Sarah Baldwin is a 3rd-year Nursing BSc student from the University of Worcester. She recently travelled to Tanzania on a nursing elective to see the differences between healthcare in the UK and the developing world. In this blog Sarah talks about her experiences:
In January 2018, I travelled to Dar es Salaam in Tanzania to complete a four-week nursing elective placement. When I arrived at the airport in Dar es Salaam, a member of the Work the World team (the organisation who planned my placement) was there waiting to meet me. We travelled together to the house I would be living in, and when we arrived, she showed us (me and the other newbies) around.
The following day, we walked to the local Dala Dala stop (a type of local bus) and jumped on one that was headed to our placement hospital. This small step made us all feel confident about where we needed to get on and off the bus each morning on the way to placement. It also gave us the opportunity to see the hospital before starting placement.
The following day was our first day of placement. I was introduced to the staff in internal medicine, which was where I spent my placement. While I was there, I rotated through neurology, respiratory, infectious diseases, nephrology, endocrinology, haematology, gastroenterology, dermatology, oncology and intensive care.
I could see straight away that this placement was going to be like nothing I had seen in the UK. Resources were extremely limited, and there was very little equipment available. The resuscitation trolley had less equipment than those in the UK, so in the event of an emergency, survival rates weren’t fantastic. It was challenging to observe emergency situations, but local nurses were great at improvising with what they had to hand.
The role of the nurse in Dar es Salaam was very different from what we’re used to in the UK. Family members were expected to undertake all personal care for a patient, whereas nurses were more task-oriented. Patient visiting rules were strict—only one relative was allowed to visit at lunchtime to provide food and assist with eating.
Patients and their families were also expected to pay for treatment unless they had health insurance, which most patients could not afford. Patients rarely had the opportunity to discuss their care with nurses and doctors. In most cases, decisions surrounding treatment were often made on their behalf. All of this made appreciate the comprehensive healthcare available in the UK.
In terms of the conditions patients presented with, many were at more advanced stages than I’d seen before. I also helped treat patients suffering from tropical infectious diseases—not something I’d seen in at home. Staff at the hospital were welcoming, and happy for me to be involved with patient care. I became more confident with each day.
We had Swahili lessons in the house twice a week. They were a lot of fun and turned out to be helpful when communicating in the hospital. I was able to introduce myself to staff and patients who appreciated my attempts!
We had lots of time to explore Tanzania during evenings and weekends. We went down to the beach every Wednesday for karaoke night, and it was one of our weekly highlights.
I went on a safari and it was an amazing experience. The organisation was great—a car picked us up from right outside the house, and we had an English-speaking guide for the whole weekend. The safari was in Mikumi National Park, which had a large variety of animals. Seeing them in the wild and being able to get so close to take photos was an amazing experience.
On another weekend, we visited Zanzibar—a white-sand paradise island a short ferry ride from Tanzania’s coast. We had our own tour guide once we reached Zanzibar and he came with us on a water safari and to Prison Island, famous for its population of giant tortoises!
I would recommend a trip like this to anyone considering an overseas elective. My advice would be to remain open minded, and remember that many differences in healthcare are down to history, religion and culture.
It was an amazing experience that I will remember forever.
Work the World specialise in tailoring overseas nursing electives in Asia, Africa and Latin America. Their destinations provide eye-opening insight into the challenges associated with delivering healthcare in the developing world.