Nursing, Tanzania Dar es Salaam

Zernell, DeniseDenise Zernell, Clinical Nurse Educator at Penn Highlands Healthcare DuBois, travelled to Dar es Salaam in Tanzania for her overseas placement and shares her experience below. 

Nursing is a gift that carries with it the opportunity to follow any alley, avenue, street, or highway we choose.  Where we elect to take those opportunities is our own choice. For many of us the caring extends beyond the doors of our facility.

I, along with two of my colleagues, recently had the chance of a lifetime to travel to Dar es Salaam in Tanzania. Although a destiny that not everyone is able to make, traveling to a country that sees healthcare under a different set of conditions is something that will forever be in my heart.  Spending 35 years in the healthcare industry working in Women’s Health of some sort, I took a leap to fulfill one of my bucket list items and I can tell you my bucket overflowed with my trip to Dar es Salam, Tanzania.

I chose to fulfill my placement in the labor and delivery unit as that has been my passion in nursing.  Being a clinical nurse educator in Obstetrics/NICU for the past several years, my eyes were truly opened and for that, I will forever be grateful.

Working with the staff at Work the World throughout my year of planning the trip, for the two weeks I was in Africa, and after the trip was nothing but great.  The pre-placement phone calls, the MyTrip planner, and those at the Work the World house in Dar es Salaam made for a smooth journey. I would be remiss if I didn’t say I wanted to back out a few times, however, the support and encouragement went above and beyond.

Zernell, DeniseWith my itinerary in place prior to departure, I felt secure in the trek. Being met at the airport by a member of the Work the World team, I felt absolutely positive that I had made the right choice. The first 24 hours, he toured us, took us to the hospital, explained and rode with me on public transportation, and basically introduced me to life in Africa. He was such a gentleman and it was evident that he truly loved his job. I feel I made a lifelong friend.

The hospital setting was much different than I expected and I quickly realized that the more you jump in and do, the greater your experience will be. The staff were so appreciative of the little things I did to help. We shared our experiences and knowledge with each other, it was certainly a teaching/learning experience. From the first couple of minutes, I knew that I had to change my American mindset and have an open mind.

Being of the baby boomer generation and living in a house with mostly millennials and generation Z’s, I held some reservations however they were quickly dispelled when I entered the front doors of the house. My housemates ranged from 18 years old to myself of 58 years old and we were from various countries with different backgrounds. Oh, how we meshed as a family. If it were not for this family, the days could have been unbearable. We took the time every day to debrief, to talk with each other, and to share stories about our careers, families, and our day. Again, I feel I made some lifelong friends.

The mothers and babies that I cared for in Tanzania taught me so many life lessons. They just wanted someone to stand beside them while they were laboring alone, to rub their backs, to hold their hand, and to let them know that someone was there to get them through while they lay on sparsely padded gurneys to deliver their most precious babies. They just wanted to know their baby was okay and that it was going to live.

Zernell, DeniseWhile we practice skin-to-skin with our newly delivered babies here in America on a daily basis, that is not the case in Africa. The day we were able to place a baby skin-to-skin and assist with breastfeeding immediately after birth was a moment that our patient will never forget as it’s not common practice in Africa. It was a moment that not only flooded our eyes with tears but helped us to realize that the smallest of gestures is a lifetime of memories.

With this being said, cultural diversity has surely been an eye-opener for me not only in healthcare but in daily living as well. What we take for granted is not the norm for those of other countries: pain control, appropriate medications, family involvement, a clean environment, and an abundance of supplies, just to name a few. From the perspectives of the patients I cared for, they only wanted compassion, politeness, and active listening.

My life has been forever changed. There are few days that go by that I don’t reflect on something that I encountered when in Africa.

My days were long, laborious, and most often tiring, but I also had the opportunity to go on a weekend safari and enjoy the markets of the country. Getting out and seeing the life that is lived in another country, the land that is shared by so many, and the hospitality of those that lived there made the experience even more special to me.

My life has been forever changed. There are few days that go by that I don’t reflect on something that I encountered when in Africa. One of the things that will never leave me is the simplicity, the low-stress, the love and appreciation that shines through all of those that I met.  I can remember specifically the day I asked a member of the Work the World team, “Does anyone get stressed out here?”, and his reply was “We are just happy with every day we are given.” He always said, “freshy-freshy”, “bomba-bomba”. And yes the Swahili lessons that were offered broke the communication barrier and got me through my two-week placement, although I can say I wasn’t the quickest learner in our group when it came to our second language.

Zernell, DeniseMy experience focused on maternity, labor and delivery, while others may focus on clinics, environments, eye, dental, etc. If I could give two pieces of advice to anyone considering a placement abroad it would be: 1. go with an open mind, 2. realize that the smallest gestures make the biggest difference. To see the sparkle in their eyes, the smile on their faces, the ear that listens to “how do you do this in America”, to the simple “thank you” for being with me makes the moments worth every second of our time.  

To sum it up, I say, “It was a million emotions wrapped into one blessing.” There certainly is no greater gift than that of “giving” all because caring is the “heart of nursing”!

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