Bradford University 2024
I have just finished my Adult Nursing degree and I wanted to understand how lucky we are to have the NHS. I was aware a few students from my university had done an international placement, so thought it would be a good experience to finish my degree off.
The importance of keeping an open mind is essential. My first impression of the hospital was shock that this was the 'gold standard' of care in Tanzania.
My first week was on OBGY, where I spent some time in the NICU, the labour ward and the pre eclamptic ICU. I was first shocked at the volume of C-sections at the hospital however, staff explained that most patients would only come to this national hospital if they were having a problematic birth. All natural births could be managed in local hospitals.
I was also shocked at the lack of resources. Due to lack of funding, they did not have disinfectant wipes or the ability to buy new beds so often the brakes didn't work and they were rusty.
I was able to have the opportunity to catheterise a couple of patients, take blood, do ECGs etc. I was able to understand that they were not able to get a fully sterile field with all the resources we would have e.g. numbing gel for catheterising however, they were resourceful with what they had.
In the UK when cannulating a patient we should never insert the same needle after a failed attempt however one of the nurses explained to me that it would be impossible to do so they made do.
I spent a day with the doctor in emergency gynaecology. As he was on call we went to each handover so he was informed on all patients in the department. While being on the pre eclamptic ICU we were handed over a patient who had an emergency c-section with query internal bleeding.
He explained that when she was opened up there was no evidence of bleeding however there had been clear fluid. They never investigated where this fluid came from and did the C-section and closed her up. It turned out that the bladder had ruptured meaning the fluid was urine. I followed her up the next day where they were trying to drain some of the fluid off her, they didn't have a portable ultrasound so were just doing this blind, so to speak.
Speaking to one of their chiefs he explained that the lady had less than a 5% chance of survival due to the complications. I asked how this could have been avoided, and he told me that in the UK this would never happen but due to limitations in procedures available, they would not always refer patients across. She sadly died later that night.
Staff were happy to explain the reasonings behind local practices. One evening we had the chief of emergency medicine come to the Work the World house and had a chat with us. In Tanzania, they say polepole which means slowly. There never seemed to be any urgency behind anything they did. Staff explained that some patients may have been travelling for days to get to the national hospital so a few hours would not differ their outcome.
One of the main differences is the role of the nurse. In the two departments, I did my placement in, there was no personal care or patient-centered care. This was left for family members to do. A patient came into emergency with DKA, he was confused and incontinent. In the UK we would of changed his clothes and freshened him up before cathertising him however in Tanzania it is not seen as one of their priorities.
During the three weeks I was there I was able to spend a weekend in Zanzibar and a weekend doing the safari. On my first weekend, me and the girls in my room all went to Zanzibar via the ferry. I was able to spend some time relaxing with the beautiful beaches and scenery in view. I was also able to do a morning horse ride on the beach and in the ocean.
The second weekend I went on a safari. We did two game drives one on Friday evening and all day Saturday. The driver was amazing, answering all our questions, going above and beyond for us.
After placement, we were able to spend time in the house or had the opportunity to do some sunbathing in hotels around the area. On Wednesdays, the house would go to Samaki Samaki a karaoke bar with cheap cocktails. On our last week the WtW team came with us. We also had BBQ night on a Thursday.
I honestly couldn’t recommend going to Tanzania more, I had some amazing experiences and made some great friends. I would say if you're thinking of doing this just take the jump you won't regret it. I came by myself and had no difficulty speaking to people and making friends.
The Work the World team were amazing! When moving departments the management team would come around and introduce us to the chiefs or 'matrons.' They always checked in on us to make sure we were having a good experience. One piece of advice would be to learn some basic Swahili before you arrive, Work the World has some useful guides which you’ll have access to when you sign up. The staff were much more responsive when you said 'Mambo' to them when arriving. The appreciation I now have for the NHS is immense.
