[Editor's note: After writing a blogpost about Africa the other day, I asked my sister, who spent last summer in Tanzania, if she had any experiences she wanted to share. Enjoy!]
This time last summer, I was partway through a two-month trip to Tanzania, where I volunteered in a small, private hospital in the city of Arusha. In light of a recent blog post about the medtech industry in Africa, I thought I might be able to share a few observations. Although my experiences were mostly limited to one private hospital in Tanzania, they might apply on a larger scale. In fact, we mentioned this MassDevice article before, and I would say that the writer, Erin Warner, and I both made some similar observations from our travels.
I arrived in Tanzania not quite knowing what to expect of their health care system. As Warner explained, health care in Africa is split between publicly-funded hospitals, where government subsidies reduce the cost of care, and private hospitals, where patients pay greater costs for care. There was certainly evidence of a two-tier health care system, with a large gap observed between public and private facilities. I was fortunate to be working in a private hospital, which was kept clean and well stocked with supplies and equipment. Even still, staff expressed hope for better laboratory equipment, computers for patient registration, etc. On the other hand, a friend of mine who became sick while we were there ended up at a public hospital, and was not impressed. The hospital was dirty, there were needles tossed in the bathroom toilets, and blood samples had been left sitting in the office. All of this was unsettling, to say the least, for someone used to the sterile cleanliness of hospitals back home. Although the doctors treated her illness, the quality of care at this clinic was certainly not up to our standards. You can read about her experience in more detail here
I was surprised by the number of patients who came to the hospital that had some sort of health insurance through their work. Then again, this was a private hospital with a good reputation. It was equally clear that many people who are in desperate need of treatment just don't have the ability to afford it. Case in point, a man who was brought to the hospital after being in a motorcycle accident nearby. He was covered in blood, had swelling and probably some broken bones, and was obviously in a lot of pain. Yet all we did was wipe up some of the blood on superficial wounds and send him off in an ambulance to the public hospital. Could he have received treatment at that hospital Absolutely. But he probably couldn't afford the more expensive care.
The hospital operated both as an in-patient ward, where people who needed ongoing care stayed, and as an out-patient clinic, which basically operated as a walk-in clinic or instead of visits to a family physician here in Canada. For the most part, there is no such thing as regular check-ups, a point that Warner also noted in her article. An exception to this is HIV patients, who need to be seen regularly to assess their health and pick up their medications. Although treatment for HIV is covered by the Tanzanian government with support from international partners, a doctor told me that there is a huge stigma surrounding HIV treatment that prevents some people from seeking care and men, in particular, were less likely to attend the clinic.
Even in the city of Arusha, which is not a rural or remote area, care is somewhat limited by a lack of specialists. While the doctors, nurses, lab technologists, and other staff that I met seemed quite knowledgeable, partnerships with other clinics and hospitals were important to provide the full spectrum of care. Specialists would occasionally travel to the hospital from a larger centre in the nearby city of Moshi in order to see patients. In other cases, patients would need to travel to a larger hospital within Tanzania or outside of the country to receive specialized care. For example, a man who was critically ill with sleeping sickness picked up from the tsetse fly had to be transferred to another hospital.
Health care in Africa definitely presents some challenges. Coming in with little expectation of what it would be like, I'd have to say that I was impressed overall with the hospital where I was placed and the staff that worked there. Is there room for improvement Of course! But it's a start.