Kara spent two weeks with us in Tanzania on a nursing placement. Kara was a healthcare assistant but wanted to gain experience of nursing in Tanzania before her post graduate nursing course. Kara shares some of her most memorable experiences – some challenging and some amazing.
The start of my project was tough. On my first day I saw a still birth, which obviously upset me and how their culture differed so much from the UK. Another upsetting moment, was arriving onto my shift and finding a baby who had passed away during the night – the nurses were aware of this, however, left him in the cot with the others (I presume this was to allow mum and family to visit and pay their respects). I stroked the baby once I realised and covered him back up.
I went to theatre and saw two c-sections where I was able to gown up and observed the birth of two children. This was an incredible experience as I was able to see the effort they put in, how sterilised they could be, the drugs used as this wasn’t often observed.
I also witnessed a lot of natural births, some having complications during labour and some without. This again was a phenomenal experience as I witnessed a new life being born into the world. I was also able to cut the cord of a baby; again, another memory I won’t forget.
There was a few times too, where the volunteers and I would be left on our own. From this, we used our initiatives and reassured the mums, tried to speak to them in English to gain an understanding of the language barrier, check the mothers to see if they were opening and whether they needed to push, listening for the baby’s heartbeat with the equipment available and assist in the delivery of the births when the nurses had finished their meetings.
The second week I was on minor injuries – where I looked after a little girl who had been hit by a motorbike and broke her tibula and fibula, she was heavily sedated and needed an X-ray which I assisted with.
Another little girl who broke her elbow and a doctor held her waist whilst the other doctor put her elbow back in place. I held her hand, reassured her and calmed her down as she screamed throughout it.
A baby of 6 months had an abscess on his arm and came to the department for it to be drained. He looked very worried as he was crying and mum had to stand back to allow the professionals work. I used my skills and knowledge and sung nursery rhymes to the little boy to settle him and make him feel at ease with the care he was receiving. After this, mum approached me and said “Asante sanar” which means thank you very much.
There was also a few dressing changes which I participated in. Playing with the children after the treatment they received with bubbles, balloons and the torches used for neurovascular observations.
I also had the opportunity to visit the local orphanage for a day. I participated with the general care of the children; feeding, nappy changes, putting them down for a nap and playing with them in the garden. Around the room there were stories of what had happened to the children to make them attend the orphanage: some stories were; died during or shortly after child birth, abandoned in the market, Mum or families could not cope due to a number of children in the household and to return when they are eating solid foods.
I would like to thank you very much for the opportunity volunteering as a nurse in Tanzania. The time I spent there was definitely an experience that consisted of very high highs and at times very low lows! I really did enjoy the experience and met some amazing people along the way.
Elective is something everyone looks forward to at medical school. Initially however, I was not sure whether to go all out on my elective or for my holidays after my medical assistantship placement (as I was given Elective 1st and Medical assistantship 2nd). Since the news came out that I would be going on my elective before I did my Medical assistantship placement, I knew I would be going with my housemate. Our initial thoughts were very varied, but we decided to look into going to Malta for our elective due to, among other things, the English-speaking natives and the price of the flights. We thought planning this would be straightforward, but it wasn’t. The hospitals in Malta required a fresh DBS form, among other things that I have since forgotten, that made the application slightly longer than we first thought. My mother, when hearing of Malta, was also weary of us using this placement, which is once in a lifetime, to go to Malta, which isn’t very exotic. Due to these reasons, we thought better of Malta and began thinking of places further afield. We also spoke to friends who had gone through agencies to plan their elective, which had made it easier for them, so this came into our fresh planning. We decided on going to Puerto Vallarta, Mexico with Global Medical Projects. We found this by simply google searching elective companies/agencies, and GMP prices and lengths of placement fit nicely.
Personally, I had already been to Mexico, and had really enjoyed it, although I had wanted to experience it more deeply than before. It is also a massive country, and I had only seen the southern east coastal region and Mexico City. This time I wanted to see the west coast, with the famous pacific sunset. My housemate had not been but had always wanted to, as his father had lived there in the past and told him to go, and he had old family friends there that he wanted to see. Other than these reasons, Mexico at the time we would be going would have the exact weather we wanted – 20 degrees at night and 30 in the daytime. We also were excited by the Mexican cuisine and were both happy to immerse ourselves into a Spanish speaking country to try and pick up some passable Spanish.
Looking back post-elective, I believe Puerto Vallarta and the surrounding area really lived up to my expectations. Additionally, Mexico is sometimes branded as unsafe with talk of cartel ruling the streets etc. In Puerto Vallarta the cartel and crime are present, but not the degree that I felt unsafe at any point. I believe that if you don’t get involved in anything dodgy in Mexico, it will rarely come to you de novo. Sticking to lighted areas is wise though.
Why with Global Medical Projects:
The definitive reasons for this are that it was so much easier to have an agency sort out everything for you (except flights), and the cost didn’t work out as too much more. I think if you are going somewhere you know/where everyone speaks your language/you are going to be on placement with family or friends, going through an agency is probably not worth it, but in our case, we felt it was. GMP provided transfers from the airport, organised our accommodation and food during weekdays, set up some beginner Spanish lessons on arrival and organised the hospital placement as well. They have been working for 20 years at this, and it showed, with everything going smoothly from start to finish.
Our shifts were to be 7am-3pm every weekday, although we were allowed to leave at 1pm when the students ate and had teaching. We also took a few days off to travel one weekend and a few days off in exchange for doing night shifts. The hospital we were working in was one of the lowest resourced hospitals in the region. The emergency department was run by 3 medical students who were basically F1’s without all the teaching, one ED consultant, one T+O consultant, and a team of nurses. Paediatrics, Internal Medicine and Surgical teams also came through to see patients and do procedures (and sometimes even hallway surgery). It was possible to join each of these teams if I wanted to, but I enjoyed working in the ED and getting to know the team more and more each day helped my Spanish and allowed me to increase my participation slowly.
We slotted in as medical students who couldn’t speak Spanish. There were only really 2 medical students who spoke good English, so it was quite difficult for us at the beginning. If you plan on doing an elective in a Spanish speaking country it is definitely a good idea to know some basic Spanish before you go. I didn’t know any. Luckily, I had google translate (so make sure your phone is unlocked and you can get a Mexican sim) and am decent at picking up language – if you struggle with this, I would highly recommend some beginner medical Spanish lessons. Saying this, by the end of my placement I was seeing patients by myself and writing notes in Spanish by myself (of course everything was checked by the medical students before being signed off by the doctor). Practically, we got to assist with CPR twice, suturing multiple times, doing ABGs, ECGs, and examining patients is universal. In this demographic of patients (from the street, don’t pay tax or have insurance), many of them couldn’t afford their medications, didn’t believe the advice given by the doctor, or had tried the medications but thought they didn’t help and only hindered. This was frustrating to see. What was more frustrating though was the hospital resources being quite low, which meant known best treatment could not be given. I think the most memorable is that Tb patients only receive levofloxacin for a couple weeks in hospital due to resources, but you or I could buy rifampicin etc. at the pharmacy across the road at any time, however the patients can’t because they can’t afford it for the long course they need.
The surrounding area:
Along the coast there are many beach towns and hidden beaches which for the most part are easily accessible by bus, or even hitch hiking which I did many times. In many of these towns surfing is a major past time. The sea food along the coast is awesome too. I went inland twice, to Guanajuato, which is where the Mexican people began winning independence from the Spanish. It is a wonderful place, and where my housemate’s family friends took us for a good time.
I began my 4-week Global Medical Projects (GMP) student paramedic placement on the 11/1/19 in Guadalajara (Mexico) after an orientation to the hospitals, ambulance services and a few Spanish lessons. The first week I worked in the Green Cross (South) emergency department and conducted health status assessments, practiced IM injections and IV cannulations, administered medications and learnt how to suture under the supervision of the qualified nurses and doctors. There was a vast array of medical and traumatic patient presentations I experienced including: a deep tendon laceration from workplace equipment, a basal skull fractures from a physical assault, respiratory emergencies including acute exacerbation of asthma and more.
My second week I worked on the Green Cross (South) Ambulances alternating between 8-hour day and 12-hour night shifts. During my ambulance placement at Green Cross (South) ambulance service I worked under the supervision of paramedics and firefighters on a patient that had been ejected 30m from his car. The car was completely destroyed, and he was said to have been travelling 100km/h before the crash. I utilised key skills such as C-Spine immobilisation, appropriate extrication and then conducted a thorough head to toe and medical examinations on route to hospital. During a couple of night shifts we also attended gun shot victims that were deceased on the scene and confirmed death. At the Green Cross ED I also assisted the doctors and nurses in intubation and ventilation of a 1YOF with a head injury that began to have seizures and required sedation. I ventilated her from the Resus room to the major hospital under the doctors supervision.
During my third and fourth week on placement I worked between the Red Cross (North) Ambulance service and in a small rural Red Cross emergency department in Toluqilla (located outside Guadalajara, Mexico). During my time at Red Cross Toluqilla we had an imminent birth and I assisted in delivery of the baby, placenta and neonatal resuscitation. I also treated two factory workers that suffered facial burns in a confined space when a machine exploded while on shift. I assisted monitoring these patients and conducted the burns appropriate treatment before they were transported to a major hospital. On my final shift at Toluquila I also had a 30YOM with 18 stab wounds present while I was working. Part of his stab wounds included protruding abdominal contents and a sucking chest wound. Under the supervision in the resus team I assisted taking vital signs, the head to toe examination and interventions keeping him stable until he was transported to a major hospital.
I had an incredible experience during my 4-week paramedic student placement with GMP in Guadalajara, Mexico. Between the Red Cross, Green Cross ED and ambulance services as well as the Toluqilla ED I practised a lot of key skills and competencies from my own personal skillset in medical and traumatic emergencies. The hands on experience I received was invaluable and I feel has accelerated my understanding of critically injured and unwell patients.
It’s been several months now since my trip to Guadalajara, Mexico, which was an unbelievably life and career changing experience. Every day I still reflect upon my time in Guadalajara, the home of my paramedic opportunity. At first prior to my 4 week trip I was a little hesitant in making my way over. I stopped thinking about all the ‘cons’ and focussed on the ‘pros’ of such an amazing opportunity that I knew would benefit myself and my passion for the prehospital environment.
Whilst feeling a little hesitant without talking to my friends or family first, I expressed interest online. Within hours Kevin from Global Medical Project (GMP) contacted me despite the time difference between Australia and the UK as he wanted to connect with me at a time that suited me best. After a great in-depth conversation with Kevin I booked the dates for my project and the following day I booked my plane ticket to Guadalajara. Despite the fact it was going to be a long journey there, I knew it was all a part of the experience and I wouldn’t change a thing.
Months prior to departing Kevin and myself were frequently communicating with any questions or assistant in my preparation. I was also in contact and communicating with the coordinator of the project in Mexico (Ariel). With fluent English we were both able to communicate prior to arriving. When I arrived I was instantly greeted by a team member of GMP, Luiz, and I instantly felt comfortable in the beautiful city of Guadalajara. I arrived on a Friday evening and wasn’t meant to start until the coming Monday, however I was too eager to start and began the next day in my assigned hospital Emergency Department.
The first week of the project was spent in the ‘Cruz Verde Norte Zappopan’ Emergency Department (ED) and was probably one of my favourite weeks of the whole project. Not directly related to the prehospital environment, however the opportunity and experience in the ED would be something I would never experience back home in Australia. My role in the ED varied, yet if I were to describe it briefly I would explain it as high acuity nursing. My roles changed every day and the tasks and skills I practiced differed for every patient that presented in ED. I mostly did night shifts as I enjoyed doing nightshift in comparison to day shift as the jobs that came in varied significantly. Some of the cases I assisted with frequently included; Gathering and monitoring vital signs, Intravenous (IV) cannulation, Intramuscular (IM) injections, Suturing wounds from basic lacerations to difficult facial wounds which included adults and children, burn management and treatment and assisted in “resus room” cases. The staff in the ED were happy to teach me skills and provide me guidance under supervision before I was then on my own completing tasks within my scope of practice that I felt comfortable doing. If you enjoy being thrown in the ‘deep end’, they definitely allow you to be thrown in if you feel comfortable. In saying this, if I ever had doubts or didn’t feel comfortable performing a certain skill they provided the support and assistance when needed.
Another reason why I enjoyed my experience in the ED so much is because I had the opportunity to be involved in several hospital-to-hospital transfers. This involved the transfer of some very sick and critically ill patients in which allowed me to provide mechanical ventilations, monitor vital signs and administer medications where necessary. After my first week in the ED I felt comfortable around the hospital staff, fellow GMP participants and was ready for what laid ahead in the prehospital environment.
The following three weeks was where I spent my time in the ambulances that were assigned to the same hospital. I spent many days at the ambulance station without going home and surviving off ‘brief naps’, however this was my choice as I was so eager to take on every opportunity that came my way. Each crew at every shift I had were warm and welcoming and gave me the opportunity to perform and assist in task. What I loved the most from my time with the paramedics was the autonomy. For example, working as much or as little as you desired. For some periods, I never left the station for days as I wanted to get as much exposure and experience as I could. The range of jobs varied from the bread and butter of falls to frequent attendance of motor vehicle accidents, scooter/motor bike collision, overdoses and sadly deceased individuals. There were plenty of opportunities to practice and maintain clinical skills learnt at home. These skills included primary and secondary surveys, spinal immobilization, application of C-collars, Intravenous catheters, complex extrications of some patients and the list could go on forever.
I felt as though I got the most out my time with the paramedics and was constantly busy, with periods of time being super quite like anywhere in the world.
Steering away from the working side of things, what made this trip so good was everything else outside of working. Firstly the culture is beautiful, everyone was friendly and made you feel welcomed despite knowing very little Spanish. The food was incredible, if you love cheap taco’s that taste amazing you’re going to love this country. The main thing that made this trip the best was the local people I worked with and all the other GMP participants that were also there. We had all come across from different places around the world, and despite this we all had one goal in mind, and that was helping others. The friendships and people I met made it a truly unforgettable trip.
In concluding my reflection on my experience volunteering in Mexico, it made me realise how lucky I have it in Australia when it comes to healthcare. Going on this experience only made me realise having a healthcare service is a privilege, not a right. For example, if you were hit by a car walking, the driver would drive off having no sense of life and you would be lucky to get an ambulance at all. I found every patient very thankful and happy about getting medical attention, because they appreciate how lucky they are. There would be nothing I would change about my journey, the organisers were fantastic, the workplace was awesome and the people were the best. The only thing I would do better in future would be more prepared in regards to my Spanish skills. Having little Spanish did hinder some learning opportunities, but I worked with what I had like English speaker and maybe google translator to assist at times.
So thankyou to everyone that made this experience for what it was. If your hesitant about embarking on a challenge like this, all I can say it just do it. You will not regret it. All I can recommend to anyone is that you get out as much as you put in. So go over and work your ‘ass’ off and you will come back with so much more exposure and more passion about what you do.
When I completed my FREUC 5 Diploma course I was ecstatic. Being only 18 years old, I saw tons of doors open right in front of my eyes. The first thing that came to mind was the fact that I had to do 750 voluntary hours before receiving my diploma and that’s where GMP comes into the picture. Global medical projects has a fantastic 12 week package especially for those who need to do their 750 hours. That’s when I thought to myself “Mexico…Why not!”
Leaving South Africa for the first time by myself was definitely a scary experience. However, once I saw the friendly eyes of Luis, a GMP employee, right on time to pick me up from the airport I felt at peace. That was only the beginning. After the pleasant car ride and a crash course history lesson on how tequila is produced I got to meet my Mexican family. Gloria…oh Gloria, my Mexican mommy who never let me walk around without shoes made me feel as if I was part of the family. I was even offered to participate in weekly dance parties that she had at her house. Gloria’s food will forever be a part of my heart and unfortunately my stomach as well!
Starting my first shift at Cruz Verde Zapopan gave me butterflies in my stomach. I’ve never had to go to an emergency room myself, let alone work in one. For a week I did 6 hour shifts of blood sweat and tears (literally) of learning how to suture, cannulate, pump stomachs and give medications. The medical staff even let you attend and participate in surgeries if they think that you are fit to do so.
After my first week I got to move over to the ambulance crew. I was a little nervous bringing out my FREUC 5 book that had to be signed after each shift as I really didn’t want to be in the way or a bother to anyone. Luckily everyone understood the necessity of logging hours and happily obliged. I was basically told that I could work as many or as little hours as I like as long as I reached the minimum requirements. The shifts run from 8am- 2pm, 2pm- 8pm and then a full 12 hour shift overnight. I however jumped at the chance to gain as much experience as possible.
One great thing is you will never get hungry because Mexican paramedics love their taco runs! They know all the best places on the block even if it’s at 3am you will always be able to find some open taco stand waiting to serve you. While on shift I had exposure to the following: car accidents, suicides, hit and runs, gunshot wounds, sick babies and many construction accidents. The beauty about volunteering in Mexico is that even if you have minimal experience beforehand, they are always happy to teach you whatever you would like to learn and let you actually apply your skills out on road. You definitely will not feel like a waste of space as the paramedics are very inclusive and want you to be as hands on as possible.
Besides the actual paramedic part, you will make friends of a life time. The paramedics at Cruz Verde and Cruz Roja want to get to know you and show you around their city which they are all very proud of. They are used to us clueless, non Spanish speaking foreigners arriving and participating in the program. For them it is an experience as well because they constantly are wanting to learn new things that you could perhaps show them to make their job easier. Guadalajara is a beautiful city with tons to offer you (my personal favourites were the night clubs and bars).
Being a FREUC graduate, I recommend Mexico for everyone on the fence to go for it! As long as you put in the effort to pitch up to as many shifts as you personally know that you have to, they will happily sign your book and support you along your journey.
Just a few tips for those of you who are going to Mexico:
Ubers aren’t the cheapest things around but are your safest form of transport to and from work. Make sure you budget enough money in for it and try share lifts with the other volunteers because the chances that you’re staying in the same house or street as them are very high.
For the FREUC students, the patient reports at the back of your book, PLEASE fill them in after your shifts because you may think that you will remember everything in a couple of days or weeks… but trust me, you won’t (vital signs; scenario’s,ect)
Lola Lolita and Babel are my personal favourite night clubs in Guadalajara but I’ll leave you to decide that for yourself.
If you can’t find enough work clothes at home before you leave for Mexico please do not stress as they have tons for you to borrow at the host houses in all shapes and sizes.
Try learn your basic Spanish terms and greetings as it will get you a lot further than you think.
TRAVEL, I know your prime focus is to volunteer but just give yourself a weekend or two to go to Tequila or Chapala, it is worth it.
Last but not least, don’t expect your placement to be like Narcos. You will be safe.
Great work Kaylin! FREUC 5 graduates can complete all or part of their 750 hours practical frontline ambulance experience with us in Mexico. Realistically, 750 hours can be completed in 12 weeks. Placements are available throughout the year and start every week on Fridays. Find out more about the Emergency Care Practicum Program
Oh, Mexico… my favourite country on earth – you never cease to impress me upon each visit. I just can’t seem to stay away!
If I’m being honest, I was nervous to attend this project in Guadalajara due to Mexico’s dangerous reputation, despite visiting the paradise beaches of the east coast previously. However, upon arrival I immediately felt comfortable in what is known as the second largest city in Mexico. I was lucky enough to be placed in Gloria’s house with her lovely family throughout my stay. We were located 100 meters away from the Expiatorio – a stunning cathedral and square that was always buzzing each night with local food markets, salsa-dancing lessons and live music. Oh, and the two rooftop bars next door became our local nightcap destinations after a long day of work!
Gloria became known as our Mexican Mumma. She cooked us amazing local food, she told us to be careful every time we went out, she became nervous when we came home later than expected, she bought us tea into bed when we weren’t feeling well, and she even held my hair back when I was vomiting from too much tequila… while also shaking her head!
My first week was spent in the Cruz Verde Emergency Department, which turned out to be an endless flow of patients in and out, mostly with traumatic injuries. Most of these were sustained from workplace accidents, motor vehicle crashes and assaults. On my first day I was able to assist in the management and treatment of my first ever gun shot wounds. I was blown away to see the patient hobble out of the ED within 3 hours of arrival after being shot through his knee and groin while continuing to bleed out!
The most shocking injuries I saw were from patients held hostage and tortured by drug cartels gangs. I was told that this is really common, even beheadings, however it only happens to victims that are members of opposing cartels and they consequently know the risks when getting involved in the first place! Life lesson – as everyone will know from Narcos – don’t sell drugs in Mexico!
I was also lucky enough to witness an orthopedic surgery of an ankle reconstruction following a severe break which was really interesting to see – I had to keep reminding myself I was in a hospital and not a building site after seeing the equipment they were using!
I also learnt skills such as how to properly irrigate, clean and suture wounds as deep as the muscle, insert nasogastric tubes and suction appropriately, and apply casts for broken bones.
The following 2 weeks I spent on the ambulance with both the Cruz Verde and Cruz Roja. Patient assessment on scene was very difficult only knowing basic Spanish. The paramedics spoke very minimal English while the patients no doubt do not speak it either! Therefore, my assessment became more practical – I would take blood pressures, heart rates, temperatures, oxygen saturations, control haemorrhage, insert intravenous cannulas and hang fluids… leaving the Spanish questioning to the paramedics! You never knew what job you were attending because the paramedics were unable to say so in English, which added excitement and nerves to the crazy experience. I also completed my first ever night shifts, which I haven’t had the opportunity to do so in Australia; I would recommend doing night shifts on the weekend, as they were busy and fun!
On our days off, we were able to explore the area in which we were living. Throughout my time in Guadalajara, I visited Chapala which is home to Mexico’s largest fresh water lake which was beautiful, we drank endless amounts of tequila in the town where tequila is made (I thought I had died and gone to heaven) and we also climbed La Barranca de Huentitan canyon which had stunning views. Nights out on the town with the other volunteers from around the world as well as the local paramedics always turned out to be a good laugh.
GMP staff such as Luis, Zuhey, Kevin and Ariel provided endless support and were just a phone call away if we ever needed anything… so thank you guys!
Overall, I had an unbelievable experience as a result of my placement in Guadalajara. I was exposed to so much trauma that I feel will benefit my future practice as a paramedic and nurse tremendously in terms of physical management and emotional response. I’m slightly disappointed to go back to being on an Australian ambulance, as it is unlikely that it will be as exciting as the situations I witnessed in Mexico! I will miss the tacos, the people and the mariachi music until I come to return once more!
So if you are a paramedic or nursing student thinking about doing this placement in Guadalajara, pack your bags and get on that plane… you won’t regret it!
Great report Bethanie! If you are interested in following in Bethanie’s footsteps and joining this type of project in Mexico, find out more here: Paramedic project in Mexico
My time in Ghana was simply unforgettable and I would one hundred and ten percent recommend it! I am seventeen and my plan is to study Medicine so I thought this would be the perfect opportunity to enhance my application and also have an adventurous summer.
I was very nervous on the plane because I had never travelled outside of Europe before and I had never been away on my own, however I was full of excitement and I think my parents were more worried than me. I had managed to get in contact with other people who I would be staying with so this made me feel more at ease.
I arrived in Accra (the capital of Ghana) late at night and Charles met me and took me to the Pink Hostel. I was very nervous and it was a huge culture shock to see the hustling city but when I arrived at the hostel I met a Swiss girl who was really friendly.
The next day I travelled to Mole National Park and met the other volunteers there. It was here I was able to see elephants and baboons for the first time. This was extraordinary and the elephants were much bigger than I expected, even the baby ones. The baboons were very cheeky and the following morning we were awoken to a baboon that had entered our room and was searching through our bags to find food. At the time it was rather scary but it was also extremely funny! The food at Mole was also great and there was a swimming pool; I would recommend going if you have the time. We also visited a local village where we went on a river safari in canoes. I was amazed to see how people live their life and it was exactly like what you see on TV. The final night we moved to Larabanga and stayed at a hostel. This made me feel like a ‘real’ traveller because the conditions were very basic but it was definitely an experience. We then had to travel to Cape Coast, where I would be staying for the next two weeks. I nearly didn’t get a flight back to Accra, but after some persuasion and a little bit of bribery I managed to make it back.
After a fun filled weekend my placement at Cape Coast teaching hospital started on Monday. I was shown around the local town and the hospital where I was able to choose between a variety of departments to spend my time in. I spent the majority of my time in the emergency department and a day in the delivery suite. This was very flexible which was great! Likewise, the time you spent at the hospital was flexible but I mostly started at 8 and finished at 2. The transport to and from the hospital was easy and consisted of two taxis taking about 10 minutes. I learnt a lot in the hospital and I witnessed and helped with things I would never have imagined. I was able to take vitals, help with taking blood, apply wound dressings and see minor surgeries. I also witnessed two cardiac arrests, where the patients survived and two deaths. This was a lot to take in but it helped being able to discuss what I saw with other future medics back at the house in the evening. It also reinforced my choice for wanting to become a doctor and demonstrated that I have the ability to overcome stressful situations. I learnt how the health service in Ghana differs from that in the UK and it made me appreciate the NHS a lot more. I think the most amazing thing I saw was a tiny, little baby crawling out of its mother’s womb and being brought into the world. The doctors and nurses were very good at explaining procedures and were all very friendly – I think that is the Ghanaian way.
The following weekend I went to Cape Coast Castle and Kakum national park with a couple of American medical students and another volunteer I had met. This was yet another amazing experience and I loved being in the canopies above the trees in Kakum. The views were stunning and the locals were very friendly and enjoyed taking photos with us. Both these attractions were fairly close to where we stayed and are both worthwhile visiting. On the Sunday, Mary (the woman who lives in the house we were staying), took three of us to church. This was inspiring and I was fascinated to see how different cultures embrace religion. We also visited Oasis, a bar/restaurant, where many tourists/volunteers go. The food there was very nice and the dancing was extremely fun. There was a mix of tourists and locals and the Ghanaian men enjoyed teaching me a few dance moves. I would strongly recommend going to Oasis on a Friday/Saturday night.
During my last week in Ghana I started to enjoy my placement even more because I was becoming more familiar with the way the hospital worked and I got to know the staff. In the evenings we played football and basketball with the local children because the boy, who lived opposite, was very keen for us to meet all his friends. I really enjoyed this and I could see that the children loved playing with us. It was a shame I had to leave the following week because I would have loved to play some more basketball with them.
On Saturday morning I headed home despite wanting to stay, but I was very proud of what I had achieved. My time there has given me the confidence to want to pursue my dream of becoming a doctor, meanwhile making me more independent, thankful for the things I take for granted and giving me the buzz of wanted to travel more of the world.
Overall, I would strongly recommend traveling with Global Medical Projects because there was a strong support system before arriving and while being in Ghana. I was also able to see and do a wide range of things in the hospital. All the staff were extremely friendly and helpful and Ghana as a place was full of culture and vibrancy.
In my final academic year in Diagnostic Radiography we are encouraged to take an elective abroad. I decided to go to India for 3 weeks with the hope of seeing how the culture, funding and general standards differed to the hospital I trained in. I also wanted to experience healthcare done in a different way to see if there was anything I could take back which developed my practice. I certainly can say it was an eye-opening experience . I met so many nice people and seen things I would never have seen back in the UK. I went with 2 other students from my university.
I chose Global Medical Projects over a couple of other organisations because I had read nothing but positive reviews. Also the pricing is much more affordable and quite frankly better value for money. I gave Kevin a ring who settled a few things for me before I went. I have Celiac disease which means I can’t have anything with (Gluten) wheat, barley or Rye in, I have to take measures to prevent any possible cross contamination as it can make me very ill. Well Kevin did all he could to find out whether I could be accommodated at the hosts house, which I am very thankful for. Once I made my booking an account was setup on the projects webpage which provided lots of valuable information such as things to do in and around the area, information on the currency and most importantly the visa information. This was invaluable as you will probably require a visa for India.
My placement hospital was at Sree Gokulam medical hospital in Venjaramoodu which is just outside Trivandrum. The hosts house was literally a 3 minute drive away which was convenient. On the first day we were introduced to everybody involved with students in the hospital. We were given a tour of the hospital which was absolutely huge!
I got the opportunity to see many procedures not commonly performed in the UK such as IVP’s and many contrast enhanced studies. There are 2 CT scanners, one is a state of the art 128 slice CT scanner. There is one Siemens 1.5T MRI which was kept busy most days. There are also 2 ultrasound rooms with a constant work flow. All the staff were very welcoming and friendly and are keen to learn what they can from you.
Generally you will work with another radiographer and possibly a couple students. General x-ray is exciting to work in, a wide range of examinations are requested such as x-rays for the flu…..and using one cassette for both views. The hosts will usually make you a packed lunch for work which was tasty, or there are many tasty food outlets in and around the hospital to choose from. You will never be too far away from nice food in India
When I arrived in Trivandrum I was met on time at the airport and given a local sim card to communicate with people when needed. I was taken to the door step of my host (Babu) who met with a cup of chai tea. The house is great, there are actually two, one across the road from the other. You feel as so you are in the middle of the jungle. There are banana, mango, jacksfruit and coconuts growing literally on your door step. The host is called Babu he is a genuine, hard working guy. Always has a smile on his face and will do anything for you, very accommodating. You are made to feel at home from the second you walk through the door. The food provided in the house was really good, not once did I get glutened! Breakfast, snacks and dinner was provided. Lunch was usually at the hospital.
My room had an ensuite shower/toilet. Generally there are three beds to a room, with males and females separated, the rooms were spacious, there were fans to keep you cool and the beds were pretty comfortable as well. The house is well kept and is clean. The toilets in the house and some in the hospital are western style. There is wifi available throughout the house. The best part of the house is the balcony on the first floor and the roof terrace, the views of the canopy are nice and it is a nice place to socialise with others in the house after work.
Babu the host was there every step of the way, if you needed anything from the shop he would grab it for you, he would take you to work in the morning and pick you up from work. Babu seems to know everyone and has contacts all over the place, he was able to arrange transport for us, recommend us hotels and places to go eat and sites to go see. There was always someone in the house if you needed them.
Travel and things to do
Kerala is a site to behold! Trivandrum the capital city of Kerala has some temples you can go see. There are some nice places to eat in the city, you can get your ayurvedic massage. Not for the faint hearted! haha.
There are the infamous backwaters which are just beautiful. After a week of working it was awesome to head up to Allepey (back waters) by train, the train journey itself is an experience. The back waters were so calm, such a contrast to the busy roads and so many people! You get to see people living by the river’s edge, diving and fishing with their bare hands.
I also took a trip to a little hippy town called Varkhala, it is by the coast, the beach is not suitable for swimming but it is an amazing place to go spend the day. Lots of things going on, kids playing, other travellers. There are plenty places to eat. You can rent scooters and explore as far as you want as well.
My most favourite place to visit on my travels was a place called Kumily in the Western Ghats mountain region. A different world. There were jungle treks, jeep safari, local chocolate factory! They grow a lot of tea amongst other things in the mountainous regions.
Whichever place I went there were opportunities to meet other travellers or western people, some places less so then others but I think that is what made the experience.
The practice of medicine in Tanzania is very different to our own. Kasia’s awesome blog really highlights the differences in nursing practices in Tanzania where facilities are limited and treatments rationed according to the patient’s ability to pay.
My children’s nursing / maternity elective in Tanzania
First day at the hospital
My first ride on the Dala Dala to placement was not as bad as I thought, although I felt bad for the man who had a rather plump lady sat next to (or rather on top of) him due to the drivers cramming in passengers like a tin of sardines.
Arriving into the hospital the first thing you notice is the large sign saying what forms of payment are accepted! My first stop would be paediatrics. On entry to the ward I had no idea what to expect. The ward staff did not check my ID, showed me where to get changed (an old disused patient room) and were happy for me to just sit with the doctor listening in on consultations. The doctor reviewed all the patients in the morning, with the mum and child going to the doctor for this. No equipment was cleaned between patients, nor hands (there were signs in Tanzanian showing thorough hand washing, however the hand gel had run out and there were no towels to dry hands with either!), yet nobody was allowed to walk on the floor whilst it was being cleaned!! A bizarre experience coming from a busy children’s ward in England where patient care is first and foremost – the nurses in West Meru ate lunch before doing IV medications which were due and although due to a language barrier I did not understand the specifics of what they said to mothers who approached them whilst on lunch, I did observe they did not move to speak to them or pause having lunch.
I helped the nurse with a child who’d had a burn covering almost 1/2 their body. The water was first sterilised by boiling it, however cold water was then added which completely defeats the object of sterilisation. The child was placed in a tub of this water to soak the skin. For the gauze, the nurse had to go to another department as it was not kept in the paediatric ward. Wearing gloves, the nurse began rubbing the child’s skin to clean it and remove dead skin. I offered to hold the child as I could see that mum was very distressed also, however the nurse shook her head at this. The child was crying. She hadn’t received any pain relief prior to this. The nurse used a razor blade to cut off large amounts of dead skin, however there had been no incisions made to prevent compartment syndrome occurring and the blade was not sterilised. Mum was comforting the child by rubbing their arm (the badly burned one) – I tried to explain to mum to rub the other arm as she could introduce infection to the open wounds as I had not witnessed anyone else informing her of this.
After a while, Mum walked off almost crying with her baby. The nurse didn’t look finished with the wounds however I think it had been too much for both mum and baby. After the debriding the nurse applied silver nitrate cream to the burned areas and Mum gave some paracetamol and ibuprofen to her baby which she’d had to bring from home along with the creams.
Walking to get the gauze we saw a man whose hand was dripping with blood. The nurse guided him to minor theatres. Despite the depth of the wound on his hand and proximity to the bone, no X-rays were done. Pain relief was not given immediately from what I saw, however I left soon after his arrival.
After this I helped with some observations on a baby who had stopped feeding. They were having IV medications administered as an injection. There were unsheathed needles scattered across the desk and no sharps bins or clinical waste bins. I could not take the baby’s blood glucose level as although there was a meter, there were no testing strips to use with it.
After this I headed back to USA river on the Dala dala to the nursery which helps mums to go to work by looking after their children, charging them in relation to their salary.
The children were at first obsessed with me, pulling my hair (which kind of hurt!!). It was difficult to tell them not to as I did not know how! I soon learned the word Acha “Stop”!
After nursery I checked out the swimming pool at Green Hills Lodge. It again was freezing but I managed 1.5km!!
Day 2 at the placement
Went to ward round in paediatrics. Child with burn still attending for daily debriding and still appears to be in pain.
Left soon after ward round to go home to X-ray and see if anything was happening there. There was a lady having her ankle reset without the use of X-ray and being plaster casted without knowing the bones are in the right place for sure. Just another day of medicine in Tanzania.
Went to the nursery again today. Very hot and children still allowed outside sans hats and suncream – surely they must still burn no? In England it’s no hat, no play, no fun today! One little girl latched onto me. She is new at nursery and kept saying “lets look for mama” and kept crying. I learned “baasi, mama badaye” loosely translated to “its okay mama will be here later”, which I seemed to be saying all day, calming Charity down… then when I had to leave all hell broke loose and I couldn’t prise her off me so I had to wait another hour until she could be distracted with lunch!
I then went to the river trees hotel, where there’s a pool and I was meeting some medical students from Arizona and Belgium who I had seen at the hospital. Again we braved the cold water… with the surprise of this pool having HOT showers!! Finally shampooed AND conditioned my hair!
Back to the house before nightfall for Swahili lesson and to do clothes washing (by hand and no doubt still drying full of washing powder as used too much) before going to meet the staff at the orphanage with Joshua…
Walking there it was loud with a tapping sound in the drains, Joshua told me it was frogs – I looked to see loads of big frogs croaking away! Crazy how the sound just filled the streets!
I went to a local orphanage in the morning then to a Masai market in town in the afternoon and out with some medical students in the evening to what I was told was one of the best bars in Arusha for foreigners – The Empire.
At the orphanage I helped with breakfast then was left to look after 6 under 3 year olds alone! Hell! They were not allowed to play outside but the door had no lock and I had no way of keeping them in, plus it seemed it was potty time every ten minutes which was a trip outside with all of them who after would run in different directions and not listen to my telling them to come inside even though I knew they were understanding my Swahili.
I tried to occupy them with colouring, but no matter how many colouring pencils each child had they still wanted the ones the others had, and would hit, bite, scratch and attempt to strangle one another to get them and this always ended in tears. I felt like screaming with them at times!
It was difficult to keep them entertained for any period of time because like most two-three year olds they got bored quickly and there were no toys other than a tennis ball!
I managed to escape around 12 as after 4 hours I was exhausted.
After I got the dala dala to Arusha to go to the Masai market where I literally was pulled from shop to shop to try and get me to buy things… Ended up buying 3 pairs of harem trousers at 15000TSh each (about £5). It was hard bargaining as most shop owners started at 40,000 Tsh for these!
After a few hours I finally managed to escape and found a guy selling fruit salads for 2000 TSH! Like a whole plate full and the fruit here tastes so much fresher! If it wasn’t a risk for smushing all over my suitcase I’d be tempted to smuggle a watermelon home!!!
Got home just before dusk and had a few hours before going back out again. Spent some time with Lillian, Beatrice’s daughter, who is the same age as me but still in high school. She’s been off school sick but goes back on Sunday until December! Apparently even at 21 she has to have permission to go home and see her parents?! And parents aren’t usually allowed to visit!! Lillian asked me about my birthday – I had gone ice skating which she hadn’t heard of! I showed her some YouTube videos which her reaction to was amazing! She was in disbelief at how people can balance!!
Peter, the taxi driver arrived and took me to Arusha, charging 40,000 for what I later learned was a 20,000 tsh trip!!!! Still not as bad as UK taxis though. Got to the bar and spent the night dancing and singing with the other hospital volunteers and orphanage volunteers.
Home by 3am ears ringing and desperate to go to bed but met some cool and some “interesting” people!
I’m writing this from the dala dala hence typos! Just been to Meru District Hospital and spent some time in major theatres! Finally one place which has handwash and running water! A lady came in for “emergency” c-section… There was meconium stained amniotic fluid and the baby’s heart rate was dropping. From making the assessment of the baby being in distress and getting the baby out it took thirty minutes!
I watched the c-section – with the whole procedure much less dignified than in the UK. The sterile field was small, and the woman lying naked completely uncovered (in the maternity ward too there was a whole bay of women lying naked with no curtains between – a stark contrast to British culture!).
When the incision was made, the skin was then stretched to prevent making a larger incision and then after one more incision, the baby’s head became visible and lots of meconium stained fluid came out. The umbilical cord was wrapped around its neck. This was unwrapped quickly and the baby’s mouth cleared of the meconium fluid to prevent aspiration. Within minutes the baby started crying – a good sign!!!
Mum saw her baby girl briefly before the baby was taken back (I got to carry her!!) to the maternity ward to be weighed and warmed up using a heat lamp as she was shivering. For the surgery the mum had just received fluids and an epidural! She began complaining of pain however the nurses said she would have to wait to go to maternity as they do not administer the pain relief in theatre as they don’t keep the injections! On return to maternity about 45 minutes later she would receive basically a weaker form of morphine, pethidine.
After this I went to the orphanage/nursery via the pharmacy to get cream for my mosquito bites 🙁 when I got there the children were all asleep!!! It was bliss! They woke up one by one and the routine starts – potties, feeding and then all hell breaks loose! Luckily today there was someone else helping me 🙂 still, when the older (5-7yr) children finished school and came back they were fighting over my hair and god knows how I will get all these mattes out!! Maybe I will get dreadlocks after all!
After 4 or so hours I decided it was me time and went for my first run since arriving. The roads are rocky so it was difficult to keep grip, and since Tanzanians on the whole do not seem to be as into keeping active as us westerners, I got a few odd looks and people humouring me pretending to run alongside and others clapping. Overall it was a good run, exploring new places and finding a cute little stream tucked away behind the houses.
And another day flown by!
Another day at the hospital – got there and there was a large police presence – the senator was in town meaning the whole hospital came to a standstill!! After the speech was finished I was hoping to spend another day in major theatres however they had no planned surgeries. Instead I followed an American trainee advanced nurse practitioner around maternity and together we did ward round assessing the women who had given birth and their babies in the postpartum ward!
I mainly took on the assessment of the newborn role (as the nurse practitioner, Tess, was not specifically paeds trained) and then just helped with manual BPs (automatic machine was broken) for the Mums. Three of the babies had low temperatures (below 35) however only two were dehydrated, both with sunken fontanelle and one difficult to rouse with a heart rate of 120bm. It was frustrating as there was no glucometer on the ward and no glucose to give the babies! The only thing we could do was encourage the mums to feed more!
One more thing to mention is that most beds were occupied by 2-3 women!! Some only 1 though, for example a woman 1 hour post c-section who was still haemorrhaging and experiencing rigors.
Later on I observed the nurses giving vaccinations to the babies – oral polio and BCG, which is in line with World Health Organisation advice for African countries!! What did make me a little uneasy was the disposal of sharps… By the time all 30 ish babies had been vaccinated, there was one very overfull and uncovered cardboard box with needles sticking out :-S
At 2pm it was time to go and help at the orphanage. I decided to stop en route to get my side braids redone with rasta… I thought 10,000 tsh was cheap so I tipped 5,000 however apparently it should only have cost me 3,000!! Still 15,000 is only £5 which I’m happy with!!
At the nursery again the children were asleep. This time when they woke up I decided to use technology and put into practice a few phrases I have learned “mtoto/watoto turia” – “child/ren behave” and “cheza visuri” – “play nicely”. Using my phone I showed them (and attempted to teach them) the song Hakuna Matata since the phrase is actually swahili for “no worries” as the song says. This kept most of them happy for almost one hour. When the battery was about to die however it was time to leave for swahili lessons anyway!!
After the lesson I went running and en route popped to a shop. Within 5 minutes it was almost pitch black and so the run home along jagged rocky roads was interesting to say the least!!
Time to get some sleep for the day ahead.
Today I went with a tour guide and Mary (our swahili teacher who decided to tag along) to the hot springs. It was a two hour drive along very rocky and bumpy roads where you could barely drive 15mph.
The journey was interesting with Masai men walking with donkeys carrying water and we saw them herding goats and sheep as well.
The springs were in the midst of barren desert like farmland (with baobob, acacia and cactus trees sparsely scattered alongside aloe vera plants), and was surprising to find in such terrain.
The water was warm ish, around 32 degrees celsius, with lots of the fish that used to be kept in tanks in the UK for eating the dead skin off your feet. If you stayed still too long (by sitting on one of the rocks for example as the water was too deep to stand) the fish would come and start nibbling so it was best to keep moving. I stayed in the water for a few hours, chatting to other British tourists and intermittently having a go on the swing over the water which took me a few attempts before I could actually jump!! First time was a disaster because I forgot to hold my nose and not breathe underwater so I felt as though I was going to drown.
I explored through the narrow gap in a row of trees lining a narrower stretch of the spring and found the lagoon where the source of the spring was – looking into the water there was a really deep hole in the sandy bed of the lagoon! Apparently it would be dangerous to swim down there as it is quicksand in the hole from what I understood.
We left around 2:30pm, after checking out the turtles/tortoise? in the shallow stream behind the shack like bar at the springs… I had no idea Tanzanian waters had turtles/tortoise?.
On the way back we stopped at the petrol station where there was a coffee place… It was amazing to have a coffee after a whole week of not one!!! Even if the cup was leaky.
When back in Usa river I went for a mooch around the market then home. Beatrice had organised to go out for dinner. The place had a buffet with some suspicious looking things so I got Joshua to check everything to make sure it was not meat!!! Still a stray piece of beef landed on my plate which left me paranoid for the rest of the meal and since it was dark in the room to eat I just had to double check it using my phone torch. Must’ve looked like a right nutter, but I think Beatrice understood (as I almost cried this morning when I saw they had bought chickens from the market which were not going to be used for eggs and were still alive…) So she got her phone torch out and double checked too!!
Nelly, one of Beatrice’s friends children, came with us which was funny because he is only 5 and kept running to random people’s tables and grabbing them playfully… Beatrice and the others laughed when I said “Mtoto njoo hapa” which is swahili for “child come here” as she did not know I knew as much swahili. The problem is that Nelly is so funny it is difficult to get annoyed with him for running off… So even telling him to behave I could not keep a straight face…
And that is it up to now…. Bed time again at last!!
Went to Arusha today to go to Africafe and get good coffee and wifi… ended up having “Hot Stepper” – a ginger, lemon and honey drink which really was “hot”. Sat there updating this blog for a few hours then walked to central market around mid dayAfter this I walked back to Africafe, stumbling upon an Asian supermarket on the way where I found Cadburys Bourneville dark chocolate! The only dark chocolate I’ve found in Arusha so far!!! I also bought soya milk and when desperate times call for desperate measures I went back to the cafe and ordered a soya cappuccino with my soya milk! 😀 Happy days.
After lunch I went go the palace hotel gym on the tenth floor overlooking mount meru – stunning but forgot to take a picture. After a lot of sweating and a good lukewarm (yay not Baltic Sea cold) shower I headed back to the dala dala.
I walked back to the house once in USA river and dropped my bags. Nobody was home but I heard a noise. I looked behind and the chickens had followed me into the house. I shooed them out then went to change my shoes… They had followed me back in!! Shooed them out again and locked up.
Went to the market in USA, with the usual walk involving the children across the road coming to hug me, where I bought some hoodies since I left my only one at the bar the other night accidentally.
Got to the hospital today just in time to see another c-section! After this I went to paediatric ward round where again it is much of the same – pneumonia and burns!
After the hospital I went to the nursery which helps by looking after children so the mothers can go to work. I learned how to carry babies African style today!!! Actually is quite easy once they’re on your back!! Planned with the owner to make an outdoors mud kitchen for messy play like in England as this will be relatively inexpensive! Will also at some point show them how to make play dough…. But in the recipe it says you have to put in fridge which I’m unsure as to whether they have.
I helped feed the children lunch (they offered me some but the lump of white corn maize flour stuff just doesn’t look all that edible!) then left to go swimming at the nearby hotel before having a Swahili lesson.
Been to the hospital today and although today is the day for planned surgeries there were none so I went to maternity instead as it’s much busier than paeds and still I get experience with care of newborns (or how not to act) and vital signs. Saw two babies born today! Again very different I’ve been told from European practice since the birth rate per woman in Tanzania is almost three times that of the UK… And there is a shortage of beds for women in labour… So if the baby isn’t ready to drop out then there’s “no bed for you”… And if the Baby is coming too slowly or isn’t out in a few pushes… There’s no patience… They are much more inclined to make cuts.. Which was rather gruesome (don’t read on if you’re squeamish) with the scissors being blunt and not sterile so acting more as pliers to rip the woman with, and the midwife trying again to cut the woman when the next push (although the baby progressed closer to being out) didn’t result in the baby being delivered.
When the baby was born it was wiped down, weighed and swaddled and left on the table while the mum was being stitched up… So I picked the baby up because it was crying and nobody was taking notice… I showed mum her baby but was not allowed to put the baby on the mother as is encouraged in UK. And here I’ve yet to see any skin to skin practice plus mums don’t get their babies to hold for up to two hours post delivery…Which inevitably results in delays in milk production and more difficulties for some… With some newborns becoming very cold and lethargic very quickly… I couldn’t say for sure whether this was due to low blood glucose as the meter to measure this is broken and there is no spare. As a precaution for a few babies who were <34 degrees Celsius and not flexing to pain, we gave 10ml of 10% glucose fluid (as that was all which was available) and held them near a heat lamp and hoped for the best. Nobody seemed at all concerned about the baby’s clenched fists and overlapping fingers distinctive of a syndrome such as Trisomy 18. An eye opening experience as to potential reasons why the newborn death rate is higher in countries such as Tanzania compared to Western countries.
After the second birth I left to go to the nursery. I played ball with the children and one of the Nannies outside, managing to pass Charity (the little girl who every day cries for her Mum and latches onto me to pick her up) to Abel, a man who works within the nursery… I pointed at Abel and said “Baba” (dad) and Charity latched onto him surprisingly well, with him even having to sit her in the minibus whilst it was cleaned. It was quite comical.
Afterwards it’s home for Swahili lessons then out for an evening run…
Just as I got to the hospital today there was a baby who had just been resuscitated after stopping breathing during delivery! Amazing. I went round the postpartum ward helping with taking vital signs of mum and baby… Lots of mums had high pulse rates due to pain, however if they didn’t have the money they could not get pain relief! One mum had a history of pregnancy induced hypertension… Her BP was slightly elevated at 145 systolic… However there was no baseline to compare this to!!!!! I gave her an IM injection of Pethidene… The strangest injection I’ve given as the nurse just hands it to me and points to where without giving me chance to change gloves or wash my hands… TIA (this is Africa) has become the general saying around here.
After going back round and checking all the babies reflexes, checking for spinibifida, cleft palate and other signs of abnormality I went over to the paediatric ward and helped with admissions there. On admission they try to cannulate all of the babies and children (mostly unsuccessfully resulting in IM injections of medication) and they test all of them for HIV.
In the resuscitation area alone was a young (possibly 1 year old) boy on humidified oxygen sat with his mum. The boy had nasal flaring, head bobbing, was using all accessory muscles and still grunting. He was trying to cry but no sound was coming out. No doctors or nurses were overseeing. The situation seemed wholly uncomfortable as if this were in UK the nurse looking after the child would most likely be there all the time, with outreach nurses being called and potential transfer to PHDU or such like. Vital signs would be taken regularly, not 6 hourly, and the child would most likely be on continuous pulse oximetry.
After we had got through the admissions I went to the nursery to make play dough with the older children (4-6year olds). Then went for a short run before having a Swahili lesson to learn animal names before going on safari this weekend.
Very busy second to last day in USA river.
Went to the hospital in the morning to help out in the postnatal ward… Now got my manual BP skills down to a tee. All the babies today were fine – well hydrated with good reflexes. One of the mums with pre-eclampsia had a BP of 158/100… I told the doctor and he questioned “it’s too high?” to which one of the Dutch midwifery students (who had got so frustrated with the inaction on the doctors part) just told the doctor “F you” and walked off. Emotions were running high as after two weeks in a foreign hospital where you see people suffering because there is a lack of compassion and unwillingness to go the extra mile for the patient it does become mentally draining!! It’s the questions of “why go into a caring profession and not put in 100% as these are people in need!” and “how do people survive here?”. According to the doctor the literature says to recheck BP six hours apart in this time. When I asked where he got his sources from he stumbled and said references. I told him he had to understand how frustrating it is that in England people would be acting quickly, and monitoring vitals more closely when there is an anomaly, not sitting back and waiting 6 hours. I explained to him a few of the things I’d seen here and what would have happened back in the UK and he began to comprehend the major differences in the systems and perhaps why there have been differences of opinions at times – I told him I respect they don’t have so many resources, but monitoring vitals when you already have a BP cuff doesn’t cost anything. He laughed and said yes and that the blood pressure would be rechecked 2 hourly, result.
There was a woman in labour crying in pain asking for a c-section because it was too painful. The nurse was shouting at her and laughing about the fact she was asking for a c-section as there was no indication (yet they did a c-section on another woman on the premise they “thought” the baby was going to be big… It was 2.7kg). No pain relief was offered and the nurse then walked away from the woman. Later on this woman was on the floor rolling in agony and going in and out of consciousness. BP and blood glucose were fine. It took 8 people to lift her (no hoists and definitely not what is taught in manual handling training) onto a wheelchair and back to the bed. The doctor concluded it was a panic attack and after ten minutes (checking foetal heart rate etc.) all hospital staff again left her alone without support, so the student midwife went over to hold her hand. I’d been able to listen to the foetal heart rate using the Doppler which is placed on the tummy. A downside of long hair is when the bun you’ve placed it in falls out at a very inconvenient time and your hair goes somewhere you really did not want it to. Go figure.
After the situation had calmed down I left for the last day at the nursery. I was exhausted by this time.
I spent some time sitting with the little ones. Namely Salha who unfortunately I haven’t been able to discuss her visa arrangements yet with her mother (joke). I’m going to miss that little one!!!
After this I went home to pack, then swim in icy cold water. After which I went up to the hotel bar in search of coffee! Filter coffee – result! None of the crappy instant stuff. Good coffee.
Back to the house to chill and watch Netflix and say goodbye to Joshua and Beatrice as tomorrow when I leave they will be out!!
Early start from Meserani snake park to our next stop at Twiga Camp near Mto Wa Mbu where we would see the Masaii people.
In the morning we dropped our bags and then went on a walking tour of the banana plantations (who knew there were more than 30 types of bananas?!) and the brave tried some fresh banana beer which did not look suitable for human consumption due to the layer of millet still being present. I only tested the banana wine… Which was nowhere near as nice ad it sounds!! Debating whether the “factory made” banana beers are worth 0.7kg of my luggage allowance now!!
After this we went to see some tribe men carving the wooden animals which are sold at the Masai Market in Arusha town. While there we noticed there were lots of lizards (actual wild ones!).
Then it was onto see the painting which is also sold. Amazing artwork but am holding fire on buying anything as currently I already have to sit on my suitcase for it to close!
After this we went for a traditional Tanzanian lunch with all sorts of dishes (2 out of about 12 plus were NOT vegan!!) – that left spinach, cabbages and vegetables, okra, aubergine, bananas, sweet potatoes, and an extremely hot chilli sauce plus various bean dishes and sweet corn and beans called Makande.
Then onto visit Mto WA Mbu where we looked at the cooking project going on which enables the Masai to have a clean cooking fuel source by teaching them to build chimneys. The Masai children were very shy and they did not like having their photos taken. There were lots of children, and the Masai women ha lots of jewellery.
After this was time to go back to the camp and those of us who signed up for the mountain bike tour set off for a journey across amazing scenery to Lake Manyara where we saw lots of flamingos, Impala, gazelles and storks. On the way back I passed through the market to buy a bunch of the red bananas we had sampled earlier, which taste sweeter yet more citrusy than normal yellow bananas!
The terrain was bumpy and I was shocked the bike held up the whole distance (and shocked they had no idea what a helmet was), yet it got me all the way back to the camp where I cooled off in the warmest pool yet in Tanzania which I’ve swam in (probably due to the sun shining
On it all day as it was still not heated), then went for my first hot shower in a long time… Amazing!!! After this it was dinner time and a glass of red wine before bed which worked wonders to help me sleep!
We arrived in Serengeti around 1pm on Saturday. No signal at all. At the entrance there were Masai children trying to get you to give them money in return for a photo, but we had been encouraged to promote responsible and sustainable travel and not give them anything at all.
There was a cool chameleon and lizard at the main entrance when we arrived, and lots of superb starlings trying to get scraps of people’s lunches.
The road the whole way was bumpy and loud, much like using a vibration plate at the gym.
En route to the campsite we went on a game drive where we saw hyenas, ostrich, lions, a leopard, warthogs, elephants, gazelle, zebra, giraffes and probably more which I cannot remember!
We arrived at our campsite for the night where we were warned of hyenas and not to go to the toilet block overnight unless absolutely necessary… which for me it was twice, however with the tent surrounded by hyenas one has to improvise, but what happens in Africa stays in Africa.
The next day was a full day gamedrive best described by the photos to be uploaded when I’ve returned to UK. Back to the same campsite again for the night. Hyenas still audible all night, difficult to sleep! Woke up in the morning to giraffe less than 50m from the tents – amazing!
The following day was a gamedrive before heading to Ngorogoro crater campsite, where the dangers in the night were buffalo. Again, no toilet trips in the night.
This day we only saw cheetah! Still, amazing!
Spent today at Ngorogoro crater… freezing!! Saw lots of zebra, buffalo, wildebeest, warthogs, lions, jackal and vervet monkeys. Not much more to say.
Back at Meserani snake park by 3pm. Not feeling too great after the long journey so headed for a walk and then to bed!
Medical experience projects are not just for students. Claire Evens joined us in Mexico for medical and paramedic work experience when considering a career change. This report is taken from the thank you letter Claire kindly sent us and makes very interesting reading:
I wanted to take this opportunity to thank you for the time I have spent volunteering for Global Medical Projects.
It has been an amazing experience from start to finish and I am truly glad it has been something I have been able to be a part of, despite my lack of previous medical experience.
The initial guidance I received from yourself was invaluable in helping me to decide on the best project and country to suit my needs. I can honestly say that after researching other companies, I believe what sets Global Medical Projects apart is the friendly, one to one guidance offered at the initial point of contact, which is neither too pushy nor too distant.
My time spent working as a volunteer here in Guadalajara has been an amazing experience to be a part of and I’m truly grateful that despite lacking in experience I was able to have the opportunity to partake in this.
From the first day I arrived at the Airport in Guadalajara I was met with gusto by Antonio at the Airport, his friendly and reassuring manner immediately put me at ease and was a great start to my experience here. Once we arrived at my accommodation I was met with equal enthusiasm by Josue and his partner Zuhey, who both had an approachable, friendly, but professional persona.
The home I have been staying in is very grandiose and although slightly antiquated, it has beautiful old style architecture. When I was first shown my room I was pleasantly surprised as it exceeded any previous expectations I had, with a comfortable double bed, adjoining shower and a TV! The relationship that I have built with my host is one of the best parts of my stay and is one which I hope will last a lifetime. We have become great friends and she has really welcomed me into her life and to her family.
I was initially quite apprehensive about starting at the hospital without any previous medical experience however it really helped re-assure me having Josue and Ariel there to settle me in and meet me at the Hospital to introduce me. I needn’t have worried as everyone has been so inclusive and friendly on each department that I’ve worked on in the Hospital. I do think that speaking a reasonable level of Spanish has helped me build closer relationships with staff and enabled me to integrate at a quicker pace into the team.
I was surprised how much I was able to get involved in the hospital despite my lack of previous experience. During my time there I was able to work on an out-patients department where adults, children and babies come to have their height and weight taken, temperature gauged and blood pressure measured. I learnt how to take the blood pressure, which for me was a first! This department was great for my Spanish, as it enabled me to practice this in a real live work setting.
I also spent time working in the emergency ward, which was by far my favourite ward, as there was a good level of banter in which I was included, so I was quickly able to fit into the team. I was able to learn how to put a cannula in, along with taking stiches out which again were both firsts for me. I also had the good fortune to meet some very friendly doctors along the way who invited me to see operations which included the removal of a uterus, the removal of an ovarian cyst, an investigation into a damaged urethra, the removal of scar tissue and cysts.
I was also able to see both a caesarean and a natural birth and help out on the mother and baby unit so I was able to experience the other side of the labour ward and see first-hand the level of care given to young Mums following the birth of their child.
I took part in a practical CPR session to learn how to resuscitate someone and was able to sit in on a very informative discussion about the importance of giving blood.
The final part of my volunteer experience has been working alongside the Red Cross ambulance staff. I was particularly nervous going into this situation without any previous medical experience especially when our first call involved us flying out the door and following an urban rescue van at about 90 miles an hour. I had goose bumps on my arms, my heart was in my chest and I didn’t have the nerve to ask what we had been called out to, as I was extremely conscious that I didn’t have any of the capabilities or knowledge to help them. However, once again I needn’t have worried as within a matter of a couple of hours I began to feel like one of the team. I got to partake in covering a local sporting event and some of the call outs involved a car accident, motorbike accident and a deep cut to the head by a possible machete.
My overall experience of Global Medical Projects has been one of extreme satisfaction. From the minute I arrived I felt immediately relaxed with everyone that I have been put in contact with on the volunteer projects and both the staff and hospital employees really went out of their way to accommodate me in every way possible. The whole set up is extremely well organised and the support given by the team in Guadalajara is second to none and I always felt that my needs were a priority and I felt I could ask for help or guidance at any time. I can really sense that Ariel eats sleeps and breaths Global Medical Projects and I can see how important it is to him that all the volunteers have a good experience and all their needs are met.
I would truly recommend anyone who is thinking about getting involved in a placement to just go ahead and do it! For me it has been a truly remarkable and potentially a life changing experience. It has enabled me to gain some valuable experience in a medical setting, improve my Spanish and to build relationships with people which I hope will last a life time.
Thank you once again for this experience.