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VSO - Sharing Skills, Changing Lives

Dr Nicola Johnson

Dr Nicola Johnson volunteered as a Paediatrician in Ndolage Hospital in Tanzania. Here she describes her experiences at work just two months into her volunteer placement.

The hospital I’m working in is run by a mission, not the government, which is the case for about half the health care facilities in Tanzania. So patients are charged for attendance, admission and everything that is used during their care. Every syringe and needle and drug and bit of cotton wool has to be remembered and prescribed. It certainly changes your attitude to waste. Having to think about everything you want to do, can the patient afford it, do they really need it doing, will it alter my management, how long will I prescribe the course of drugs for, has this patient not been given the drugs I prescribed because they didn't have the money but you don't discover for days (a common occurrence). This is a very good education for someone brought up in the NHS and used to having everything you need there for free, having to think about whether you really need a test or investigation, or to use a new piece of kit for this that or the other.

My job here is to be the children's doctor for Ndolage. Previously seeing the children on the ward was done twice a week (as all ward rounds are). So I've caused a little surprise by insisting on doing a ward round everyday, sending sick children to 'ICU' (just a different room where they get some observations done as oppose to a twice daily temperature and there is some oxygen available which works) and hopefully just showing an interest in the kids. But they do come in very sick and die a lot, and it is hard work from that point of view. What I really miss is colleagues just to discuss the difficult cases with, and a consultant to hand over responsibility for it all at the end of the day. Funny being senior house officer, registrar and consultant all at once, and being on call 24 hours a day 7 days a week…

I enjoy seeing the children and trying to find out what is happening, and getting anti malaria treatment and blood into some of the really sick ones and seeing them bounce back is amazing. Just a little problem in that the three-year-olds tend to scream in terror at the sight of me - most of them have never seen a white face before. It must be a nightmare to wake up and find this huge white monster standing over your bed. It can make trying to examine them a bit taxing, but provides endless laughs for the mothers and nurses - just makes me feel a freak!

VSO are clear that you should not try and do too much in the first few months. It’s about learning my way around and seeing what the needs and issues are. At the moment I'm trying to institute some formal teaching and write guidelines for basic treatments. That way my knowledge and experience will remain in Ndolage Hospital long after I’ve returned home.