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.
Preparation
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.
Placement
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
Accommodation
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.
Support
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
Kasia
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!
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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!
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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!
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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.
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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!!
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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.
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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.
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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…
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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.
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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!!
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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!
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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:
Dear Kevin,
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.
Kind regards
Ashleigh with the ambulance crew at the green cross
My name is Ashleigh and I am currently in my third year of studying Paramedic Science. In between my second and third year I decided to head to Guadalajara for what was meant to be three weeks (I ended up staying for 5). I decided to undertake this volunteer placement to expose myself to the diverse culture of Mexico. I also thought that it would be a great learning experience for trauma emergencies – I wasn’t wrong!
My first week was spent in the emergency department of Cruz Roja (Red Cross). Cruz Roja was approximately a 30 minute walk from my host family so I often walked with other volunteers to see the beautiful city of Guadalajara. The doctors at Cruz Roja were very welcoming, spoke good English and loved making sure I was getting involved. Throughout the week I worked mostly from 7am-2pm and would sometimes go in for the evening. Cruz Roja was quieter than I had expected but I still experienced more than I have on placements at home.
I then asked if I was able to work at Cruz Verde (Green Cross) and that was not a problem. This was where I would make friends and memories that would last a life time! I worked a couple of shifts in the emergency department before spending the rest of my time in the ambulance. In the clinic I was accompanied by the student doctors, who again spoke good English. The level of trust the doctors held within other volunteers and I was incredible! The highlight of my time in the clinic was learning to suture and watching small surgeries (well attempting to).
Ashleigh with the ambulance crew at the Cruz Verde
Throughout my time working as the third person in the ambulance, I experienced things I would have never imagined! Again, the ambulance service was quieter than I had expected, I believe this is due to the cost, most people prefer to drive themselves (yes people will drive a family member in cardiac arrest to the hospital). In saying this, I still attended a car or motorbike accident every single day. Other cases I frequently attended to included; cardiac arrests, strokes, diabetic emergencies, shootings and stabbings! I attended many interesting, unusual and at times very rewarding cases. The one case that stood out for me the most was a multi casualty accident involving two police cars and approximately 20 pedestrians. Being my first major trauma incident, this case was obviously very hard for me. However I feel as though it has developed me into a better paramedic. The biggest learning point gained from this experience was that sometimes words are not needed. The feeling of being able to comfort and care for a number of seriously injured causalities, who did not speak my language, was a truly rewarding experience that I will carry with me forever.
The paramedics at Cruz Verde were no doubt some of the most caring people I have ever met. They were all very welcoming and constantly asked if I was okay – making me feel at home. They always insisted on taking me for tacos or hotdogs (strongly recommend) even if it was 2am. I made friendships that I know will last a lifetime. I worked around the clock, often doing consecutive 18 hour shifts, although you can work as much or as little as you like!
Overall my experience with Global Medical Projects was nothing short of incredible. The GMP staff were all very welcoming before and during my stay. Kevin was a great help with any concerns prior to my trip and always replied as soon as possible. He also insured I was more than comfortable and made fast arrangements when I decided to stay for an extra two weeks. The GMP staff in Guadalajara work around the clock to always insure you are safe and are more than happy to show you around and help with any concerns.
My recommendation for anyone considering taking this trip of a life time is to just do it! Step out of your comfort zone and I can promise you it will be more than worth it. Learn as much Spanish as possible, drink as much tequila as possible, eat as many tacos as possible, but most of all have the absolute time of your life! I am already considering planning a trip back!
If you would like to follow in Ashleigh’s footsteps, you can find out more here Student Paramedic projects in Mexico
Richard Ford is a physiotherapy student at the University of Salford. He joined our project in Mexico volunteering to work with disabled children.
I spent 5 weeks at Hogares de la Caridad in Guadalajara, Mexico. This was my first time volunteering, being in Mexico and working with children.
The children at this orphanage have cerebral palsy and some also have autism. Parts of Mexico receive very little funding for those who have been abandoned due to their disability. Physiotherapy is vitally important for these children and it is because they had received so little treatment for their condition in the past that some of them are now left with debilitating conditions.
I saw how cerebral palsy and this lack of treatment affects children, treating a mixture of patients. I had to quickly learn the importance of using non-verbal communication skills because many of the children couldn’t understand English and some could not communicate at all. One of the children I treated was four years old and was unable to talk, walk or feed himself.
I also worked with a child who hated physiotherapy treatment and who would scream anytime someone touched him. He was blind and had a cephalic disorder. Sometimes, a balance would have to be made between giving him vital physiotherapy treatment and leaving him be. Occasionally, we had to persist with his therapy, stretching his muscles and massaging him even though he was crying.
The main treatments I used were massage, stretches, gait education, and proprioceptive exercises but it was not all about physiotherapy. I also helped with the day-to-day care of the children. This included spending time with the children and helping with feeding them at lunchtimes.
For part of my time in Mexico, I travelled to Peurto Vallarta to volunteer at a day care centre for children called Pasitos de Luz. These children had a range of disabilities caused by various diseases which meant that they were all in need of physiotherapy. This clinic had quite basic and limited facilities so I had to come up with different ways in which to provide forms of treatment for the children, for instance gently rubbing grains of rice against their legs and arms to act as a proprioceptive feedback mechanism to regain balance and sensation. In addition to the treatment, the children were just happy to see some new faces and play lots of games.
The trip gave me a real insight into physiotherapy and the treatment of disabilities in Mexico. One of the key lessons I learnt was how important is was to work with the whole team at the orphanage including the nurses, doctors, managers, other volunteers and physiotherapists to provide holistic care for the children.
I arrived late on a Saturday night in a down pour of torrential rain, deafening thunder claps and fork lightening. I could barely see out of the window on my taxi journey from the airport. I was a bit disorientated after a twenty-four hour journey, but I had arrived in Mexico. I was warmly welcomed by the the family (who would treat me as one of their own for the next three weeks), as well as one of the Global Medical team and some volunteers already on placement (who would then take me out for a welcome beer)
My name is Rob and I am currently a third year paramedic student studying in England. At the end my second year I took the decision to head to Mexico for a three week volunteer placement, working in the Emergency Department (ED) and on the ambulances in the city of Guadalajara.
I worked six hour shifts, either morning or afternoon following the shifts of the hospital staff and paramedics but you can work as much or as little as you like (afternoons and nights being the busier shifts). My first week was spent in the clinic acclimatising to the language and culture. I was surprised by the amount of people that bring themselves or family members to hospital, people only call an ambulance when they are not physically able to bring themselves in. I saw people with broken legs, hips and even one with a spinal fracture being carried in by family members/friends. Even one chap covered in over one hundred bee stings just walk into the department before he collapsed in shock. In my time at the clinic I was able to help with the daily tasks such as wound care, bandaging, suturing, cannulation, ECGs and drug administration, I was also able to watch some minor surgeries in quiet times in the ED. I also spent a lot of my time with the doctors in the emergency department discussing differences in treatment and training, which helped me come away with a greater appreciation for the equipment and training that we take for granted in the UK.
The shifts in Mexico were a lot quieter than what I am used to in the UK, this I believe, is due to the fact that people only call when it is really necessary. I averaged two or three jobs in my six hour shifts. However, when you do get a job it is usually trauma or a medical emergency. One memorable day the first job attended was to a ninety year old lady who had been hit by a car (over 250 car Vs pedestrian deaths so far this year in Guadalajara alone). The next job was to an elderly man who had suffered a TIA, there are no carry chairs in mexican ambulances so improvisation is key to the job. We tied this elderly chap into a small armchair with a bed sheet and carried him down the three flights of stairs, head first. After that a young man who had fallen two stories, from the fifth floor of a building under construction and landed face first on the third floor. The first issue was reaching the patient, we had to get up to the third floor using a ladder which we pulled up behind us each time to reach the next floor. The lucky patient was conscious and appeared to have no other injuries other than a mouth lacking teeth and blood loss from that general area. We rolled him onto a rescue board and immobilized him with collar and blocks. Then began the wait for the “Bomberos” (fire brigade). The extraction of this young man was very impressive once the “bomberos” arrived. They harnessed up the rescue board with ropes and lowered him down feet first one floor at a time. Fire at the top with paramedics catching at the bottom. Pretty hair raising work jumping across steel girders with nothing but three stories of space below.
The staff in both the clinic and on the ambulance were very welcoming, I went for a breakfast of tacos most days with either the nurses or paramedics. Most weekends the other volunteers and myself were invited out by the paramedics and doctors to sample the night life of the city, salsa dancing, lucha libre (mexican wrestling), mariachis and tequila! The city itself is beautiful and welcoming to tourists so take some time to explore the sights, food, music and culture that it has to offer.
As well as new friends and memories on of the things I will take away from this experience is how rich we are in education and support in the UK. These guys do an incredible job with little money/governmental support and sometimes archaic equipment. I recommend anybody working in or planning to work in medicine/paramedicine to take on this experience, to head to mexico with an open mind, to work hard (you will get out what you put in), to eat tacos, drink tequila, dance salsa, and to learn about a different way of living and working.
Over the summer I travelled to Trivandrum, India for a two week pre-medical placement with Global Medical Projects. I was eager to gain more hospital work experience and the opportunity to observe a foreign healthcare system really appealed to me.
Leading up to my trip I was very nervous and found the thought of travelling by myself to an unknown city, far from home rather daunting! However, there was so much support from Global Medical Project’s staff, particularly the coordinator Kevin Dynan. Any concerns I had were addressed and questions answered, ensuring that I was fully prepared for the adventure ahead.
Before I arrived in India, Babu the director who is based in Kerala had already received my CV and from this he organised all of the hospital placements for me, according to my interests. On arrival in Trivandrum airport, I was greeted by as friendly staff member who had arranged transport to take me to my accommodation. The Volunteers house is comfortable and well equipped, I enjoyed relaxing on the balcony in the evenings after placement.
In India I experienced a number of medical specialties. I spent most of my time in the NMS Mission Hospital where I shadowed consultants and nurses who were very accommodating, answering any questions I had and explaining patient illnesses.
The highlight of my work experience was the A&E department, where I developed great friendships with the staff, who were very passionate about their work. I witnessed some intense medical emergencies, including a Cardiac Arrest and an epileptic seizure. I loved learning how to take an ECG of a patient’s heart and to identify an abnormal rhythm caused by a myocardial infarction.
I also had the opportunity to volunteer at the Palliative Care Charity called Pallium. I got to join the medical team in their home visits of rurally placed patients who didn’t have access to a hospital. It was exciting travelling in the 4×4 jeep on narrow dirt tracks with stunning scenery of backwaters and coconut trees all around. We delivered essential medication, bandages and food to rurally isolated patients and it was so rewarding to see how grateful they were for our support. Many of the patients had type 2 Diabetes and it wasn’t uncommon to see amputations and diabetic bed sores. At the end of the day, the medical team treated me to some traditional indian snacks and coffee in a local Restaurant.
I volunteered in the leperosy clinic, helping post-surgery patients with muscle exercises. My wish to experience Genecology is India was also fulfilled. Not only did I get to shadow a senior gynaecologist but I also had the opportunity to see an emergency Cesarean Section and care for the premature babies in the Neonatal Ward.
At the weekends we had free time to travel. My favourite experience was visiting a region called Alleppey, which had some of the most beautiful backwaters in the world! The group hired a houseboat and we got a guided tour of the area, I didn’t stop taking photos as everywhere was so beautiful. We even got to stop off along the canal and buy fresh coconut milk from a local and take pictures with his pet Falcon! It was a great opportunity to get to know other volunteers and we really bonded with each other. If you like to experience weird and wonderful foods, then India is definitely the place for you! At the weekend we were spoilt for choice as where to eat dinner, and price wasn’t an issue as the average feast cost us about three pounds each! At the volunteers’ house, “Chef Babu” ensured we didn’t go hungry and made some really delicious meals for the volunteers coming home from placement. My favourite dish was Samba, served with an indian pancake called a Parotta.
In all, my trip to India was a once in a lifetime experience and I would encourage anyone interested in gaining work experience to take this unique opportunity to explore another healthcare system, an exciting new culture and make new friendships in the process.
My name is Emily Haines, and I have embarked on two unforgettable experiences in Africa. My life-long ambition is to become a doctor, and watching medical volunteers in Africa on BBC news TV channel one day motivated me to get in touch with Global Medical Projects to find out more. I was instantly hooked on the idea of embarking on an unforgettable lifetime experience in a Third world country! Although my trips took much planning in terms of finances and dates, it was certainly worthwhile. On my gap year prior to university, I took a month long trip for a medical and orphanage project in Ghana. Central Regional hospital in Cape Coast was where I spent the majority of my time, and it really opened up my eyes to the large differences between developing healthcare systems and the developed. In the evenings, I visited a small orphanage in the village of Ansapetu, where I met many children that were grateful for even a friendly face showing up at their door. It doesn’t stop there though! 2 years after reflecting on my time in Ghana, I could not wait to begin another project in another African setting, so I chose Tanzania. I was in Tanzania for 3 weeks, where I did another project, set in Meru District Hospital, and ‘Cradle of Love’ orphanage. People may think the two African projects I did were almost the same experiences, but I would definitely disagree. I came back from both experiences having learnt different practices, cultures and languages!
Flying to Ghana was the first time I had ever travelled abroad alone, which was I must admit, quite daunting to begin with. Going into the unknown I really did not know what to expect, but I remember the day I arrived in Ghana like it was yesterday. From meeting Eric, my host, at the airport in Accra, I immediately felt like I was in safe hands. Seeing the bustling capital city of Accra, I instantly had culture shock, but my fascination over-rode my initial worries. The 3 hour journey to Cape coast was an interesting one, seeing the poverty stricken people in mud huts without sufficient clothing on their backs, confirmed what I’d seen in the media was real. However, I also noticed the wealthier side of the area, no longer did I see mud huts but well- constructed houses made of brick. Following this journey to Cape coast town I had arrived at my accommodation in Abura, and Mary, Eric’s wife, and Ruth, the housekeeper, were there to greet me. I was overwhelmed with how friendly and helpful they were and our personalities clicked right away. I also met one of a few volunteers I would be staying with; she helped me settle in by giving me advice, one being a warning of the frequent power-cuts that occur in the house, which I definitely got used to! However, the house had a lot more to offer than I’d expected, there was internet access so I could contact my family easily and a warm shower! Having the weekend to settle in before beginning placement allowed me to take in my surroundings and immerse myself in the different culture. George, the house supervisor and guide took me around Cape Coast educating me about the tourist attractions, including the beaches, Cape Coast castle and local customs and religions, and this really helped me to bond with the locals and shop owners straight away! I was overwhelmed by the friendliness of the locals, greeting strangers in the street was indeed a novelty. I often heard the words ‘Obruni!’ called out to me by the children in the street, I was told it meant I was foreign to them and I would hear it often during my stay. Trying the wonderful African food for the first time was also a new experience; my adjustment to the spice was certainly comical for my host family!
As I began working in the hospital on the Monday, I was greeted by the matron of the hospital who asked me what areas of medicine I was interested in. After this I was allocated to the female medical ward for the first week. I asked doctors them what time they began their ward rounds each day, which was around 10 o’clock, and I soon realised that Ghanaians sense of time was very different to people’s in the UK, as it was different every day, there was no strict schedule. Whilst the doctors had not arrived yet I assisted the nurses with drug administration, dressing changes, and I probed them with questions. I learnt that Malaria was a common condition amongst the women on the ward; Ghanaians taking prevention medicine for it was rare as many could not afford this. Another ailment I observed was particularly prominent in the area was Anaemia, which highlighted to me the diet of many Ghanaians was insufficient in iron-rich food. As a result, I asked doctors if they could improve this by encouraging patients to eat a healthier diet. One thing that interested me was the treatment of Alzhemier’s disease; Ginko Giloba extract was used as a herbal medicine to prevent brain degeneration. Nurses told me of the healthcare system in Ghana, which meant that it isn’t free at the point of care like the NHS. People have to pay for their healthcare insurance, and in a number of cases I saw the distress of patients who could not afford to pay for treatments, they simply got turned away. As doctors arrived on the wards I observed their bedside manner, asked the doctors questions, and despite some language barriers between me and some patients I communicated with many. I was even lucky enough to mix in with the medical students on the wards and once in a class, where I got taught clinical skills and participated in question and answers sessions based on clinic consultations, this was challenging having only completed A levels, but I learnt a lot! The doctors could not have been more helpful and were extremely motivating whilst educating the students. The paediatric ward was a favourite of mine, and following ward rounds I joined the doctors in the clinic where I observed a wide range of various conditions. I noticed that Malnutrition was a serious issue amongst young people, many children had to be put on a treatment called ‘plumby nut’ to increase their nutrition and weight. There was an obvious lack of privacy and confidentiality during patient consultations, although patients had a completely laidback attitude about this which was surprising. In the surgical ward, I soon began to notice the limited resources present in Ghana, as many patients waited a long time to be admitted to surgery, since there was only one operating room in the hospital. One day I was able to directly treat school children’s wounds in a rural village, this was extremely gratifying and the children were even excited to receive a plaster! I felt I gained a broad insight into the healthcare in Africa in Cape Coast hospital, and one day when I qualify as a doctor, going back to treat patients would be even better.
Every day after 6 hours at the hospital, I would retreat home for a quick lunch break (watermelon!) and head off to Ansapetu, where the orphanage was located. This would involve getting a taxi straight from Abura which took around 15 minutes but was very cheap! The children were aged from around 2 to 18 years, which allowed me to interact with differing abilities and interests. James was the founder of the orphanage, who my financial contributions were directly going to. It was satisfying to know that the orphanage was receiving some financial help, as it was very basic, with an obvious air of limited resources. Helena was the other coordinator and she and James were extremely welcoming upon my arrival each day. I would create games with the children after school, such as ‘hide and seek’ with the girls, football with the boys, and I frequently helped the children with homework given to them from school. It was interesting to find out the various future aspirations of the children, and it was refreshing to see they had great ambitions despite being in a situation with money difficulties. I would often help Helena set out dinner for the children, this included fish and banku, this was an interesting food with a white, gooey consistency, which I tried and definitely approved of! Table manners were very strict, as eating only with your right hand and not with the left was the accepted etiquette. Praying before food was a regular occurrence, and I really enjoyed taking part in the children’s respect for god. I helped the children to wash the dishes each day following dinner, and another great opportunity to bond with them was knocking down oranges from the trees in the garden! Learning the children’s names was at first a challenge, but getting to know each child individually it became second nature. Going back to the orphanage to see the children would most definitely be something I am thinking about.
My time in Ghana did not only involve working hard, I also visited many tourist attractions on the weekends and relaxed in local volunteer hotspots in the evenings. There were about 5 of us volunteers coming and going at different time points, but we all managed to spend time with each-other outside of our busy schedules. Going out and meeting new people was a regular Friday night event, Oasis bar was always a great place for ‘westerners’ and the locals to mix, I met many people from Canada, Australia, and other European countries! Going out for food was always a way us volunteers treated ourselves, and some of us missed the odd plate of western food; ‘The castle’ restaurant was a personal favourite of mine! On weekends, I would always think of buying some souvenirs from the local markets. I came back with wooden masks, printed bags and jewellery. One weekend we visited Kakum national park, this involved walking through the forest with a tour guide and over an arial walkway over the canopy of the trees, which I would recommend if you want to conquer a fear of heights! Hans cottage was another place I visited, this was a hotel that overlooked a small lake with crocodiles here, me and the other volunteers had the chance to watch them being fed, and I even had a photo sitting with one! I visited a couple of beach resorts to indulge and swim in the sea; Coconut Grove and Anomabo beach resorts had wonderful staff service and although food prices were higher than what you would get in central cape coast, they were still pretty cheap! One of my favourite attractions was Elimina Castle, where I learnt a bit of African history and the slave trade. Learning the bongo drums each week was an exciting new activity, yet it was harder than it looked! I also went along with Mary to a Christian church service on a Sunday, people’s energetic attitudes and singing during church was inspirational. I will never forget the experience of going solo to Ghana, it was not what I expected but even better, I most definitely recommend it!
Many people combine time at the hospital with time at the orphanage and this combination often works well. Combined placements are only £100 – $160 – €120 extra to cover the additional donation to the orphanage.
My name is Jack and I’m a 2nd year BSc biomedical science student preparing for postgraduate entry into medicine. Of the many choices that Global Medical Projects offer – I chose to take the 2-week volunteer project away in the small village of Meru, Tanzania.
The arrival
After the longest flight I’ve ever taken, I was thankful that the time difference in Tanzania isn’t too different to that in the UK! (2 hours ahead). Kilimanjaro airport is a small airport but nonetheless – landing in a country halfway across the world can be daunting! Thankfully, due to the planning of GMP, it was organized for us (I was with my friend Luke) to meet GMP’s Tanzanian contact -Elias and our host who we would be staying with – Zablon.
The trip to Zablon’s house in Usa river (pronounced oosa – we were calling it the USA river!) took some time but it passed quickly as Zablon was cheerfully explaining the names of all the mountains and why they were named that way. Zablon then went on to explain how he had just got married and was excited for us to meet his new wife Pretty!
Upon arriving at Zablon’s (and Pretty’s) house on the Friday, Elias took our passports and photos to go and get our work visas sorted for the following week – leaving the weekend for us to settle in.
Settling in
Zablon and Pretty were fantastic hosts and cooked us meals every night. I wont ruin the experience for you by telling you what they made us, but I will say that we tried some of the traditional Tanzanian dishes and they were delicious!
It wasn’t long before I was given the title of Mr. Bean as I couldn’t stop making our hosts laugh – part of this was because my Swahili was pretty awful and I often mispronounced words so that they started meaning very different things to what I was trying to say!
Zablon and Pretty are two of the most happy and kind people I have ever met. Zablon is an examiner for trainee teachers and pretty is a teacher at the local school in Usa near the house. Zablon and Pretty met when Pretty was training to be a teacher and Zablon was assessing her – before long they fell in love and got married. Luke and I had the privilege of watching their wedding video (which they were very proud of).
First weekend
During the first weekend, Luke and I decided to rest for half of it to get over our lack of sleep on the flight, and then visit the market in Usa River. Zablon came with us to show us around and find our feet. He also showed us where we would be taking the Dala Dala (the public transport) to the Meru district hospital on the Monday. From this point onwards we could find our way round Usa relatively well.
Luke and I discovered that Mango juice is relatively cheap and tastes delicious but the chocolate was really expensive!
The Hospital Experience
Luke and I were given the choice of whatever department we wanted to work in. We aimed to cover most of the hospital’s departments (there weren’t many) within the 2 weeks we were there.
To begin with, Luke was placed in the Male ward and I was placed in the female ward. My first impression was that compared to the hospitals in the UK, the facilities (as expected) were very limited. Privacy was a luxury and had to be paid for, ward rounds and scheduled times were rarely stuck to and everyone there had a serious problem (you generally wouldn’t find a local going into hospital unless it was of great importance).
Here are some of the things I saw in the female ward:
• Anaemia due to immunocompromisation – given antiretrovirals
• Secondary criminal abortion attempt – resulting in infection – Amoxicillin given
• Cervical cancer – X-ray confirmed metastasis of cancer – referred to palliative care
• Possible ectopic pregnancy – patient was 37 and had 6 children – refused pregnancy test
• Child with a broken femur – plaster casts are not available so the leg was immobilized and suspended
• PVB – with denial of being pregnant despite urine test proving +ve
• Diabetic patient with very high blood sugar
• 91 year old patient with hypertension
• A woman with a diabetic foot which was amputated – unfortunately this lead to impaired lymphatic drainage and she got generalized bodily swelling – she also had liver cirrhosis
• Psychiatric patient who had to be sedated several times but still wouldn’t stop shouting – referred to psychiatric nurse
• Patient with dysentery
Interesting note – many women get pregnant in Tanzania due to incorrect use of the contraceptive pill. They take it just before or during the act – hence they often get pregnant.
After the female ward, I made my way into major surgery and was shocked to see that they were performing surgery with the window open!
Some of the things I saw in Major surgery:
• C-section – patient given a similar injection to an epidural – the uterus was pulled out of the body to be sutured! The baby had to be removed by C-section as it was obliquely oriented and was pressing on the aorta causing hypertensive crisis
• Total Hysterectomy – this had to be done as the patient had over 7+ uterine myomas! The uterus weighed 2.5kg and was 22cm wide!
Paediatrics was next after major surgery:
• Severe pneumonia – fluid in lungs – unable to feed – antibiotics given
• Bronchiolitis – viral infection
• Trauma above ear and Vitamin K deficiency
• Immunocompromised child – exposed to mother with HIV (placental HIV) – given antiretrovirals
• Severe burns – 50% of torso! Given ketamine to relieve pain and rehydrated – also antibiotics as a preventative measure
• Child that had drunk kerosene due to it being put in a soft drink bottle (apparently a common thing to happen in Tanzania!) – caused pneumonia
After Paediatrics I decided to spend the afternoon in Minor surgery – having said this – some of what was thought as minor surgery there could be deemed as major surgery in the UK! (I have only put in what I think are the minor ones):
• Circumcision under no anaethetic – baby was starved before surgery and then breast fed to stop crying
• Plaster removal
After Minor surgery it was the male ward:
• Spinal TB with bed sores – Anti TB drugs and dressing/rotation for bed sores (Potts disease)
• Distal 1/3 of clavicle fracture – head of humerus dislocated – caused by car accident
• Hepatic Encephalopathy – suspected Hepatitis B
• Lacerated head and swollen right eye – head x-ray taken – from car accident
• Chronic asthmatic
• Swollen leg – Elephantitis – lymphatic obstruction
• Stroke with hemiplegia
I then went on to spend a few days at the C.T.C (Care Treatment Centre) for those with HIV with Luke. We learned that the C.T.C mostly consisted of treatment counseling and that villagers were recruited and trained in special HIV treatment schools to care for their own at home. The HIV clinic/CTC was there to ensure that HIV wasn’t spread between patients. We were told that anaemia was a common side effect of antiretrovirals. We also learnt that all HIV +ve patients were given a form confirming their condition and all the drugs they are taking
I also managed to visit radiotherapy, the maternity wards and the outpatient’s clinic, but I don’t want to ruin all the experience for you so I will only say that you need to visit them yourself! The one area of the hospital that Luke and I didn’t manage to visit was the TB clinic – this was due to the risk of us catching TB!
Donations (coats, books etc.)
By the end of our hospital visit, Luke and I thought we would donate our white lab coats, a few of our medical books and some antibacterial hand wash (all of which is hard to come by in the hospital!)
The school (Pretty)
Before we left Zablon and Pretty, Pretty gave us the opportunity to sit in on a friend of hers class. Somewhat fittingly, they were learning about first aid! Luke and I explained some of what we had learned about treating burns to the class as the teacher translated – the class then asked us questions.
Conclusion
Tanzania is an amazing place and the sheer quantity of things you can do there is practically limitless! Luke and I thought we would take advantage of the fact we were so close to the Serengeti and after our final week working at the hospital we went on a safari.
Why this project was good and why I recommend it
This project will open your eyes to what all those charity programs are trying to raise money for! You will experience what its like to be a Doctor in Tanzania and see what its like to be a patient there too. You will see what limited resources the hospital has and what they do the try and get round their limitations. You will have hands on experiences with patients and apply some of the things you’ve learnt in the past. You can’t get a purer project than this when it comes to the basics of medicine!
On top of this you have the opportunity to get to know the community at Usa River and perhaps even go on a safari like Luke and I did.
I’d like to thank all those who helped me pay for this life changing trip, those who helped me organize it (Kevin Dynan in the UK and Elias in Tanzania) and of course the wonderful Zablon and Pretty, whom without them – I would have not left the country feeling nearly as cultured and satisfied as I did.
My name is Emily Haines, and I have embarked on two unforgettable experiences in Africa. My life-long ambition is to become a doctor, and watching medical volunteers in Africa on BBC news TV channel one day motivated me to get in touch with Global Medical Projects to find out more. I was instantly hooked on the idea of embarking on an unforgettable lifetime experience in a Third world country! Although my trips took much planning in terms of finances and dates, it was certainly worthwhile. On my gap year prior to university, I took a month long trip for a medical and orphanage project in Ghana. Central Regional hospital in Cape Coast was where I spent the majority of my time, and it really opened up my eyes to the large differences between developing healthcare systems and the developed. Two years after reflecting on my time in Ghana, I could not wait to begin another project in another African setting, so I chose Tanzania. I was in Tanzania for 3 weeks, where I did another project, set in Meru District Hospital, and ‘Cradle of Love’ orphanage. People may think the two African projects I did were almost the same experiences, but I would definitely disagree. I came back from both experiences having learnt different practices, cultures and languages!
You can read about Emily’s medical and orphanage project in Ghana here. My 3 weeks in Tanzania was certainly another eye-opening experience, which I completed this summer before my final year of my Pharmacology degree. As the plane touched down in Kilimanjaro international airport, seeing the peak of Mount Kilimanjaro was absolutely breath-taking. By this point, I was eager to meet my host family. Arriving in Usa River, the children in the street were already greeting me and I knew I was going to settle in well. Pretty and Zablon, a couple who were hosting me made me feel at home right away, Zablon told me and the other volunteers about his sugar cane growing in the front garden, which was delicious! One thing different from Ghana was the cold shower and a hole in the ground for a toilet, which wasn’t such a bad thing as I may have expected. The food I was given by the lovely house maid, Neema, were in such generous portions, and I found myself eating a lot of rice, chicken and avocado! Chips mayai- a chip omelette was definitely a popular option with 4 of us volunteers staying in Zablon and Pretty’s house. Being called part of their family throughout the weeks was a great feeling and frequently watching the world cup with them during dinner time was always a good laugh! Sometimes we joined our host family and their friends in choir practice, I was overwhelmed by the amazing voices I heard, and it was great fun. Pretty also showed me and the other volunteers her and Zablon’s wedding photos and told us stories of how they met, I was very interested to hear about the culture of relationships in Tanzania.
For my medical placement in Meru District Hospital in Tengeru, I was told to catch the Dala Dala bus with the other volunteers, which was an interesting; sitting close to Tanzanians was a great way to meet the locals! A journey from Usa River to Meru hospital cost only about 300 Tanzanian shillings, this was about 10 pence, so very cheap. I had some expectations of what the hospital may be like since previously working in Ghana, but it was different in some ways. It was a lot smaller and underprivileged than Cape Coast hospital. There were also some problems I noticed such as dangers in transporting the female patients from the maternity ward to surgery for their Caesarean sections, but building a safe walkway was funded by an American charity. Throughout my medical project, I visited the male ward and encountered various conditions, with HIV/AIDS being the number one disease in terms of occurrence. From speaking to the nurses I picked up a lot of medical terms in the native language- Swahili. This helped me to understand medical notes to find out what patients had and what treatments they were on. The follow up of a malnourished, heart failure patient with a doctor and medical student is one that will stick in my mind- devising a treatment plan using our combined knowledge, really gave me a chance to learn some clinical skills with a patient-based approach. Another patient that stays with me was a victim of a motor cycle accident with major brain injury; his affected memory meant it was impossible to contact his family and he could not afford an MRI scan, which was a serious problem that we aimed to tackle. Using a clinical handbook and the BNF as a prescribing guide, me and the other volunteers formed a strong relationship with the doctors; they taught us the practice of medicine and we discussed best treatments for patients.
Diabetes was a common ailment in the area; a diabetic clinic was held twice a week and I could see some issues related to patient compliance, on being leg amputations from necrosis as a result. I resorted to suggesting to the matron maybe creating some simple posters to educate patients regarding their condition. Observing the cervical screening procedure was intriguing, the methods employed by using acetic acid to detect cancer cells were as a result of limited resources. Seeing women getting diagnosed with a HIV rapid test was very sad and overwhelming for the patients, but the doctor’s approach was very empathetic and thorough in investigating reasons. Visiting major surgery was an exciting opportunity, I was lucky enough to observe a C- section, and the intricacy required to stitch the incision back up was amazing. I spent the majority of my time in minor surgery, what me and the other volunteers called ‘minor ops’. Here I had the chance to treat patient wounds, such as stitching and bandaging. I also carried out emergency treatments, fracture diagnoses and castings. Children were given ketamine as a general anaesthetic, showing some treatment limitations. The different causes of people’s wounds was nothing I had seen before, severe wounds from gang fights, dog bites and farming equipment were some I encountered. Working in the hospital pharmacy was a completely different experience to my summer part-time job as a dispenser in the UK. There was a shortage of staff so I had to give patients advice and their medications in the absence of the pharmacist. There was also lack of drugs which was a problem for patients as it delayed many of them receiving antibiotics from hospital acquired infections. However, despite the lack of resources, many of staff in Meru had a persistent, caring attitude with patients, which was very admirable. In my last week, I was lucky enough to learn about Meru and it being a government-run hospital. An anthropologist from the US spoke to me about funding for her project to improve the hospital infrastructure, which was a common issue there. This motivated me to donate some money to the project, to improve the safety of the hospital buildings. There are many experiences in the hospital I had that will be hard to forget, and I truly appreciate the willingness of the doctors in the hospital to teach a complete stranger like me. Applying my knowledge on different treatments in the hospital, I really felt I made a contribution to the healthcare, and because of the lack of drugs in the hospital, educating the nurses and doctors of ones they did not know of, I was giving something back to them, which was especially fulfilling.
I always looked forward to volunteering at ‘Cradle of Love’ Orphanage every day from 2 til 5pm. I would catch a Dala Dala from Tengeru to Usa River, and walk 5 minutes to the orphanage. One thing I did not expect when I arrived was the security of the orphanage; there were iron gates with a security guard outside, which were certainly reassuring for the owner! Being introduced to the toddlers and babies was an exciting experience and I had never looked after children at such a young age! I was told some of the children in the orphanage were abandoned or some parents could not afford to keep their babies, the latter made me realise many of the parents put their children in Cradle for good reasons. Some children had HIV infection and one had rickets, but the dedicated attitude of the nannies provided the best care for them. Usually when I arrived the toddlers and ‘wobblers’ would have woken up from their afternoon naptime, when they were full of energy to say the least! The babies loved attention from all the volunteers there, and this made me feel I was making a difference. Playing in the garden was a favourite activity for the children; this was obvious from their immediate excitement when we got out the shoebox to put on their shoes! One thing I did find challenging whilst working in the orphanage was dividing my attention to the different children, and many wanted a turn on the swing-set at the same time. But there were other activities for the children to do, such as playing on the slides or with the toys inside the home. Once I had the chance to change a little boy’s nappy, which to be honest, I had never even done before! Throughout my time at the orphanage, I got to know the children’s personalities very well and so I knew what they did and didn’t like, which was essential to make their day a happy one. Seeing the children laughing from a small game of ‘chase’, I noticed even in a place with little resource the children could enjoy themselves. Dinnertime each day was very eventful. With the other volunteers, I would assemble the table and chairs for the toddlers to sit at a small table together. Some days if the children were in a mischievous mood they wouldn’t want to sit down but make me catch them first! This was initially difficult, but through learning each child’s preferences and from gaining their trust, it became a lot easier. The words ‘Jakula’ meaning ‘food’ in Swahili was always a trigger for their excitement! Being at Cradle of Love, I realised that giving some attention and loving communication to the children was definitely a way to brighten up both mine and their day.
But again, my time in Tanzania was filled with many fun activities outside of working! Once a week, Joshua, our Tanzanian Volunteer coordinator gave me and other volunteers I lived near Swahili lessons, which was a great help in terms of constructing sentences to speak to the locals, and even the patients in the hospital. Learning some basic greetings such as ‘Habari’, ‘Shikamoo’ and ‘Jumbo’ were different ways to greet different ages of people. We were also taught the names of different foods such as Orange being ‘Chungwa’, making it a lot easier when buying food in the markets! I visited a few Safaris, which were a highlight of the trip! The first weekend I visited Arusha national park, where I managed to see a lot of monkeys and even giraffes in the distance! Previously hearing about safaris and seeing them were completely different; Tarangire and the Ngorongoro crater were so beautiful it felt surreal, and seeing the elephants, zebras and lions was my favourite part. At this time, from staying at a campsite in Africa, I got a real feel of the African night-time air. Visiting a snake farm, I learnt about a wide range of the different species and some, about their lethal abilities. I even held a snake for the first time. Moshi hot springs was very enjoyable for me, despite the bumpy journey to get there! Swinging off a rope to fall into the warm waters was exhilarating, and if I stayed still, I could feel the fish nibbling my feet, I couldn’t complain about a free pedicure! A regular activity was visiting the local bar in Usa River and making friends with some locals, after this a group of us volunteers and some locals went onto Via Via, a club in the central town of Arusha. A mix of western and African music created an amazing laidback atmosphere, and was the perfect chance to meet other volunteers from all over the world. I will never forget our driver, Peter, who gave me advice on where to go and took us volunteers to places at a discounted price compared to taxis, and despite a small language barrier between us, I considered him a close friend. My experiences in Tanzania were unforgettable, and not only did I feel myself develop as a person, but I made some life-long friends that I hope to see again one day. Staying with Zablon and Pretty were most definitely the best hosts you could ask for. I have a parting gift from them that reads ‘Karibu’, meaning ‘Welcome’ and I think of this as a symbol for them welcoming me back there some day. They taught me that people coming from two completely different parts of the world can be as close as a family.
I definitely recommend taking a trip to Ghana or Tanzania, these were both life-changing experiences that really put aspects of life into perspective. I have definitely grown as a person as a result of these trips, and I will forever cherish my memories and the many things I have learnt. I chose Global Medical Projects because they really do care about you making the most of your experiences. Throughout my stays in Ghana and Tanzania I felt a great sense of security with Global Medical Projects, despite being in a foreign area. I’d like to thank Kevin Dynan for giving me so much advice prior to my journeys and for making the application process a smooth one. I also thank Eric and Mary Essuah, who were fantastic in ensuring my stay in Ghana was safe, organised and enjoyable. Zablon and Pretty Mgonja were two amazing people who made sure I made the most of my stay Tanzania, which I am very grateful for.
Many people combine time at the hospital with time at the orphanage and this combination often works well. Combined placements are only £100 – $160 – €120 extra to cover the additional donation to the orphanage.
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!
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.
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.
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.
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.
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.
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!
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!
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.
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.
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!
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.
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.
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.
Dear Kevin,
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 spent 5 weeks at Hogares de la Caridad in Guadalajara, Mexico. This was my first time volunteering, being in Mexico and working with children.
The main treatments I used were massage, stretches, gait education, and proprioceptive exercises but it was not all about physiotherapy. I also helped with the day-to-day care of the children. This included spending time with the children and helping with feeding them at lunchtimes.
The trip gave me a real insight into physiotherapy and the treatment of disabilities in Mexico. One of the key lessons I learnt was how important is was to work with the whole team at the orphanage including the nurses, doctors, managers, other volunteers and physiotherapists to provide holistic care for the children.
I arrived late on a Saturday night in a down pour of torrential rain, deafening thunder claps and fork lightening. I could barely see out of the window on my taxi journey from the airport. I was a bit disorientated after a twenty-four hour journey, but I had arrived in Mexico. I was warmly welcomed by the the family (who would treat me as one of their own for the next three weeks), as well as one of the Global Medical team and some volunteers already on placement (who would then take me out for a welcome beer)
I worked six hour shifts, either morning or afternoon following the shifts of the hospital staff and paramedics but you can work as much or as little as you like (afternoons and nights being the busier shifts). My first week was spent in the clinic acclimatising to the language and culture. I was surprised by the amount of people that bring themselves or family members to hospital, people only call an ambulance when they are not physically able to bring themselves in. I saw people with broken legs, hips and even one with a spinal fracture being carried in by family members/friends. Even one chap covered in over one hundred bee stings just walk into the department before he collapsed in shock. In my time at the clinic I was able to help with the daily tasks such as wound care, bandaging, suturing, cannulation, ECGs and drug administration, I was also able to watch some minor surgeries in quiet times in the ED. I also spent a lot of my time with the doctors in the emergency department discussing differences in treatment and training, which helped me come away with a greater appreciation for the equipment and training that we take for granted in the UK.
The shifts in Mexico were a lot quieter than what I am used to in the UK, this I believe, is due to the fact that people only call when it is really necessary. I averaged two or three jobs in my six hour shifts. However, when you do get a job it is usually trauma or a medical emergency. One memorable day the first job attended was to a ninety year old lady who had been hit by a car (over 250 car Vs pedestrian deaths so far this year in Guadalajara alone). The next job was to an elderly man who had suffered a TIA, there are no carry chairs in mexican ambulances so improvisation is key to the job. We tied this elderly chap into a small armchair with a bed sheet and carried him down the three flights of stairs, head first. After that a young man who had fallen two stories, from the fifth floor of a building under construction and landed face first on the third floor. The first issue was reaching the patient, we had to get up to the third floor using a ladder which we pulled up behind us each time to reach the next floor. The lucky patient was conscious and appeared to have no other injuries other than a mouth lacking teeth and blood loss from that general area. We rolled him onto a rescue board and immobilized him with collar and blocks. Then began the wait for the “Bomberos” (fire brigade). The extraction of this young man was very impressive once the “bomberos” arrived. They harnessed up the rescue board with ropes and lowered him down feet first one floor at a time. Fire at the top with paramedics catching at the bottom. Pretty hair raising work jumping across steel girders with nothing but three stories of space below.
The staff in both the clinic and on the ambulance were very welcoming, I went for a breakfast of tacos most days with either the nurses or paramedics. Most weekends the other volunteers and myself were invited out by the paramedics and doctors to sample the night life of the city, salsa dancing, lucha libre (mexican wrestling), mariachis and tequila! The city itself is beautiful and welcoming to tourists so take some time to explore the sights, food, music and culture that it has to offer.
As well as new friends and memories on of the things I will take away from this experience is how rich we are in education and support in the UK. These guys do an incredible job with little money/governmental support and sometimes archaic equipment. I recommend anybody working in or planning to work in medicine/paramedicine to take on this experience, to head to mexico with an open mind, to work hard (you will get out what you put in), to eat tacos, drink tequila, dance salsa, and to learn about a different way of living and working.
Over the summer I travelled to Trivandrum, India for a two week pre-medical placement with Global Medical Projects. I was eager to gain more hospital work experience and the opportunity to observe a foreign healthcare system really appealed to me.
In India I experienced a number of medical specialties. I spent most of my time in the NMS Mission Hospital where I shadowed consultants and nurses who were very accommodating, answering any questions I had and explaining patient illnesses.
I also had the opportunity to volunteer at the Palliative Care Charity called Pallium. I got to join the medical team in their home visits of rurally placed patients who didn’t have access to a hospital. It was exciting travelling in the 4×4 jeep on narrow dirt tracks with stunning scenery of backwaters and coconut trees all around. We delivered essential medication, bandages and food to rurally isolated patients and it was so rewarding to see how grateful they were for our support. Many of the patients had type 2 Diabetes and it wasn’t uncommon to see amputations and diabetic bed sores. At the end of the day, the medical team treated me to some traditional indian snacks and coffee in a local Restaurant.
At the weekends we had free time to travel. My favourite experience was visiting a region called Alleppey, which had some of the most beautiful backwaters in the world! The group hired a houseboat and we got a guided tour of the area, I didn’t stop taking photos as everywhere was so beautiful. We even got to stop off along the canal and buy fresh coconut milk from a local and take pictures with his pet Falcon! It was a great opportunity to get to know other volunteers and we really bonded with each other. If you like to experience weird and wonderful foods, then India is definitely the place for you! At the weekend we were spoilt for choice as where to eat dinner, and price wasn’t an issue as the average feast cost us about three pounds each! At the volunteers’ house, “Chef Babu” ensured we didn’t go hungry and made some really delicious meals for the volunteers coming home from placement. My favourite dish was Samba, served with an indian pancake called a Parotta.
My name is Emily Haines, and I have embarked on two unforgettable experiences in Africa. My life-long ambition is to become a doctor, and watching medical volunteers in Africa on BBC news TV channel one day motivated me to get in touch with Global Medical Projects to find out more. I was instantly hooked on the idea of embarking on an unforgettable lifetime experience in a Third world country! Although my trips took much planning in terms of finances and dates, it was certainly worthwhile. On my gap year prior to university, I took a month long trip for a medical and orphanage project in Ghana. Central Regional hospital in Cape Coast was where I spent the majority of my time, and it really opened up my eyes to the large differences between developing healthcare systems and the developed. In the evenings, I visited a small orphanage in the village of Ansapetu, where I met many children that were grateful for even a friendly face showing up at their door. It doesn’t stop there though! 2 years after reflecting on my time in Ghana, I could not wait to begin another project in another African setting, so I chose Tanzania. I was in Tanzania for 3 weeks, where I did another project, set in Meru District Hospital, and ‘Cradle of Love’ orphanage. People may think the two African projects I did were almost the same experiences, but I would definitely disagree. I came back from both experiences having learnt different practices, cultures and languages!
Flying to Ghana was the first time I had ever travelled abroad alone, which was I must admit, quite daunting to begin with. Going into the unknown I really did not know what to expect, but I remember the day I arrived in Ghana like it was yesterday. From meeting Eric, my host, at the airport in Accra, I immediately felt like I was in safe hands. Seeing the bustling capital city of Accra, I instantly had culture shock, but my fascination over-rode my initial worries. The 3 hour journey to Cape coast was an interesting one, seeing the poverty stricken people in mud huts without sufficient clothing on their backs, confirmed what I’d seen in the media was real. However, I also noticed the wealthier side of the area, no longer did I see mud huts but well- constructed houses made of brick. Following this journey to Cape coast town I had arrived at my accommodation in Abura, and Mary, Eric’s wife, and Ruth, the housekeeper, were there to greet me. I was overwhelmed with how friendly and helpful they were and our personalities clicked right away. I also met one of a few volunteers I would be staying with; she helped me settle in by giving me advice, one being a warning of the frequent power-cuts that occur in the house, which I definitely got used to! However, the house had a lot more to offer than I’d expected, there was internet access so I could contact my family easily and a warm shower! Having the weekend to settle in before beginning placement allowed me to take in my surroundings and immerse myself in the different culture. George, the house supervisor and guide took me around Cape Coast educating me about the tourist attractions, including the beaches, Cape Coast castle and local customs and religions, and this really helped me to bond with the locals and shop owners straight away! I was overwhelmed by the friendliness of the locals, greeting strangers in the street was indeed a novelty. I often heard the words ‘Obruni!’ called out to me by the children in the street, I was told it meant I was foreign to them and I would hear it often during my stay. Trying the wonderful African food for the first time was also a new experience; my adjustment to the spice was certainly comical for my host family!
As I began working in the hospital on the Monday, I was greeted by the matron of the hospital who asked me what areas of medicine I was interested in. After this I was allocated to the female medical ward for the first week. I asked doctors them what time they began their ward rounds each day, which was around 10 o’clock, and I soon realised that Ghanaians sense of time was very different to people’s in the UK, as it was different every day, there was no strict schedule. Whilst the doctors had not arrived yet I assisted the nurses with drug administration, dressing changes, and I probed them with questions. I learnt that Malaria was a common condition amongst the women on the ward; Ghanaians taking prevention medicine for it was rare as many could not afford this. Another ailment I observed was particularly prominent in the area was Anaemia, which highlighted to me the diet of many Ghanaians was insufficient in iron-rich food. As a result, I asked doctors if they could improve this by encouraging patients to eat a healthier diet. One thing that interested me was the treatment of Alzhemier’s disease; Ginko Giloba extract was used as a herbal medicine to prevent brain degeneration. Nurses told me of the healthcare system in Ghana, which meant that it isn’t free at the point of care like the NHS. People have to pay for their healthcare insurance, and in a number of cases I saw the distress of patients who could not afford to pay for treatments, they simply got turned away. As doctors arrived on the wards I observed their bedside manner, asked the doctors questions, and despite some language barriers between me and some patients I communicated with many. I was even lucky enough to mix in with the medical students on the wards and once in a class, where I got taught clinical skills and participated in question and answers sessions based on clinic consultations, this was challenging having only completed A levels, but I learnt a lot! The doctors could not have been more helpful and were extremely motivating whilst educating the students. The paediatric ward was a favourite of mine, and following ward rounds I joined the doctors in the clinic where I observed a wide range of various conditions. I noticed that Malnutrition was a serious issue amongst young people, many children had to be put on a treatment called ‘plumby nut’ to increase their nutrition and weight. There was an obvious lack of privacy and confidentiality during patient consultations, although patients had a completely laidback attitude about this which was surprising. In the surgical ward, I soon began to notice the limited resources present in Ghana, as many patients waited a long time to be admitted to surgery, since there was only one operating room in the hospital. One day I was able to directly treat school children’s wounds in a rural village, this was extremely gratifying and the children were even excited to receive a plaster! I felt I gained a broad insight into the healthcare in Africa in Cape Coast hospital, and one day when I qualify as a doctor, going back to treat patients would be even better.
Every day after 6 hours at the hospital, I would retreat home for a quick lunch break (watermelon!) and head off to Ansapetu, where the orphanage was located. This would involve getting a taxi straight from Abura which took around 15 minutes but was very cheap! The children were aged from around 2 to 18 years, which allowed me to interact with differing abilities and interests. James was the founder of the orphanage, who my financial contributions were directly going to. It was satisfying to know that the orphanage was receiving some financial help, as it was very basic, with an obvious air of limited resources. Helena was the other coordinator and she and James were extremely welcoming upon my arrival each day. I would create games with the children after school, such as ‘hide and seek’ with the girls, football with the boys, and I frequently helped the children with homework given to them from school. It was interesting to find out the various future aspirations of the children, and it was refreshing to see they had great ambitions despite being in a situation with money difficulties. I would often help Helena set out dinner for the children, this included fish and banku, this was an interesting food with a white, gooey consistency, which I tried and definitely approved of! Table manners were very strict, as eating only with your right hand and not with the left was the accepted etiquette. Praying before food was a regular occurrence, and I really enjoyed taking part in the children’s respect for god. I helped the children to wash the dishes each day following dinner, and another great opportunity to bond with them was knocking down oranges from the trees in the garden! Learning the children’s names was at first a challenge, but getting to know each child individually it became second nature. Going back to the orphanage to see the children would most definitely be something I am thinking about.
My time in Ghana did not only involve working hard, I also visited many tourist attractions on the weekends and relaxed in local volunteer hotspots in the evenings. There were about 5 of us volunteers coming and going at different time points, but we all managed to spend time with each-other outside of our busy schedules. Going out and meeting new people was a regular Friday night event, Oasis bar was always a great place for ‘westerners’ and the locals to mix, I met many people from Canada, Australia, and other European countries! Going out for food was always a way us volunteers treated ourselves, and some of us missed the odd plate of western food; ‘The castle’ restaurant was a personal favourite of mine! On weekends, I would always think of buying some souvenirs from the local markets. I came back with wooden masks, printed bags and jewellery. One weekend we visited Kakum national park, this involved walking through the forest with a tour guide and over an arial walkway over the canopy of the trees, which I would recommend if you want to conquer a fear of heights! Hans cottage was another place I visited, this was a hotel that overlooked a small lake with crocodiles here, me and the other volunteers had the chance to watch them being fed, and I even had a photo sitting with one! I visited a couple of beach resorts to indulge and swim in the sea; Coconut Grove and Anomabo beach resorts had wonderful staff service and although food prices were higher than what you would get in central cape coast, they were still pretty cheap! One of my favourite attractions was Elimina Castle, where I learnt a bit of African history and the slave trade. Learning the bongo drums each week was an exciting new activity, yet it was harder than it looked! I also went along with Mary to a Christian church service on a Sunday, people’s energetic attitudes and singing during church was inspirational. I will never forget the experience of going solo to Ghana, it was not what I expected but even better, I most definitely recommend it!
My name is Jack and I’m a 2nd year BSc biomedical science student preparing for postgraduate entry into medicine. Of the many choices that Global Medical Projects offer – I chose to take the 2-week volunteer project away in the small village of Meru, Tanzania.
Zablon and Pretty were fantastic hosts and cooked us meals every night. I wont ruin the experience for you by telling you what they made us, but I will say that we tried some of the traditional Tanzanian dishes and they were delicious!
During the first weekend, Luke and I decided to rest for half of it to get over our lack of sleep on the flight, and then visit the market in Usa River. Zablon came with us to show us around and find our feet. He also showed us where we would be taking the Dala Dala (the public transport) to the Meru district hospital on the Monday. From this point onwards we could find our way round Usa relatively well.
To begin with, Luke was placed in the Male ward and I was placed in the female ward. My first impression was that compared to the hospitals in the UK, the facilities (as expected) were very limited. Privacy was a luxury and had to be paid for, ward rounds and scheduled times were rarely stuck to and everyone there had a serious problem (you generally wouldn’t find a local going into hospital unless it was of great importance).
Interesting note – many women get pregnant in Tanzania due to incorrect use of the contraceptive pill. They take it just before or during the act – hence they often get pregnant.
After Paediatrics I decided to spend the afternoon in Minor surgery – having said this – some of what was thought as minor surgery there could be deemed as major surgery in the UK! (I have only put in what I think are the minor ones):
Tanzania is an amazing place and the sheer quantity of things you can do there is practically limitless! Luke and I thought we would take advantage of the fact we were so close to the Serengeti and after our final week working at the hospital we went on a safari.
This project will open your eyes to what all those charity programs are trying to raise money for! You will experience what its like to be a Doctor in Tanzania and see what its like to be a patient there too. You will see what limited resources the hospital has and what they do the try and get round their limitations. You will have hands on experiences with patients and apply some of the things you’ve learnt in the past. You can’t get a purer project than this when it comes to the basics of medicine!
My 3 weeks in Tanzania was certainly another eye-opening experience, which I completed this summer before my final year of my Pharmacology degree. As the plane touched down in Kilimanjaro international airport, seeing the peak of Mount Kilimanjaro was absolutely breath-taking. By this point, I was eager to meet my host family. Arriving in Usa River, the children in the street were already greeting me and I knew I was going to settle in well. Pretty and Zablon, a couple who were hosting me made me feel at home right away, Zablon told me and the other volunteers about his sugar cane growing in the front garden, which was delicious! One thing different from Ghana was the cold shower and a hole in the ground for a toilet, which wasn’t such a bad thing as I may have expected. The food I was given by the lovely house maid, Neema, were in such generous portions, and I found myself eating a lot of rice, chicken and avocado! Chips mayai- a chip omelette was definitely a popular option with 4 of us volunteers staying in Zablon and Pretty’s house. Being called part of their family throughout the weeks was a great feeling and frequently watching the world cup with them during dinner time was always a good laugh! Sometimes we joined our host family and their friends in choir practice, I was overwhelmed by the amazing voices I heard, and it was great fun. Pretty also showed me and the other volunteers her and Zablon’s wedding photos and told us stories of how they met, I was very interested to hear about the culture of relationships in Tanzania.
For my medical placement in Meru District Hospital in Tengeru, I was told to catch the Dala Dala bus with the other volunteers, which was an interesting; sitting close to Tanzanians was a great way to meet the locals! A journey from Usa River to Meru hospital cost only about 300 Tanzanian shillings, this was about 10 pence, so very cheap. I had some expectations of what the hospital may be like since previously working in Ghana, but it was different in some ways. It was a lot smaller and underprivileged than Cape Coast hospital. There were also some problems I noticed such as dangers in transporting the female patients from the maternity ward to surgery for their Caesarean sections, but building a safe walkway was funded by an American charity. Throughout my medical project, I visited the male ward and encountered various conditions, with HIV/AIDS being the number one disease in terms of occurrence. From speaking to the nurses I picked up a lot of medical terms in the native language- Swahili. This helped me to understand medical notes to find out what patients had and what treatments they were on. The follow up of a malnourished, heart failure patient with a doctor and medical student is one that will stick in my mind- devising a treatment plan using our combined knowledge, really gave me a chance to learn some clinical skills with a patient-based approach. Another patient that stays with me was a victim of a motor cycle accident with major brain injury; his affected memory meant it was impossible to contact his family and he could not afford an MRI scan, which was a serious problem that we aimed to tackle. Using a clinical handbook and the BNF as a prescribing guide, me and the other volunteers formed a strong relationship with the doctors; they taught us the practice of medicine and we discussed best treatments for patients.
I always looked forward to volunteering at ‘Cradle of Love’ Orphanage every day from 2 til 5pm. I would catch a Dala Dala from Tengeru to Usa River, and walk 5 minutes to the orphanage. One thing I did not expect when I arrived was the security of the orphanage; there were iron gates with a security guard outside, which were certainly reassuring for the owner! Being introduced to the toddlers and babies was an exciting experience and I had never looked after children at such a young age! I was told some of the children in the orphanage were abandoned or some parents could not afford to keep their babies, the latter made me realise many of the parents put their children in Cradle for good reasons. Some children had HIV infection and one had rickets, but the dedicated attitude of the nannies provided the best care for them. Usually when I arrived the toddlers and ‘wobblers’ would have woken up from their afternoon naptime, when they were full of energy to say the least! The babies loved attention from all the volunteers there, and this made me feel I was making a difference. Playing in the garden was a favourite activity for the children; this was obvious from their immediate excitement when we got out the shoebox to put on their shoes! One thing I did find challenging whilst working in the orphanage was dividing my attention to the different children, and many wanted a turn on the swing-set at the same time. But there were other activities for the children to do, such as playing on the slides or with the toys inside the home. Once I had the chance to change a little boy’s nappy, which to be honest, I had never even done before! Throughout my time at the orphanage, I got to know the children’s personalities very well and so I knew what they did and didn’t like, which was essential to make their day a happy one. Seeing the children laughing from a small game of ‘chase’, I noticed even in a place with little resource the children could enjoy themselves. Dinnertime each day was very eventful. With the other volunteers, I would assemble the table and chairs for the toddlers to sit at a small table together. Some days if the children were in a mischievous mood they wouldn’t want to sit down but make me catch them first! This was initially difficult, but through learning each child’s preferences and from gaining their trust, it became a lot easier. The words ‘Jakula’ meaning ‘food’ in Swahili was always a trigger for their excitement! Being at Cradle of Love, I realised that giving some attention and loving communication to the children was definitely a way to brighten up both mine and their day.
I definitely recommend taking a trip to Ghana or Tanzania, these were both life-changing experiences that really put aspects of life into perspective. I have definitely grown as a person as a result of these trips, and I will forever cherish my memories and the many things I have learnt. I chose Global Medical Projects because they really do care about you making the most of your experiences. Throughout my stays in Ghana and Tanzania I felt a great sense of security with Global Medical Projects, despite being in a foreign area. I’d like to thank Kevin Dynan for giving me so much advice prior to my journeys and for making the application process a smooth one. I also thank Eric and Mary Essuah, who were fantastic in ensuring my stay in Ghana was safe, organised and enjoyable. Zablon and Pretty Mgonja were two amazing people who made sure I made the most of my stay Tanzania, which I am very grateful for.