Planning your electives in Tanzania - in general

From Student BMJ

Planning your elective - Tanzania

Mark Wilson gives you some tips on arranging an elective in Tanzania

On the coast of east Africa, Tanzania comprises the mainland and a number of small islands such as Zanzibar and Tanganyika. The scenery varies greatly from the coastal lowlands to the volcanic highlands and the Great Rift Valley. The highlands are home to Mount Kilimanjaro, Africa's highest peak.

Tanzania is famous for its wildlife. Wildebeest herds, zebras, lions, cheetahs, and hyenas are in abundance. The beaches are beautiful and the cities are friendly. If you want an exotic island break then visit Pemba or Mafia, which aren't yet overrun by tourists.

Tanzania has a long history. One of the oldest human remains at 1.75 million years old was recently found here. The various African tribes (mainly Masai from Kenya) intermarried with trading Arabs 2000 years ago forming a new people with their own language, Swahili.

There's plenty to do;

climb Mount Kilimanjaro,

see the Ngorongoro Crater (the largest unbroken caldera in the world),

visit Olduvai Gorge, the Serengeti, Arusha, Tarangire, and Lake Manyara National Parks.

Then go south to Selous Game Reserve, Mikumi, Ruaha, and Udzungwa Mountains National Parks, and don't forget to visit Zanzibar.

Medicine

Basic medical care is state funded, although there are also a number of Christian missions. There are four major referral hospitals: the Muhimbili National Hospital which caters for the east, Kilimanjaro Christian Medical Centre for the north, Bugando Hospital for the west, and Mbeya Hospital which serves the southern highlands. The government runs 17 regional and 55 district hospitals; missions run around 56 hospitals.

Despite relatively good medical care, diarrhoea, respiratory diseases, and malaria are still big killers. Prevalence of HIV is increasing and is around 20% in rural regions (8% is the national average). Most hospital work--such as ward rounds and writing notes--is done in English,
but most patients only speak Swahili. A detailed background to health care
structure in Tanzania can be found at www.tanzania.go.tz/healthf

Visas

You will need to get a visa, which costs £38. The High Commission's address is Tanzania High Commission, 43 Hertford Street, London W1Y 8DB (tel 020 7499 8951; fax 020 7491 9321; www.tanzania-online.gov.uk).

Immunisations

You should ensure you are up to date for hepatitis A and B, typhoid, polio, tuberculosis, and tetanus. Rabies is sometimes recommended. Malaria (the malignant falciparum form), exists all year throughout the country below 1800 m and current advice on prophylaxis should be sought before travelling. You should also consider taking HIV post-exposure prophylaxis.

Some medical schools and government hospitals

• Muhimbili University College of Health Sciences--Office of the Principal, PO Box 65 001, Dar es Salaam, Tanzania (tel 15 302 6; email dfmed@much.ac.tz; www.muchs.ac.tz; www.udsm.ac.tz). They can organise electives, for example in Mbeya Consultant Hospital. Only around 50 Tanzanian students enroll each year and there is a high dropout rate; this makes Tanzania short of doctors.
• Kilimanjaro Christian Medical Centre--PO Box 3010, Moshi, Tanzania (tel 00 255 57 54 263/52 291; fax 055 54 381; www.kcmc.ac.tz). This 450 bed hospital is situated in the foothills of Mount Kilimanjaro. It also has its own medical school.
• Bugando Hospital--PO Box 1370, Mwanza, Tanzania (tel 068 40 610; www.bugando.org). The University College of Health Sciences at Bugando Medical Center is established as a Catholic college with four schools: medical, nursing, pharmacotherapy, and dental. The Hospital has 800 beds for the population of 8 million people in northwest Tanzania.
• Mbeya Referral Hospital--PO Box 419, Mbeya, Tanzania (tel 065 3576). A large referral hospital (by Tanzanian standards) in southwest Tanzania. It is a teaching centre for clinical assistants, who do a similar job to junior doctors.
• Mnazi Mmoja Hospital--PO Box 338, Zanzibar, Tanzania (tel 00 255 54 31 071)
• Hindu Mandal Hospital--PO Box 581, Dar es Salaam, Tanzania (tel 00 255 51 110 237/110 428)
• Agha Khan Hospital--PO Box 2289, Dar es Salaam, Tanzania (tel 00 255 51 114 096)

Some mission hospitals

• Berega Mission Hospital Berega--Morogoro, Tanzania. This mission hospital has 120 beds and poor conditions; an excellent though remote elective.
• St Anne's Hospital--PO Box 2, Liuli (via Songea), Tanzania (connected via USPG charity). This is a remote, small, 100 bed Anglican mission hospital on the banks of Lake Malawi.
• St Francis Hospital--Kwo Mkono, Handeni District, Tanzania. Another Anglican 70 bed general mission hospital offering a range of health programmes including rural clinics.

Mark Wilson, author of Medic's Guide to Work and Electives Around the World, Royal London Hospital, London
Email: mark@medicstravel.com