Medical Student
1-month internship in Tanzania
‘Oh no!’, I thought when I got the email from SISM informing me that I had been selected to go to CUAMM Hospital in Tosamaganga, Iringa in Tanzania for a month. I had tried for two months in a row, rewriting the motivational letter and the letter of expectations hundreds of times, and enrolling in the CUAMM group in my city to have a better chance of being in the top four of the national rankings. But it had not been enough.
I was in my final year of medical school, undecided about my post-graduate future and with an enormous desire to leave for new experiences. So I decided to participate in other SISM calls, eventually accepting a hospital placement in Kiev. ‘Who will explain this to my parents now?’, I thought. But it didn’t matter. It was all too important an opportunity for me and I could not give it up.
I called off Kiev, explained to my parents the importance of this experience, left my rented house to save some precious money, got my passport, bought my plane ticket and on 28 May 2021 I arrived in Dar Es Salaam, Tanzania, together with Miriam, my travelling companion.
The next day we began to taste a bit of everyday life in Africa: at 7 am we left for an eight-hour jeep journey to Tosamaganga, a small village at 1600 metres altitude where the hospital and guest house were located and where we would live for the next month together with five Italian JPOs (paediatrics, gynaecology and internal medicine residents).
They were fundamental because they were a bit like my big sisters. Their programme lasts six months and they walked me through their clinical and African life experience for the whole month. They taught me useful phrases in Kiswahili for communicating with hospitalised mothers, introduced me to all the Tanzanian doctors and nurses, took me around the neighbouring villages and the city of Iringa, advised me on the best safari to go on, and kept me company in the evenings after an exhausting day’s work. Along with them, all the local doctors and nurses were invaluable, taking me under their wings; between a walk in the corridors and a samosa at the bar, we discussed the most interesting cases of the day, allowing me to understand the influence of African culture on patient management.
So we soon became a family, people with the sole purpose of helping and learning, supporting each other in times of difficulty and discouragement. And I do not deny that there were difficult times.
The plan for the month was to tour the departments of paediatrics and neonatology, obstetrics and internal medicine every week for four weeks, and then choose the last week to go back to the department we liked the most.
My first day I was in the Child Ward, where infants and children were admitted for various conditions, mainly infectious diseases and malnutrition. I was there for three weeks. I can recall every single patient the JPO and I visited (the attending was on holiday for the duration of my stay) and there are so many stories I could tell that perhaps not even a whole book would suffice.
I remember the anger and frustration I felt when I heard the screams of children when they were being treated for severe burns or fractures without any pain relief because relatives could not afford the drugs. I remember the sense of emptiness and despondency when a baby died from a snake bite or when I tried in vain to resuscitate an infant who came into the world too early. I remember the despair of having to tell a family that their child’s illness was too advanced and that there was nothing more we could do.
I feel them all inside me, as if they were scars that I always carry with me, in everything I do.
And in doing so, I also think of all the others, those who, thanks to us, made it and went “nyumbani”, home. I think of Mia, who arrived on a stretcher with three haemoglobin points because of malaria, without the strength even to speak, who wanted to stay and play on the slide on the day she was discharged. I think of Loveness, a beautiful little girl with kwashiokor malnutrition and likely nephritic syndrome, who probably has at home the little lantern she stole from me one day in the ward. I think of Steward and the memory games we played together during his painful convalescence from a broken leg. I think of Adi, a child with spastic tetraparesis due to birth anoxia, HIV and TB positive, whom we managed to send home to his family the day before I left for Italy. I think of all the mothers and their dances of elation when we finally said to her with a smile: “Mama, nyumbani”. And so in moments of despondency I take all these memories, hold them tightly to me and move on. And I remember that if I am now specialising in paediatrics, I owe it to them.