Lessons from Tanzania Medical Mission Trip 2020
By: Seethal Sara Thomas, FNP-BC
Working and living in New York City has given me an opportunity to quickly learn skills, incorporate evidence-based research into practice, and gain experience in specialized services. Despite my experience here, I was always curious about healthcare systems in other countries. In the middle of my Master’s Program, I was asked to join a nurse friend on a medical mission trip. She explained the goal was to set up clinics in rural parts of Tanzania and she needed volunteers to help staff the clinic. Being a second-generation American citizen, I was eager to use my knowledge and skills to help people in an underserved country. The organization we traveled with is called International Service Learning (ISL), and they set us up with a local team leader/translator, a local doctor, a local driver/translator, an Inn to stay in, and some reading materials on the most common infections and ailments in the region. Before I knew it, I was on a flight with 5 other nurses, a non-medical volunteer, and one nurse practitioner reviewing the materials provided to sharpen my knowledge about the most common ailments and treatments. There are several lessons gleaned from my experience, but my intention is to focus on the most important lessons for people interested in organizing or participating in a medical mission trip.
Donated items from Afya bag displayed on table
What to bring. My mom taught me that if you visit someone for the first time, do not go empty handed. The team leader sent a brief email about the necessities to bring such as: stethoscope, otoscope, blood pressure cuff, hand sanitizer, sunscreen, and bug repellant. We did not know what type of setting we would see patients in, whether it would be an office, at a home, or if the place would have any additional supplies. I only knew I needed some tools to conduct a physical assessment. We were fortunate enough to have several bags of donations from each nurse’s institution and a foundation called Afya. Afya saves medical supplies from going to waste and gives a second life to use these tools where there is limited availability. If you plan to travel to a place in need and can carry their Afya Luggage for Life bag, please connect with them. As a health professional, you may be aware of the limitations a lack of tools and supplies puts on the quality of care. As a health professional you might also notice the startling amount of waste there is within the industry. I’ll admit I never realized how much could be rescued till I asked. In the Afya bag we had a large supply of over-the-counter medication, antibiotics, baby products, rehydration tablets, masks, and reading glasses.
What we did: My dad taught me to never help half-heartedly. Our group stayed in Moshi which is close to Mount Kilimanjaro. We traveled 1-2 hours daily on dirt roads to arrive at old mud, wood, and clay buildings in more rural areas in Tanzania. Transportation is difficult in those areas because there aren’t many paved roads or cars or public transportation options available. We set up clinics with the supplies we brought and a few tables and chairs. There were hundreds of people at the clinic, people who traveled over an hour on foot to be seen by one of us because it was the most feasible option to receive any sort of care and assessment. We were “all hands-on deck”. Even the non-medical professional helped us by getting heights and weights for all the children and directing the patients where to go. As we walked through the village, people implored that we would see bed-ridden and crippled members of the community. The people were always interested to hear any diagnosis or reason for the disability, and what, if anything, they could do to help their condition. I also noticed some people would travel and describe ailments of others who were too ill to come themselves. We would offer a short term supply for any medications we had and recommend to the doctor to write prescriptions on his pad for any medication that the patient would need to go to the pharmacy for. The kids were curious about our group, many were playful and even taught us some Swahili. The older adults seemed to welcome our presence and they appreciated reading glasses the most. They said it helped alleviate the strain on their eyes while they tried to read their bibles at night. We counted 200-300 patients a day between us 5 people with the doctor circulating any prescription needs or procedures. Some stories we heard were heartbreaking, some diagnosis needed to be referred out, all the days were long, hot, and quite tiring - but somehow there was a newfound energy and alertness to each day. I attribute it to the nature of the work and the kindness of the people. Despite the low access to healthcare, the community seemed vibrant, strong, and happy. It was a truly humbling and rewarding experience.
Reflection: We treated people in these communities, prayed with them, ate with them, and tried to give recommendations to them that fit within their way of living. If I could do it again, I would make sure to bring more antibiotics and local analgesics. We encountered cases where local analgesia would have improved the experience for the patient and infections were the top diagnosis we encountered. Next, I would bring more blood pressure cuffs for home monitoring. We frequently had to newly diagnose people with hypertension and home monitoring is an important aspect of treatment. Reading glasses, though we didn’t have a comprehensive optometry clinic set up, were a favorite item for the locals, so I would have liked to bring more to share. We went in early March 2020, before the Covid-19 NYC shutdown. Luckily, none of our clinic days in Tanzania were impacted by the pandemic and there were no reports of either native or volunteer getting sick after our visit. We left all the masks and hand sanitizer we brought for them to use and taught about effective hand washing and social distancing as the news of the pandemic reached the locals where we were.
Fun: ISL also offers a few days of guided exploration after the days of service. This includes a trip to Tarangire National Park, Ngorongoro Conservation area, a waterfall, and hot spring all with the translators and team lead we had just worked with during clinic days. These were incredible adventures!
In summary: Medical service trips are a great way to give back and get some hands-on experience. I would recommend having some training and experience before you go to be able to offer more services and advice. I had about 5 years nursing experience at the time of going, but since there’s not a lot of technology or need for specialized skills, having good history and assessment skills goes a long way! We went with a non-medical volunteer, and she was helpful in obtaining heights and weights and among other tasks! Regardless of your experience in the medical field, there is always something to be done and you’ll have a team to help you through it!
