Welcome to another installment of my elective to Tanzania - pull up a chair as this is a long post. If you are anything like me you may wish to get a coffee☕...just a suggestion.
Now, a little bit of context to this letter below. I applied for a grant from my University Alumni Panel. I gave a presentation to them and they very kindly decided to award me a sum of money.
In doing so, I agreed to write to them about my trip and how it will benefit my future career.
So, I thought that you may wish to read what I put.
Anyways, enjoy your coffee, sit comfortably and read on ....
Dear Donors of the Alumni Fund,
Re: Award for my three-week nursing elective to Tanzania in August 2017
My sincerest thanks for the very kind and generous award.
I was able to use this money to facilitate a visit to a Masai tribe/family. This was an extension to my planned safari trip and allowed me to appreciate more fully, the culture of the Masai.
Some funds were used to allow me to call home more frequently using only mobile data. This also meant that equally, I could share information with my Tanzanian colleagues, about some of the theory and practices that we use in the UK within mental health.
Naturally, it also helped towards the general cost of the overall elective.
For the time that I spent in Tanzania, at Muhimbili National Hospital, I experienced various areas of mental health provision.
This included spending time in the child & adolescent outpatients’ clinics, where I was able to join the psychiatric team and meet with young children with ADHD and autism. I was made to feel a part of the team and was asked for my opinion on some of the cases.
I spent time in the general psychiatric wards too and was able to assist the staff in caring for the patients residing there. I felt extremely comfortable in spending time with all of the patients and enjoyed some fun times which included singing and dancing. I had feedback from staff to say that the patients had enjoyed this time very much.
There is just one female and one male ward I was given access to patient files and readily discussed the presentations and delivery of treatment to patients.
On the acute ward, staff were able to help me understand the process of admission and the pathway that a patient takes through the department. Normally there would be two wards; one female and one male. However, currently, due to high admission rates of males, the two wards are used for males only. Female patients are placed either in the female psychiatric ward or, if in dire need, patients are placed on the general female wards elsewhere in the hospital. The patients enjoyed teaching me aspects of speaking Swahili and I too was able to help them with their English.
For a number of days, I spent time in the methadone clinic. Here, I was able to give out medications for HIV and TB to the patients that attended every day. On occasions, I was trusted to do this on my own with minimal assistance from other nursing staff.
I was given information on the health authority’s/hospital’s thinking around treatment for addiction. In this clinic I was able to share a theory that we use in the UK, around change and the process of change. Staff found this very useful, and thanks to the data that I had added to my mobile phone, I was able to do this at the time, without having to wait until another day.
Throughout my time within the mental health department at Muhimbili National Hospital. I was given full respect and was supported throughout to observe and take part in patient care. I was given endless help with speaking Swahili, both by staff and patients. I was complimented on my ability to learn the language adequately, so that I could start to tackle the language barrier between us. In doing this I felt that I was able to gain a little trust from patients and staff alike.
My Tanzanian student colleagues were also helpful to me with language. On one occasion, three students invited myself and another WtW elective student, to have lunch with them. This was cooked for us all to share, by the students in their accommodation. We were able to discuss practices and learning in the UK, Tanzania and also in the USA, thanks to my WtW student colleague being from Tennessee. We could also discuss how life is very different in the 3 countries, covering life’s expectations both by self and from others.
I feel that the patients especially liked to be able to assist me with the language and learning, appearing to enjoy teaching me about something that they know best. I was able to enjoy laughter with them, mainly at my pronunciation of certain words.
Whilst my main objective was to see what staff in Tanzania do for mental health with presumably nothing as much as we have in the UK, I feel that I gained a lot more from it than just that.
I feel that I gained a sense of being quite humbled by the work that is done there. I continuously felt heartened by the attitude of the staff to the treatment and care of patients. They were using terms that I was used to such as patient centred care and holistic care.
Staff explained to me the reasons for patients being admitted to hospital. Together we were able to discuss the ideas and hurdles around stigma and adherence to treatment. I understood, and observed, that this was being changed through access to public health classes for patients and families. This included advice covering topics such as sexual health, maintaining good mental health and wellbeing, to environmental advice around housing and nutrition. All these sessions were given to the patients and families/carers free of charge, enabling them to have a place to ask questions and get the help and/or advice, relevant to their individual needs.
My observations and discussions with medical and nursing staff at Muhimbili National Hospital, having gained their trust and mutual respect, highlighted many things to me. In the main, we were able to agree that whilst mental health treatment and provision is some 30 years behind that of the UK, they are heading in the right direction. One doctor I spoke to appeared disheartened in saying that things were moving very slowly forward. I was able to counter this and reframe it positively in saying that yes whilst it may feel that things are moving slowly, they are, and will continue to be, moving in the right direction. I used the idea from Confucius who said something along the lines of ‘a journey of a thousand miles starts with the first step’. She liked this idea and I am hopeful that she was able to share in my feelings of positivity.
I made some great friends while in Dar-es-Salaam and feel that it was a total privilege to experience the care and treatment within the hospital setting.
I made two large blog entries whilst in Tanzania to give an update on my progress and how I had been spending my time in Dar-es-Salaam, both during work time and down time. I am happy to make this available to you and it can be found at http://myelective.ollosson.co.uk/Blog.php. Please feel free to visit and use any information you wish. I will be leaving my website and blog up for historical purposes so that future elective students may read about my trip and hopefully take some inspiration to, as the UEA’smotto states, “Do Different”.
I am thankful to the Alumni Fund/Donors in awarding me substantial monies for my elective. It has helped me in better understanding the importance of public health, early intervention, community working and talking therapies. This is something that is applicable, regardless of age.
This elective has been an experience that will stay with me for always and will shape the way that I see patient care during my future career in the ways that I have alluded to above.
My sincerest thanks once again to you all for the generous award.
With my kindest regards and best wishes