Healthcare in Tanzania is crazy. I went on a tour of
Kilimanjaro Christian Medical Center yesterday and was shocked by the wards I
saw. What would be considered a med-surg floor had hallways lined with cots
filled with patients, and 10 beds per room. Peeling plaster, bare concrete
floors, overcrowding; forget about things like IV pumps, one of the ob-gyn
residents told me they had to cancel all surgeries the other day because there
was no blood in the blood bank. I might go donate, since nobody in the US will
want my blood when I get back. But this is one of the largest, best, and
well-funded hospitals in Tanzania. A resident said they don’t have access to
imaging studies like CT scans or MRIs, so surgery is often performed without a
firm diagnosis, based on physical assessment information. So like, “we think
you might have a brain hemorrhage so we’re going to do a craniotomy and see if
that’s therapeutic.”
Another crazy thing that same ob-gyn resident was saying was
that the labor and delivery culture here is so different. Like women labor in
silence. Silence. If she makes any
sounds during labor, even if it’s just a little whimpering, she will get
slapped and told to be quiet, or a member of the healthcare team might say she
is being “uncooperative.” When she is getting close to deliver she’ll start
rocking and then whoosh! Out comes a
baby! I told the resident if anyone slapped me and told me to be quiet while I
was laboring I would slap them right back; cultural differences, eh.
Another rumor I’ve heard is the
lack of bedside manner among doctors and nurses. I haven’t seen this myself as
I haven’t spent enough time on the floor yet, but therapeutic communication is
apparently not a thing here. Patients aren’t kept informed about their care,
patients don’t make any decisions, it’s apparently pretty rough. I am curious
to spend some time on a unit and observe how things run and what the nurses are
like.
I spent my first day at the
school today, and that was interesting. The teachers all lectured for two hours
straight. No break, very little student interaction, just the teacher talking
for two hours; one teacher asked the students if there were any questions one
time, at the very end of his lecture. It was kind of mind numbing. I am also
now even more nervous to be the one to teach. I will definitely NOT be standing
up there and talking for two hours, but if this is what students are used to,
how will they react when I ask them to participate? Will they even do it? What
kind of activities can I use to engage them and make class more relevant and interesting?
So today I just sat in on the
classes. The first teacher gave half his lecture in Swahili, even though
English is technically the language of education in Tanzania. During the second
class, a student asked the teacher a question in Swahili and the teacher said “the
language is English” and made him repeat it in English. I guess it just depends
on the teacher. I am a little worried that the students will be able to
understand me when I teach. Our accents are so different, I often find myself
trying to politely ask people to repeat themselves, and they sometimes ask me
to as well. But anyway, this week is likely going to be observation only, and
next week I am going to the hospital with some of the nursing students. I
talked to the pharmacology teacher after class today and she said I can teach
for her within the next couple weeks, she will give me a topic on Friday. So
that is exciting/nervous. One day down!
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