My Experience with the Tanzanian Health Care System

I recently had my first and hopefully only experience with the Tanzanian health care system. It started at the University Health Services Clinic. When I made it in to the office to be seen by the doctor, I was asked to describe my condition. On my description only I was referred to Mikocheni Hospital. I made it there after a bit of a journey Friday afternoon, only to be asked to come back in the morning. Saturday I returned to the hospital and checked in. I waited for awhile. I knew the doctor was in but I didn’t know how I would know it was my turn. I waited for about an hour and a half before the other ladies waiting by the door motioned me in. I sat down at another desk to describe what was going on. The doctor, the Director General of the hospital, took my word for it and sent me to another nurse who would take me to “the theater” to take care of my issue.

I was led into the next building and up a bunch of stairs to a hospital room. After about a half an hour a nurse came in to get my papers. At this point I had a million questions, none of which the nurse would answer. She kept demanding that I sign the papers. When I wouldn’t she would leave the room and come back fifteen minutes later telling me to sign the papers again and not answering my questions. More than once I tried to leave. She kept telling me “Don’t Worry!” Eventually I ended up wrapped in a sheet, sitting in a room alone for about an hour.

As I was about to be put under anesthesia, I realized how many things hadn’t been done. I had not been weighed, asked about current allergies or medications, or even examined. I was about to have a surgical procedure done without ever being examined before I was put on the table. Before I knew it I was out cold and then waking up with my feet hanging off the end of the stretcher being rolled into the recovery room. A bit later I was more conscious, I looked about and had to try to remember where I was. A few minutes later Chris showed up. It was nice to see a friendly face after a day of confusion, pain and tears.

My experience was so differenct from anything I’ve ever experienced or will ever experience in the states. There were so many procedures and protocols what were not followed that I am accustomed to. At one point I contemplated writing my allergies on my chest in Sharpie because it is the one writing instrument I had in my purse. Coming into the Tanzanian healthcare system, I brought with me all of my previous experience and ideas about what type of care I should receive and how I should be treated. None my expectations or preconceptions about how I would be treated as a patient were honored. The whole process does not encourage patients to be informed about their own health and ask questions about their treatment. On the whole as different as the system is it works for the majority of the people here. The viewpoint is just so different. At home, patients are encouraged to be informed about their own health and ask questions to be somewhat in charge of their own health. Patients in Tanzania take the doctor’s word as law. My doctor and nurses didn’t know what to think when I was asking questions. They weren’t willing to provide information only reassurance. It wasn’t a language barrier either. My doctor spoke English very well. He seemed uncomfortable answering the questions I had. He only provided reassurance that I would be OK and the staff could handle my situation.

Since I hope to one day work with the Tanzanian healthcare system, it was a good experience for me to be a patient. I have a new appreciation for what I know and love at home in my University Health Center.