My name is Chris and I spent one month volunteering on a medical project elective in the village of Meru, Tanzania. During my time in Africa, I worked in many different departments at Meru District Hospital, but I enjoyed my experiences in the ER and major surgery theater the most. Meru District Hospital was situated near the heart of third world Kilimanjaro, Tanzania, an area impoverished with limited resources in many aspects of health care, whether it is the medicine distributed, sterilization supplies, or the way the public was educated on healthcare. In an area where health insurance didn't exist, people of all shapes and sizes would crowd the emergency room daily with many different health concerns. It was during this month I learned exactly what it would take to work as a medical doctor in an area of unwarranted variation (Figure 1).

Figure 1

When I arrived in Africa after a day and a half of flying halfway across the globe, I was exhausted. If I didn't have the weekend to rest, I'm not sure if I would have been ready to work that first Monday. It was during the weekend though that I was able to embrace a bit of the Africa feel. One aspect I really appreciated right away was the community bond I felt between all members of the village I stayed in, Usa River. As I drove on the main road to get to the village from the airport, my host family Zablon and Pretty Mgonja explained how thick the soil was throughout the Kilimanjaro area, and as a result it was extremely dry and clean water was often a major issue. Right away I realized that it was these little things that would begin to make an impact on me throughout my trip (Figure 2).

Figure 2

As my first week at the hospital began, I was introduced to the DalaDala, a public transport van that would travel from village to village to take me to work. At the hospital, I was greeted by the hospital matron and after reviewing my resume, the matron requested I deliver a presentation on immunology to the entire hospital. Before the matron gave me permission to begin my work, she showed me every department within the hospital. As we walked along the district hospital I saw how every department resembled a piece of a puzzle; it was like the hospital was a village in itself. Some of the departments included pediatrics, major and minor surgery (ER), female and male ward, AIDS ward, and even a TB ward. The matron permitted access to every department, but because of my passion to become a surgeon, I immediately dove right into work at the ER department. When I began my work, the staff treated me very much like a medical student; the nurses and doctors were so welcoming and eager for me to learn and practice new skills. At first, much of the staff was very instructive, teaching me the basics of suturing and injecting needles, but by the end of the first week there was nothing or nobody to hold me back, I was caring for dozens of patients all on my own every day.. It almost felt too good to be true (Figure 3).

Figure 3

As my time in Africa grew, I was finding myself more and more involved in the ER and surgery department so much that even ethical issues in medicine were starting to surface amidst my experiences. One of the most startling issues was that many of my patients were young females who had given themselves abortions. Because abortions were illegal in Tanzania, young women would often damage their bodies by giving themselves an abortion; it was my duty to make sure to clean out the reproductive tract and make sure the woman would not have any further health issues down the road. These kinds of situations made me aware of how politics and social situations can influence certain factors in healthcare and it made me understand how my only view was simply to help a person in any way that I could. My time in the ER helped me deal with injections, POP casts from broken limbs, auscultations, catheters, and stabbings and wound cleaning, seizures, gunshots, and even motor vehicle accidents. I was getting so involved and with the amount of trust and responsibility that was bestowed upon me, it just felt right to keep going. Sometimes I would clean out an infection, whether on an infant or an elderly man, I knew how bad it would hurt to make that incision to flush out the abscess, so I would sometimes just let the patient hold onto me and squeeze my arm whenever it would hurt them just so I could hurt a little bit too and feel their pain. In my mind it was all definitely a case of learning fast, being confident, and embracing any challenge with a grain of salt, but I wanted all of that so bad... I wanted to keep learning; it was like I had something to prove. The ER shaped me the most out of all the departments, but it was being able to assist with both suturing during a cesarean and hernia surgery in the major surgery department that really made my experiences most memorable (Figure 4).

Figure 4

Easily the best thing about working at the Meru District Hospital came in my last week of work. Of all the time I spent working, I felt the most experienced in my last week, and as a result the matron and staff allowed me to do rounds in the male and female ward. I would show up to work and begin my rounds around 8am and would finish up by 11am. Some of my cases included stroke, malaria, and AIDS patients. I remember sometimes being amazed at how different such cases were than the standard patient one might see at a hospital back in the US. I took each patient as a lesson, spending time with them, analyzing their treatment regimen, and making sure their condition was on its way to being stable. I must have looked like such an alien to some of those people, but that never stopped me from giving them my best care. My most memorable moment though was when I had the opportunity to deliver a baby in the female ward. It was perhaps the most exhilarating moment in my life, being able to take charge in such a situation. It felt completely natural. I look back on my achievements and realize that I would not have been able to do some of these things in the US. These are some of the moments that I will remember for a long, long time (Figure 5).

Figure 5

On my last day at the hospital, the entire hospital staff showed up to listen to my presentation. During my placement I truly felt that infectious diseases and unwarranted variation prohibited many of the people from being healthy, so I decided to base my presentation on the basics of innate and acquired immunity. The entire presentation lasted about 45 minutes, followed by a series of questions asked by several staff members. Near the end of my presentation, some of the doctors and head staff members made me feel humbled by acknowledging all the work I did in the last month at their hospital. As I write these 3 months since I returned from my trip, some of the faces still stick with me. These people really gave up their time to teach a stranger. Of all the feelings I felt during this trip, I realized that there really are a lot of good people in the world; you just have to carry an open heart. I found that ultimately if you truly pour your heart into what you believe in, even if it makes you vulnerable, amazing things can and will happen (Figure 6).

Figure 6

Even though the application process and the grueling flight hours may have seemed like a challenge at first, going through this experience with Global Medical Projects helped me to meet some really amazing people that I consider a part of my family now. When you share the same meals, experiences, and a roof under your head with people who are there to take care of you, you establish this connection that can truly last a lifetime if you let it. At first I was a bit concerned being the only volunteer to stay with my host family, but both were fantastic in meeting any of my needs/requests, including picking me up from the airport, assisting me with my bus fare to work when I needed it, and even helping me plan an excursion to the island of Zanzibar for a weekend trip. Perhaps the thing I valued the most that they showed me was an orphanage down the road from where I was staying called "Good Hope." After visiting the orphanage 2 weeks into my stay, I told myself that I would visit the kid’s every day after work no matter what. Seeing those smiling faces really made the trip worth it, and because of the orphanage I made a promise to myself that I would go back to Usa River once my journey to becoming a doctor is complete (Figure 7).

Figure 7

I assume you can organize your own placement directly with Meru hospital if you wanted to, but I would strongly recommend going through a company such as Global Medical Projects the first time around, as this provides you with the safety and security which, in my opinion, truly matters when you may seem like a complete stranger to the country and it is easy to stand out. I am truly grateful for all that the staff at Meru District Hospital went through to teach me how to be a better medical professional and I am forever humbled to be so warmly welcomed by the entire village of Usa River during my placement. When I arrived to Usa River, I remember going to the village church on my second day and feeling like a stranger completely lost in the culture, but as I think back on my journey, I think of Usa River and Tanzania on a whole as a hidden place, tucked safely away from the world, concealed by the high walls of the Meru and Kilimanjaro mountains. It all almost felt like being in a place rich with strange beauty, like being in a dream. I would like to further extend a thank you to my family and friends for supporting me through my journey, the staff at the Commonwealth Medical College for inspiring me to strive past any limit, and to Kevin Dynan of Global Medical Projects for helping me through the entire application process. All of these amazing people have helped me grow in ways unimaginable, but my warmest gratitude goes out to the Mgonja family in Usa River, Zablon and Pretty - for teaching me that you don't have to be blood related to be a part of a family, I promise to hold onto that bond no matter where my experiences may take me. 

None.

Author declares that there is no conflict of interest.