Over the summer I travelled to Trivandrum, India for a two week pre-medical placement with Global Medical Projects. I was eager to gain more hospital work experience and the opportunity to observe a foreign healthcare system really appealed to me.
Leading up to my trip I was very nervous and found the thought of travelling by myself to an unknown city, far from home rather daunting! However, there was so much support from Global Medical Project’s staff, particularly the coordinator Kevin Dynan. Any concerns I had were addressed and questions answered, ensuring that I was fully prepared for the adventure ahead.
Before I arrived in India, Babu the director who is based in Kerala had already received my CV and from this he organised all of the hospital placements for me, according to my interests. On arrival in Trivandrum airport, I was greeted by as friendly staff member who had arranged transport to take me to my accommodation. The Volunteers house is comfortable and well equipped, I enjoyed relaxing on the balcony in the evenings after placement.
In India I experienced a number of medical specialties. I spent most of my time in the NMS Mission Hospital where I shadowed consultants and nurses who were very accommodating, answering any questions I had and explaining patient illnesses.
The highlight of my work experience was the A&E department, where I developed great friendships with the staff, who were very passionate about their work. I witnessed some intense medical emergencies, including a Cardiac Arrest and an epileptic seizure. I loved learning how to take an ECG of a patient’s heart and to identify an abnormal rhythm caused by a myocardial infarction.
I also had the opportunity to volunteer at the Palliative Care Charity called Pallium. I got to join the medical team in their home visits of rurally placed patients who didn’t have access to a hospital. It was exciting travelling in the 4×4 jeep on narrow dirt tracks with stunning scenery of backwaters and coconut trees all around. We delivered essential medication, bandages and food to rurally isolated patients and it was so rewarding to see how grateful they were for our support. Many of the patients had type 2 Diabetes and it wasn’t uncommon to see amputations and diabetic bed sores. At the end of the day, the medical team treated me to some traditional indian snacks and coffee in a local Restaurant.
I volunteered in the leperosy clinic, helping post-surgery patients with muscle exercises. My wish to experience Genecology is India was also fulfilled. Not only did I get to shadow a senior gynaecologist but I also had the opportunity to see an emergency Cesarean Section and care for the premature babies in the Neonatal Ward.
At the weekends we had free time to travel. My favourite experience was visiting a region called Alleppey, which had some of the most beautiful backwaters in the world! The group hired a houseboat and we got a guided tour of the area, I didn’t stop taking photos as everywhere was so beautiful. We even got to stop off along the canal and buy fresh coconut milk from a local and take pictures with his pet Falcon! It was a great opportunity to get to know other volunteers and we really bonded with each other. If you like to experience weird and wonderful foods, then India is definitely the place for you! At the weekend we were spoilt for choice as where to eat dinner, and price wasn’t an issue as the average feast cost us about three pounds each! At the volunteers’ house, “Chef Babu” ensured we didn’t go hungry and made some really delicious meals for the volunteers coming home from placement. My favourite dish was Samba, served with an indian pancake called a Parotta.
In all, my trip to India was a once in a lifetime experience and I would encourage anyone interested in gaining work experience to take this unique opportunity to explore another healthcare system, an exciting new culture and make new friendships in the process.
My name is Emily Haines, and I have embarked on two unforgettable experiences in Africa. My life-long ambition is to become a doctor, and watching medical volunteers in Africa on BBC news TV channel one day motivated me to get in touch with Global Medical Projects to find out more. I was instantly hooked on the idea of embarking on an unforgettable lifetime experience in a Third world country! Although my trips took much planning in terms of finances and dates, it was certainly worthwhile. On my gap year prior to university, I took a month long trip for a medical and orphanage project in Ghana. Central Regional hospital in Cape Coast was where I spent the majority of my time, and it really opened up my eyes to the large differences between developing healthcare systems and the developed. In the evenings, I visited a small orphanage in the village of Ansapetu, where I met many children that were grateful for even a friendly face showing up at their door. It doesn’t stop there though! 2 years after reflecting on my time in Ghana, I could not wait to begin another project in another African setting, so I chose Tanzania. I was in Tanzania for 3 weeks, where I did another project, set in Meru District Hospital, and ‘Cradle of Love’ orphanage. People may think the two African projects I did were almost the same experiences, but I would definitely disagree. I came back from both experiences having learnt different practices, cultures and languages!
Flying to Ghana was the first time I had ever travelled abroad alone, which was I must admit, quite daunting to begin with. Going into the unknown I really did not know what to expect, but I remember the day I arrived in Ghana like it was yesterday. From meeting Eric, my host, at the airport in Accra, I immediately felt like I was in safe hands. Seeing the bustling capital city of Accra, I instantly had culture shock, but my fascination over-rode my initial worries. The 3 hour journey to Cape coast was an interesting one, seeing the poverty stricken people in mud huts without sufficient clothing on their backs, confirmed what I’d seen in the media was real. However, I also noticed the wealthier side of the area, no longer did I see mud huts but well- constructed houses made of brick. Following this journey to Cape coast town I had arrived at my accommodation in Abura, and Mary, Eric’s wife, and Ruth, the housekeeper, were there to greet me. I was overwhelmed with how friendly and helpful they were and our personalities clicked right away. I also met one of a few volunteers I would be staying with; she helped me settle in by giving me advice, one being a warning of the frequent power-cuts that occur in the house, which I definitely got used to! However, the house had a lot more to offer than I’d expected, there was internet access so I could contact my family easily and a warm shower! Having the weekend to settle in before beginning placement allowed me to take in my surroundings and immerse myself in the different culture. George, the house supervisor and guide took me around Cape Coast educating me about the tourist attractions, including the beaches, Cape Coast castle and local customs and religions, and this really helped me to bond with the locals and shop owners straight away! I was overwhelmed by the friendliness of the locals, greeting strangers in the street was indeed a novelty. I often heard the words ‘Obruni!’ called out to me by the children in the street, I was told it meant I was foreign to them and I would hear it often during my stay. Trying the wonderful African food for the first time was also a new experience; my adjustment to the spice was certainly comical for my host family!
As I began working in the hospital on the Monday, I was greeted by the matron of the hospital who asked me what areas of medicine I was interested in. After this I was allocated to the female medical ward for the first week. I asked doctors them what time they began their ward rounds each day, which was around 10 o’clock, and I soon realised that Ghanaians sense of time was very different to people’s in the UK, as it was different every day, there was no strict schedule. Whilst the doctors had not arrived yet I assisted the nurses with drug administration, dressing changes, and I probed them with questions. I learnt that Malaria was a common condition amongst the women on the ward; Ghanaians taking prevention medicine for it was rare as many could not afford this. Another ailment I observed was particularly prominent in the area was Anaemia, which highlighted to me the diet of many Ghanaians was insufficient in iron-rich food. As a result, I asked doctors if they could improve this by encouraging patients to eat a healthier diet. One thing that interested me was the treatment of Alzhemier’s disease; Ginko Giloba extract was used as a herbal medicine to prevent brain degeneration. Nurses told me of the healthcare system in Ghana, which meant that it isn’t free at the point of care like the NHS. People have to pay for their healthcare insurance, and in a number of cases I saw the distress of patients who could not afford to pay for treatments, they simply got turned away. As doctors arrived on the wards I observed their bedside manner, asked the doctors questions, and despite some language barriers between me and some patients I communicated with many. I was even lucky enough to mix in with the medical students on the wards and once in a class, where I got taught clinical skills and participated in question and answers sessions based on clinic consultations, this was challenging having only completed A levels, but I learnt a lot! The doctors could not have been more helpful and were extremely motivating whilst educating the students. The paediatric ward was a favourite of mine, and following ward rounds I joined the doctors in the clinic where I observed a wide range of various conditions. I noticed that Malnutrition was a serious issue amongst young people, many children had to be put on a treatment called ‘plumby nut’ to increase their nutrition and weight. There was an obvious lack of privacy and confidentiality during patient consultations, although patients had a completely laidback attitude about this which was surprising. In the surgical ward, I soon began to notice the limited resources present in Ghana, as many patients waited a long time to be admitted to surgery, since there was only one operating room in the hospital. One day I was able to directly treat school children’s wounds in a rural village, this was extremely gratifying and the children were even excited to receive a plaster! I felt I gained a broad insight into the healthcare in Africa in Cape Coast hospital, and one day when I qualify as a doctor, going back to treat patients would be even better.
Every day after 6 hours at the hospital, I would retreat home for a quick lunch break (watermelon!) and head off to Ansapetu, where the orphanage was located. This would involve getting a taxi straight from Abura which took around 15 minutes but was very cheap! The children were aged from around 2 to 18 years, which allowed me to interact with differing abilities and interests. James was the founder of the orphanage, who my financial contributions were directly going to. It was satisfying to know that the orphanage was receiving some financial help, as it was very basic, with an obvious air of limited resources. Helena was the other coordinator and she and James were extremely welcoming upon my arrival each day. I would create games with the children after school, such as ‘hide and seek’ with the girls, football with the boys, and I frequently helped the children with homework given to them from school. It was interesting to find out the various future aspirations of the children, and it was refreshing to see they had great ambitions despite being in a situation with money difficulties. I would often help Helena set out dinner for the children, this included fish and banku, this was an interesting food with a white, gooey consistency, which I tried and definitely approved of! Table manners were very strict, as eating only with your right hand and not with the left was the accepted etiquette. Praying before food was a regular occurrence, and I really enjoyed taking part in the children’s respect for god. I helped the children to wash the dishes each day following dinner, and another great opportunity to bond with them was knocking down oranges from the trees in the garden! Learning the children’s names was at first a challenge, but getting to know each child individually it became second nature. Going back to the orphanage to see the children would most definitely be something I am thinking about.
My time in Ghana did not only involve working hard, I also visited many tourist attractions on the weekends and relaxed in local volunteer hotspots in the evenings. There were about 5 of us volunteers coming and going at different time points, but we all managed to spend time with each-other outside of our busy schedules. Going out and meeting new people was a regular Friday night event, Oasis bar was always a great place for ‘westerners’ and the locals to mix, I met many people from Canada, Australia, and other European countries! Going out for food was always a way us volunteers treated ourselves, and some of us missed the odd plate of western food; ‘The castle’ restaurant was a personal favourite of mine! On weekends, I would always think of buying some souvenirs from the local markets. I came back with wooden masks, printed bags and jewellery. One weekend we visited Kakum national park, this involved walking through the forest with a tour guide and over an arial walkway over the canopy of the trees, which I would recommend if you want to conquer a fear of heights! Hans cottage was another place I visited, this was a hotel that overlooked a small lake with crocodiles here, me and the other volunteers had the chance to watch them being fed, and I even had a photo sitting with one! I visited a couple of beach resorts to indulge and swim in the sea; Coconut Grove and Anomabo beach resorts had wonderful staff service and although food prices were higher than what you would get in central cape coast, they were still pretty cheap! One of my favourite attractions was Elimina Castle, where I learnt a bit of African history and the slave trade. Learning the bongo drums each week was an exciting new activity, yet it was harder than it looked! I also went along with Mary to a Christian church service on a Sunday, people’s energetic attitudes and singing during church was inspirational. I will never forget the experience of going solo to Ghana, it was not what I expected but even better, I most definitely recommend it!
Many people combine time at the hospital with time at the orphanage and this combination often works well. Combined placements are only £100 – $160 – €120 extra to cover the additional donation to the orphanage.
My name is Jack and I’m a 2nd year BSc biomedical science student preparing for postgraduate entry into medicine. Of the many choices that Global Medical Projects offer – I chose to take the 2-week volunteer project away in the small village of Meru, Tanzania.
The arrival
After the longest flight I’ve ever taken, I was thankful that the time difference in Tanzania isn’t too different to that in the UK! (2 hours ahead). Kilimanjaro airport is a small airport but nonetheless – landing in a country halfway across the world can be daunting! Thankfully, due to the planning of GMP, it was organized for us (I was with my friend Luke) to meet GMP’s Tanzanian contact -Elias and our host who we would be staying with – Zablon.
The trip to Zablon’s house in Usa river (pronounced oosa – we were calling it the USA river!) took some time but it passed quickly as Zablon was cheerfully explaining the names of all the mountains and why they were named that way. Zablon then went on to explain how he had just got married and was excited for us to meet his new wife Pretty!
Upon arriving at Zablon’s (and Pretty’s) house on the Friday, Elias took our passports and photos to go and get our work visas sorted for the following week – leaving the weekend for us to settle in.
Settling in
Zablon and Pretty were fantastic hosts and cooked us meals every night. I wont ruin the experience for you by telling you what they made us, but I will say that we tried some of the traditional Tanzanian dishes and they were delicious!
It wasn’t long before I was given the title of Mr. Bean as I couldn’t stop making our hosts laugh – part of this was because my Swahili was pretty awful and I often mispronounced words so that they started meaning very different things to what I was trying to say!
Zablon and Pretty are two of the most happy and kind people I have ever met. Zablon is an examiner for trainee teachers and pretty is a teacher at the local school in Usa near the house. Zablon and Pretty met when Pretty was training to be a teacher and Zablon was assessing her – before long they fell in love and got married. Luke and I had the privilege of watching their wedding video (which they were very proud of).
First weekend
During the first weekend, Luke and I decided to rest for half of it to get over our lack of sleep on the flight, and then visit the market in Usa River. Zablon came with us to show us around and find our feet. He also showed us where we would be taking the Dala Dala (the public transport) to the Meru district hospital on the Monday. From this point onwards we could find our way round Usa relatively well.
Luke and I discovered that Mango juice is relatively cheap and tastes delicious but the chocolate was really expensive!
The Hospital Experience
Luke and I were given the choice of whatever department we wanted to work in. We aimed to cover most of the hospital’s departments (there weren’t many) within the 2 weeks we were there.
To begin with, Luke was placed in the Male ward and I was placed in the female ward. My first impression was that compared to the hospitals in the UK, the facilities (as expected) were very limited. Privacy was a luxury and had to be paid for, ward rounds and scheduled times were rarely stuck to and everyone there had a serious problem (you generally wouldn’t find a local going into hospital unless it was of great importance).
Here are some of the things I saw in the female ward:
• Anaemia due to immunocompromisation – given antiretrovirals
• Secondary criminal abortion attempt – resulting in infection – Amoxicillin given
• Cervical cancer – X-ray confirmed metastasis of cancer – referred to palliative care
• Possible ectopic pregnancy – patient was 37 and had 6 children – refused pregnancy test
• Child with a broken femur – plaster casts are not available so the leg was immobilized and suspended
• PVB – with denial of being pregnant despite urine test proving +ve
• Diabetic patient with very high blood sugar
• 91 year old patient with hypertension
• A woman with a diabetic foot which was amputated – unfortunately this lead to impaired lymphatic drainage and she got generalized bodily swelling – she also had liver cirrhosis
• Psychiatric patient who had to be sedated several times but still wouldn’t stop shouting – referred to psychiatric nurse
• Patient with dysentery
Interesting note – many women get pregnant in Tanzania due to incorrect use of the contraceptive pill. They take it just before or during the act – hence they often get pregnant.
After the female ward, I made my way into major surgery and was shocked to see that they were performing surgery with the window open!
Some of the things I saw in Major surgery:
• C-section – patient given a similar injection to an epidural – the uterus was pulled out of the body to be sutured! The baby had to be removed by C-section as it was obliquely oriented and was pressing on the aorta causing hypertensive crisis
• Total Hysterectomy – this had to be done as the patient had over 7+ uterine myomas! The uterus weighed 2.5kg and was 22cm wide!
Paediatrics was next after major surgery:
• Severe pneumonia – fluid in lungs – unable to feed – antibiotics given
• Bronchiolitis – viral infection
• Trauma above ear and Vitamin K deficiency
• Immunocompromised child – exposed to mother with HIV (placental HIV) – given antiretrovirals
• Severe burns – 50% of torso! Given ketamine to relieve pain and rehydrated – also antibiotics as a preventative measure
• Child that had drunk kerosene due to it being put in a soft drink bottle (apparently a common thing to happen in Tanzania!) – caused pneumonia
After Paediatrics I decided to spend the afternoon in Minor surgery – having said this – some of what was thought as minor surgery there could be deemed as major surgery in the UK! (I have only put in what I think are the minor ones):
• Circumcision under no anaethetic – baby was starved before surgery and then breast fed to stop crying
• Plaster removal
After Minor surgery it was the male ward:
• Spinal TB with bed sores – Anti TB drugs and dressing/rotation for bed sores (Potts disease)
• Distal 1/3 of clavicle fracture – head of humerus dislocated – caused by car accident
• Hepatic Encephalopathy – suspected Hepatitis B
• Lacerated head and swollen right eye – head x-ray taken – from car accident
• Chronic asthmatic
• Swollen leg – Elephantitis – lymphatic obstruction
• Stroke with hemiplegia
I then went on to spend a few days at the C.T.C (Care Treatment Centre) for those with HIV with Luke. We learned that the C.T.C mostly consisted of treatment counseling and that villagers were recruited and trained in special HIV treatment schools to care for their own at home. The HIV clinic/CTC was there to ensure that HIV wasn’t spread between patients. We were told that anaemia was a common side effect of antiretrovirals. We also learnt that all HIV +ve patients were given a form confirming their condition and all the drugs they are taking
I also managed to visit radiotherapy, the maternity wards and the outpatient’s clinic, but I don’t want to ruin all the experience for you so I will only say that you need to visit them yourself! The one area of the hospital that Luke and I didn’t manage to visit was the TB clinic – this was due to the risk of us catching TB!
Donations (coats, books etc.)
By the end of our hospital visit, Luke and I thought we would donate our white lab coats, a few of our medical books and some antibacterial hand wash (all of which is hard to come by in the hospital!)
The school (Pretty)
Before we left Zablon and Pretty, Pretty gave us the opportunity to sit in on a friend of hers class. Somewhat fittingly, they were learning about first aid! Luke and I explained some of what we had learned about treating burns to the class as the teacher translated – the class then asked us questions.
Conclusion
Tanzania is an amazing place and the sheer quantity of things you can do there is practically limitless! Luke and I thought we would take advantage of the fact we were so close to the Serengeti and after our final week working at the hospital we went on a safari.
Why this project was good and why I recommend it
This project will open your eyes to what all those charity programs are trying to raise money for! You will experience what its like to be a Doctor in Tanzania and see what its like to be a patient there too. You will see what limited resources the hospital has and what they do the try and get round their limitations. You will have hands on experiences with patients and apply some of the things you’ve learnt in the past. You can’t get a purer project than this when it comes to the basics of medicine!
On top of this you have the opportunity to get to know the community at Usa River and perhaps even go on a safari like Luke and I did.
I’d like to thank all those who helped me pay for this life changing trip, those who helped me organize it (Kevin Dynan in the UK and Elias in Tanzania) and of course the wonderful Zablon and Pretty, whom without them – I would have not left the country feeling nearly as cultured and satisfied as I did.
My name is Emily Haines, and I have embarked on two unforgettable experiences in Africa. My life-long ambition is to become a doctor, and watching medical volunteers in Africa on BBC news TV channel one day motivated me to get in touch with Global Medical Projects to find out more. I was instantly hooked on the idea of embarking on an unforgettable lifetime experience in a Third world country! Although my trips took much planning in terms of finances and dates, it was certainly worthwhile. On my gap year prior to university, I took a month long trip for a medical and orphanage project in Ghana. Central Regional hospital in Cape Coast was where I spent the majority of my time, and it really opened up my eyes to the large differences between developing healthcare systems and the developed. Two years after reflecting on my time in Ghana, I could not wait to begin another project in another African setting, so I chose Tanzania. I was in Tanzania for 3 weeks, where I did another project, set in Meru District Hospital, and ‘Cradle of Love’ orphanage. People may think the two African projects I did were almost the same experiences, but I would definitely disagree. I came back from both experiences having learnt different practices, cultures and languages!
You can read about Emily’s medical and orphanage project in Ghana here. My 3 weeks in Tanzania was certainly another eye-opening experience, which I completed this summer before my final year of my Pharmacology degree. As the plane touched down in Kilimanjaro international airport, seeing the peak of Mount Kilimanjaro was absolutely breath-taking. By this point, I was eager to meet my host family. Arriving in Usa River, the children in the street were already greeting me and I knew I was going to settle in well. Pretty and Zablon, a couple who were hosting me made me feel at home right away, Zablon told me and the other volunteers about his sugar cane growing in the front garden, which was delicious! One thing different from Ghana was the cold shower and a hole in the ground for a toilet, which wasn’t such a bad thing as I may have expected. The food I was given by the lovely house maid, Neema, were in such generous portions, and I found myself eating a lot of rice, chicken and avocado! Chips mayai- a chip omelette was definitely a popular option with 4 of us volunteers staying in Zablon and Pretty’s house. Being called part of their family throughout the weeks was a great feeling and frequently watching the world cup with them during dinner time was always a good laugh! Sometimes we joined our host family and their friends in choir practice, I was overwhelmed by the amazing voices I heard, and it was great fun. Pretty also showed me and the other volunteers her and Zablon’s wedding photos and told us stories of how they met, I was very interested to hear about the culture of relationships in Tanzania.
For my medical placement in Meru District Hospital in Tengeru, I was told to catch the Dala Dala bus with the other volunteers, which was an interesting; sitting close to Tanzanians was a great way to meet the locals! A journey from Usa River to Meru hospital cost only about 300 Tanzanian shillings, this was about 10 pence, so very cheap. I had some expectations of what the hospital may be like since previously working in Ghana, but it was different in some ways. It was a lot smaller and underprivileged than Cape Coast hospital. There were also some problems I noticed such as dangers in transporting the female patients from the maternity ward to surgery for their Caesarean sections, but building a safe walkway was funded by an American charity. Throughout my medical project, I visited the male ward and encountered various conditions, with HIV/AIDS being the number one disease in terms of occurrence. From speaking to the nurses I picked up a lot of medical terms in the native language- Swahili. This helped me to understand medical notes to find out what patients had and what treatments they were on. The follow up of a malnourished, heart failure patient with a doctor and medical student is one that will stick in my mind- devising a treatment plan using our combined knowledge, really gave me a chance to learn some clinical skills with a patient-based approach. Another patient that stays with me was a victim of a motor cycle accident with major brain injury; his affected memory meant it was impossible to contact his family and he could not afford an MRI scan, which was a serious problem that we aimed to tackle. Using a clinical handbook and the BNF as a prescribing guide, me and the other volunteers formed a strong relationship with the doctors; they taught us the practice of medicine and we discussed best treatments for patients.
Diabetes was a common ailment in the area; a diabetic clinic was held twice a week and I could see some issues related to patient compliance, on being leg amputations from necrosis as a result. I resorted to suggesting to the matron maybe creating some simple posters to educate patients regarding their condition. Observing the cervical screening procedure was intriguing, the methods employed by using acetic acid to detect cancer cells were as a result of limited resources. Seeing women getting diagnosed with a HIV rapid test was very sad and overwhelming for the patients, but the doctor’s approach was very empathetic and thorough in investigating reasons. Visiting major surgery was an exciting opportunity, I was lucky enough to observe a C- section, and the intricacy required to stitch the incision back up was amazing. I spent the majority of my time in minor surgery, what me and the other volunteers called ‘minor ops’. Here I had the chance to treat patient wounds, such as stitching and bandaging. I also carried out emergency treatments, fracture diagnoses and castings. Children were given ketamine as a general anaesthetic, showing some treatment limitations. The different causes of people’s wounds was nothing I had seen before, severe wounds from gang fights, dog bites and farming equipment were some I encountered. Working in the hospital pharmacy was a completely different experience to my summer part-time job as a dispenser in the UK. There was a shortage of staff so I had to give patients advice and their medications in the absence of the pharmacist. There was also lack of drugs which was a problem for patients as it delayed many of them receiving antibiotics from hospital acquired infections. However, despite the lack of resources, many of staff in Meru had a persistent, caring attitude with patients, which was very admirable. In my last week, I was lucky enough to learn about Meru and it being a government-run hospital. An anthropologist from the US spoke to me about funding for her project to improve the hospital infrastructure, which was a common issue there. This motivated me to donate some money to the project, to improve the safety of the hospital buildings. There are many experiences in the hospital I had that will be hard to forget, and I truly appreciate the willingness of the doctors in the hospital to teach a complete stranger like me. Applying my knowledge on different treatments in the hospital, I really felt I made a contribution to the healthcare, and because of the lack of drugs in the hospital, educating the nurses and doctors of ones they did not know of, I was giving something back to them, which was especially fulfilling.
I always looked forward to volunteering at ‘Cradle of Love’ Orphanage every day from 2 til 5pm. I would catch a Dala Dala from Tengeru to Usa River, and walk 5 minutes to the orphanage. One thing I did not expect when I arrived was the security of the orphanage; there were iron gates with a security guard outside, which were certainly reassuring for the owner! Being introduced to the toddlers and babies was an exciting experience and I had never looked after children at such a young age! I was told some of the children in the orphanage were abandoned or some parents could not afford to keep their babies, the latter made me realise many of the parents put their children in Cradle for good reasons. Some children had HIV infection and one had rickets, but the dedicated attitude of the nannies provided the best care for them. Usually when I arrived the toddlers and ‘wobblers’ would have woken up from their afternoon naptime, when they were full of energy to say the least! The babies loved attention from all the volunteers there, and this made me feel I was making a difference. Playing in the garden was a favourite activity for the children; this was obvious from their immediate excitement when we got out the shoebox to put on their shoes! One thing I did find challenging whilst working in the orphanage was dividing my attention to the different children, and many wanted a turn on the swing-set at the same time. But there were other activities for the children to do, such as playing on the slides or with the toys inside the home. Once I had the chance to change a little boy’s nappy, which to be honest, I had never even done before! Throughout my time at the orphanage, I got to know the children’s personalities very well and so I knew what they did and didn’t like, which was essential to make their day a happy one. Seeing the children laughing from a small game of ‘chase’, I noticed even in a place with little resource the children could enjoy themselves. Dinnertime each day was very eventful. With the other volunteers, I would assemble the table and chairs for the toddlers to sit at a small table together. Some days if the children were in a mischievous mood they wouldn’t want to sit down but make me catch them first! This was initially difficult, but through learning each child’s preferences and from gaining their trust, it became a lot easier. The words ‘Jakula’ meaning ‘food’ in Swahili was always a trigger for their excitement! Being at Cradle of Love, I realised that giving some attention and loving communication to the children was definitely a way to brighten up both mine and their day.
But again, my time in Tanzania was filled with many fun activities outside of working! Once a week, Joshua, our Tanzanian Volunteer coordinator gave me and other volunteers I lived near Swahili lessons, which was a great help in terms of constructing sentences to speak to the locals, and even the patients in the hospital. Learning some basic greetings such as ‘Habari’, ‘Shikamoo’ and ‘Jumbo’ were different ways to greet different ages of people. We were also taught the names of different foods such as Orange being ‘Chungwa’, making it a lot easier when buying food in the markets! I visited a few Safaris, which were a highlight of the trip! The first weekend I visited Arusha national park, where I managed to see a lot of monkeys and even giraffes in the distance! Previously hearing about safaris and seeing them were completely different; Tarangire and the Ngorongoro crater were so beautiful it felt surreal, and seeing the elephants, zebras and lions was my favourite part. At this time, from staying at a campsite in Africa, I got a real feel of the African night-time air. Visiting a snake farm, I learnt about a wide range of the different species and some, about their lethal abilities. I even held a snake for the first time. Moshi hot springs was very enjoyable for me, despite the bumpy journey to get there! Swinging off a rope to fall into the warm waters was exhilarating, and if I stayed still, I could feel the fish nibbling my feet, I couldn’t complain about a free pedicure! A regular activity was visiting the local bar in Usa River and making friends with some locals, after this a group of us volunteers and some locals went onto Via Via, a club in the central town of Arusha. A mix of western and African music created an amazing laidback atmosphere, and was the perfect chance to meet other volunteers from all over the world. I will never forget our driver, Peter, who gave me advice on where to go and took us volunteers to places at a discounted price compared to taxis, and despite a small language barrier between us, I considered him a close friend. My experiences in Tanzania were unforgettable, and not only did I feel myself develop as a person, but I made some life-long friends that I hope to see again one day. Staying with Zablon and Pretty were most definitely the best hosts you could ask for. I have a parting gift from them that reads ‘Karibu’, meaning ‘Welcome’ and I think of this as a symbol for them welcoming me back there some day. They taught me that people coming from two completely different parts of the world can be as close as a family.
I definitely recommend taking a trip to Ghana or Tanzania, these were both life-changing experiences that really put aspects of life into perspective. I have definitely grown as a person as a result of these trips, and I will forever cherish my memories and the many things I have learnt. I chose Global Medical Projects because they really do care about you making the most of your experiences. Throughout my stays in Ghana and Tanzania I felt a great sense of security with Global Medical Projects, despite being in a foreign area. I’d like to thank Kevin Dynan for giving me so much advice prior to my journeys and for making the application process a smooth one. I also thank Eric and Mary Essuah, who were fantastic in ensuring my stay in Ghana was safe, organised and enjoyable. Zablon and Pretty Mgonja were two amazing people who made sure I made the most of my stay Tanzania, which I am very grateful for.
Many people combine time at the hospital with time at the orphanage and this combination often works well. Combined placements are only £100 – $160 – €120 extra to cover the additional donation to the orphanage.
My name is Dan Hazelton, a second year Biomedical Science student, and I spent three weeks on a combined medical and volunteering project in Meru Hospital and Cradle of Love orphanage in Tanzania. Both were located in Meru, a small area in the shadow of Mt. Meru, to the west of its ‘older brother’, Mt. Kilimanjaro. My girlfriend and I stayed with a family in the small village of Usa River, which slowly became our home over the coming weeks.
On the first day, after 16 hours of grueling travelling through three countries, I arrived at Kilimanjaro airport, in dire need of the weekend to recover. However, a fellow volunteer had other ideas, and I ended up at Arusha National Park the following day, a thoroughly enjoyable trip, even if I was asleep for half of it! After being collected from the airport by Charles, a local taxi driver who we would see many more times around Usa River throughout our trip, we made our way to the Mgonja household in Usa River. We were met there by two of the loveliest people I have had the fortune to meet- Zablon and Pretty. Pretty was pregnant while I was visiting, and I hope to go back soon to meet the latest member of the family! Throughout the first weekend, I noticed the stark contrasts between daily life in a country such as this and what I was used to back in the UK. However, the close knit community feeling was apparent from the beginning; from the way everyone greeted each other as they passed, to how well Zablon and Pretty knew their neighbours from all over Usa River!
My combined project saw me visit the hospital in the morning each day, after which I would make my way to the orphanage for the afternoon- a long but fulfilling day! At the beginning of my first week, Joshua Kuboja, the local coordinator, introduced us to the Dala dala. I had heard about transport such as this prior to leaving, but to experience it is another thing entirely. Although a full dala dala could be quite cramped, I loved how regular they were, so much so that I rarely saw the Usa River dala dala stop without one! Using one to reach the hospital, I began my first day by meeting the matron, who was very friendly, and quite evidently wanted to improve the hospital by asking for our feedback at the end of the trip. She proceeded to give the other volunteers and I a tour of the various wards, including paediatrics, female, male, minor and major surgery, outpatients, and family planning. I immediately noticed that the wards were allocated based on necessity; the most common diseases had their own wards, such as Diabetic clinic or the TB ward. I realised that this was a consequence of the general lack of resources in the country; the hospital treated the majority first, then allocating resources to other areas when they become available, the most sensible approach.
I visited every ward, but spent most of my time in Minor Surgery, as I loved the hands on aspect there. The doctor on duty, or a medical student on her elective, would always be happy to teach me basic procedures, such as wound dressing removal/changing, plaster cast application/removal, and stitch removal, and help me complete them myself. In addition, being ‘in the thick of it’ allowed me to apply knowledge that I had already learnt, and to build upon it. For instance, I changed the dressings of a patient nicknamed ‘Babu’ (Swahili for grandfather), then watched as a final year medical student advised the doctor to change his antibiotics, as it was evident from the state of his wound that his infection was resistant.
Viewing major surgery was another major highlight for me; seeing my first caesarian section was exhilarating, the baby’s first cries were wonderful to hear, as a new life was brought into the world. Again, differences between here and the UK were on show, with some aspects such as equipment and drugs used completely different to those used in the UK. For instance, I was initially surprised to see ketamine used as a local anesthetic, but was quickly informed that the one in use here was the non-recreational type. I also saw a vaginal cyst removal during my time in Major ops, and was impressed with the speed and precision with which the doctors completed the procedure.
After spending the majority of the first week in Major ops, the following weekend was a bank holiday (lucky!), so we decided to go to Arusha for the weekend. Taking the dala dala further than I had previously, as the hospital was at the halfway point in a village called Tengeru, was a bit daunting but not a problem at all in the end. Once in Arusha, I realised just how large a city it was- a sprawling, chaotic, but ultimately amazing, concentration of people from all over the world, with buildings that all looked different. You could literally have bought anything in Arusha; shops selling motorcycle parts sat next to diners, which were situated opposite souvenir stores. Over the weekend, we visited the Maasai market for some haggling and buying of souvenirs, and Meserani Snake Park just outside the town for some reptile viewing and interaction. A very enjoyable weekend indeed.
The following week, I began work in the Male ward, and moved between the other wards as the week progressed. Viewing and assisting in wards rounds allowed me to monitor progress of patients over time, and see the journey that a patient took through it- from outpatients, through the wards, and into minor or major surgery if necessary. Outpatients was particularly interesting; the sheer breadth of diseases on show was astonishing, with many eradicated or far less common in the UK, such as HIV, TB, and Hepatitis B. Doctors used preliminary tests for the these diseases, and allowed me to test patients myself in due time. Often, diseases such as diabetes that are prevalent in the UK had progressed further than I had ever seen- a man came in with an amputated foot due to gangrene. I found out that progression of diseases such as these were often due to poor compliance and nutrition, a situation common in the country. My time in outpatients was topped by fulfillment of a small childhood wish- to learn how to use a stethoscope. I always remember having one when I was young, and am grateful that I finally got the chance to use a real one!
Overall, my work experience in the hospital was a truly amazing experience, both teaching me a great deal about all aspects of medicine and healthcare, whilst allowing me to grow as a person in confidence, making some great friends and, ultimately, helping people. However, as you would expect, there were several areas of possible improvement within the hospital, some with fairly simple solutions, others with more deep rooted causes. Therefore, in my feedback, I tried to target only the problems that could be easily solved, to try to make an impact during my short time at the hospital. Also, some doctors were less approachable and less willing to share their knowledge that, although it was initially more difficult to learn at times, it taught me to use my initiative more- a surprising silver lining in the situation.
In addition to the hospital, I visited a local orphanage in the afternoons, which offered a different experience entirely. Cradle of Love, an orphanage halfway between the hospital and Usa River, was fairly well funded, with good facilities and plenty of staff and volunteers, which surprised me initially, as I was expecting a far more degraded infrastructure. After visiting a far less privileged orphanage later on the trip, I realised that the children at Cradle were lucky to be here, but no less deprived of the most innate human craving- attention and care. Over the next three weeks, I cared for children from babies to around age 3, playing with them and assisting feeding. I had worked with children before in the UK, but not this young, and was surprised in many ways. The children were split into four groups depending on walking ability (and age): babies, crawlers, wobblers, and toddlers. I spent most time with the wobblers and toddlers, as I enjoyed the more hands on and busier style with the older kids. Full of energy and very clingy as children of that age are, I proceeded to build such strong relationships with some kids that I didn’t want to leave at the end of each day! I can honestly say that there are not many better feelings than giving attention to children that are so obviously deprived of care, and not many worse feelings than leaving at the end! Unfortunately, some of the kids weren’t used to men at all, and proceeded to cry whenever I went near them, which was the opposite of what I intended! Ultimately, although I know the kids won’t remember me, I will always treasure the time I had with them, as they brought out my inner child, and made me realise how lucky I am to have parents.
On another note, before I began to research Tanzania as a country, I didn’t realise how rich it is- not in monetary terms, but in culture, in natural wonders, and in surprises. Unfortunately, I could not visit the Serengeti, or climb Kilimanjaro, or stay on Zanzibar, but I plan to do all these things when I go back, as I have heard amazing things about them. In fact, I wouldn’t have been able to do all those things in the time that I had even if I tried! Instead, I went on safari to Tarangire and Ngorogoro National Parks, and can honestly say it was unbelievable. The pictures don’t do it justice; you must visit yourself!
In the evenings, the volunteers and I would have Swahili lessons, taught by Joshua, which offered a glimpse of the culture of Tanzania. I enjoyed learning the language, as it was surprisingly easy to learn once you knew the basics. It also helped no end in the hospital, as I was soon able to pick up bits and pieces from the conversations between doctors and patients, making the experience easier and more satisfying.
One day, I wish to go back to Tanzania and stay with Zablon and Pretty (and hopefully their son/daughter!), but I’m so glad that I chose to organize my first visit through Global Medical Projects, as it offered safety and security that I would have struggled to find myself. Therefore, I’d like to thank Kevin Dynan and Joshua Kuboja for their help, as I could not have had this wonderful experience without them. Also, I’d like to thank Zablon and Pretty, who were the perfect family to live with; friendly, kind, and welcoming, I can’t thank them enough for putting up with me for three weeks! Also, the friends I made out there will stay with me forever- the staff at my places of work, and the volunteers that I spent my time with, they all contributed to my amazing experience.
In conclusion, I’d definitely recommend the combined project that I chose, as it provided two different aspects of Tanzanian society, offering a more comprehensive view than I would imagine a single project does. It was a wonderful life experience, and one that will stay with me for life, but is also very useful to those prospective medical students, as it taught me a great deal about the profession, its successes and difficulties, and helped me grow as a person.
Many people combine time at the hospital with time at the orphanage and this combination often works well. Combined placements are only £100 – $160 – €120 extra to cover the additional donation to the orphanage.
My name is Chris and I spent one month volunteering on a medical project elective in the village of Meru,Tanzania. During my time in Africa, I worked in many different departments at Meru District Hospital, but I enjoyed my experiences in the ER and major surgery theater the most. Meru District Hospital was situated near the heart of third world Kilimanjaro, Tanzania, an area impoverished with limited resources in many aspects of health care, whether it be the medicine distributed, sterilization supplies, or the way the public was educated on healthcare. In an area where health insurance didn’t exist, people of all shapes and sizes would crowd the emergency room daily with many different health concerns. It was during this month I learned exactly what it would take to work as a medical doctor in an area of unwarranted variation.
When I arrived in Africa after a day and a half of flying halfway across the globe, I was exhausted. If I didn’t have the weekend to rest, I’m not sure if I would have been ready to work that first Monday. It was during the weekend though that I was able to embrace a bit of the Africa feel. One aspect I really appreciated right away was the community bond I felt between all members of the village I stayed in, Usa River. As I drove on the main road to get to the village from the airport, my host family Zablon and Pretty Mgonja explained how thick the soil was throughout the Kilimanjaro area, and as a result it was extremely dry and clean water was often a major issue. Right away I realized that it was these little things that would begin to make an impact on me throughout my trip.
As my first week at the hospital began, I was introduced to the Dala Dala, a public transport van that would travel from village to village to take me to work. At the hospital, I was greeted by the hospital matron and after reviewing my resume, the matron requested I deliver a presentation on immunology to the entire hospital. Before the matron gave me permission to begin my work, she showed me every department within the hospital. As we walked along the district hospital I saw how every department resembled a piece of a puzzle; it was like the hospital was a village in itself. Some of the departments included pediatrics, major and minor surgery (ER), female and male ward, AIDS ward, and even a TB ward. The matron permitted access to every department, but because of my passion to become a surgeon, I immediately dove right into work at the ER department. When I began my work, the staff treated me very much like a medical student; the nurses and doctors were so
welcoming and eager for me to learn and practice new skills. At first, much of the staff was very instructive, teaching me the basics of suturing and injecting needles, but by the end of the first week there was nothing or nobody to hold me back, I was caring for dozens of patients all on my own every day..it almost felt too good to be true.
As my time in Africa grew, I was finding myself more and more involved in the ER and surgery department, so much that even ethical issues in medicine were starting to surface amidst my experiences. One of the most startling issues was that many of my patients were young females who had given themselves abortions. Because abortions were illegal in Tanzania, young women would often damage their bodies by giving themselves an abortion; it was my duty to make sure to clean out the reproductive tract and make sure the woman would not have any further health issues down the road. These kind of situations made me aware of how politics and social situations can influence certain factors in healthcare and it made me understand how my only view was simply to help a person in any way that I could. My time in the ER helped me deal with injections, POP casts from broken limbs, auscultations, catheters, stabbings and wound cleaning, seizures, gunshots, and even motor vehicle accidents. I was getting so involved and with the amount of trust and responsibility that was bestowed upon me, it just felt right to keep going. Sometimes I would clean out an infection, whether on an infant or an elderly man, I knew how bad it would hurt to make that incision to flush out the abscess, so I would sometimes just let the patient hold onto me and squeeze my arm whenever it would hurt them just so I could hurt a little bit too and feel their pain. In my mind It was all definitely a case of learning fast, being confident, and embracing any challenge with a grain of salt, but I wanted all of that so bad…I wanted to keep learning; It was like I had something to prove. The ER shaped me the most out of all the departments, but it was being able to assist with both suturing during a cesarean and hernia surgery in the major surgery department that really made my experiences most memorable.
Easily the best thing about working at the Meru District Hospital came in my last week of work. Of all the time I spent working, I felt the most experienced in my last week, and as a result the matron and staff allowed me to do rounds in the male and female ward. I would show up to work and begin my rounds around 8am and would finish up by 11am. Some of my cases included stroke, malaria, and AIDS patients. I remember sometimes being amazed at how different such cases were than the standard patient one might see at a hospital back in the US. I took each patient as a lesson, spending time with them, analyzing their treatment regimen, and making sure their condition was on its way to being stable. I must have looked like such an alien to some of those people, but that never stopped me from giving them my best care. My most memorable moment though was when I had the opportunity to deliver a baby in the female ward. It was perhaps the most exhilarating moment in my life, being able to take charge in such a situation. It felt completely natural. I look back on my achievements and realize that I would not have been able to do some of these things in the US. These are some of the moments that I will remember for a long, long time.
On my last day at the hospital, the entire hospital staff showed up to listen to my presentation. During my placement I truly felt that infectious diseases and unwarranted variation prohibited many of the people from being healthy, so I decided to base my presentation on the basics of innate and acquired immunity.The entire presentation lasted about 45 minutes, followed by a series of questions asked by several staff members. Near the end of my presentation, some of the doctors and head staff members made me feel humbled by acknowledging all the work I did in the last month at their hospital. As I write this 3 months since I returned from my trip, some of the faces still stick with me. These people really gave up their time to teach a stranger. Of all the feelings I felt during this trip, I realized that there really are a lot of good people in the world, you just have to carry an open heart. I found that ultimately if you truly pour your heart into what you believe in, even if it makes you vulnerable, amazing things can and will happen.
Even though the application process and the gruelling flight hours may have seemed like a challenge at first, going through this experience with Global Medical Projects helped me to meet some really amazing people that I consider a part of my family now. When you share the same meals, experiences, and a roof under your head with people who are there to take care of you, you establish this connection that can truly last a lifetime if you let it. At first I was a bit concerned being the only volunteer to stay with my host family, but both were fantastic in meeting any of my needs/requests, including picking me up from the airport, assisting me with my bus fare to work when I needed it, and even helping me plan an excursion to the island of Zanzibar for a weekend trip. Perhaps the thing I valued the most that they showed me was an orphanage down the road from where I was staying called “Good Hope.” After visiting the orphanage 2 weeks into my stay, I told myself that I would visit the kids everyday after work no matter what. Seeing those smiling faces really made the trip worth it, and because of the orphanage I made a promise to myself that I would go back to Usa River once my journey to becoming a doctor is complete.
Like Chris, you can combine the medical project with time in the orphanage. This is only an additional £100 / $160 / 120€. Read more about the orphanage projects here
I assume you can organize your own placement directly with Meru hospital if you wanted to, but I would strongly recommend going through a company such as Global Medical Projects the first time around, as this provides you with the safety and security which, in my opinion, truly matters when you may seem like a complete stranger to the country and it is easy to stand out. I am truly grateful for all that the staff at Meru District Hospital went through to teach me how to be a better medical professional and I am forever humbled to be so warmly welcomed by the entire village of Usa River during my placement. When I arrived to Usa River, I remember going to the village church on my second day and feeling like a stranger completely lost in the culture, but as I think back on my journey, I think of Usa River and Tanzania on a whole as a hidden place, tucked safely away from the world, concealed by the high walls of the Meru and Kilimanjaro mountains. It all almost felt like being in a place rich with strange beauty, like being in a dream. I would like to further extend a thank you to my family and friends for supporting me through my journey, the staff at the Commonwealth Medical College for inspiring me to strive past any limit, and to Kevin Dynan of Global Medical Projects for helping me through the entire application process. All of these amazing people have helped me grow in ways unimaginable, but my warmest gratitude goes out to the Mgonja family in Usa River, Zablon and Pretty – for teaching me that you don’t have to be blood related to be a part of a family, I promise to hold onto that bond no matter where my experiences may take me.
With a sweaty hand, I nervously clutched my backpack and stepped foot out of the plane. I took a deep breath as I admired the warm, yet quiet evening in Mexico. There were no other planes at the airport and the sun had just set. In the distance, I could see the soft-glow of the airport lights surround me as I patiently waited for the shuttle to bring me to the nearby terminal. Who would be picking me up? I know someone is coming, but I don’t speak that good of Spanish. I hope they can speak a little bit of English. I was nervous and so many questions flooded my mind, but it was now. Now, was the time for me to step out my comfort zone. I had just flown out of the United States for the first time in my life and my volunteer journey with Global Medical Projects was about to begin.
For the past two years, I have worked as a paramedic in the United States. Although I love my job as a paramedic, I had always had a desire to provide care in an underserved area outside of the United States. By volunteering abroad, I was hoping I would gain invaluable knowledge by experiencing another culture, learning about other health care systems, and by being exposed to different medical differentials and techniques. Little did I know that as I nervously stepped out of the plane that evening, I would be fulfilling all of those desires by the end of my trip.
After being picked up that evening by Alberto, one of the volunteer coordinators for Global Medical Projects (and yes, he spoke English very well), I was taken to my “families” house. Prior to arrival, I knew I was going to be assigned to live with a family in Guadalajara and that the family would be providing me with 3 meals a day as well as a clean, safe living quarters. The coordination with getting to Mexico was effortless. Kevin, the program director based out of the United Kingdom, was very quick at responding to calls/emails and kept me informed with any changes in living arrangements, assignments, and with answering any questions/concerns that I had.
When I first arrived at the house, I immediately felt at ease. Since I had a late arrival that evening, the family had just finished eating and had been expecting my arrival. They were overjoyed to meet me and welcomed me right away to eat some of the meal they had just finished. The father of the family spoke a little bit of English, but he encouraged me to use some of my Spanish since the mother did not speak any English and she was quite excited to talk to me. After gaining some confidence from the father’s encouragement, I felt comfortable attempting to use my basic Spanish (with, of course, a little help from Google Translator). Not only was the family waiting to greet me, there were two guys sitting at the kitchen table. The two guys were student paramedics/ volunteers from the United Kingdom who had already been volunteering for a week longer than myself. The two volunteers were wonderful and they shuffled me up the stairs to show me my bedroom.
Although my room had two beds in it, I had my own room and shared a bathroom with the other two volunteers (who also had their own rooms). Mary, the house mom, kept the space very clean and was constantly concerned if we were getting enough to eat or if we needed anything. This fantastic hospitality remained the whole trip and the house really felt like my home away from home. There were many nights of delicious family dinners followed with great conversation, games, and laughter in the upstairs living room.
My first day in the city was relaxed. I was able to sleep in before Alberto returned the next day to take me around the city. We wandered the city and soaked in the culture. Alberto made sure to take me to some of the best food and drink spots. Although the city was hustling and bustling, it was so much fun because we were able to take the city bus around to see so much of the city including: the old churches, family owned coffee and food shops, shopping centers, the heart of downtown Guadalajara, and the other main hospital. Alberto took me to Cruz Verde, the hospital I would be volunteering at, and introduced me to the staff. The staff hardly spoke English, but that didn’t stop them from trying to talk to me- they were incredibly friendly and inviting! They wanted to know who I was, what I wanted to help with, and what I already knew.
I spent a bulk of my three weeks in the hospital.The hospital experience was perfect. As volunteers, we took the bus and train to the hospital every morning around 7 am. We were “on-duty” from 8 am to 2pm. I was able to assist and perform many procedures (under the guidance of one of the physicians) that are not normally in the scope of practice for a paramedic in the states. Some of the most memorable things that I was able to do included removing and doing stitches, directly assisting in the operating room, helping put casts on patients, assisting with cleaning and wrapping wounds, starting IV’s/setting up drips of medications, assisting during cardiac arrest, and etc. The list could go on. Some interesting cases that I saw included: multiple cardiac arrests, a scorpion sting on a little girl, a traumatic femur fracture, a man stung by hundreds of bees, and a man who went into anaphylaxis due to eating a duck egg.
In the emergency room, as a volunteer if you simply asked, you could learn and assist with almost anything under the guidance of the doctors. They truly wanted us to learn and help as much as possible. Not only was I able to pick their brains about medical procedures, but I was able to understand how their health care system worked. By the end of our trip, the doctors and nurses became close friends to us. We often went out in the evenings together and they truly made us feel like we were part of the hospital family.
Following my experience in the hospital, I decided that I wanted to branch out and volunteer for the night shift on the ambulance. The ambulance night shifts were 12 hours long. I was paired up with another volunteer for the evening shifts so I was not riding the bus and train to the hospital by myself. We were on separate ambulances, but we stayed in the paramedic quarters in the hospital when we weren’t on calls.
The only way to describe the paramedics is with one word: passionate! They were incredibly passionate about their job and were extremely proud to be able to provide people care in a pre-hospital setting.. Although their trucks are not equipped with cardiac monitors and cardiac drugs like the US and UK, they otherwise had similar pre-hospital drugs and interventions. Since the city and hospital does not have a lot of money to put into the ambulance service, the paramedics were very careful not to be wasteful and they often “created” there own splints as necessary. Some calls that we worked included: many motor vehicle and bike accidents, dog bites, very sick elders, and traumatic injuries on work sites.
As a volunteer, I rode third person in the back of the ambulance’s captain chair. (Let’s just put it this way: you definitely had to buckle in and hold on when they were driving emergency traffic or you risked flying out of your chair!). The director of EMS made sure that we stayed with the same paramedics during our time volunteering. My two paramedics were no different than the hospital staff in the respect that they wanted me to be at home. Between calls, they would often sneak me away to see something “cool” or to eat a traditional meal that I was “required to eat” before leaving Mexico. They made sure I got the true Mexican experience. In the field, similar to the hospital, the paramedics let me function as a paramedic. I noticed in the homes that the residents of the city were extremely respectful and thankful for the paramedics. It was a wonderful experience to see and the respectfulness truly reflected the “Mexican way of life” (as they would often tell me about).
When we weren’t working in the hospital and on the ambulances, we were able to venture around the city of Guadalajara and surrounding cities. The evenings were often full of fun adventures to shop, eat, drink, and enjoy the Latin culture. The weekends were especially exciting because we elected not to work on the weekends (although you could if you wanted or needed to). As a group, we picked places we wanted to go see and would travel to them via Uber or the bus. One weekend, we took a bus to Puerto Vallarta. Puerto Vallarta was a neighboring beach city about 4 hours away. We were able to book an “Air B n B” hotel room for extremely cheap to stay right on the beach. Another weekend, we got rained into a “fiesta” in a nearby city and enjoyed some local drinks and festivities- not so bad to be rained in with good food and company!
After my three weeks were up, I found it difficult to leave. The culture was incredibly inviting, I felt part of the hospital and EMS staff, and I had made wonderful friends. I’m already looking forward to the next opportunity I get to go back. Thank you Global Medical Projects for providing a safe, fun, and invaluable learning experience that was, and is, an experience of a lifetime!”
My pre-university medical placement in India by Tish Jervis
Tish has very kindly sent us some extracts from her blog about her time with us in India. Tish is applying for graduate entry medicine and used her time with us in India to gain some valuable work experience.
April 25th: After a small delay at Heathrow Airport, my Jet Airways flight to Delhi took off with no problems. I managed to secure myself one of the emergency exits seats which is always a winner when your a 6ft giant and on an overnight flight. With a small bit of turbulence and 7 hours later we arrived in Delhi Airport where I had a 3 hour wait before my connecting flight to Trivandrum. I was absolutely starving at this point but with the shear fear of Delhi Belly and the only options for food being Yo China (interesting) and McDonalds, I settled for some crisps and India’s version of dairy milk (sadly no comparison to ours.) My next flight was a transit flight so went via Bangalore on its way to Trivandrum, where I finally arrived at 7pm on Thursday 21st April.
I was met by a very sweet young Indian man who drove me from the airport to the volunteer accommodation (45 minutes away.) Stepping out of the air conditioned airport into 38 degree heat and humidity was a bit of a shock, not the mention the exciting chaos, colour and smells that came with it. After nearly being knocked flat by an autorickshaw driver we headed for what would be my home for the next 4 weeks.
On arrival I was greeted by Babu (Head of the Global Volunteers Medical Project and Owner of the house) and Sudah (a very friendly lady who is Project Co-ordinator.) The house stood out from the surrounding greenery, due to its bright orange and pink colour. I was given a very warm and friendly welcome and then shown to my room before being cooked an Indian omelette for supper before heading to bed. Trying to sleep in 38 degrees with a fan blowing hot air isn’t easy and involves having at least 3 showers throughout the night.
The next day began with a coconut Idiyappam curry with rice which was delicious and a good way to get straight into the Indian culture. A tailor lady came to the house to take my measurements and we went shopping for fabric from which she kindly made me two typical Indian woman’s outfits to wear during my placements in the hospital. I spent the rest of the day checking out the local area, finishing with supper in the nearby Indian Coffee House.
On Saturday I drove with Babu to his doctors appointment in a primary care clinic in a hospital 1 hour away from the house (Nirmala Hospital.) I met Dr Sreejith who is a primary care doctor with a specialist interest in Paediatrics and Diabetes. I then spent the afternoon in the local beach resort where you can pay the equivalent of 10 pounds (1,000 rupees) to use the pool and other facilities and have a delicious buffet supper at the end of the day. I watched the sunset from the beach outside the resort and then headed home by autorickshaw after supper.
Sunday began with a trip to church with Sudah followed by a visit to the disabled girls orphanage and convent. This was a rather amazing experience and I felt very honoured to meet all of the girls who all had beautiful smiles. I will come back in the evenings during my placement to help them with physiotherapy, meal times and learning how to read and write in English. In the afternoon Babu, Sudah and I drove to Varkala Beach to watch the sunset and walk along the cliff tops. From here we met another doctor friend of Babu’s who is a Gynaecologist in Kerala and went for some puttu (steamed cylinders of rice, filled with spiced vegetables) for supper before heading home.
After a weekend of getting used to everything I will start my placement tomorrow morning!
May 2nd: I began my placement with 3 days at a Primary Care Hospital in Trivandrum. Nirmala Hospital is a privately run hospital that is made up of a clinic room, emergency room and a 10 bed admission ward. During my time here I shadowed a General Practitioner with a specialist interest in diabetes (Dr Sreejith.) Morning clinic here runs from 9-1pm with the main cases being seen involving infection, diabetes and allergy and asthma. It was quite notable how many of the population suffer from diabetes due to a diet rich in carbohydrate and sugar. I learnt alot about the healthcare system in India and the coexistence of government run and private/corporate hospitals. A visit to this private GP costs 130 rupees which is the equivalent of just over 1 pound. Patients then have to pay for any further investigations required and any medicines needed. Pharma companies visit daily to delivery physician samples of particular drugs that they are advertising. The clinicians keep these samples and give them to patients free of charge, for those who cannot afford prescription medications.
On my first day I learnt how to take blood pressure using a sphygmomanometer and a stethoscope. I had practiced this once on a nurse before the doctor sent me into the next room and asked me to measure the blood pressure of every patient before they came to see him (in at the deep end, but I learnt quickly!) Tuesday followed a similar pattern, observing in the primary care clinic. Although very sadly an emergency case came in on Tuesday evening (16 yr old boy, drowning incident) and sadly he was unable to be resuscitated! The rip currents off the coast of India are particularly strong. On Wednesday, as well as attending the morning clinic, I was invited to Dr Sreejith’s house for a delicious chicken biryani before shadowing his specialist paediatric clinic in SK hospital. I met his lovely wife who is a dentist, his parents and his two little boys. They were all very welcoming and happy to see me. At the SK hospital most cases involved allergy, asthma, bronchitis, bacteria enteritis and chickenpox. I also got to briefly visit the labour ward and neonatal unit where I met a very tiny baby who had been born prematurely at 25 + 2 weeks. I then attended the evening clinic back at Nirmala Hospital (5-8pm.) I learnt a huge amount whilst shadowing Dr Sreejith and it was very clear that the health system out here is much more doctor led with less patient involvement in the plan of care as opposed to the system we have at home. It was also interesting to see how much of the consultation time was spent educating patients in regards to diet or inhaler therapy (most patients have a fear of inhalers for various reasons.)
I spent Thursday and Friday at St. John’s Medical College, Community Hospital. On Thursday I shadowed in the paediatric clinic from 9-1pm. Dr Preethi Menon (Consultant Paediatrician) taught me a large amount about observation in young children, respiratory distress and the main illnesses that she sees: allergy, abuse, croop, epilglottitis, fungal rash, asthma and infection. I observed a young boy with dysentry on the observation ward and visited an older boy who was suffering from a high grade fever amongst other things associated with dengue fever. On Friday I observed the haemodialysis unit, where patients with Chronic Kidney Disease (CKD) receive dialysis 2 times a week, with each session lasting 4 hours. The staff nurse on this unit were very friendly and explained to me exactly how the dialysis machines work and the causes of CKD and any complications of dialysis. Each dialysis session costs the patient 700 rupees which is the equivalent to 7 pounds. Many of the patients on this unit suffered from oedema and breathing difficulties due to fluid accumulation as a result of their disease. One of the gentlemen having his dialysis at the time was particularly friendly and kept calling me ‘giant princess.’ I decided to take that one as a compliment as he had managed to rectify his use of the masculine word giant, with a more feminine princess.
During the afternoons Babu, Sudah and I visited the Lake Palace Hotel for tea, cooked delicious curries at home, played cards with the little boy who lives next door and went shopping at the markets. I now know how to make a delicious vegetable and coconut curry so I will try my best to recreate this when I get home.
On Friday evening I went to Waters Edge Beach Resort of Samudra Beach, Kovalam. Here I spent the weekend in the sun, enjoying some fishing and swimming. I returned back home to the volunteer house on Sunday evening after a 2 hour rickshaw ride. I think it is fair to say that the 4 car wide overtake that they seem to have adopted quite readily out here on the roads is LETHAL. All I know is if I had taken my driving test in India I certainly would have passed first time, instead of fifth!
May 8th: Another week has flown by out here where I spent my time in St. John’s Community Hospital shadowing various specialties. On Monday I split my time between shadowing a GP and an ENT consultant. Cases seen in general practice included throat and chest infections, lower leg oedema and diabetic complications. Time in ENT was really interesting and I certainly learnt that small toddlers will find anything to put up their nose. In one morning the consultant removed 2 pearls, one ball of paper and a pea from various toddler’s noses. Aside from foreign objects stuck in orifices, other cases included otomycosis (fungal infection of the outer ear), thyroglossal cysts, surgery to repair the ripped earring hole of an elderly woman, tonsilitis, acute superior otitis media (inflammation of the middle ear) and rhinitis (inflammation of the membrane inside the nose.) The ENT consultant spoke very good English and was able to explain a great deal to me, for which I was very grateful.
On Tuesday I visited the Leprosy Centre that is attached to St. Johns, where treated leprosy patients are offered physiotherapy and reconstructive surgery to help correct for hand and feet complications as a result of the nervous system involvement in leprosy. Here I spent time with the physiotherapist, meeting the patients staying in the centre and observing their physio sessions. When I arrived the physio had very kindly put together a powerpoint presentation in English for me that taught me about leprosy, its causes, its complications and its treatment. This was really interesting as it is not a disease regularly seen in the UK. The majority of the patients staying in the centre are there for care of their ulcers that usually develop due to loss of sensation in various parts of the body, leading to the inability to feel heat or pain. This can often result in ulcers, that if left untreated can reach as deep as the bone, causing further complications. Here in India they treat ulcers using SSOD: soaking, scrubbing, oiling and dressing. This reduces infection and leads to ulcer healing. Other common complications seen were foot drops and claw hands which are caused by the leprosy bacteria damaging the nervous system. It was very exciting watching a leprosy patient learn to weight bear and eventually take a few steps after foot surgery. Due to the stigma that exists in the community in regards to leprosy, the opportunity for reconstructive surgery (paid for by the government) is rather wonderful for these patients who face a lot of exclusion in their daily lives. I saw some amazing videos of some patients before and after surgery, and the real difference that it makes. The prevalence of leprosy in India used to be 60 per 10,000 but since the introduction of the Leprosy Elimination Action Programme this has dropped to <1 care per 10,000.
On Wednesday we drove to collect a dialysis patient from their home and took them to hospital for their treatment. I then spent the rest of the day helping on the dialysis unit. The patient that we collected suffers a lot financially and as a result, after his next 10 sessions of dialysis (currently covered by a government scheme) he will be able to pay for 2 sessions out of his own money before he and his family will not be able to afford his treatment anymore. Through a very kind donation from a colleague at Great Ormond Street we hope to try and help him and his family pay for his treatment for a little longer. We had visited him and his family at their home on Tuesday afternoon to talk to them about their situation and his illnesses. It is very sad quite how many people in India either don’t seek medical assistance in the first place or can’t complete their treatment due to financial problems. In the afternoon I visited the Cancer and Palliative Care Centre which was very moving. The most common type of cancer in Kerala seems to be leukaemia which they find very difficult to treat. I met 3 cancer patients and their families, one patient who had fallen from a tree and suffered lower body paralysis due to spinal cord damage and one patient suffering from whole body stiffness due to late stage Parkinson’s. This centre is very impressive and professionally run to ensure that all patients have a painless and peaceful end of life. The nuns regularly visit the patients and their families on this ward and there is a very beautiful chapel in the centre. On Friday I split my time between a GP with a specialist interest in palliative care and ENT.
In the evenings we visited Attingal market, tried many Indian baked treats, played cards with Kannan (who lives next door), visited patients in their homes and went to Saigramam. Saigramam is a non profit organisation that is rather beautiful and includes an orphanage, an old people’s home, some amazing temples, an art village and a cow farm. We walked around the grounds and visited the children in the orphanage and the old people’s home. I met a little boy called Sadheesh who is 5 years old and who’s parents had both sadly died in an accident. He was definitely King of the Orphanage and had the worlds biggest smile. A lot of the children here do still have parents but they can’t afford to look after them. This means that every once in a while they do go home for a visit which is nice.
Babu (Project Co-ordinator) left for the UK on Monday to see his family so I am now being very well looked after by Sudha (Project Mediator) and Deepak a nursing student who is currently sitting his entrance exams for medical school which seem to be very tough out here. I have also spent a lot of time with some of Deepak and Sudha’s friends, mainly Dipin and his wife Rumie who are both very lovely. I am very excited to meet their 2 year old daughter this week.
After a relaxing weekend on the beach, it is back to work again tomorrow. The focus for this week is gynaecology, obstetrics and paediatrics. My dream!
May 15: This was my favourite week so far. I think this was mainly because I was placed in Anchal Hospital for Mother and Child which is heaven when you are as obsessed with small babies as I am. On this route from home to work I saw a fair few elephant commutes, which definitely beats the London tube anyday of the week!
On Monday morning I was placed in the outpatient department with a female Gynaecologist. In India the majority of gynaecologists are in fact female, whilst in the UK the majority are male. I began the morning in theatre watching Postpartum Sterilisation of a women who had given birth to her second child 3 days before and did not want anymore children. This was a very interesting operation to watch and it was rather insightful being exposed to surgery and the workings of the theatres in a country so different to our own. Once the operation was over and the patient had come round her 3 day old baby came for a feed and I got to hold him afterwards which made my day! In the afternoon I shadowed a consultant paediatrician who spoke brilliant English and explained each case to me in great detail. The main illnesses seen here were fever, abdominal pain, constipation, loose bowels, allergy and asthma, skin rashes, dengue, mumps, abscesses and the added extra of ear piercing. I helped hold down a little 4 year old boy on the emergency ward whilst they cut open and drained an abscess that he had on his hair line (poor little thing!) Following this I did the ward round with the paediatrician where I met a newborn baby with jaundice who was receiving phototherapy and a number of children with high grade fevers. I stayed with the gynaecologist and paediatrician for the rest of the week and also spent some time with the nurses on the wards.
Tuesday’s gynaecology experience brought a lot of ultrasound scans, cases of gestational diabetes, down syndrome tests using ultrasound (by measuring the nuchal translucency and development of the nasal bridge), UTIs, gestational nausea and the removal of fibroids. In India they usually do a pregnancy scan at 6-7 weeks (to see intrauterine growth), 11-12 weeks (to check development of the nasal bridge), 20 weeks (to check foetal growth), 36 weeks (to monitor placenta function.) In India foetal sex determination is illegal so every baby is a surprise sex wise which is quite exciting. In the afternoon the paediatric outpatients was very quiet so I spent my time on the wards with the nurses. One particular nurse called Sumi was lovely and asked me to teach her some English words as we went around. On the ward I saw abdominal burns, jaundice babies, IV cannulation, upper respiratory infections and a lot of children with fevers. At about 3 pm one of the water pipes in one of the patient’s bedrooms burst and water was quite literally pouring everywhere with the whole first floor flooded within minutes. Patients were being treated in the corridors and the lift as the water could not be stopped!!
Wednesday involved hypertensive patients, menorrhagia and ultrasounds in the gynaecology department. We discussed the risks of overweight and underweight mothers to both the mother and child during pregnancy. It was concluded that underweight mothers have a better prognosis due to the complications such as hypertension, thrombosis risk and gestational diabetes associated with overweight mothers. I then spent a bit of time in the casualty department with nurses Bincy and Sumi. It was very quiet and involved a few patients coming for injections for gastritis and insulin injections for diabetes. I then went up to the second floor to meet a baby who had been born the previous day. He was so tiny and the family asked me to hold him as they believe that a westerner holding their baby is a blessing (I certainly wasn’t complaining.) The paediatric department was very busy with a lot of children with fevers (common at this time of year), vaccinations, URTIs, nebulisation, mumps, dengue fever and very sadly the diagnosis of quite late stage meningitis in a very young little girl. I learnt a few Malayalam words (the language spoken in this state of Kerala): vedana (pain), dhala (head), mookk (nose), pani (fever) and chood (hot)-the spellings may not be quite right! At the end of the day I watched my first ever circumcision of an 8 year old boy under local anaesthetic (ouch!) In India boys usually have this done from birth to 4 years old.
Thursday was a very exciting day as I got to see my first delivery out here. I had spent the morning with the gynaecologist seeing patients for scans, incontinence, dysuria, infertility and polycystic ovaries. I had just begun with the paediatrician when I was called to the labour room. The patient had been in labour since 6 am and she was 2 hours away from having to have an emergency caesarean but luckily the baby decided it was time. Here they give prostaglandins to make the cervix soft and oxytocin to stimulate contractions. Two nurses were pushing on her tummy whilst the gynaecologist was helping the baby at the other end. I was far too close to all the action when the waters broke and was covered from head to toe but it was an amazing thing to see. It was very professional having the gynaecologist for the delivery and the paediatrician to examine the baby the second it arrives! Husbands and family are not allowed in the delivery room during the births.
On Friday we visited the Bethania Rehabilitation Centre for the Disabled in Kumarapuram. This centre is run by Bethany Convent Sisters of Immaculate Christ. It is home to 70 girls from the age of 12-50 years old. The centre provides living and rehabilitation facilities with different sessions run daily for the girls. I was lucky enough to see an english lesson, a type writing class, paper card making, tailoring and sewing, computer writing, handwriting and to visit the book printing and binding press attached to the centre. The girls were lovely and introduced themselves and the town in which they lived. One girl did the most beautiful dance whilst another sang a song for me. During the typewriting, computer writing and handwriting lessons they were copying from english text about pollution which was very impressive. This centre is free of charge and is a rather amazing facility for these girls to learn different skills and rehabilitate. We then went into Trivandrum to purchase a wheelchair that we are donating to a dialysis patient who struggles financially and who can very sadly no longer walk very far. After this we visited Pallium India which is a hospital for pain management and palliative care where I will be placed for a few days next week. It focuses on ‘care beyond cure’ and has a lot of patients suffering from spinal cord injury. Next week I will visit the clinical hospital and go on home visits with the community palliative care team.
In the evenings I planned for the rest of my time out here with Emily and Lottie, was thrashed again and again by Kannan at chess and got to meet Dipin and Rumie’s beautiful little daughter Anna!
Beach for the weekend which was very stormy with some seriously impressive lightning. Tomorrow is election day in Kerala which they have been counting down to and campaigning for for a while now. It is the election for the fourteenth legislative assembly to elect representatives of the 140 constituencies in Kerala.
May 20: My final week began with election day in Kerala which was extremely full on but very cool to experience. All the campaigning before and the celebrations afterwards were a lot of fun! As a result of such celebrations all roads are a nightmare so we spent the day watching it all from the balcony and eating delicious pancakes with maple syrup. In the evening we got a rickshaw to see a dialysis patient Sudhkaran and deliver him his wheelchair. He was so happy to receive this as this means that his wife can now take him to hospital for his treatment by wheelchair and bus instead of on the back of a motorway (which is risky business in Kerala.) Unfortunately he lost the use of his face muscles after his first stroke so in the photos below he may not look very smiley but he loved it and wanted to get in it straight away!
Tuesday and Wednesday I spent at Pallium India Hospital for palliative care (care beyond cure.) This hospital deals with lifelong illnesses, pain management and palliative care. I spent Tuesday at the hospital shadowing doctors and nurses and on Wednesday I went with the team on the home care visits. Whilst on the in patient ward I saw a patient with a giant cell tumour in her left ileum, a women with a neck ulcer that had become infected with maggots (that morning the nurse had removed 100 maggots from her neck!) and an elderly man with cancer of the oropharynx. This inpatient ward can accommodate up to 15 patients but on this day it was relatively quiet. I learnt a lot on the ward rounds with the doctors, especially about the different types of pain management used and the side effects that different patients experience. The most common being delirium following the administration of morphine. Most patients are discharged back home once their pain is under control unless they have chosen to stay until their last few days, in which case these days are made as peaceful as possible. The hospital also runs a rehabilitation program for people with paralysis. This is a collaborative project of Pallium India with the Department of Social Justice, Government of Kerala. The centre can accommodate up to 4 patients at once and each patient usually comes for 45-50 days of rehabilitation. Whilst I was visiting there was a young boy with hemiplegia (paralysis of one side of the body), a lady with a demyelinating disease and as a result had paraplegia and 2 young men also with paraplegia. The young boy spoke very good English and was an extremely talented little artist. He showed me all of his watercolour paintings with his masterpiece being an A3 Ferrari which was very cool. I spent a lot of time speaking to the social workers during lunch. One spoke very good English and is off to New Zealand next month which is very exciting for him as it will be the first time that he has left India. I met the chairman of the hospital who was a very lovely man and who spoke to me about medicine for a while. Wednesday’s home care visits begun at 8.30 am and included 7 different patients, finishing at 4 pm. The home care team involved 1 doctor, 1 nurse, 3 volunteers, me and a driver. All patients visited were either bed ridden or couldn’t access a hospital due to the remoteness of their house. The cases seen included oral cancer, lung cancer, hemiplegia, obstructive hydrocephalus, uncontrolled diabetes and geriatric patients. The doctor and nurse checked the patient’s vitals (pulse, blood pressure and chest) and replenished any regular medicines that the patients required. I got to perform my first chest auscultation on a patient and his wife gave me one of her jungle pineapples to say thank you which was very sweet. A lot of the patients lived up in Kerala’s jungle meaning that to get to them we had to park the mini bus and walk through the jungle, dodging falling coconuts from the trees above and crossing a few rivers. At one point a fast moving snake came straight across the path in front of me (you can see from the photo below that I wasn’t best pleased!) The patients seen all lived in stone huts with tarpaulin or tin roofs with minimal electricity supplies. On the trees surrounding their houses they engraved water run-off paths ending in coconuts to collect the rain water which is very clever! It was rather amazing being able to see these home visits and make comparisons to the ones that I have experienced in the UK in general practice (they certainly didn’t involve any jungle hikes or snakes!)
Thursday and Friday were spent saying goodbye to all the patients and doctors and nurses that had so kindly looked after me for the last 4 weeks. I delivered the donations that I have kindly received from a number of you which allowed us to sponsor the two dialysis patients who are struggling financially for 30 more sessions of dialysis, buy Sudhkaran his wheelchair, help Babu (who makes the delicious food at home) afford an operation he needs on his leg and supply the Beth Sadia Disabled Orphanage with some support for food, medicines and rehabilitation aids. On Friday I visited Beth Sadia Disabled Orphanage for the last time. I was welcomed by the two sisters with a delicious lunch that allowed me to try some new Keralan dishes. I then spent the next few hours with the girls in the orphanage practicing their handwriting, singing and playing musical statues. They were a big fan of ‘Barbie Girl’ and one girl knew all of the words and told me to perform it with her. Of course she was designated the role of Barbie and I was Ken!! Some of the girls then did individual performances which were all amazing and they gave me some of their flowers that they had been making that morning when I left. I’ve never seen a bunch of girls with such big smiles! They asked me to come back when I was a real doctor and live with them. In a few years time that is where you may find me.
Thank you to Babu I, Sudha, Deepak, Babu II and everyone else out here who has made my last month such an amazing experience. Tomorrow I meet up with the girls to see the rest of India. Wifi may be minimal so for now this may be it on the blog front. Until next time Kerala!
My medical work experience in an accident and emergency clinic in Mexico
Emily Johnson
My name is Emily and I spent 5 weeks volunteering on a medical project in the city of Guadalajara, Mexico. I was working in the Green Cross, an emergency trauma clinic that provides urgent medical care ranging from cuts and scrapes to life threatening illnesses or injuries. The Green Cross clinic was located in a poorer area of the city and was accessible to those without health insurance which meant I got to meet all sorts of different people. I can honestly say my time spent there was probably one of the best experiences of my life.
Whilst working on this project I had the opportunity to learn from and experience so many different situations. I was treated very much like a medical student, the nurses and doctors were so welcoming and so eager for me to learn and practice new skills. On a regular basis I would take blood pressures, insert cannulas to start IV’s, cast broken limbs, inject painkillers and clean, bandage and suture wounds. During my time there I literally saw everything including broken and dislocated bones, open wounds, heart attacks, burns, gunshot wounds, stabbings, epileptic seizures and drug overdoses’. I was amazed at how much I could get involved and how much trust and responsibility was often bestowed upon me. It was definitely a case of learn fast, be confident and embrace any challenges that came your way.
A typical day for me working in Mexico started with the always adventurous bus ride to the Green Cross clinic, definitely the cheapest roller coaster I have ever been on! I would work Monday to Friday starting in the afternoons and leaving in the evening before it got dark. I would spend the day assisting the doctors and nurses treating any patients that came in. Sometimes I asked to stay and do the night shift which was always exciting – lots of alcohol, drugs, assaults and stabbings. I was never short of an opportunity to practice my stitching on a night shift! Some days it would be really quiet and then suddenly get very busy. The great thing is that I would turn up to the start of my shift and have no idea what was going to come through the doors. There was a large team of doctors and nurses in the clinic, another volunteer also joined me half way into my project which was nice. I made so many great friends and although there was a significant language barrier between me and some of the Mexican staff we were still able to enjoy a joke and get on really well. I even managed to befriend some of the paramedics and sweet talk my way onto an ambulance ride along; what an exhilarating experience that was.
Easily the best thing about working at the Green Cross clinic was the opportunity of being able to do and achieve things that I would not be able to do in the UK. There are some moments that I will remember for a long time including a couple of occasions when we had patients that were so ill or injured that they required resuscitating. I did have to perform CPR on two people, unfortunately both attempts failed but I felt honoured to have been able to try and help these people when they needed it the most. These kinds of situations are challenging but they do make you realise how stronger person you can be. It was also amazing to work within a different culture and see how unspoilt and unassuming the people of Mexico are. I will now never take the health care system I have at home for granted.
If anyone is considering doing a medical project in Mexico, I cannot recommend it enough. You will gain invaluable experience, especially if you are considering a career in the medical world. I would suggest you take plenty of scrubs to wear and some good stain remover, mine started off white but got messy very quickly! I would also recommend that you go with some basic Spanish skills, I managed to get by but I do wish I could have communicated better with the staff and especially the patients. Overall this project was exciting, interesting and challenging and I would do it all again in a heartbeat.
My Paramedic Work Experience Placement in Puerto Vallarta – Tony
Tony and the paramedic crew
I have recently returned from a 5 week paramedic work experience placement with the Red Cross in Puerto Vallarta, Mexico. I am applying to train to be a paramedic in the UK so I was looking to increase my general medical knowledge and learn more about the skills required to be a paramedic. Puerto Vallarta is a coastal town popular with tourists, it is the second largest city in the state of Jalisco. The Red Cross are the primary ambulance service in the city which means the variety and scope of experience I gained here was excellent.
On arrival into Puerto Vallarta, Jorge, my host, picked me up from the airport and took me to his house where I would be living for the next 5 weeks. He also gave me a tour of the local area and showed me the Red Cross clinic, only a short walk from his house.
Tony in the emergency clinic
I was primarily working alongside the paramedics in the ambulances however I did spend substantial time in the clinic assisting the doctors and nurses. They were very flexible in terms of the hours and days that you decide to work. In order to gain the most out of the experience I worked 6 days per week and shifts ranged from 10-24 hours including days and nights. The staff were extremely welcoming and friendly. Despite not having any previous medical qualifications and only basic Spanish I was astonished by the level of responsibility and involvement I was given from day one. Every emergency call-out I had a very hands-on role assisting the paramedics. This included escorting the patients, measuring heart rate, blood pressure, blood sugar levels, administering oxygen and providing reassurance. I also received training on how to insert cannulas.
Transferring the paediatric patient
Many of the more minor emergency call outs/ duties included slips and trips, patients with low blood sugar levels, minor cuts, patient transfer duties and a very fun night providing onsite medical cover at a music festival. One of the most interesting was the transfer of a prematurely born baby which was a very delicate and intricate operation. More major incidents included car/ motorcycle accidents, trauma, shootings, seizures, heart attacks and drug overdoses. Due to the variety of both patients and incidences there were many different places patients had to be taken for treatment. Those with more minor injuries or without medical insurance were treated at the Red Cross clinic. Others were taken to the public or private hospitals across the city. This provided an excellent opportunity for me to observe the working relationships between paramedics, patients and other healthcare professionals.
Tony attending a traffic collision
It was fascinating to see first-hand the scope and processes involved in the role of a paramedic in addition to simply providing medical care. Whether it was communication skills with the patients, accurate recording of details and events, maintaining patient confidentiality and dignity, providing reassurance to family members or liaising with other emergency services. On occasions where the patients were American or English tourists who could not speak Spanish, I helped provide instruction and support which was excellent experience in preparation for my future career as a paramedic. The placement also provided a good insight into the reality of the role. Most notably the largest number of incidents were relatively minor with communication and support being the most vital skill. The fact that one day can be completely different to the next with some days or certain times of the week being very busy and others quieter. It can also expose you to critical situations where you need to act quickly and calmly, which can be mentally challenging but an essential element of emergency medical care. I found this an extremely rewarding part of the experience.
I would highly recommend a paramedic placement in Mexico! It certainly provides an opportunity to gain experience and responsibility much more quickly with little previous training than is possible in the UK. In terms of advice I would give would be that you only get out what you put it. Much of the training I received was through asking to be shown how to perform certain processes. Simply try to get involved and help out in any way you can. This will very much be welcomed and will hugely increase the amount you gain from the experience. If you can’t speak Spanish this is not an issue but the more you know the better. Try to learn as much as possible before you go.
Christmas at the emergency clinic
The Mexican people are extremely friendly and welcoming, I made many good friends and had great fun working with the paramedics despite my very basic level of Spanish. As I was there over the whole Christmas period I worked the night shift on Christmas Eve which involved a surprise visit to one of the paramedic’s family homes at midnight where I was welcomed in and treated to a full meal with the family! On one of my days off they invited me to a BBQ and a few drinks on the beach which was a very enjoyable day.
This experience was a great way to learn about all the different elements of the role and has only increased my enthusiasm for a career as a Paramedic. I would highly recommend this to anyone who is considering or currently undertaking a career in emergency medical care.
Over the summer I travelled to Trivandrum, India for a two week pre-medical placement with Global Medical Projects. I was eager to gain more hospital work experience and the opportunity to observe a foreign healthcare system really appealed to me.
In India I experienced a number of medical specialties. I spent most of my time in the NMS Mission Hospital where I shadowed consultants and nurses who were very accommodating, answering any questions I had and explaining patient illnesses.
I also had the opportunity to volunteer at the Palliative Care Charity called Pallium. I got to join the medical team in their home visits of rurally placed patients who didn’t have access to a hospital. It was exciting travelling in the 4×4 jeep on narrow dirt tracks with stunning scenery of backwaters and coconut trees all around. We delivered essential medication, bandages and food to rurally isolated patients and it was so rewarding to see how grateful they were for our support. Many of the patients had type 2 Diabetes and it wasn’t uncommon to see amputations and diabetic bed sores. At the end of the day, the medical team treated me to some traditional indian snacks and coffee in a local Restaurant.
At the weekends we had free time to travel. My favourite experience was visiting a region called Alleppey, which had some of the most beautiful backwaters in the world! The group hired a houseboat and we got a guided tour of the area, I didn’t stop taking photos as everywhere was so beautiful. We even got to stop off along the canal and buy fresh coconut milk from a local and take pictures with his pet Falcon! It was a great opportunity to get to know other volunteers and we really bonded with each other. If you like to experience weird and wonderful foods, then India is definitely the place for you! At the weekend we were spoilt for choice as where to eat dinner, and price wasn’t an issue as the average feast cost us about three pounds each! At the volunteers’ house, “Chef Babu” ensured we didn’t go hungry and made some really delicious meals for the volunteers coming home from placement. My favourite dish was Samba, served with an indian pancake called a Parotta.
My name is Emily Haines, and I have embarked on two unforgettable experiences in Africa. My life-long ambition is to become a doctor, and watching medical volunteers in Africa on BBC news TV channel one day motivated me to get in touch with Global Medical Projects to find out more. I was instantly hooked on the idea of embarking on an unforgettable lifetime experience in a Third world country! Although my trips took much planning in terms of finances and dates, it was certainly worthwhile. On my gap year prior to university, I took a month long trip for a medical and orphanage project in Ghana. Central Regional hospital in Cape Coast was where I spent the majority of my time, and it really opened up my eyes to the large differences between developing healthcare systems and the developed. In the evenings, I visited a small orphanage in the village of Ansapetu, where I met many children that were grateful for even a friendly face showing up at their door. It doesn’t stop there though! 2 years after reflecting on my time in Ghana, I could not wait to begin another project in another African setting, so I chose Tanzania. I was in Tanzania for 3 weeks, where I did another project, set in Meru District Hospital, and ‘Cradle of Love’ orphanage. People may think the two African projects I did were almost the same experiences, but I would definitely disagree. I came back from both experiences having learnt different practices, cultures and languages!
Flying to Ghana was the first time I had ever travelled abroad alone, which was I must admit, quite daunting to begin with. Going into the unknown I really did not know what to expect, but I remember the day I arrived in Ghana like it was yesterday. From meeting Eric, my host, at the airport in Accra, I immediately felt like I was in safe hands. Seeing the bustling capital city of Accra, I instantly had culture shock, but my fascination over-rode my initial worries. The 3 hour journey to Cape coast was an interesting one, seeing the poverty stricken people in mud huts without sufficient clothing on their backs, confirmed what I’d seen in the media was real. However, I also noticed the wealthier side of the area, no longer did I see mud huts but well- constructed houses made of brick. Following this journey to Cape coast town I had arrived at my accommodation in Abura, and Mary, Eric’s wife, and Ruth, the housekeeper, were there to greet me. I was overwhelmed with how friendly and helpful they were and our personalities clicked right away. I also met one of a few volunteers I would be staying with; she helped me settle in by giving me advice, one being a warning of the frequent power-cuts that occur in the house, which I definitely got used to! However, the house had a lot more to offer than I’d expected, there was internet access so I could contact my family easily and a warm shower! Having the weekend to settle in before beginning placement allowed me to take in my surroundings and immerse myself in the different culture. George, the house supervisor and guide took me around Cape Coast educating me about the tourist attractions, including the beaches, Cape Coast castle and local customs and religions, and this really helped me to bond with the locals and shop owners straight away! I was overwhelmed by the friendliness of the locals, greeting strangers in the street was indeed a novelty. I often heard the words ‘Obruni!’ called out to me by the children in the street, I was told it meant I was foreign to them and I would hear it often during my stay. Trying the wonderful African food for the first time was also a new experience; my adjustment to the spice was certainly comical for my host family!
As I began working in the hospital on the Monday, I was greeted by the matron of the hospital who asked me what areas of medicine I was interested in. After this I was allocated to the female medical ward for the first week. I asked doctors them what time they began their ward rounds each day, which was around 10 o’clock, and I soon realised that Ghanaians sense of time was very different to people’s in the UK, as it was different every day, there was no strict schedule. Whilst the doctors had not arrived yet I assisted the nurses with drug administration, dressing changes, and I probed them with questions. I learnt that Malaria was a common condition amongst the women on the ward; Ghanaians taking prevention medicine for it was rare as many could not afford this. Another ailment I observed was particularly prominent in the area was Anaemia, which highlighted to me the diet of many Ghanaians was insufficient in iron-rich food. As a result, I asked doctors if they could improve this by encouraging patients to eat a healthier diet. One thing that interested me was the treatment of Alzhemier’s disease; Ginko Giloba extract was used as a herbal medicine to prevent brain degeneration. Nurses told me of the healthcare system in Ghana, which meant that it isn’t free at the point of care like the NHS. People have to pay for their healthcare insurance, and in a number of cases I saw the distress of patients who could not afford to pay for treatments, they simply got turned away. As doctors arrived on the wards I observed their bedside manner, asked the doctors questions, and despite some language barriers between me and some patients I communicated with many. I was even lucky enough to mix in with the medical students on the wards and once in a class, where I got taught clinical skills and participated in question and answers sessions based on clinic consultations, this was challenging having only completed A levels, but I learnt a lot! The doctors could not have been more helpful and were extremely motivating whilst educating the students. The paediatric ward was a favourite of mine, and following ward rounds I joined the doctors in the clinic where I observed a wide range of various conditions. I noticed that Malnutrition was a serious issue amongst young people, many children had to be put on a treatment called ‘plumby nut’ to increase their nutrition and weight. There was an obvious lack of privacy and confidentiality during patient consultations, although patients had a completely laidback attitude about this which was surprising. In the surgical ward, I soon began to notice the limited resources present in Ghana, as many patients waited a long time to be admitted to surgery, since there was only one operating room in the hospital. One day I was able to directly treat school children’s wounds in a rural village, this was extremely gratifying and the children were even excited to receive a plaster! I felt I gained a broad insight into the healthcare in Africa in Cape Coast hospital, and one day when I qualify as a doctor, going back to treat patients would be even better.
Every day after 6 hours at the hospital, I would retreat home for a quick lunch break (watermelon!) and head off to Ansapetu, where the orphanage was located. This would involve getting a taxi straight from Abura which took around 15 minutes but was very cheap! The children were aged from around 2 to 18 years, which allowed me to interact with differing abilities and interests. James was the founder of the orphanage, who my financial contributions were directly going to. It was satisfying to know that the orphanage was receiving some financial help, as it was very basic, with an obvious air of limited resources. Helena was the other coordinator and she and James were extremely welcoming upon my arrival each day. I would create games with the children after school, such as ‘hide and seek’ with the girls, football with the boys, and I frequently helped the children with homework given to them from school. It was interesting to find out the various future aspirations of the children, and it was refreshing to see they had great ambitions despite being in a situation with money difficulties. I would often help Helena set out dinner for the children, this included fish and banku, this was an interesting food with a white, gooey consistency, which I tried and definitely approved of! Table manners were very strict, as eating only with your right hand and not with the left was the accepted etiquette. Praying before food was a regular occurrence, and I really enjoyed taking part in the children’s respect for god. I helped the children to wash the dishes each day following dinner, and another great opportunity to bond with them was knocking down oranges from the trees in the garden! Learning the children’s names was at first a challenge, but getting to know each child individually it became second nature. Going back to the orphanage to see the children would most definitely be something I am thinking about.
My time in Ghana did not only involve working hard, I also visited many tourist attractions on the weekends and relaxed in local volunteer hotspots in the evenings. There were about 5 of us volunteers coming and going at different time points, but we all managed to spend time with each-other outside of our busy schedules. Going out and meeting new people was a regular Friday night event, Oasis bar was always a great place for ‘westerners’ and the locals to mix, I met many people from Canada, Australia, and other European countries! Going out for food was always a way us volunteers treated ourselves, and some of us missed the odd plate of western food; ‘The castle’ restaurant was a personal favourite of mine! On weekends, I would always think of buying some souvenirs from the local markets. I came back with wooden masks, printed bags and jewellery. One weekend we visited Kakum national park, this involved walking through the forest with a tour guide and over an arial walkway over the canopy of the trees, which I would recommend if you want to conquer a fear of heights! Hans cottage was another place I visited, this was a hotel that overlooked a small lake with crocodiles here, me and the other volunteers had the chance to watch them being fed, and I even had a photo sitting with one! I visited a couple of beach resorts to indulge and swim in the sea; Coconut Grove and Anomabo beach resorts had wonderful staff service and although food prices were higher than what you would get in central cape coast, they were still pretty cheap! One of my favourite attractions was Elimina Castle, where I learnt a bit of African history and the slave trade. Learning the bongo drums each week was an exciting new activity, yet it was harder than it looked! I also went along with Mary to a Christian church service on a Sunday, people’s energetic attitudes and singing during church was inspirational. I will never forget the experience of going solo to Ghana, it was not what I expected but even better, I most definitely recommend it!
My name is Jack and I’m a 2nd year BSc biomedical science student preparing for postgraduate entry into medicine. Of the many choices that Global Medical Projects offer – I chose to take the 2-week volunteer project away in the small village of Meru, Tanzania.
Zablon and Pretty were fantastic hosts and cooked us meals every night. I wont ruin the experience for you by telling you what they made us, but I will say that we tried some of the traditional Tanzanian dishes and they were delicious!
During the first weekend, Luke and I decided to rest for half of it to get over our lack of sleep on the flight, and then visit the market in Usa River. Zablon came with us to show us around and find our feet. He also showed us where we would be taking the Dala Dala (the public transport) to the Meru district hospital on the Monday. From this point onwards we could find our way round Usa relatively well.
To begin with, Luke was placed in the Male ward and I was placed in the female ward. My first impression was that compared to the hospitals in the UK, the facilities (as expected) were very limited. Privacy was a luxury and had to be paid for, ward rounds and scheduled times were rarely stuck to and everyone there had a serious problem (you generally wouldn’t find a local going into hospital unless it was of great importance).
Interesting note – many women get pregnant in Tanzania due to incorrect use of the contraceptive pill. They take it just before or during the act – hence they often get pregnant.
After Paediatrics I decided to spend the afternoon in Minor surgery – having said this – some of what was thought as minor surgery there could be deemed as major surgery in the UK! (I have only put in what I think are the minor ones):
Tanzania is an amazing place and the sheer quantity of things you can do there is practically limitless! Luke and I thought we would take advantage of the fact we were so close to the Serengeti and after our final week working at the hospital we went on a safari.
This project will open your eyes to what all those charity programs are trying to raise money for! You will experience what its like to be a Doctor in Tanzania and see what its like to be a patient there too. You will see what limited resources the hospital has and what they do the try and get round their limitations. You will have hands on experiences with patients and apply some of the things you’ve learnt in the past. You can’t get a purer project than this when it comes to the basics of medicine!
My 3 weeks in Tanzania was certainly another eye-opening experience, which I completed this summer before my final year of my Pharmacology degree. As the plane touched down in Kilimanjaro international airport, seeing the peak of Mount Kilimanjaro was absolutely breath-taking. By this point, I was eager to meet my host family. Arriving in Usa River, the children in the street were already greeting me and I knew I was going to settle in well. Pretty and Zablon, a couple who were hosting me made me feel at home right away, Zablon told me and the other volunteers about his sugar cane growing in the front garden, which was delicious! One thing different from Ghana was the cold shower and a hole in the ground for a toilet, which wasn’t such a bad thing as I may have expected. The food I was given by the lovely house maid, Neema, were in such generous portions, and I found myself eating a lot of rice, chicken and avocado! Chips mayai- a chip omelette was definitely a popular option with 4 of us volunteers staying in Zablon and Pretty’s house. Being called part of their family throughout the weeks was a great feeling and frequently watching the world cup with them during dinner time was always a good laugh! Sometimes we joined our host family and their friends in choir practice, I was overwhelmed by the amazing voices I heard, and it was great fun. Pretty also showed me and the other volunteers her and Zablon’s wedding photos and told us stories of how they met, I was very interested to hear about the culture of relationships in Tanzania.
For my medical placement in Meru District Hospital in Tengeru, I was told to catch the Dala Dala bus with the other volunteers, which was an interesting; sitting close to Tanzanians was a great way to meet the locals! A journey from Usa River to Meru hospital cost only about 300 Tanzanian shillings, this was about 10 pence, so very cheap. I had some expectations of what the hospital may be like since previously working in Ghana, but it was different in some ways. It was a lot smaller and underprivileged than Cape Coast hospital. There were also some problems I noticed such as dangers in transporting the female patients from the maternity ward to surgery for their Caesarean sections, but building a safe walkway was funded by an American charity. Throughout my medical project, I visited the male ward and encountered various conditions, with HIV/AIDS being the number one disease in terms of occurrence. From speaking to the nurses I picked up a lot of medical terms in the native language- Swahili. This helped me to understand medical notes to find out what patients had and what treatments they were on. The follow up of a malnourished, heart failure patient with a doctor and medical student is one that will stick in my mind- devising a treatment plan using our combined knowledge, really gave me a chance to learn some clinical skills with a patient-based approach. Another patient that stays with me was a victim of a motor cycle accident with major brain injury; his affected memory meant it was impossible to contact his family and he could not afford an MRI scan, which was a serious problem that we aimed to tackle. Using a clinical handbook and the BNF as a prescribing guide, me and the other volunteers formed a strong relationship with the doctors; they taught us the practice of medicine and we discussed best treatments for patients.
I always looked forward to volunteering at ‘Cradle of Love’ Orphanage every day from 2 til 5pm. I would catch a Dala Dala from Tengeru to Usa River, and walk 5 minutes to the orphanage. One thing I did not expect when I arrived was the security of the orphanage; there were iron gates with a security guard outside, which were certainly reassuring for the owner! Being introduced to the toddlers and babies was an exciting experience and I had never looked after children at such a young age! I was told some of the children in the orphanage were abandoned or some parents could not afford to keep their babies, the latter made me realise many of the parents put their children in Cradle for good reasons. Some children had HIV infection and one had rickets, but the dedicated attitude of the nannies provided the best care for them. Usually when I arrived the toddlers and ‘wobblers’ would have woken up from their afternoon naptime, when they were full of energy to say the least! The babies loved attention from all the volunteers there, and this made me feel I was making a difference. Playing in the garden was a favourite activity for the children; this was obvious from their immediate excitement when we got out the shoebox to put on their shoes! One thing I did find challenging whilst working in the orphanage was dividing my attention to the different children, and many wanted a turn on the swing-set at the same time. But there were other activities for the children to do, such as playing on the slides or with the toys inside the home. Once I had the chance to change a little boy’s nappy, which to be honest, I had never even done before! Throughout my time at the orphanage, I got to know the children’s personalities very well and so I knew what they did and didn’t like, which was essential to make their day a happy one. Seeing the children laughing from a small game of ‘chase’, I noticed even in a place with little resource the children could enjoy themselves. Dinnertime each day was very eventful. With the other volunteers, I would assemble the table and chairs for the toddlers to sit at a small table together. Some days if the children were in a mischievous mood they wouldn’t want to sit down but make me catch them first! This was initially difficult, but through learning each child’s preferences and from gaining their trust, it became a lot easier. The words ‘Jakula’ meaning ‘food’ in Swahili was always a trigger for their excitement! Being at Cradle of Love, I realised that giving some attention and loving communication to the children was definitely a way to brighten up both mine and their day.
I definitely recommend taking a trip to Ghana or Tanzania, these were both life-changing experiences that really put aspects of life into perspective. I have definitely grown as a person as a result of these trips, and I will forever cherish my memories and the many things I have learnt. I chose Global Medical Projects because they really do care about you making the most of your experiences. Throughout my stays in Ghana and Tanzania I felt a great sense of security with Global Medical Projects, despite being in a foreign area. I’d like to thank Kevin Dynan for giving me so much advice prior to my journeys and for making the application process a smooth one. I also thank Eric and Mary Essuah, who were fantastic in ensuring my stay in Ghana was safe, organised and enjoyable. Zablon and Pretty Mgonja were two amazing people who made sure I made the most of my stay Tanzania, which I am very grateful for.
On the first day, after 16 hours of grueling travelling through three countries, I arrived at Kilimanjaro airport, in dire need of the weekend to recover. However, a fellow volunteer had other ideas, and I ended up at Arusha National Park the following day, a thoroughly enjoyable trip, even if I was asleep for half of it! After being collected from the airport by Charles, a local taxi driver who we would see many more times around Usa River throughout our trip, we made our way to the Mgonja household in Usa River. We were met there by two of the loveliest people I have had the fortune to meet- Zablon and Pretty. Pretty was pregnant while I was visiting, and I hope to go back soon to meet the latest member of the family! Throughout the first weekend, I noticed the stark contrasts between daily life in a country such as this and what I was used to back in the UK. However, the close knit community feeling was apparent from the beginning; from the way everyone greeted each other as they passed, to how well Zablon and Pretty knew their neighbours from all over Usa River!
Viewing major surgery was another major highlight for me; seeing my first caesarian section was exhilarating, the baby’s first cries were wonderful to hear, as a new life was brought into the world. Again, differences between here and the UK were on show, with some aspects such as equipment and drugs used completely different to those used in the UK. For instance, I was initially surprised to see ketamine used as a local anesthetic, but was quickly informed that the one in use here was the non-recreational type. I also saw a vaginal cyst removal during my time in Major ops, and was impressed with the speed and precision with which the doctors completed the procedure.
In addition to the hospital, I visited a local orphanage in the afternoons, which offered a different experience entirely. Cradle of Love, an orphanage halfway between the hospital and Usa River, was fairly well funded, with good facilities and plenty of staff and volunteers, which surprised me initially, as I was expecting a far more degraded infrastructure. After visiting a far less privileged orphanage later on the trip, I realised that the children at Cradle were lucky to be here, but no less deprived of the most innate human craving- attention and care. Over the next three weeks, I cared for children from babies to around age 3, playing with them and assisting feeding. I had worked with children before in the UK, but not this young, and was surprised in many ways. The children were split into four groups depending on walking ability (and age): babies, crawlers, wobblers, and toddlers. I spent most time with the wobblers and toddlers, as I enjoyed the more hands on and busier style with the older kids. Full of energy and very clingy as children of that age are, I proceeded to build such strong relationships with some kids that I didn’t want to leave at the end of each day! I can honestly say that there are not many better feelings than giving attention to children that are so obviously deprived of care, and not many worse feelings than leaving at the end! Unfortunately, some of the kids weren’t used to men at all, and proceeded to cry whenever I went near them, which was the opposite of what I intended! Ultimately, although I know the kids won’t remember me, I will always treasure the time I had with them, as they brought out my inner child, and made me realise how lucky I am to have parents.
On another note, before I began to research Tanzania as a country, I didn’t realise how rich it is- not in monetary terms, but in culture, in natural wonders, and in surprises. Unfortunately, I could not visit the Serengeti, or climb Kilimanjaro, or stay on Zanzibar, but I plan to do all these things when I go back, as I have heard amazing things about them. In fact, I wouldn’t have been able to do all those things in the time that I had even if I tried! Instead, I went on safari to Tarangire and Ngorogoro National Parks, and can honestly say it was unbelievable. The pictures don’t do it justice; you must visit yourself!
My name is Chris and I spent one month volunteering on a medical project elective in the village of Meru,Tanzania. During my time in Africa, I worked in many different departments at Meru District Hospital, but I enjoyed my experiences in the ER and major surgery theater the most. Meru District Hospital was situated near the heart of third world Kilimanjaro, Tanzania, an area impoverished with limited resources in many aspects of health care, whether it be the medicine distributed, sterilization supplies, or the way the public was educated on healthcare. In an area where health insurance didn’t exist, people of all shapes and sizes would crowd the emergency room daily with many different health concerns. It was during this month I learned exactly what it would take to work as a medical doctor in an area of unwarranted variation.
As my first week at the hospital began, I was introduced to the Dala Dala, a public transport van that would travel from village to village to take me to work. At the hospital, I was greeted by the hospital matron and after reviewing my resume, the matron requested I deliver a presentation on immunology to the entire hospital. Before the matron gave me permission to begin my work, she showed me every department within the hospital. As we walked along the district hospital I saw how every department resembled a piece of a puzzle; it was like the hospital was a village in itself. Some of the departments included pediatrics, major and minor surgery (ER), female and male ward, AIDS ward, and even a TB ward. The matron permitted access to every department, but because of my passion to become a surgeon, I immediately dove right into work at the ER department. When I began my work, the staff treated me very much like a medical student; the nurses and doctors were so
As my time in Africa grew, I was finding myself more and more involved in the ER and surgery department, so much that even ethical issues in medicine were starting to surface amidst my experiences. One of the most startling issues was that many of my patients were young females who had given themselves abortions. Because abortions were illegal in Tanzania, young women would often damage their bodies by giving themselves an abortion; it was my duty to make sure to clean out the reproductive tract and make sure the woman would not have any further health issues down the road. These kind of situations made me aware of how politics and social situations can influence certain factors in healthcare and it made me understand how my only view was simply to help a person in any way that I could. My time in the ER helped me deal with injections, POP casts from broken limbs, auscultations, catheters, stabbings and wound cleaning, seizures, gunshots, and even motor vehicle accidents. I was getting so involved and with the amount of trust and responsibility that was bestowed upon me, it just felt right to keep going. Sometimes I would clean out an infection, whether on an infant or an elderly man, I knew how bad it would hurt to make that incision to flush out the abscess, so I would sometimes just let the patient hold onto me and squeeze my arm whenever it would hurt them just so I could hurt a little bit too and feel their pain. In my mind It was all definitely a case of learning fast, being confident, and embracing any challenge with a grain of salt, but I wanted all of that so bad…I wanted to keep learning; It was like I had something to prove. The ER shaped me the most out of all the departments, but it was being able to assist with both suturing during a cesarean and hernia surgery in the major surgery department that really made my experiences most memorable.
Easily the best thing about working at the Meru District Hospital came in my last week of work. Of all the time I spent working, I felt the most experienced in my last week, and as a result the matron and staff allowed me to do rounds in the male and female ward. I would show up to work and begin my rounds around 8am and would finish up by 11am. Some of my cases included stroke, malaria, and AIDS patients. I remember sometimes being amazed at how different such cases were than the standard patient one might see at a hospital back in the US. I took each patient as a lesson, spending time with them, analyzing their treatment regimen, and making sure their condition was on its way to being stable. I must have looked like such an alien to some of those people, but that never stopped me from giving them my best care. My most memorable moment though was when I had the opportunity to deliver a baby in the female ward. It was perhaps the most exhilarating moment in my life, being able to take charge in such a situation. It felt completely natural. I look back on my achievements and realize that I would not have been able to do some of these things in the US. These are some of the moments that I will remember for a long, long time.
On my last day at the hospital, the entire hospital staff showed up to listen to my presentation. During my placement I truly felt that infectious diseases and unwarranted variation prohibited many of the people from being healthy, so I decided to base my presentation on the basics of innate and acquired immunity.The entire presentation lasted about 45 minutes, followed by a series of questions asked by several staff members. Near the end of my presentation, some of the doctors and head staff members made me feel humbled by acknowledging all the work I did in the last month at their hospital. As I write this 3 months since I returned from my trip, some of the faces still stick with me. These people really gave up their time to teach a stranger. Of all the feelings I felt during this trip, I realized that there really are a lot of good people in the world, you just have to carry an open heart. I found that ultimately if you truly pour your heart into what you believe in, even if it makes you vulnerable, amazing things can and will happen.
Even though the application process and the gruelling flight hours may have seemed like a challenge at first, going through this experience with Global Medical Projects helped me to meet some really amazing people that I consider a part of my family now. When you share the same meals, experiences, and a roof under your head with people who are there to take care of you, you establish this connection that can truly last a lifetime if you let it. At first I was a bit concerned being the only volunteer to stay with my host family, but both were fantastic in meeting any of my needs/requests, including picking me up from the airport, assisting me with my bus fare to work when I needed it, and even helping me plan an excursion to the island of Zanzibar for a weekend trip. Perhaps the thing I valued the most that they showed me was an orphanage down the road from where I was staying called “Good Hope.” After visiting the orphanage 2 weeks into my stay, I told myself that I would visit the kids everyday after work no matter what. Seeing those smiling faces really made the trip worth it, and because of the orphanage I made a promise to myself that I would go back to Usa River once my journey to becoming a doctor is complete.
I assume you can organize your own placement directly with Meru hospital if you wanted to, but I would strongly recommend going through a company such as Global Medical Projects the first time around, as this provides you with the safety and security which, in my opinion, truly matters when you may seem like a complete stranger to the country and it is easy to stand out. I am truly grateful for all that the staff at Meru District Hospital went through to teach me how to be a better medical professional and I am forever humbled to be so warmly welcomed by the entire village of Usa River during my placement. When I arrived to Usa River, I remember going to the village church on my second day and feeling like a stranger completely lost in the culture, but as I think back on my journey, I think of Usa River and Tanzania on a whole as a hidden place, tucked safely away from the world, concealed by the high walls of the Meru and Kilimanjaro mountains. It all almost felt like being in a place rich with strange beauty, like being in a dream. I would like to further extend a thank you to my family and friends for supporting me through my journey, the staff at the Commonwealth Medical College for inspiring me to strive past any limit, and to Kevin Dynan of Global Medical Projects for helping me through the entire application process. All of these amazing people have helped me grow in ways unimaginable, but my warmest gratitude goes out to the Mgonja family in Usa River, Zablon and Pretty – for teaching me that you don’t have to be blood related to be a part of a family, I promise to hold onto that bond no matter where my experiences may take me.
After being picked up that evening by Alberto, one of the volunteer coordinators for Global Medical Projects (and yes, he spoke English very well), I was taken to my “families” house. Prior to arrival, I knew I was going to be assigned to live with a family in Guadalajara and that the family would be providing me with 3 meals a day as well as a clean, safe living quarters. The coordination with getting to Mexico was effortless. Kevin, the program director based out of the United Kingdom, was very quick at responding to calls/emails and kept me informed with any changes in living arrangements, assignments, and with answering any questions/concerns that I had.
I spent a bulk of my three weeks in the hospital.The hospital experience was perfect. As volunteers, we took the bus and train to the hospital every morning around 7 am. We were “on-duty” from 8 am to 2pm. I was able to assist and perform many procedures (under the guidance of one of the physicians) that are not normally in the scope of practice for a paramedic in the states. Some of the most memorable things that I was able to do included removing and doing stitches, directly assisting in the operating room, helping put casts on patients, assisting with cleaning and wrapping wounds, starting IV’s/setting up drips of medications, assisting during cardiac arrest, and etc. The list could go on. Some interesting cases that I saw included: multiple cardiac arrests, a scorpion sting on a little girl, a traumatic femur fracture, a man stung by hundreds of bees, and a man who went into anaphylaxis due to eating a duck egg.
In the emergency room, as a volunteer if you simply asked, you could learn and assist with almost anything under the guidance of the doctors. They truly wanted us to learn and help as much as possible. Not only was I able to pick their brains about medical procedures, but I was able to understand how their health care system worked. By the end of our trip, the doctors and nurses became close friends to us. We often went out in the evenings together and they truly made us feel like we were part of the hospital family.
As a volunteer, I rode third person in the back of the ambulance’s captain chair. (Let’s just put it this way: you definitely had to buckle in and hold on when they were driving emergency traffic or you risked flying out of your chair!). The director of EMS made sure that we stayed with the same paramedics during our time volunteering. My two paramedics were no different than the hospital staff in the respect that they wanted me to be at home. Between calls, they would often sneak me away to see something “cool” or to eat a traditional meal that I was “required to eat” before leaving Mexico. They made sure I got the true Mexican experience. In the field, similar to the hospital, the paramedics let me function as a paramedic. I noticed in the homes that the residents of the city were extremely respectful and thankful for the paramedics. It was a wonderful experience to see and the respectfulness truly reflected the “Mexican way of life” (as they would often tell me about).
When we weren’t working in the hospital and on the ambulances, we were able to venture around the city of Guadalajara and surrounding cities. The evenings were often full of fun adventures to shop, eat, drink, and enjoy the Latin culture. The weekends were especially exciting because we elected not to work on the weekends (although you could if you wanted or needed to). As a group, we picked places we wanted to go see and would travel to them via Uber or the bus. One weekend, we took a bus to Puerto Vallarta. Puerto Vallarta was a neighboring beach city about 4 hours away. We were able to book an “Air B n B” hotel room for extremely cheap to stay right on the beach. Another weekend, we got rained into a “fiesta” in a nearby city and enjoyed some local drinks and festivities- not so bad to be rained in with good food and company!
After my three weeks were up, I found it difficult to leave. The culture was incredibly inviting, I felt part of the hospital and EMS staff, and I had made wonderful friends. I’m already looking forward to the next opportunity I get to go back. Thank you Global Medical Projects for providing a safe, fun, and invaluable learning experience that was, and is, an experience of a lifetime!”
On arrival I was greeted by Babu (Head of the Global Volunteers Medical Project and Owner of the house) and Sudah (a very friendly lady who is Project Co-ordinator.) The house stood out from the surrounding greenery, due to its bright orange and pink colour. I was given a very warm and friendly welcome and then shown to my room before being cooked an Indian omelette for supper before heading to bed. Trying to sleep in 38 degrees with a fan blowing hot air isn’t easy and involves having at least 3 showers throughout the night.
On my first day I learnt how to take blood pressure using a 
On Friday evening I went to Waters Edge Beach Resort of Samudra Beach, Kovalam. Here I spent the weekend in the sun, enjoying some fishing and swimming. I returned back home to the volunteer house on Sunday evening after a 2 hour rickshaw ride. I think it is fair to say that the 4 car wide overtake that they seem to have adopted quite readily out here on the roads is LETHAL. All I know is if I had taken my driving test in India I certainly would have passed first time, instead of fifth!
May 8th: Another week has flown by out here where I spent my time in St. John’s Community Hospital shadowing various specialties. On Monday I split my time between shadowing a GP and an ENT consultant. Cases seen in general practice included throat and chest infections, lower leg oedema and diabetic complications. Time in ENT was really interesting and I certainly learnt that small toddlers will find anything to put up their nose. In one morning the consultant removed 2 pearls, one ball of paper and a pea from various toddler’s noses. Aside from foreign objects stuck in orifices, other cases included otomycosis (fungal infection of the outer ear), thyroglossal cysts, surgery to repair the ripped earring hole of an elderly woman, tonsilitis, acute superior otitis media (inflammation of the middle ear) and rhinitis (inflammation of the membrane inside the nose.) The ENT consultant spoke very good English and was able to explain a great deal to me, for which I was very grateful.
May 15: This was my favourite week so far. I think this was mainly because I was placed in Anchal Hospital for Mother and Child which is heaven when you are as obsessed with small babies as I am. On this route from home to work I saw a fair few elephant commutes, which definitely beats the London tube anyday of the week!
On Friday we visited the Bethania Rehabilitation Centre for the Disabled in Kumarapuram. This centre is run by Bethany Convent Sisters of Immaculate Christ. It is home to 70 girls from the age of 12-50 years old. The centre provides living and rehabilitation facilities with different sessions run daily for the girls. I was lucky enough to see an english lesson, a type writing class, paper card making, tailoring and sewing, computer writing, handwriting and to visit the book printing and binding press attached to the centre. The girls were lovely and introduced themselves and the town in which they lived. One girl did the most beautiful dance whilst another sang a song for me. During the typewriting, computer writing and handwriting lessons they were copying from english text about pollution which was very impressive. This centre is free of charge and is a rather amazing facility for these girls to learn different skills and rehabilitate. We then went into Trivandrum to purchase a wheelchair that we are donating to a dialysis patient who struggles financially and who can very sadly no longer walk very far. After this we visited Pallium India which is a hospital for pain management and palliative care where I will be placed for a few days next week. It focuses on ‘care beyond cure’ and has a lot of patients suffering from spinal cord injury. Next week I will visit the clinical hospital and go on home visits with the community palliative care team.
Tuesday and Wednesday I spent at Pallium India Hospital for palliative care (care beyond cure.) This hospital deals with lifelong illnesses, pain management and palliative care. I spent Tuesday at the hospital shadowing doctors and nurses and on Wednesday I went with the team on the home care visits. Whilst on the in patient ward I saw a patient with a giant cell tumour in her left ileum, a women with a neck ulcer that had become infected with maggots (that morning the nurse had removed 100 maggots from her neck!) and an elderly man with cancer of the oropharynx. This inpatient ward can accommodate up to 15 patients but on this day it was relatively quiet. I learnt a lot on the ward rounds with the doctors, especially about the different types of pain management used and the side effects that different patients experience. The most common being delirium following the administration of morphine. Most patients are discharged back home once their pain is under control unless they have chosen to stay until their last few days, in which case these days are made as peaceful as possible. The hospital also runs a rehabilitation program for people with paralysis. This is a collaborative project of Pallium India with the Department of Social Justice, Government of Kerala. The centre can accommodate up to 4 patients at once and each patient usually comes for 45-50 days of rehabilitation. Whilst I was visiting there was a young boy with hemiplegia (paralysis of one side of the body), a lady with a demyelinating disease and as a result had paraplegia and 2 young men also with paraplegia. The young boy spoke very good English and was an extremely talented little artist. He showed me all of his watercolour paintings with his masterpiece being an A3 Ferrari which was very cool. I spent a lot of time speaking to the social workers during lunch. One spoke very good English and is off to New Zealand next month which is very exciting for him as it will be the first time that he has left India. I met the chairman of the hospital who was a very lovely man and who spoke to me about medicine for a while. Wednesday’s home care visits begun at 8.30 am and included 7 different patients, finishing at 4 pm. The home care team involved 1 doctor, 1 nurse, 3 volunteers, me and a driver. All patients visited were either bed ridden or couldn’t access a hospital due to the remoteness of their house. The cases seen included oral cancer, lung cancer, hemiplegia, obstructive hydrocephalus, uncontrolled diabetes and geriatric patients. The doctor and nurse checked the patient’s vitals (pulse, blood pressure and chest) and replenished any regular medicines that the patients required. I got to perform my first chest auscultation on a patient and his wife gave me one of her jungle pineapples to say thank you which was very sweet. A lot of the patients lived up in Kerala’s jungle meaning that to get to them we had to park the mini bus and walk through the jungle, dodging falling coconuts from the trees above and crossing a few rivers. At one point a fast moving snake came straight across the path in front of me (you can see from the photo below that I wasn’t best pleased!) The patients seen all lived in stone huts with tarpaulin or tin roofs with minimal electricity supplies. On the trees surrounding their houses they engraved water run-off paths ending in coconuts to collect the rain water which is very clever! It was rather amazing being able to see these home visits and make comparisons to the ones that I have experienced in the UK in general practice (they certainly didn’t involve any jungle hikes or snakes!)
My name is Emily and I spent 5 weeks volunteering on a medical project in the city of Guadalajara, Mexico. I was working in the Green Cross, an emergency trauma clinic that provides urgent medical care ranging from cuts and scrapes to life threatening illnesses or injuries. The Green Cross clinic was located in a poorer area of the city and was accessible to those without health insurance which meant I got to meet all sorts of different people. I can honestly say my time spent there was probably one of the best experiences of my life.
A typical day for me working in Mexico started with the always adventurous bus ride to the Green Cross clinic, definitely the cheapest roller coaster I have ever been on! I would work Monday to Friday starting in the afternoons and leaving in the evening before it got dark. I would spend the day assisting the doctors and nurses treating any patients that came in. Sometimes I asked to stay and do the night shift which was always exciting – lots of alcohol, drugs, assaults and stabbings. I was never short of an opportunity to practice my stitching on a night shift! Some days it would be really quiet and then suddenly get very busy. The great thing is that I would turn up to the start of my shift and have no idea what was going to come through the doors. There was a large team of doctors and nurses in the clinic, another volunteer also joined me half way into my project which was nice. I made so many great friends and although there was a significant language barrier between me and some of the Mexican staff we were still able to enjoy a joke and get on really well. I even managed to befriend some of the paramedics and sweet talk my way onto an ambulance ride along; what an exhilarating experience that was.
If anyone is considering doing a medical project in Mexico, I cannot recommend it enough. You will gain invaluable experience, especially if you are considering a career in the medical world. I would suggest you take plenty of scrubs to wear and some good stain remover, mine started off white but got messy very quickly! I would also recommend that you go with some basic Spanish skills, I managed to get by but I do wish I could have communicated better with the staff and especially the patients. Overall this project was exciting, interesting and challenging and I would do it all again in a heartbeat.
