Medical caravan in Msitu wa Tembo

“They say that travel broadens the mind and broadens the horizons”. I cannot agree less with this statement when it comes to volunteering in developing countries. My name is Joanna and I have been working as a staff nurse on the Cardiac Intensive Care unit for just over 2 years. I have joined the charity and decided to volunteer for many reasons; to develop professionally and personally too. It was my first ever trip as nurse to do humanitarian work and I can tell you now… it changes your perspective on life, you start seeing the bigger picture when it comes to volunteering and you develop your assessment skill as a clinician in a whole new dimensions.

By saying this, I want to refer to a specific event… medical caravan in Msitu wa Tembo.

To start off, the highlight of the trip was actually living in the village and interacting with community on day to day basis. Spending time and interacting with local population helped me understand more about Maasai culture which in turn helped me to build successful professional relationships and ultimately made me culturally aware person.

In UK, the nursing practice must be performed strictly in line with The Code of Practice and I found it challenging that those standards weren’t met whilst in Tanzania. I came across quite a few ethical dilemmas that would not happen in western world. During the medical caravan, I did something I have never done before, triage the sickest people waiting to be seen. Across around 350 people waiting outside the dispensary, it was my role to use my clinical judgment skills and recognise adults and children who needs immediate attendance. In a western world of modern medicine, we rely on monitors and gadgets that do it all for us nurses, doctors and other healthcare professionals. Here, I had a stethoscope, watch and thermometer. It was a good lesson and practice of those basic assessment skills. Although, I had limited knowledge of Swahili (spoken language of Tanzania), reflecting on it, you don’t need it to communicate verbally. The use of alternatives and non verbal communication as well as observation skills played a big part. Respiratory rate, breath sounds, temperature, blood pressure and visual appearance determined my decisions. I have certainly developed my leadership skills in prioritising who could go first to a dispensary, that was already full of patients. What helped, was educational factsheets, articles and group discussions of common disorders, diseases in the region. I felt that by having limited amount of equipment, I was practicing a thorough clinical examinations that helped me to improve as a better professional.

In addition, the team, various scopes of practice, excellent communication and working as a whole team made this event so successful and enjoyable. The number of patients seen and treated was enormous, and the feeling by the end of the day surreal. That evening we all sat together and reflected on medical caravan experience; words cannot really express how many skills we have gained on various levels; clinical, personal, cultural, spiritual and many more.

When you’ve got limited resources, you learn to be ingenious, a bit more lateral thinking.

Joanna Broza
Cardiac Intensive Care Staff Nurse