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Finally Medical School!!! Part 2: Africa

I was not sure whether this or my England post should be first, but whatever, it probably does not matter. Now, this is the part of my endeavour toward med school that includes Africa. These travels changed me and my viewpoint on life, society, and humanity. This post will be written with in the perspective of my university endeavour.

I had just started working at Burger King and was undergoing my training to become a shift manager. The thoughts of travelling or backpacking had been developing since I went to the IB and wanted to do my Service part of CAS abroad, but at the time I had no money. But now, after working at Burger King for a couple of months, I could afford at least a short trip, which suited my 2-week Christmas time off perfectly.

After some nervous check-ups of several volunteering sites I booked one through African Impact, where I would live at Antelope Park and work at a local healthcare centre. By then, I though I was going there to save the world. I took quite some time to understand that this was not going to be the case. But, went I did.

After a transit in Switzerland, Zürich I believe, I remember landing in Zimbabwe and Harare, and stopping to take a picture of the ”Welcome to Zimbabwe” sign. I was then received by a white Zimbabwean and her husband who drove me to the first over-night stay in Harare, because the 4-hour bus to Gweru was not due until the next day. In the car, he told me a bit about her experiences of the black-white struggles in the country. The most memorable she told me was when they had to flee their farm because army veterans were looting the countryside, and when the couple returned to the farm they found their dogs spikes on the fences around the farm. I had read a bit about Zimbabwe before I went, and having studied History Higher Level I thought I knew the world up and down, but that story was shocking. The first real encounter with the real world for me.

Well at Antelope Park, which turned out to be a game reserve park (I had no idea although it was written at African Impact’s website), I settled in well and met the other volunteers. All but two of us were working with the lion project at the park, which I saw as nothing but a way of increasing tourism revenues because they actually never did anything of real value (they cleaned the cages, that was probably the greatest impact these volunteers had). We ate and lived well, because the Park was also a camping for tourists. And when I came out to the suburbs outside the big city (the Park was perhaps 30 minutes from the city) the contrast to the luxurious Park was striking; people lived in shacks, not worthy to be called stables in Sweden, and cooked outside in front of the house over small fires.

I was shocked by how they lived. In the beginning one asks oneself where they really live, because one cannot simply believe it! And when I came to the healthcare centre, it got even worse. Because, in Sweden, public buildings and institutions are expected to be top-notch and state-of-the-art. But here, again, the facilities would not even count as stables back home. Spoiled as I was, the chairs and tables were worn-out and dirty. The toilets, if they even worked, were just the porcelain seat and nothing else (no water, of course, but a bucket). The waiting room was a room with benches, where dozens of pregnant women and women with newly born children waited for their check-ups at the pre- and ante-natal departments. No computers at the reception. No reception! Barely any doors to the building. I could describe the birth department to you, but I am afraid that might be too offensive – the hygiene was, to state this simply, very, very, very bad.

The first thing we did was helping to keep notes on the mothers’ and new-borns’ health at the birth department. I remember not doing anything of value, and I was a bit disappointed that we volunteers jut went there like tourists to see an old church. We paid to come and look at sick people. A horrendous system.

I was finally put to ‘work’ when I asked for something to do and was given two different medical packages and was ordered to sort a certain number of the one and the other and put them all in small plastic bags. I had no supervision, which was rather irresponsible by the staff since it was ARVs I distributed – treatment against AIDS. I remember sitting in the reception and doing this, when a small boy, not more than 12 years of age, came in and looked at me with a scared look on his face. We did not share a common language, so I just pointed to the chairs in the waiting room (this was not the same as to the birth department). I was so ashamed. There I was, not knowing exactly what I was doing or why. I had paid to come there, but made no difference whatsoever. I felt like a tourist, which I was, at the clinic. Did I indirectly view the patients there as animals? Was I wrong to be there? Was I just another western colonialist or imperialist, coming there to profit from the suffering of the poor? My answer today would be yes to those questions. I learnt a lot from these experiences, about human value and respect. Still, I was going to come back to Africa.

This map shows Tanzania, the big safari nation together with Kenya. I went here after another 10 months at Burger King where I had worked solely with the aim of being able to afford another African volunteering trip. I knew from my Zimbabwean experiences that I needed to come to a more professional project, where the volunteers got a clearer role in the clinics. I knew of course that I would not do anything practical, but I hope to at least see e.g. surgeries. A project that fitted my goals was the medical project in Dar es-Salaam, the capital in Tanzania. This time I went with Projects Abroad, which was cheaper than African Impact (about the same cost for more than double the stay). In Tanzania, I had a much better experience.

I was more prepared for what was waiting for me, and instead of living with the volunteers at a game reserve park, I now lived in the more ‘fashionable’ quarters of the capital, in a Tanzanian family, with the dala-dala (the local buss, or mini-van) stopping just outside the house. Taking the dala-dala trip to Mwananyamala State Hospital took about an hour in each direction, but there was so much to see that it felt like five minutes. Well at the hospital, I was impressed because I had at first expected the extremely bad facilities like in Gweru. However, I was at the same time frustrated that the regular wards again looked like stables. The beds looked like prison beds, with dirty mattresses and mosquito nets hanging from the roof. The doors to most wards were always open to let ‘fresh’ air in: modern ventilation and disinfection systems were of course not available. Fans in the roof served as air refreshers.

There were many wards, ranging from laboratory to birth ward, surgery, infectious disease, and diabetes. The wide spectrum of specialities together with the tropic element of it felt very intriguing; a mix of my fascination for experiencing new cultures and my scientific knowledge.

Every Wednesday and Thursday were surgical days, when all surgeries that could be planned were scheduled. Those were my favourite days. When everybody else went home at 13, I stayed at least until 16 when the last patients were operated on. I had never seen anything like it before. Skilled doctors actually cutting in people and making a direct and often life-saving intervention. To me, that is what medicine should be about. These doctors provided me with my first role models for how doctors should be. I mean, there is a real danger in romanticising about surgery and medicine because of TV shows such as Grey’s Anatomy and Scrubs, not to mention House or ER. But now I know how it looks when it is bad (not the worst, but still bad).

Every day at Mwananyamala, we first had a morning meeting and a handing over between the night and day shifts. These were mainly held in English for a start but shifted over to Swahili rather quickly, so I did not really learn anything there. However, after the morning meetings we rounded with the senior and junior doctors. Those were great, seeing all patients in the wards and having their conditions at least briefly explained. We, at our hospital we were about 4 or 5 volunteers, came upon HIV/AIDS, TB, Urine Tract Infections, Acute Watery Diarrhoea, burns, tropical pyomyositis, meningitis, cancer, and broken bones, to mention a few.

During the rounds, we volunteers had some problems in knowing how to deal with the patients. Often, Europeans and Asians are considered high status in Africa, because of obvious reasons (imperialism…), and hence the patients would look at us with begging eyes, but we could do nothing, barely speak to them due to the linguistic barrier. We often stood beside, watching the doctors perform treatments or redress wounds. Cleaning the incision from the surgery of the pyomyositis patient was as hard to watch every time, because the patient would scream out with pain even after mild local anaesthesia. In Sweden, that would have been no problem because: 1) we probably would not have tropical pyomyositis to begin with, and 2) we have the resources to provide good medicines and drugs to all patients. My confidence in western medicine has thus increased, although the media in these countries often make the hospitals and the healthcare systems look bad, because I know how far we have come.

These were only some of my insights and a few of the lessons learnt from my travels. I initially thought I would use these trips solely to show that I care about the world to the British universities that wanted to see that I had life experience. However, the travels really had great impacts on me. Greater than I could have ever anticipated. Today, I try to always remind myself of the situations people live through in much worse countries than mine. Sweden is probably top 5 in the world to live in, with all its opportunities, equality, and security nets. I want to help other countries reach the same level of greatness, and my Africa travels have induced in me the life goal of working abroad again in the future, preferably for an NGO such as Médecins Sans Frontières, making a real difference in the real world, contributing to bettering the world. That is the basic idea, at least, but I know that there is a fine line between wanting to help and actually mean it and wanting to feel needed in an imperialistic manner. That will serve as my next challenge, to not fall into that trap.

***

Part 1: England

Part 3: Sweden

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2 comments on “Finally Medical School!!! Part 2: Africa

  1. Pingback: Finally Medical School!!! Part 3: Sweden « En Strålande Utsikt

  2. Pingback: FINALLY MEDICAL SCHOOL!!! Part 1: England « En Strålande Utsikt

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