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Electives - Global Health

Tanzania Program

Elective Number: 1524 (International) (arranged)

Rotation Supervisors: Drs. Eric Houpt & Tania Thomas

Designated signer: April Ballard, Center for Global Health

Available: all Rotations

Prerequisites: At least a month prior to beginning the rotation complete the Elective requirements on the Forms page. For Scholarship information, contact April Ballard, Program Supervisor, Center for Global Health 243-6383.

Application Procedure: Spaces are limited therefore prospective students should contact Dr. Thomas, tat3x@virginia.edu, by the summer of the 4th year. The student should identify in writing his/her personal and professional goals for the rotation. After a brief interview process Dr. Thomas will then need:

- An updated CV, including applicant's full name, sex, date of birth, nationality, email address, subject and stage of study

- Medical School transcript (unofficial is ok)

- Personal statement, including applicant's relevant background, personal/professional goals and the objectives of their elective period, as well as preferred site, specific dates they wish to attend, their first and second choice of department affiliation, and estimated budget.

Dr. Thomas will provide a letter of recommendation to complete the application package for either KCMC or HLH. Anticipate a couple of months for official approval. At the end of the rotation all students write a one-page summary of their experiences, in the context of what their goals were beforehand.

Time to Report: not announced

Place to Report: not announced

Duration: Minimum 4 weeks on the wards (not accounting for travel time to/from site)

Attendance: Attendance at elective activities is mandatory.

  • Anyone who is ill or has a personal or family emergency must contact Student Affairs and the Attending on Service.
  • Students are allowed to take off up to 1 day per week to interview between November 1 and February 1.
    • Specific days missed must be approved by the Attending on Service.

Available: This elective is not available to visiting students

Number of students per rotation: 6

Course Description: The UVA Tanzania Program allows clinical rotations at Kilimanjaro Christian Medical Centre in Moshi or at Haydom Lutheran Hospital in Haydom. Given the short time period most students have, visiting only one site is feasible. It is recommended that students spend as long as possible in Tanzania in order to maximize their exposure and assimilation.

Kilimanjaro Christian Medical Centre (KCMC) is in a small city, Moshi, and is one of four tertiary referral medical centers and medical schools in the country. A range of Tanzanian health care workers are undergoing training, from nurses to
Medical Officers to residents. The breadth of disease, from tropical infections and HIV related illnesses, to non-communicable diseases including diabetes, strokes and cardiovascular disease, is enormous and the ability to make accurate diagnoses are relatively good for the country (e.g., xray, ultrasound, biopsy, endoscopy/bronchoscopy, fluoroscopy, echocardiography, pathology, clinical laboratory, research laboratories). Attending physicians are mostly Tanzanian although several expatriate physicians volunteer at KCMC as well. Several UVA medical students to date have performed elective clinical rotations at KCMC in fields including internal medicine, pathology, pediatrics, obstetrics/gynecology, anesthesiology and surgery. UVA students and residents have teamed up with Tanzanian residents performing their required dissertation project and these collaborations have been highly productive and gratifying.

Haydom Lutheran Hospital (HLH) is remotely situated in the southwest corner of the Mbulu District. Haydom village has a population of about 20,000 and the hospital serves a large swath of rural Tanzania of approximately 390,000 people. The main ethnic groups residing there are Iraqw and Tatog; others in small numbers are Iramba, Nyaturu and Hadza. HLH is a very busy hospital with a staff of 580 and 400 beds. All services are provided, from surgery to OB/GYN to pediatrics and a large medicine ward. The hospital is well functioning and a CT scanner is on site (one of the only ones in the region). Both Tanzanian medical officers, medical doctors, and expatriate medical doctors staff the hospital. This is a superb “bush” hospital experience.

Infectious diseases are substantial problems in Tanzania, including malaria, tuberculosis, pneumonia, diarrheal diseases, HIV infection (4-7%), etc., however the full range of medical conditions are seen, including increases in hypertension, diabetes, trauma, lung disease, etc. At both sites all medical discussions are in English. Although most patients speak Swahili, there is sufficient Tanzanian staff on the rounding teams that this language barrier is minimized. In addition to acquiring tremendous clinical knowledge, all students will acquire an understanding of the health contexts that affect the great majority of the world’s people. Without exception students have broadened their horizons and developed long lasting career interests in global health. Key ingredients for the success of this rotation include an ability to work in difficult circumstances, flexibility, warmth, a non-judgmental disposition, and an ability to make the best of things.

Costs, Itinerary & Housing
Connections are easily made on KLM which flies nonstop to Kilimanjaro Airport (JRO) through Amsterdam (~$1800 RT from Dulles). Base costs are approximately US$100 Tourist visa to enter Tanzania and $250 in registration fees (paid to the hospital on arrival – this covers the administrative cost and temporary work permit fees). Additional ward fees include $100/month at KCMC and $100/week at HLH. Accommodation is available on site and will be arranged. Living costs in Moshi run about US$125 per month per person for shared accommodation and a similar amount for food; electricity and internet charges are also extra. Living costs in Haydom run about $140/week including three meals/day and electricity; internet charges are extra. Many visitors allow an extra few days after their clinical experience for safari to Serengeti, Ngorongoro, or Tarangire National Parks, to climb Mt. Kilimanjaro, or visit the Zanzibar coast. Tourism is expensive (few hundred dollars per day).

Safety
There are risks inherent in such an experience abroad and this program requires complete personal responsibility. Although Tanzania is relatively safe for Africa, potentially life-threatening risks include those of tropical diseases, personal assaults, automobile accidents and others that may be impossible to foresee. Contingency plans for needlestick/occupational HIV exposure, health insurance, evacuation insurance, etc. should be made through UVA International Studies office.