Itigi Hospital, Itigi, Tanzania
Itigi Hospital, Tanzania
Although the town of Itigi only has a population of about 1000 people, the hospital serves a large catchment area with the district population of >200,000. The town of Itigi is in the Manyoni District central Tanzania on the railway line. It is extremely poor with the surrounding desert and savannah plains.
Tanzania with a population of 37 million is the largest of the countries on the east coast of Africa. The country is named after Tanganyika mainland part, and the Zanzibar islands off its east coast and has been a member of the Commonwealth since gaining independence in 1961.
The economy is reliant on agriculture as well as natural mineral sources and tourism. Tanzania is a popular tourist destination due to scenic highlands in the north where Mt Kilimanjaro is located and gameparks such as the Serengeti National Park.
A wide variety of clinical cases relating to a developing country. Lots of malaria, HIV related opportunistic infections, leprosy, obstetrics and gynaecology, burns and trauma a lot of which is violent trauma. This includes thievery, rape, use of machetes and removal of spears from the chest/abdomen. Caesarean sections were common.
The hospital is in an area where the Masai tribes (nomadic) frequently wandered through. Often they would have late stage infected wounds etc for which they had sought advice from witchdoctors before presenting to a hospital. Therefore a lot of late end-stage disease.
Rural clinics involved triaging and treating many hundreds of patients queuing up waiting to see the doctors. No antiretroviral medications were available at the time I was volunteering.
- Attending outpatients, wards and rural clinics on a daily basis.
- Daily paediatric ward rounds
- Tuesdays and Thursdays: HIV clinic
- Wednesdays: Rural outreach clinics
- Friday: Obstetrics clinic
- Saturdays: Outreach paediatric, neonatal clinic mainly concentrating on education, assessment of malnutrition, education about HIV, assessment of diarrhoeal illness in children.
Little to no facilities:
- One x-ray machine which operated only 1 day a week.
- No blood haematology or biochemistry
- No ultrasound machine
- Do your own microscopy: on urine, blood film for malaria, and white cells.
Fairly long working hours. 8am to 7-8pm at night from Monday to Saturday
Accommodation was very basic. A one bedroom mud brick hut which was shared between two people. There is no showering or toilet facilities in the house itself but facilities were available in the hospital. It is common to have a guard protect the house at nights. No electricity, use of kerosene lamps and a cooking pit.
Only very basic food was available. Maize, eggs, potatoes, vegetables and a small goat was provided every four months. Lunch was provided and served by the hospital as was storage of food requiring refrigeration.
No phone or internet access at the hospital when I was there. Letters arrived once a month.
Locally trained paediatrician, malaria specialist and physician as well clinical officers in midwifery and paediatrics. Once a month on a rotating basis, a visiting specialist would fly in to perform specialist operations for one and a half days straight eg. TURPS, hysterectomies etc. On these days you are expected to do the assisting which would often continue non-stop well into the early evening.
Swahili was the official language: learnt primarily on the job. There is the availability of an interpreter who was often a local teenager.
Not many facilities; railway station, post office, water well, bus stop and a general market about 15 km away.
Flight into Dar es salaam before catching a train to Itigi.
The placement was arranged through The Overseas Exchange Scheme (TOES) Oxford University and was self-funded through fund raising.
There were travel opportunities. Many local gameparks and occasionally sightings of wildlife (impala, warthogs) around the outskirts of the rural clinics.
Lot of great places to visit including:
- Lake Victoria
- Safari game parks
- Mount Kilimanjaro trek
Doctor in Charge