University of Central Lancashire 2023

Midwifery, Tanzania Dar es Salaam

I chose to undertake my elective placement in Dar es Salaam because Tanzania was a destination that I had always had my eye on. For many years it had been my dream to visit this beautiful East African county.

So I could fulfil this dream, one of my criteria when researching universities to study at was that they needed to offer an opportunity to undertake an elective abroad. Dar es Salaam always appealed to me as it's just a stone's throw away from the beautiful pristine white beaches of Zanzibar island and the rich historical culture that the country is laced with.

I was told on multiple occasions to prepare myself for the culture shock, but nothing could have prepared me for what I would experience at the hospital. I did go in with an open mind which helped, and I knew there would be times I would find it mentally tough, but when I saw the state of the hospital my heart dropped.

I saw labour beds lined next to each other, with only a thin curtain to preserve women's privacy. This would never be seen in a UK hospital where each woman has her own labour room with full privacy and confidentiality. The women in Dar es Salaam had to labour and give birth in a room full of strangers.

Not to mention the fact that they had no birth partners to support them, so although they were surrounded by people. Due to the limited funds and resources, these women were offered no pain relief, and even low-level drugs such as paracetamol had very limited availability.

Seeing up to five women sharing a postnatal bed, with their babies gathered in the middle, was tough to see.

The hospital staff were always so friendly and welcoming and made sure we were well looked after. I was worried before the trip that I would be ignored in the hospitals due to the language barrier and lack of knowledge about the healthcare system there. But I was quickly proved wrong — the staff were excited to see us every day, and would welcome us to the wards with open arms.

They would delegate tasks like taking vitals, transferring patients, restocking etc. They would always involve us in conversation, and explain what was going on and were keen to converse with us and to talk about our experiences in Tanzania. Staff were fascinated by the differences between healthcare services in the UK and Tanzania. They would explain the reasons why they do things the way they do, and the most common reasons were limited resources and cultural traditions.

Communicating with staff was easy as most spoke English. They were keen to teach us Swahili too and thanks to the language lessons in the Work the World house everyone was impressed with the (limited) Swahili we already knew.

One of my more prominent memories is from when I was in NICU. The unit was overwhelmed, with as many as fifty babies being treated. I was introduced to a beautiful baby girl and was asked to bathe and feed her. Staff informed me that this little girl was found abandoned in the street and only in NICU until she was well enough to be taken to the orphanage.

What was more shocking was how common this was in Tanzania. Women frequently abandon babies due to extreme poverty and the fact that they simply don’t have the money to sustain a child. I visited the baby every day of my trip and enquired about the orphanage she would be sent to, but the staff were unsure as there are dozens of orphanages in Dar es Salaam.

In the evenings, we were never short of things to do and places to visit. As there were so many of us in the house, most days everyone would split into smaller groups and go to the markets, or the beach, or out for food/ drinks, or simply chill out by the pool.

On set days, we would have big group activities planned e.g. every Wednesday was Karaoke night, so the whole house would go out to the local Karaoke bar. Thursdays were BBQ night and African dancing, the whole house would gather on the balcony for a delicious fresh buffet BBQ followed by hilarious African dancing.

I was there for two weekends, on the first we went to the Safari, it was incredible to see wild animals up close and personal in their natural habitat. On the second weekend, we spent our time exploring the beautiful exotic island of Zanzibar. Relaxing on the beaches, meeting the world-famous 200-year-old tortoises, and swimming with dolphins.

I would advise anyone with the option to undertake an abroad placement to bite the bullet and DO IT!! You won’t regret it, the memories and friends that you make there will last a lifetime. It has increased my clinical competence, my people skills and my confidence to travel alone.

I was very anxious leading up to the trip, especially as I was going alone. But all my anxieties melted away as soon as I touched down and met the amazing, supportive team on the ground. Everyone welcomed me with open arms and made me feel at home. It honestly felt like I was made to be there! This was a once-in-a-lifetime opportunity and I’m so glad I went, I regret nothing other than that I should have stayed for longer!

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