Treating refugees in Tanzania: A Typical Day

Saschveen has recently returned from assignment with Médecins Sans Frontières / Doctors Without Borders (MSF) in Nduta, Tanzania, where she was providing vital healthcare to the many Burundian refugees there. She shares her diary from the time...

My friends and family have asked me what it is that I actually do here, or to describe a typical “day-in-the-life”. In some ways my role here is very different to what I did back home, even though I have had a very varied and broad career thus far, and have worked in various areas of medicine.

Saschveen and the team use ultrasound to examine a child's leg in the Nduta Refugee Camp, Tanzania

With Dr Simon Masanja and clinical officer Joseph Boniface, using ultrasound to guide a knee procedure Photo: MSF

In a single day I can go from helping to resuscitate a patient in the emergency department, to putting a child under sedation for a painful procedure. Then I could be liaising with the tuberculosis team to help manage a case of drug resistant TB, brainstorming ways to help our outpatient clinics function more smoothly, or helping the pharmacy plan for the supply needs of the wards for the year to come.

Later I might do a training for our medical interpreters and clinical officers, or even walk around the hospital site with the logistics team to complete our emergency preparedness plan, deciding where to set up decontamination areas for people affected by tear gas.

In other words, there is never a dull moment in the day here for sure.

Saschveen stands wih the 16-strong MSF clinical team, all holding their certificates from a paediatric training

Team photo after completing our paediatric training. Photo: MSF.

As I mentioned in my last post, there is so much more coordination and collaboration with the other departments outside of the medical realm here, and there is a lot more creative problem-solving, and thinking sometimes outside the box, compared to how I would be required to manage issues back home.

For example, soon after I arrived, we had a series of children with femur (thigh-bone) fractures, and normally back home these would be sent to a specialist orthopaedic hospital who would put them in state-of -the art “traction” devices to help straighten out the leg using weights and a pulley-system, to help the bone set back in its more normal position.

Thank goodness for the field manuals!

Unfortunately we are lacking not only an x-ray machine but also other technical devices and referral options, so I found myself with a colleague adapting a custom-build traction device to use in certain cases. To do this we relied on the excellent MSF field guide on managing surgical problems with few resources (thank goodness for the field manuals!).

Collaborating with the logistics team, we were able to have the carpenters modify what we needed for the patients. It may have just been the most “MacGyver” moment of my medical career thus far, and although it wasn’t the most advanced and modern method, at least we could go part of the way to providing at least some of the care that these patients need.