From Elective Reviews - Tanzania - Muheza District Hospital, 2006 - Anne-Marie Stone, medical elective
I went to Tanzania on my medical elective with a desire to make a difference. I was desperate to make an impact and save lives, and generally get the “feel good glow” of inputting into a third world country and making use of my medical knowledge. My time there taught me so much about medicine, about God and about perseverance. I left with a lot more character, realising that humility and a desire to please God and not men are key foundations to making effective change in our world.
Tanzania is a very beautiful and very poor country. It is very different from its neighbouring countries in that there is surprisingly little political strife or corruption. From the soaring heights of Mount Kilimanjaro to the cool plains of the Serengetti and the tropical humidity of Tanga it is a country full of promise. However the people struggle daily with water and electricity shortages. And like its neighbours it is a nation ravaged by HIV.
I went to a rural hospital for seven weeks. There were 5 fully trained doctors 15 clinical officers and about 30 nurses for a 250 bed hospital. Generally there were two to three patients per bed and each ward was dark and almost unbearably hot. We daily had water cuts and electricity cuts, which was not ideal at night in theatre! I spent most of my time on the surgical team, which consisted of me and the surgeon! I took on the role of managing the ward and minor surgical cases such as incision and drainage, and suturing. I was also taught how to set fractures, perform herniotomies, hydrocoelectomies and was left to manage a whole host of surgical emergencies! It was a true apprenticeship with the see one, do one, teach one approach and it gave me a lot of confidence. I really enjoyed the practical aspects of my time there however I found the resource allocation distressing.
It was interesting to observe the disparity between our centre and the HIV centre adjacent to it. The non-governmental organisation funded AIDS facilities had a CD4 counter, and yet our hospital's lab next door could not even test for electrolytes. HIV patients received free treatment whilst I saw children cry with pain with fractures that there parents could not afford to have treated. It was especially hard because we were told we were not allowed to pay for individual treatment for patients from our own pockets. This upset me particularly as it goes against the biblical precedent that;
'If anyone has material possessions and sees his brother in need but has no pity on him how can the love of God be in him? Dear children let us not love with words and tongue but with actions and in truth.' 1 John 3.17-18
However the more time I spent there the more I realised that when we have resources to give it is better to think carefully about how to distribute them and to do so with humility and discernment. The local people told me of the great resentment that had been caused through well meaning westerners choosing to give money to some and not others, and how it just caused harm to the community. I recognised in myself that my motivation for giving sometimes came from a desire to showcase my own generosity and get the satisfaction of “saving someone”. God calls us to serve him, not ourselves and that in these circumstances a quick fix may cause more harm than good. A better way to help was to give money to the administrators who would deal it out fairly. Although this was less glamorous and slightly heartbreaking when faced with the individual suffering it was right.
However this attitude can also have harmful effects. The Christians at the hospital, particularly the western ones had often a very hardened view of their roles in Tanzania. It can become easy to see all your efforts as a drop in the ocean or as pointless. Particularly for me; I recognised fairly swiftly how naive I was to believe I could do a huge amount in my short time there. Again this despondency was not of God and I was reminded of this scripture:
Therefore, my dear brothers, stand firm. Let nothing move you. Always give yourselves fully to the work of the Lord, because you know that your labour in the Lord is not in vain. 1 Corinthians 15:58
I loved being in Tanzania. We had very few showers and rarely electricity when we wanted to eat but the people were welcoming and the medicine was challenging and exciting. I needed God to get me through every day, particularly when running the paediatric ward at night and watching my patients die. However God's constant provision for my needs not only boosted my faith but really witnessed to the non-christian students with me in a powerful way. I left inspired and challenged.