Habari za asubuhi from Tanzania

Well, here we are at 2 1/2 weeks in and only a few days to go until I come home to the UK and to my dear admin' of course. I have missed him loads while here.

But, I made a promise that I would throw myself into the elective and do my best to enjoy the time here.

I feel that I have done that totally with what I have observed while here.

It has been fascinating to have insight into the various clinics that are run here. How referrals happen and how a patient can go through the system.

Its been good to see that there are a number of similarities to practice in the UK such as person centred care and holistic care. Those in the health care line of work will know that these are big words when it comes to mental health and general health care too!

Coming out here I maintained that I did not wish to read about the care provided as I wanted to experience it first hand and form my own opinion on how things are done here.

I have also maintained the idea that "this is the way it's done here and I am not going to change it - it is what it is".

I have observed that the staff at the hospital do the very best for the patients with the resources they have.

And, whilst they may have limited resources, the interaction between staff and patients has been noted to be respectful at all times.
Some may be lead into thinking that this is just because they are being observed by us mizungu (white foreigner) students from the UK looking at what they are doing.
However, I would beg to differ.

I have spoken to staff that like to give patients accompanied grounds leave and go for walks to make sure they get fresh air and sunshine. It is known that fresh air and sunshine can boost low mood in some patients.

I feel that I have been extremely privileged to be able to spend time in the mental health department at Muhimbili Hospital here in Dar-es-Salaam.

On Friday I plan to take all the donated items to the head of the mental health department, Mr Peter, and hand these over as a way of thanking him for allowing me this opportunity.

I am hopeful that these gifts will be welcomed by him and will help his department as best as possible.
I can only thank those of you that have donated items for this elective and say that they have been most useful and have helped me no end in my time here.

So what about other news?  I hear you say.

Well, I have required a few days off :-( not because i wanted to but because I had to!
One day of the ol' Tanzanian Tango and yesterday and today off sick!
This is due to a culmination of things amounting to a student coming here hacking n coughing everywhere and not treating it, humidity, dust and there is also building works going on next door. This causes much cement dust so you can see how these things can happen.
So rather than go in with a cough and cold around unwell patients, I have opted for the professional grown up option of getting treatment from the pharmacy and staying at the house. Not ideal as I wish to go in and miss being there. But I cannot go there feeling less than 100% can I?

Therefore I am sitting here at the house updating my blog to let you guys know how it's all going.
I'm trying to be productive!!

In other news....

During down time I have been to Bongoyo Island with a couple of other student nurses. It's reached by a "ferry" and is quite small but lovely. The day we went, it was a bit grey but we did have sun and in fairness it was still lovely and warm.

What else...?

Ah yes, we went to the Mwenge market to buy some bits for home. I got postcards and some other bits and bobs so will need to post them today!

We have been out for meals and eaten well with good company.


Today, I am to go to a charity football match at the national stadium in Dar'. I understand that it is a charity shield match, a friendly between the two big names in Tanzanian football. The whole house is going to go and Mohammed (the Work the World placement/house manager) has arranged for us to go by coach as there are 20 of us going. Well basically its the whole house.



Whilst I am not the biggest football fan and much prefer rugby, I understand that the atmosphere there is fantastic and as the whole house is going as well as some of the WtW staff too, I thought sod it, why not?

We'll leave here at 2pm and should, in theory, be back in time for tea :-) I hope to take some photos which I will post up once back in the UK.

Ah yes, talking of photos, given the confidentiality and consent and all that, I have very few pictures from my placement. Any that I have and will put here will have been taken with consent.
So apologies if there haven't been many piccies from Muhimbili.

Pictures from elsewhere though? these I do have.

What else? ah yes...the football kit that I was given.
One of my lecturers very kindly gave me some junior football kit of Norwich City FC and a signed football. I have agreed to hand these over to the MH dept head, Mr Peter, as they are in the process of sorting out a mental health inpatient ward for kids. I feel that it would be good for them to use there.
Football as I am sure you will be aware, is a huge past-time here, so I feel that it will benefit the kids that will come in to this new environment and give them something that they can do together that may improve mood etc. So my thanks to Steve Wilkinson for the kit and especially the ball. The kids will love it.

I did think of giving it to the orphanage but I had heard reports that although nice things may be taken in like notebooks etc, they were not always being given to the kids. This is sad and may be indicative of how things are here in such situations. That  said I have not seen this first hand but the number of reports I have been given saying the same thing leaves me feeling slightly disheartened for the kids.

Hence it going to the hospital for the new inpatient unit that is coming soon.

Ah yes.....the other big thing that happened.......SAFARI .....

Was it like a wildlife park in the UK? Most definitely not....

It was so fantastic to see the animals in their natural habitat, not surrounded by high fences and wires. We had  a herd of elephants go behind our jeep, they were so quiet. Amazing given that they weigh around 3 tonnes each.
We saw most of the big 5 - lioness, hippo's, elephants, gnu's, wart-hogs, giraffe, zebra, crocodiles and the most colourful birds I have seen outside of India.
The team that took us to Mikumi National Park were Rama' and Henry.
Of note, Henry is of Masai heritage and was a fabulous chef, cooking all our food on something resembling a BBQ. He made really tasty food tho. Everyone needs a Henry in their kitchen!

Given Henry's heritage and links with the Masai, we were privileged to spend a few hours with the local Masai family. They dressed us up in the purple material in a way that they dress. Bart, one of the dentist students, being the only male there, was dressed as a Masai warrior.

I learned that Masai are farmers meaning that they take care of cattle. In the UK, farmers can be working with cattle or crops. Here in Tanzania, crop farmers are referred to as pastoralists.
I had a fab time there and was respected as an older person. One of the older women was able to show me how they dance and before you ask, yes I too was expected to dance.

Now for those who have never seen Masai women dance, it involves much jumping around and chanting/singing. Now, I am not a slim effort of a human and am not much into exercise. But, I did "dance" like them. Naturally we all loved but they seemed to like the fact that I took part at least.

I think overall, that the experience that I have had here, will remain with me forever. I think that it has left its mark on my heart and that I will always have good memories of my time here.

So I guess I am left asking myself the question about what will I take from here for my further career and my practice?
I could say its seeing how little they actually have and how the practice done here differs to the UK. I think that it makes me appreciate exactly what we do have in the UK and when people moan about services offered, I can speak with confidence about the level of resources here and how they are used.

I thought I would come here and take home particular skills and ideas. On reflection I feel that the whole experience has changed my outlook towards mental health and has only acted to enhance my passion of working in the mental health field.

Will  it make me a better nurse? who knows....but what I do know is that my calm nature has been noted by others while here and that my outlook on Tanzanian practice is as non-judgemental as possible.

I have had many laughs and conversations with patients and have appreciated the time that they have given to me. I don't think they will ever understand how lucky I feel coming here and meeting them.

It has been helpful to have a Swahili teacher twice a week and has served me well in practice.


So, as I sit here, nursing a soddin' cold, I ask myself would I do it again? Would I recommend it to others?
Yes, most definitely. It not for the fainthearted, I think that is a given. However, to broaden your experience in your own field of nursing and to discuss these with other like-minded people at the house? then yes, I would certainly give it the thumbs up.

I am sure that in further posts I will recall bits and bobs of this elective and I hope that I will be able to continue to post them for your reading pleasure.

Meanwhile, this mizungu is going to make a chai with some honey and take some more meds.

I may even have a sneaky coffee - as ya do!

ttfn peeps

Kwaheri

K xx