Asante Sana Tazania

Half-term holiday. What an excellent invention. If you’re asking, like me, what exactly I have done to deserve this having spent 6 weeks sitting back receiving world-class teaching, living in a fantastic city with a view of Kilimanjaro out of the window and going on obligatory nights out, safaris and trips in order to complete my ‘hidden curriculum’ – the answer is not much. But I’m not complaining. As here I am on Zanzibar with the very difficult decision of whether to spend the day on the picture postcard white sands of Paje beach, swimming in the bath-warm crystal clear water, or taking a wooden Dhowe trip to snorkel round the corals. It does feel a little wrong.

So has this joker ‘diploma’ crew achieved anything in 6 weeks? Well, apart from making a thorough assessment of most of the restaurants, cafes, music and dancing venues in Moshi, we have definitely learnt a good bit of tropical medicine and done a fair amount of grappling with issues of access to healthcare in resource-limited settings such as Tanzania. This is a constant underlying theme of every module. Inevitable really when studying together - Tanzanian doctor, whose national health expenditure is around 2.4% that of the UK doctor’s they’re sitting next to.

It makes for some interesting discussion on the gold standard management of stroke when a head scan is unlikely to be an option, or for the treatment of malaria when first-line medicines are just not available. Inevitably we have to come up with 2 solutions to every problem: this is what we would like to do (and what would probably happen in the ‘West’), and this is what’s ‘appropriate’ for a ‘developing’ country like yours. It does not feel comfortable. But it is, sadly, real life.

And then there is the other dichotomy of experience between African and Western doctors. A definite highlight so far was when half way through an interview about access to healthcare in mountain villages the group realized the lady was actually in labour! One of the Tanzanian doctors, without any fuss, monitoring, sterilization or equipment calmly delivered the baby and carried on the interview. The ‘Western’ doctors looked on in wonder.

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I will really miss Moshi. Tanzania is a truly beautiful country. The people I met, despite their militant insistence that I speak Swahili at all times, were incredibly friendly. They took time to show us the best priced tailors, crossed the road to tell us to be careful with our bags (ok – so not everyone is friendly) and threw us an amazing party when we left to say thank you for our custom! I will miss the warm but breezy climate, my (downhill) run home from hospital along Jackaranda lined roads with the mountain overseeing, and the flamboyant wedding parades complete with roaming brass bands around town every Thursday, Friday and Saturday. It is a quirky town, well worth a visit, and was an excellent place to settle in to the diploma. Somehow I think the capital cities of Nairobi and Kampala will have some very different quirks on offer… I’ll let you known how that goes.