weeks that followed, God showed me exactly why I was there, and proved to me that I was very much cut out for this challenge after all.
Being in a place like Tanzania makes you question everything about life and God there is to question. Just when it seems so difficult to imagine that an all-powerful God can rule over such an unjust world, something happens to remind you that He is very much at work around you. As one colleague from Leeds who I met in Moshi put it, 'Working here really makes you question what you believe. So many things have happened in setting up this place (an orphanage) that cannot all be coincidence.'
During my time in Tanzania, especially during the hardest times, my inspiration came from the words of Dan Schutte's hymn:
'Here I am, Lord,
Is it I, Lord?
I have heard you calling in the night.
I will go, Lord,
If you lead me,
I will hold your people in my heart.
Within days, KCMC was very much home. There is always a strong community of international visitors living in the doctors' compound, as well as a small number of permanent missionary doctors from overseas. It was so refreshing to live in a community where being Christian was the norm, and was not something to be hidden away and not discussed, as it so often seems to be back home. This was perfectly illustrated when one morning as I was stood reading some notes, one of the hospital chaplains walked by, said good morning and asked, 'What denomination are you?' One of the sources of great strength and spiritual development during my stay was the weekly bible study, hosted by a missionary doctor living on the compound and attracting many of Moshi's ex-pat community, working on different projects, as well as one or two African staff from the hospital.
Sadly, the hospital is not always the haven it is meant to be. Financial restraints mean that treatment is very much dependent on a patient's ability to pay, which is highly frustrating, and the lack of resources, even in what is reputedly Tanzania's best hospital is made even more sad by the fact that it is due as much to pride and politics as it is to availability. One missionary doctor working at the hospital said that Africa's biggest problem is its refusal to be helped. It is of course easy to see why there is resentment towards wazungu (foreigners) trying to change things, but frustrating when experience shows that things could be done so much better.
Among the most touching moments of my time in Africa, were several days I spent doing outreach work with the aforementioned orphanage, Light in Africa, who run clinics for children out in the bush and run Christian schools as well as several children's homes. One such morning was spent playing with, feeding and providing medical care to a group of street children in a dusty town on the Moshi-Arusha highway, statistically the world's most dangerous road. These children had very literally, nothing. The clothes they wore were given to them by Light in Africa, and the hot meal they received was the only one they would receive all week. The saddest thing, however, was that the only thing they really wanted, was affection. They yearned to hold your hand, be picked up and carried around more than any material thing you could possibly give them.
One of the most humbling things about Tanzania is seeing those who have been dealt one of the roughest hands life can deal being so grateful to God for what they do have, whilst in our own privileged society, many do not acknowledge God at all.
I would certainly recommend KCMC to anybody considering an elective in Africa but who is concerned about a lack of support. There is a good support network professionally, with ultimate responsibility resting with the doctors, a good educational ethos around the hospital, and a strong support network around the compound from other visiting students and doctors. There are also many European residents in Moshi working on various education, medical and church projects who you are likely to meet. My only regret is perhaps that I did not have a little more responsibility, although I think this varies between departments.
I did not end up doing much of what I expected, paediatric surgery, at KCMC. Do I regret my choice? Not a bit. I discovered more about myself, my faith and my aspirations for the future, than I ever thought possible in Africa. I cannot wait until the opportunity arises to go back for a while, maybe to carry out surgery myself in a few years time!