COVID-19 coloured this medical outreach!

Up till the day of departure, team members had to consider whether or not to go. Each of us had to make up their own mind and find peace with their decision. One tries to make a wise decision in relationship to their own relatives and colleagues.

Considerations NOT to go:     

• Risk of bringing the contamination there.     

• What if you can't come back because of Lockdowns     

• What if you would be needed here  (at work, older parents or family getting sick..)

• Are there enough protective measures for your own safety in Tanzania?     

• What if you get sick there? There is no ICU/Oxygen/Ventilation machines. 

Considerations to go:      

• Patients have been counting and waiting for us for the last six months.      

• Provide continuity to a hospital where specialist care is already so little available     

• There is always a certain health risk with every outreach for us as team members    

• Even in uncertain times such as these, should we let people / colleagues down in Tanzania?      

• Expenses made, scheduled days off have already been created by colleagues.

• Possible cancellations and searching for new outreach possibilities is difficult….

With a stripped-down team, we finally left just the three of us.

Erik Staal (trauma surgeon) Malouk Lap (tropical doctor) Jiska Kamstra (nurse)

In the suitcases only the essentials. The rest filled with medical materials and a lot of suture material which the hospital asked for due to a major shortage. We were warmly welcomed again, but now with a somewhat awkward distance, because of the corona messages, which had also come through. The hospital had not made a radio call this time to inform people extra that we are there.

Yet again, there were many distressing cases of patients waiting for surgery.

Monday a full clinic, where we had to make a stricter selection. Because we are now only with 1 surgeon, so limited capacity. First, we attended the patients who were already in the surgical departments and needed urgent surgery. This outreach only two enlarged thyroids where removed, the others can wait another half year...? No matter how uncomfortable…

Two anxiously waiting young men finally got the surgery they longed for to get rid of their intestinal stoma. Living with a colostomy often means living in social isolation. There are no stoma materials to properly take care of the diverted flow of faeces.  Some operations on young adults, who had become disabled due to non-healing bone fractures after an accident. These can be repaired and rehabilitated by means of screws, plates and pins.

Three more girls with serious clubfeet, who were already very late for such a correction but finally saved enough money to get this operation done. An then the five young children with standing deviations of their legs, which we had not gotten around to in the previous outreach. They were now again patiently waiting for their opportunity.

Erik operated full days together with Malouk. But also together with Rian Jager, who has been working there as a tropical doctor for the last three years. Jiska again plunged into the planning and pre- and postoperative care of patients. Visited departments, assessed and selected new patients, requesting blood and X-ray examinations, coordinated with the physiotherapist and so on.

We noticed a growing concern about contamination with COVID-19 particularly among the small group of "middle-class people and city dwellers’ (Mwanza) who apparently have more access to information via radio, TV, internet ...  We were able to think with the staff about preventive measures so minimise the chance of infection. A colleague back home, who had decided not to go with us, made a nice contribution, which could be used to make mouth masks.

The technical department made several mobile washbasins with buckets of water and dissolved chlorine tablets. Everyone who enters the hospital now rinses his or her hands with this solution. Sister Marie-Jose Voeten (hospital director) and Rian Jager spent time each day providing all hospital staff with information on how to deal with potentially infected patients; how to protect themselves and their families to reduce the risk of infection. Daily extra teaching moments were created to keep staff informed with the new information and WHO guidelines.

In the Netherlands, the SIMBA and Friends of Sengerema foundations have joined forces to raise funds via social media / Facebook, in order to support the hospital in purchasing the necessary materials.

Creative new ways have been found to greet each other, which brought a lot of hilarity and cheerfulness. Greeting each other every day is a very important form of social interaction in Tanzania and therefore a valuable part of life.   

In between we tried to supervise the progress on the construction of the container house. The containers were still largely filled with materials for the hospital, which we had sent with both foundations. Great that this is made possible by so many donations. Who knows, we may already use the guesthouse for the next medical outreach in September.

We came back a few days ahead of schedule. This was quite a challenge. Countries were closing their borders and our flights got cancelled. Last minute we were able to get seats on the very last KLM flight out of Tanzania, because a larger plane was sent.  We came back in a completely different Netherlands than when we left.

We have mixed feelings. Worries about how things will go in Tanzania when the Corona virus spreads around as it does here in Europe. Many families sleep in one room, there is no running water and soap is a luxury. Busses the boats are over packed. One has to go to the busy markets every day to buy food. Going to a funeral and wedding is something very important. The churches and mosques remain open, "in the evening they all sit around a fire.....”Its encouraging to see how choirs/bands are so creative in composing new songs and dances to inform the people about preventing infection. Maybe the Corona visus had already swept thru the country, we heard from so many people that they hadn’t been so sick in years and that a nasty fluw had past by just a few weeks before

We have been asked so many times to stay there for our own safety and not to go back to Europe. Even now that we are back we get many messages asking how we are doing.   All in all, a completely different outreach than expected and planned. Nevertheless, we look back with gratitude on a period in which we were able to help many people who had been waiting for treatment for the last six months! How grateful and happy they are.