Two weeks immersed in the Tanzanian healthcare system brought into stark focus the country’s limitations, yet it provided inspiration for four nursing students
Our experience in Tanzania put us out of our comfort zone and gave us an opportunity to apply our clinical and communication skills in a very different setting. It also offered an opportunity to learn about primary and preventative health care specifically from a global perspective.
We were part of a group of 20 nursing students who did a two-week clinical placement in Tanzania facilitated by the Global Health Alliance Western Australian (GHAWA). We travelled to Hubert Kairuki Memorial University and Amana Hospital in the Tanzanian former capital city of Dar Es Salaam, as well as two rural community health centres, Masaki and Masangaya health centres for supervised clinical training in an international context.
Our placement last November challenged our assumptions of the things we take for granted and highlighted our clinical strengths and weaknesses, while allowing an opportunity to explore the possibilities of international work. Importantly it also reminded us of the fragility of life and the strength of the human spirit while bringing into focus the reasons we had decided to be nurses.
Holistic care and the fundamental element of caring at the heart of nursing were brought into stark focus. We were conscious that we were not “medical tourists” and the placement highlighted our cultural awareness, global social responsibilities and both how well resourced the Australian health service is and how wasteful we can sometimes be in the Western world.
The majority of the placement was observational, however, there were opportunities to conduct general patient assessments, undertake vital signs, administer oral medications, undertake wound care and provide fundamental nursing care. We were placed in acute adult, paediatric medical and surgical wards, and community clinics, that covered a wide range of medical and surgical conditions.
The placement allowed for a great deal of interaction with Tanzanian patients and their families and we were also involved in providing emotional support and reassurance. We learnt about disease surveillance methods and the administrative and financial aspects of the Tanzanian health system.
We observed the treatment and care of people with TB, malaria, HIV/AIDS, serious wounds, including burns and a number of cases of deliberate poisoning. As such, the placement offered a fantastic opportunity to gain insights into the diseases and conditions that are rare in Australia. The placement experience reinforced the pivotal place communication and listening skills play in nursing care provision.
We enjoyed working collaboratively with students from other West Australian and international universities and the opportunity to learn from first-hand experience. We worked with and alongside Tanzanian health professionals in a very different environment where we could and were encouraged to learn about infectious disease and reflect on the limitations of a resource poor health service. The placement also prompted a significant degree of reflection about our personal and professional values and about nursing practice. We all felt welcomed by the people, the clinical staff and enjoyed the whole experience of preparing, travelling, and being part of a team of nursing students.
The most confronting issue in Tanzania was the inability of patients to afford medications and hence limit the level of medical treatment and nursing care they could receive. It was also difficult to reconcile the absence of any appropriate resuscitation equipment and this proved very hard to come to terms with.
We understood that we were not there to nurture the patients or impose a set of Western values and it was often the case, that in certain situation, with a lack of resources and funds as well as being frustrating, it was quite an emotional experience to come to terms with. Seeing patients often sharing beds and laying straight as arrows, not moving a muscle, only perspiring and quivering with fever and being unable to intervene in any meaning full way was at times heart-breaking.
On occasions we were almost overwhelmed with a sense of injustice at the global health disparities and inequalities, the realisation that we had a fairly superficial understanding of the causes and complexities of how other health services worked or any capacity to impact on them in a meaningful way.
We learnt the value of being culturally aware, culturally humble and we returned with an increased desire to work in underprivileged areas, overseas and in Australia. We learnt a great deal about Tanzania and experienced the vibrancy, energy, courage, resourcefulness and optimism of the Tanzanian people, as well as the impact or burden of diseases such as malaria and HIV/AIDS.
We were able to reflect on the values and beliefs that inform our own practice and on our motivation for wanting to be nurses. It reinforced the great opportunities we have in Australia and helped us appreciate the choices we have, to the point where the culture shock seemed greater when we returned to Australia.
Going to Tanzania provided an opportunity to focus on the fundamental principles of good nursing care and practice and prompted us to consider why nursing is such a unique and worthwhile profession.
Sophie Henry, Regan Preston, Sasha Webb Were and Dan Ballenger are second-year master of nursing science students at the University of Western Australia. They were accompanied by Associate Professor David Stanley.Do you have an idea for a story?
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