Day 3

 I’m Yusra - a third year family medicine resident that has joined the annual trip to Tanzania this year. 

The three days we’ve spent here have been very interesting. We started off the first two days in Moshi and spent today travelling to Dar Es Salaam. Moshi was lush, green, and quiet whereas Dar is a giant metropolitan city - busy with people of all walks of life, traffic with non-existing lanes, and 90% humidity. Cole, Tawa and I went on one of our daily walks after landing in Dar and spent the majority of our time trying to evade motorbikes running into us! 

In between these two cities, I’m already noticing significant socioeconomic differences. While at KCMC, we had a chance to accompany a nurse, Anna as she travelled around Moshi for home palliative care visits. From a gangrenous foot in a 40-something year old female who could not afford an amputation, to a rapidly progressing soft tissue sarcoid tumor with purulent drainage and pathological angiogenesis, Anna spent time talking to them and performing wound cares.  All 5 patients were financially restricted to gain treatment, resulting in their disease process worsening and now seeing Anna for palliative intent. The level of poverty was striking; most of these residences did not have any flooring let alone electricity, and one house did not even have a toilet.

In contrast, during our first night in Dar, we were graciously taken to a rooftop hotel overlooking the Indian Ocean for dinner. Most guests were impeccably dressed, with hotel staff escorting us inside with remarkable courtesy.It was a great dinner and really showcased Tanzania as the beautiful country that it is. 

It is really challenging sometimes to see the stark contrast in the level of poverty we see and the lives we get to live purely due to geographical luck. As someone who works at a safety-net hospital in the US, I’m not unfamiliar with many socioeconomic barriers that many of our patients face. However, continuing to see barriers to health especially in the extent that we’ve seen here, is a challenging and completely helpless feeling especially knowing that it is in the hands of people a lot more powerful than us to improve these conditions on a national scale.

There's no immediate solution to relieve economic disparities. However, what I plan to take from this experience is to reflect on the privileges handed to us and not letting myself be desensitized as I get further in my training. Anna’s caring nature and her compassionate care has been inspiring and I hope to be like her one day.

We are headed to Ilula at 06:30 tomorrow so I am headed off to bed! Thanks for reading :) 

Yusra