Jonathan Donnelly - Doctor in Tanzania
My name is Jonathan Donnelly. I am 26 years old and I currently live in Tauranga, New Zealand, though I am originally from Northern Ireland. I have been a medical doctor for just over three years, qualifying from Queen’s University Belfast in 2013. My speciality now is Internal Medicine, and my current job is working as a Registrar in Neurology and Stroke Medicine at Tauranga Hospital.
My work involves caring for patients who have suffered a stroke, ranging from their initial presentation to the emergency department to overseeing their recovery and rehabilitation. Additionally, I work with outpatients and look after complex neurological cases referred to the Consultant Neurologist. Out-of-hours, I am responsible for admission of all patients from ER with medical problems, as well as all medical wards, sick surgical patients, Intensive care and coronary care.
Why I chose to volunteer
It may sound cliché, but I became a doctor to gain skills and knowledge that I could use to help people. While I was still a medical student, I travelled to Ghana for my elective placement at the start of my fifth and final year of medical school. I was placed in a hospital in Takoradi, a small coastal town with very few resources, and my six-week experience was amazing. When deciding to volunteer with Projects Abroad, I was now far more qualified and experienced, and could use my newfound skills and knowledge to make more of an impact in Tanzania.
I hope to specialise in general and critical care medicine in the future and I felt that the wide range of experiences I would receive during my placement in Tanzania would be unique and invaluable. I chose Projects Abroad due to their various offers of specific medical projects for professionals like myself. The Projects Abroad team were extremely helpful and enthusiastic every step of the way. They helped me become organised prior to my trip, picked me up once I arrived, and were constantly friendly and available throughout my time in Tanzania.
Volunteering at a hospital in Tanzania
I was placed at Sinza Palestini Hospital in Dar es Salaam, specifically in the Minor Injuries unit adjacent to the Emergency department. I worked there with Dr. Stanley Maganga who, in his own words, was a “general doctor,” and each day we were referred a wide variety of cases, which included elective hernia repairs and circumcisions, traumatic injuries, fractures, post-operative infections, breast cancers, miscarriages, parasitic infections, tuberculosis, HIV complications, burns, and many more medical, surgical and gynaecological conditions.
Typically, we would start seeing patients at around 8.30 AM and finish around 3.30 PM, with a varying caseload (sometimes up to 30 patients a day). Occasionally, Dr Maganga was assisted by other general surgeons and physicians in this duty, as well as team of highly skilled nurses, but often had to take on this huge workload by himself, with very limited resources.
My role as a volunteer doctor in Tanzania
As I am a fully qualified doctor, and most of my fellow volunteers were still students, I was able to assist Dr. Maganga immensely, sometimes taking on patients with relatively simple issues by myself (for example, assessing and changing post-operative and wound dressings, removing sutures, and applying plaster casts for fractures). However, most of the time, I was assisting with minor operations, IV cannulation etc. This allowed Dr Maganga to take much needed and well-deserved breaks, as well as catch up on mountains of paperwork.
I also helped teach some of the other volunteers, some of whom had very little medical experience prior to their trip. Outside the hospital, I was able to take part in health screening at the local orphanage, which involved checking the children for fungal infections, dental problems, eye conditions, skin issues and any other complaints. As the only qualified medical professional there, I helped oversee and supervise the other volunteers while also performing and documenting the health checks myself, recommending which pharmacological treatments for any conditions we found.
My experience of working at a Tanzanian hospital
I was mostly spared the shock of what little resources there were to work with at Sinza, having been to an African hospital before. However, working in a hospital where things like suture material, surgical instruments and even gloves are in limited supply was an eye-opening experience. Frequently, we were using damaged equipment, as there was simply no alternative, and I had to adapt quickly to working without many tools that I am used to (e.g. using rubber gloves as tourniquets, using suture blades without handles, holding x-rays up to the light instead of loading them on a computer screen).
Things we take for granted, like routine blood tests, ECGs, and CT scans were rarely, if ever, done, simply due to lack of resources. The medicine you practice is therefore purified to doing whatever you can with what you have on hand, and trying your best not to waste anything. I was also exposed to conditions and procedures that I would not see a lot of back home or here in New Zealand, such as Malaria and other parasitic infections, HIV complications, and an unfortunately high rate of missed miscarriages.
Dr Maganga taught me so much about these conditions that I would not normally have the opportunity to learn so much about, including getting practical experience in proper gynaecological exams and evacuation of retained products of conception. A far cry from doing medical ward rounds and discharge paperwork!
Living and working in Tanzania
While I learned so much practical medical and surgical knowledge from my time in Sinza, perhaps what was truly unforgettable was the rest of my time in Tanzania. I may only have been there two short weeks, but in that time, I experienced so much of Tanzanian culture and made amazing friends that I still talk to today. In fact, I have even been to visit one of the volunteers in Chicago since then, giving me yet more amazing travel experiences!
A typical day would be getting up at around 7-7.30 AM, having breakfast with your host family, then taking off into the searing heat (even in winter…) to the hospital, either walking to the Dala-Dala (bus) or being lazy (like me…) and getting a Bujaj – a makeshift three-wheel taxi. After work, we would often go to the mall for lunch, sometimes meeting the volunteers from the other hospitals.
Evenings could be spent either quietly in the house, or heading to the local beach bar to relax and socialise, and there were occasional social events organised by Projects Abroad. I only managed to get one weekend to explore the country, but I made the best of it by travelling to the Selous game reserve to go on Safari, spending three days seeing giraffes, monkeys, hippos, rare birds, and antelope in their natural habitat – we even caught a lucky glimpse of two relaxing lionesses up close!
Advice to future volunteers
The most important thing I would tell anyone wanting to volunteer in Tanzania is to keep an open mind – for medical students and doctors. This is not going to look anything like what you’re used to. You could see things that will shock you, anger you, or even bring you to tears. However, do not judge, as often you will be inspired by the people here, as they try to the best they can with what little they have and you may have a new appreciation of the resources that are available to you at home. The experiences you will have here, both in hospital and out, will stay with you for the rest of your life, and you make friendships that are truly special. Above all, enjoy yourself and do your best!