Medical students from the UK visit Zanzibar

Isobel Ramsay, a friend of Pat and Janie’s from Norfolk, travelled to Zanzibar with a party of medical students from the UK in April. They spent some time at Mnazi Moja Hospital, and then based themselves in Jambiani. Isobel has written this interesting and informative report:

I and three of my fellow medical students, spent part of our medical elective on Zanzibar, splitting our time between Mnazi Mmoja hospital in Stone Town (Zanzibar’s capital) and Jambiani, a village on the east side of the island and home to ZAP – Zanzibar Action Project.

Working in Mnazi Mmoja was an eye opening experience. With diagnostic tests often taking weeks to produce results and a lack of people qualified to interpret them, our clinical skills were very much put to the test. On my first day, approaching what I thought was a group of doctors on ward round, I was faced with a barrage of questions and soon realised that all my answers including my treatment suggestions were being written down in the notes! Definitely a change from being a medical student back home.

Between us we gained experience in general medicine, obstetrics and gynaecology, dermatology, infectious diseases, HIV medicine and psychiatry (which takes place in a separate hospital, Kidongo Chikundu – to read more click here.)

Although there seemed to be plenty of medication available, there seemed to be little knowledge in how to use it. The exception to this was the HIV clinic, which, unlike the other departments, was similar to HIV clinics back home. With a plenty of infectious diseases (tetanus, malaria, diarrhoea) alongside the more familiar diabetes, heart failure and kidney problems, this was an excellent introduction to medicine in the developing world.

After the heat and hassle of Stone Town, it was a relief to escape to Jambiani, a beautiful village stretched out along 7km of coast. Having read about ZAP in their newsletters and online, we were interested to see their work for ourselves.

We installed ourselves in a hotel on the beachfront with stunning views of the sea, working showers and clean towels (much needed after a month of travelling!) and started our stay in Jambiani with what was to be the first of many meals involving octopus and chips.

The next morning we met with the enthusiastic Mr Pandu ( ZAP’s managing director in Zanzibar), clothed in bright green ZAP T-shirt, who took us on an excellent guided tour through the village.

First stop was the nursery/primary school where a large number of children were jostling each other in a queue for porridge. Surrounded by small people, we were handed our own mugs and had porridge ladled in – surprisingly tasty and spicy. We were fortunate enough to be able to go and watch and join in with some of their classes. We were roped in to help out with learning the names of animals, body parts and family members (very useful for our Swahili) and watched while the entire class of about 25 seven-year-olds, wrote their names on the board. They seemed very well behaved compared to a group of seven-year-olds back home!

Next stop was the secondary school which Mr Pandu showed us round, trying not to distract the chemistry and maths lessons that were going on. Based in the school, is the women’s sewing group started up by ZAP. We were very impressed by the sewing lesson which was in progress at the time we visited which involved practising dress making using newspaper.

Our last stop was the Jambiani Community Academy where we met Mr Vuai, who was very helpful in sorting us out with internet access. After weeks of computers which kept crashing and switching off of their own accord and internet going at snail’s pace, the computers here were wonderful!

Being medical students, our main interest was in the Jambiani Clinic - run by the hardworking Dr Hamza. Unlike the doctors in the hospital, who all seem to disappear at about 1pm, he starts at 7.30 am and wades through patients until there are no more, pretty much without a break. When we first appeared early on a Monday morning, a large crowd had already gathered. We found Dr Hamza in his consulting room, half hidden behind a pile of books and pots of pills, already measuring out paracetamol into small plastic bags with a spoon. Not only does he contend with Jambiani’s ill, but such is the reputation of his clinic, people from the neighbouring villages (which have their own clinics) also come to visit, giving him a heavy workload. We sat in on some of his clinics and helped out with examining the patients who were mostly young children with coughs and fevers.

Of the doctors we’d come into contact with on Zanzibar, Dr Hamza was among the most impressive, in particular with his prescribing practice, being quite conservative with his antibiotic use and not wasting the medications that he had and with his use of the diagnostic tests available in the laboratory section of the clinic.

We also spent some time with the midwife who runs Jambiani’s antenatal clinic. This was great experience for us and we were looking forward to helping out with deliveries in the delivery room in the clinic (unfortunately nobody in the village gave birth while we were there!).

One of the things that interested us most were the various graphs decorating Dr Hamza’s office, charting the incidence of different diseases in Jambiani. 10 years ago, malaria was a major problem, now the list looks much more western with asthma and hypertension high up the list suggesting a definite improvement in local awareness of disease transmission.

Overall we had an excellent time with ample opportunity to see interesting medicine and spend afternoons on the beach, watch local football games and find fishermen who would bring in fresh fish for supper. I would like to thank Pat and Janie for their help in arranging our time in Jambiani and Mr Pandu, Mr Vuai and Dr Hamza for showing us round and making us welcome. Fingers crossed we’ll be back some day if we manage to get some holiday from working for the NHS!

Isobel Ramsay

April 2010

Return to Volunteers Page.