My name is Kim Mudde, I am 22 years old and a nursing student at the BBL vocational education level 4 at the Beatrix hospital in Gorinchem, the Netherlands. I have great affinity with nursing and also with travelling. During my internship abroad I was able to combine these two passions, which led to an unforgettable learning experience.

For my internship I went -with help from Harry the Vries- to Tanzania. Harry worked as an orthopaedic surgeon at the Beatrix hospital and frequently travels to Tanzania himself. After a selection procedure and a lot of email-contact I was able to do my internship for seven weeks at the Haydom Lutheran Hospital in Tanzania!

Getting to know Tanzania and the Haydom hospital

Arriving in Tanzania with the small airplane from the ‘Flying Medical Service’ was already quit a special experience. After the cows were chased away from the ‘runway’, we could finally land and I was welcomed by Brian Savage and by the Matron (the head sister) of the hospital.

Upon arrival I was brought to my private room and afterwards the Matron showed me the hospital. The hospital provides services to an area where 390,000 people live. Therefore it is always very crowded at the hospital, patients sometimes have to wait for a long time to receive medical aid.

The hospital has approximately 350 beds and is divided into 7 departments: Internal Medical ward, Maternity ward, Paediatric ward, Surgical ward 1,2, Intensive Care Unit and TB ward. Each department has its own unit. There are also 2 outpatient clinics; a polyclinic for mother and child care, and a general outpatient department for men. In each hospital room there are –on average- 15 to 20 ill patients. Their family members are taking care of them, providing them with food and drinks and helping them getting dressed.

The main ethnic groups that live in this area are the Iraqw and the Tatoga (including the Barabaig) each with their own language (and cultural background). Since the local nurses and doctors mainly speak Kiswahili there are sometimes problems in communication.

The nurses are very task-oriented and concentrate on their daily tasks, for example medication, doctor rounds, injections, wounds, cleaning etc.

I was impressed when the Matron showed me around in the hospital. I was especially touched when I saw the many people in the hospital wards and the difficult circumstances they were in.

Working at the hospital

The day after my arrival I started to work at the Haydom hospital. During my stay of 7 weeks I worked at all the different departments, except on the TB ward. Each day began with a number of daily activities (consultation, X-ray meetings, doctor rounds etc.), starting with the morning devotion in church where I enjoyed the passionate singing of the nurses.

Impressions from the field

The days/weeks were filled with the above-mentioned activities. It has been a great educational experience. The most memorable experiences I will describe briefly:

• On the Obstetrics department I assisted with normal and abnormal
childbirths. It was great to assist during a caesarean section.
• On the children’s ward there were many children with burns,
unfortunately there was inadequate pain medication. Burns occur often in
Tanzania because there are many open fires for cooking.
• The outreach clinic was a nice experience: we drove to small
villages to check/advise the pregnant women and to vaccinate babies and
children.
• The outreach clinics with the FMS (Flying Medical Service, comparable to
the flying doctors) were special: with the FMS plane we went to areas that
cannot easily be reached by road.
• I’ve learned to look for and identify creative solutions to problems.
• When I was working on the IC I found it difficult to observe that a human
life in Tanzania seems to have less value than a human life in Holland.
•  It was difficult choose to which patient I would give oxygen, when there
was only one working oxygen machine.
•  During my work on the internal medical ward I saw patients in very
difficult situations.

The most common diseases on the internal medical ward:

1. Pneumonia
2. Malaria
3. Relapsing fever
4. Gladiasis
5. CCF, congestive cardiac failure
6. High blood pressure
7. Epilepsy
8. Amoebiasis
9. Diabetes
10. HIV/Aids

Other common diseases are:

11. TB
12. Diarrhea/gastritis
13. Malnutrition
14. Burns in children
15. Osteomyelitis
16. Bone fractures
17. Cancer
18. Genital mutilation
19. Syphilis
20. Typhoid

An experience to never forget!

My internship at the Haydom Lutheran Hospital was an incredible learning experience: one to never forget!

For more information about the hospital, you can visit the website: www.haydom.com