International Health Studies Grant 2014-15 in Action: Reflection on Medicine in Tanzania

In October 2014, Gregory Haman - at the time, a 4th year medical student at Harvard Medical School, received a grant from the Foundation’s International Health Studies Grant Program. Below is a synopsis of his international experience from January 15, 2015 to February 28, 2015

I recently completed a two-month clinical rotation in Mwanza, Tanzania. I worked with patients admitted to Bugando Medical Center (BMC), a 900-bed referral hospital, and Sekou Toure Hospital, a government run regional hospital that BMC has partnered with. Having previously served as a secondary school teacher in Tanzania for three years, I was especially grateful to have the opportunity to spend several months in Tanzania where I aim to continue working in the future.   

I was graciously welcomed by my Tanzanian colleagues and became fast friends with several of the fellow medical students and interns. I was struck by the high number of patients that interns were responsible for at Sekou Toure Hospital. It was not unusual for a Tanzanian intern to formulate a care plan for as many as 40 patients during morning rounds, and frequently several were very sick. Their hard work impressed me daily.

A recurring theme in the care of individual patients was overcoming the practical barriers to providing important treatments. Financial constraints were very common; patients were often prescribed medications but were unable to pay for them. As providers, my colleagues and I often struggled to find a path forward when rounding on a patient who was not getting the most efficacious treatment because he or she could not afford it. My colleagues and I needed to advocate for our patients in ways that had not been necessary in my training in the USA. Practical barriers preventing my colleagues and I from offering ideal care was a daily occurrence.

Though my two months of training in Tanzania were brief relative to the duration of my medical training in the USA, it did make me grateful for the relatively lesser degree to which cost-consciousness and access to the most effective treatments limits care at the hospitals I trained at in the USA. The experience also strengthened my desire to address such barriers in my future work.  

A highlight for me during my time at Sekou Toure Hospital was befriending and working with ten clinical officer students. Just having started their training, they wanted further training in physical examination skills, and I was happy to lead teaching sessions for these students on the respiratory, cardiovascular, and neurological exams. 

My time at BMC was invaluable to the career I envision: practicing and teaching medicine in Tanzania. I am a firm believer that to be a good teacher, first you have to be a good student, and this opportunity immersed me in the role of being a Tanzanian medical student. From this perspective I gained insight into the strengths and shortcomings of Tanzanian medical education and ideas on how I can be a more effective teacher. I was fortunate to form memorable connections with many of my patients as I advocated on their behalves. My task going forward is to use the gift of medical training that I have been given to advocate on behalf of patients, addressing the practical barriers to care and working together with my Tanzanian colleagues to remove them.

- Gregory Haman

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