Karah Waters
Karah Waters
Tanzania 2017
VIEW FINAL REPORT
Mambo! I am a recent nursing graduate seeking to experience healthcare and African culture in Tanzania. I will be working in a hospital in Dar es Salaam as well as a clinic in the Kidodi village. Join me as I embark on this escapade of being engulfed in healthcare abroad.

Aga Khan- September 5th

Being the Patient
This last week was probably the first time I was really home sick and wanted to go home. When you’re not feeling well in a foreign country it really makes you long to be home. I honestly wasn’t sick or anything! I was just in a lot of pain. Thursday of last week I had a little red spot under my left armpit. Over the next 5 days it kept getting bigger and was hurting more and more. It got so bad to the point that on Tuesday, September the 5th, when I was at work I couldn’t even lift my arm up. I had to hold onto my arm at the hospital to help decrease the pain. When I got home from work I knew I needed to get it checked out. I went to Mo who is the program manager and asked him if I could be seen by a doctor anywhere. He said that I will go  to Aga Khan. This is a private hospital in Dar which is a lot different to Muhimbili which is a public hospital and is the biggest regional hospital in Tanzania.
I was extremely hesitant and scared that I was having to actually go to the hospital! In AFRICA. I made sure to get two different kinds of international health insurance because I was so worried about something like this happening and the last thing I wanted to happen was to get treatment here. Not that it’s a bad place but it’s severely under resourced and not everyone abides by hand sanitation and proper sterile technique. It was SUCH an eye opening experience being on the flip side of the healthcare system. Like being a patient rather than a nurse or healthcare professional. My heart was beating so fast and I was so scared. I didn’t know what I was going to have to have done. Mo said I would go with Jessica who is the program assistant and they called a taxi for me and we were off. I kept asking Jessica if there was another place we could go to like a doctors clinic like we have back in the states like a Walgreens walk in clinic or fast pace. However, she said that there aren’t any places like that and if there are they’re extremely rare and under resourced. So you have to go to the hospital. We got there and walked up to a counter to explain what was going on. Everyone was speaking Swahili around me and Jessica would translate after they were done talking. The woman at the counter had told Jessica since I was a new patient and had never been there before that I needed to check in and give my information to the new patient area. We went to this room and opened the door but no one was there. So we waited outside the room until a gentleman approached us and asked if we needed to be seen. A few moments later he got a lady who told me to come into the room. She spoke English as well as Swahili. I sat down and she went to a computer. There was a tv that I could view that showed everything she was typing. She asked my name, DOB, emergency contact, etc. Instead of asking where I was from she just put foreigner. She asked what doctor was I seeing. I told her I didn’t know. After she got my information she then made me a folder with all of my information. She told me to go to billing with the folder. I went to billing (which by the way nothing was laid out easily. Everything was all over the place). Once I arrived to billing they asked me what doctor did I need to see. I honestly had no idea! I thought a skin doctor maybe? Jessica said we weren’t sure so we’d have a nurse look at me. We then went to a hallway where a nurse was sitting and taking someone’s vitals. Jessica explained the situation and she said to have a seat and that she’d be right with us. However, once she finished with that patient she left the hallway and went to another room. She then came back to the hallway a few minutes later and started talking to someone on her cell phone. It’s so interesting here how the doctors and nurses will do that! I’ve seen several nurses hanging up IV bags and then they get a phone call on their personal cell. They’ll stop what they’re doing with the patient right there and will begin to talk on their phone and have a full on conversation. 30 minutes went by and I was getting a little upset. How the culture is here can be very different and almost annoying. Usually I can let it role off my back and it doesn’t bother me. Everyone is just very hakuna matata, no worries. No one ever rushes or stresses about things. There’s a saying they use, “Swahili time.” Which basically means they’ll get to it when they get to it. They may say they’ll be there at 8am. They may be there by then or they may be there at 10am. Not because they’re late but just because. Jessica told me to sit beside the nurse because she may have forgotten about us. So I got up and sat right beside the nurse while she was still on the phone with her friend. She looked at me and soon ended her phone conversation. She apologized to Jessica in Swahili and simply said she had forgotten about me. Without even asking my name or telling me her name she simply asked me what was wrong. I showed her my arm. She didn’t even touch it or look at it for more than 5 seconds. She started making phone calls to the hospital and got me a spot with a Dr. We went upstairs where we waited once again for the doctor to see us. Someone finally stepped out of one of the rooms and summoned me into his office. He was on his phone talking with someone at his desk. He pointed to the chair for me to sit down. Once again, I was just twiddling my thumbs while he was on his cell phone with a friend. It was so strange to me! He was an Indian man problem in his late 50’s or early 60’s with a thick accent. Once he got off he just looked at me and was like, “So, what’s the problem?” I explained I had a big red bump under my armpit and he just said go sit over there. Which was the examination table. Once I sat down he walked over towards me and touched the mass under my arm. Without gloves on or anything. After looking at it for about 10 seconds he was like, “That’s an abscess. We’re going to have to make an incision and drain it.” He began writing orders down. It was so different compared to the US. Typically the nurse will get your vitals, take your history, etc. And the doctor will ask you the same questions. No one had even asked if I had any allergies! He began to collect his backpack and belongings while saying I would have to have surgery. S U R G E R Y ?!?! I tried to maintain my composure and simply said, “How big will this incision be?” He said, “Oh, not that big. It’ll be a minor surgery.” He just summoned me to the door at that point and we stepped outside his office. When I asked him where we’re going he explained that I had to go to billing and pay and that his assistant would do the minor operation in the OPERATING ROOM. At this point I was holding in all my tears and fear. It was like I was in a bad dream. This was something I had to address and get fixed. I couldn’t ignore it. But the place I was in was extremely scary. It was like facing a fear you never knew you had all of a sudden and you knew know matter what you did you couldn’t prevent it from happening. He pointed to billing which was on the same floor we were on and then he pointed downstairs and said to go through those doors. I literally felt like I was walking to my death. I may be over exaggerating here but I really did. Every step I took, every breath I breathed, every time I swallowed my heart beat just kept getting faster and faster. I wanted to run out of there and not look  back. I approached the billing counter where I pre-paid for the surgery, dressings, and the 5 minute doctor consolation. Jessica and I then went downstairs to the operating area. We were just standing in the middle of the hallway waiting for the assistant. Within 15 minutes a lady probably in her late 20’s or early 30’s approached me. I felt a lot better with her compared to the main doctor.  She explained she was the assistant and would be doing my surgery. She pointed me to the operating room I would be in. I sat up on the bed and just took a big gulp. I was staring around the room just taking everything in. The lights were a bit dim and there were mosquitoes flying nearby the bed. I looked at the sheets on the bed and there was a dark droplet of blood that had stained the sheet about 2 inches from where my legs were hanging off the table. The assistant began to get everything prepared. I was eyeing her like a hawk. Making sure she never contaminated her sterile field. She didn’t. I was very relieved and at the same time impressed. It made me feel a little bit better knowing that I was in competent hands of someone. 
feeling of being white in hospital. everyone stared. I was an outsider. not their normal person you’d pass by in the hall
chaotic
waiting, not too bad actually
Jessica thought it was great
how they feel but in their shoes and they were in US?
Didn’t even ask allergies Everything happens for a reason. When I got back from working I talked with Mo who is the program manager and asked him if there was anyway I could please go to the doctor to get it checked out. He called for a taxi and I went with Jessica, the program assistant to which is a private hospital. Mo kept saying it would be a mzungu hospital which meant it would be a lot like a western hospital and not like the one I work at. The one that I work at is a public hospital and not in a harsh way but I wouldn’t really want anyone to even touch me there. I was so scared that I was having to actually go to the hospital! In AFRICA. I made sure to get two different kinds of international health insurance because I was so worried about something like this happening and the last thing I wanted to happen was to get treatment here. Not that it’s a bad place but it’s severely under resourced and not everyone abides by hand sanitation and proper sterile technique.
It was SUCH an eye opening experience being on the flip side of the healthcare system. Like being a patient rather than a nurse or healthcare professional. My heart was beating so fast and I was so scared. I didn’t know what I was going to have to have done. I kept asking Jessica if there was another place we could go to like a doctors clinic like we have back in the states like a Walgreens walk in clinic or fast pace. However, she said that there aren’t any places like that and if there are they’re extremely rare and under resourced. So you have to go to the hospital.
We got there and walked up to a counter to explain what was going on. Everyone was speaking Swahili around me and Jessica would translate after they were done talking. The woman at the counter had told Jessica since I was a new patient and had never been there before that I needed to check in and give my information to the new patient area. We went to this room and opened the door but no one was there. So we waited outside the room until a gentleman approached us and asked if we needed to be seen. A few moments later he got a lady who told me to come into the room. She spoke English as well as Swahili. I sat down and she went to a computer. There was a tv that I could view that showed everything she was typing. She asked my name, DOB, emergency contact, etc. Instead of asking where I was from she just put foreigner. She asked what doctor was I seeing. I told her I didn’t know. After she got my information she then made me a folder. She told me to go to billing. I went to billing (which by the way nothing was laid out easily. Everything was all over the place). Once I arrived to billing they asked me what doctor did I need to see. I honestly had no idea! I thought a skin doctor maybe? Jessica said we weren’t sure so we’d have a nurse look at me. We then went to a hallway where a nurse was sitting and taking someone’s vitals. Jessica explained the situation and she said to have a seat and that she’d be right with us. However, once she finished with that patient she left the hallway and went to another room. She then came back to the hallway a few minutes later and started talking to someone on her cell phone. It’s so interesting here how the doctors and nurses will do that! I’ve seen several nurses hanging up IV bags and then they get a phone call on their personal cell. They’ll stop what they’re doing with the patient right there and will begin to talk on their phone and have a full on conversation. 30 minutes went by and I was getting a little upset. How the culture is here can be very different and almost annoying. Usually I can let it role off my back and it doesn’t bother me. Everyone is just very hakuna Maratha, no worries. No one ever rushes or stresses about things. There’s a saying they use, “Swahili time.” Which basically means they’ll get to it when they get to it. They may say they’ll be there at 8am. They may be there by then or they may be there at 10am. Not because they’re late but just because. Jessica told me to sit beside the nurse because she may have forgotten about us. So I got up and sat right beside the nurse while she was still on the phone with her friend. She looked at me and soon ended her phone conversation. She apologized to Jessica in Swahili and simply said she had forgotten about me. Without even asking my name or telling me her name she simply asked me what was wrong. I showed her my arm. She didn’t even touch it or look at it for more than 5 seconds. She stRted making phone calls to the hospital and got me a spot with a Dr. We went upstairs where we waited once again for the doctor to see us. Someone finally summoned me into his office. He was on his phone talking with someone at his desk. He pointed to the chair for me to sit down. Once again, I was just twiddling my thumbs while he was on his cell phone with a friend. It was so strange to me! Once he got off he just looked at me and was like, “So, what’s the problem?” I explained I had a big red bump under my armpit and he just go sit over there. Which was the examination table. Once I sat down he walked over towards me and touched the mass under my arm. Without gloves on or anything. After looking at it for about 10 seconds he was like, “That’s an abscess. We’re going to have to make an incision and drain it.” He began writing orders down. It was so different compared to the US. Typically the nurse will get your vitals, take your history, etc. And the doctor will ask you the same questions Didn’t even ask allergies Everything happens for a reason.

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