Day 13

 Ilula, Tanzania

Today is the day before our last full day in Ilula. I am writing after a long but fulfilling day—one that began with a heart failure presentation at morning report and ended with a quiet walk through town.

I was nervous about the presentation this morning. The audience included both our visiting group and our Tanzanian hosts—hospital leadership, staff, and students training as clinical officers and nurses. As the day went on, a few comments and brief conversations reassured me that the topic had landed well. Nothing dramatic, just enough to let me exhale and carry on with the day.

Later in the evening, during my walk through town, I ran into two first-year clinical officer students. They were already in conversation with Dr. Randy and recognized me from the morning report. They told me they had assumed I was Tanzanian and were surprised by my American accent. That comment stayed with me. Earlier in the week, people had spoken to me in Swahili, only to realize I didn’t understand. This moment felt different—less awkward, more grounding.

The two students shared parts of their stories with me. They said they were “proud” of me, which caught me off guard. They talked about how they had hoped to become radiologists or dentists but enrolled in clinical officer training because of family expectations. There was no bitterness in how they spoke—just honesty. When we parted, I realized how easily that brief exchange had turned into a meaningful one. I felt honored to have listened, and quietly hopeful that the conversation may have stirred something for them, as it did for me.

Throughout the week, I made a conscious effort to be clinically present, and it has been rewarding. I learned through inpatient ward rounds with Dr. Joseph, the medical officer in charge, alongside Drs. Randy, Cole, John, Solveig, and Yusra. I scrubbed in on a cesarean section, performed bedside ultrasounds to guide clinical care, and learned about toxidromes through teaching with Dr. Cole. These moments, taken together, shaped my experience more than I anticipated.

During my walk that evening, it became clear how attached I have grown to Ilula. As our time here draws to a close, a quiet sadness has set in. I will miss the familiar streets—usually loud, but softer tonight. I will miss the children calling out “hello” and “how are you,” eager to practice their English. I will miss the constant hum of motorcycles, the honking of bajajis, the repeated “you are welcome” offered throughout the hospital day, the smell of earth mixed with fresh air after the afternoon rain, and even the Sunday church and choir.

It feels like a bittersweet moment—one I am not quite ready to leave behind.

Yours,

Tawa