{"id":6994,"date":"2011-02-03T10:59:24","date_gmt":"2011-02-03T09:59:24","guid":{"rendered":"https:\/\/blogs.bmj.com\/bmj\/?p=6994"},"modified":"2011-02-03T11:16:39","modified_gmt":"2011-02-03T10:16:39","slug":"mervyn-dean-on-adjusting-to-work-in-tanzania","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2011\/02\/03\/mervyn-dean-on-adjusting-to-work-in-tanzania\/","title":{"rendered":"Mervyn Dean on adjusting to work in Tanzania"},"content":{"rendered":"<p><img loading=\"lazy\" decoding=\"async\" src=\"http:\/\/www.bmj.com\/site\/blog\/icons\/mervyn_dean.jpg\" alt=\"Mervyn_Dean\" width=\"160\" height=\"110\" align=\"left\" \/>It used to be, and may still be, that in the tourist shops here one could buy a T-shirt bearing the words, \u201cNo hurry in Africa.\u201d\u00a0 I now understand what it means, and I\u2019m sure that many reading this who have worked in Africa will not be surprised at my experience to date. I am a palliative care physician recently retired from my post in Corner Brook, NL, Canada.\u00a0 I have come on a voluntary basis to the Kilimanjaro Christian Medical Centre (KCMC) in Moshi, northeastern Tanzania, to help provide and teach palliative care.\u00a0 The medical director is very enthusiastic about palliative care but although a few others here share his enthusiasm a formal service does not exist, and it seems not all understand the concept of palliative care (although, there are some back home for whom that could be said!).<!--more--><\/p>\n<p>My first day here was to start with a 09:00 appointment with the medical director, for which I arrived 10 minutes early despite having been warned that he\u2019d almost certainly be late.\u00a0 We met at 11:15.\u00a0 There was no apology for keeping me waiting, but he welcomed me enthusiastically and I received over two hours of his undivided attention as we discussed my role here and he introduced me to various relevant people.\u00a0A colleague told me that during his time with me one or more other people were likely kept waiting. The same colleague also told me to expect my first week or two to be slow and not to be impatient.\u00a0It was good advice, although the bit about not being impatient was difficult for me to follow.<\/p>\n<p>From my point of view I\u2019ve had a lot of wasted time, sometimes waiting an hour or more to meet with someone.\u00a0But once we do meet the outcome has mostly been productive.\u00a0I keep reminding myself that one reason for my coming here was to experience medicine in a different culture.\u00a0I am experiencing that different culture and some of it is clashing with my culture in ways I did not anticipate.<\/p>\n<p>I want to respect the local culture and not impose my Canadian practices and values, but talking to other CFAs (Newfoundland term \u2013 \u201ccome from away\u201d) here it seems that one does have to be proactive to achieve anything.\u00a0So, by being a bit pushy and making contact with a nurse with an interest in palliative care I have managed to see a few patients.\u00a0It was gratifying to come back to one patient the next day and hear from a nurse on that floor that \u201cfor some reason\u201d his pain was much better. I also managed to arrange three teaching sessions to either medical students or a mixture of students and junior doctors.\u00a0Morphine is a relatively new drug here, and few have experience of using it, so I hope I can give enough physicians and nurses the knowledge and confidence to use it appropriately. The need is there.<\/p>\n<p>So, I\u2019m slowly learning the African way, and trying to gently but firmly promote my agenda.\u00a0To that end, next week looks promising.\u00a0I met with my \u201cpreceptor\u201d and we have agreed to change the manner of my clinical involvement. In addition, arrangements are in hand for me to meet with some of those in charge of education at the attached medical college. I have another six weeks here and am gaining optimism that that will be long enough for me to achieve some of my aims.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>It used to be, and may still be, that in the tourist shops here one could buy a T-shirt bearing the words, \u201cNo hurry in Africa.\u201d\u00a0 I now understand what [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2011\/02\/03\/mervyn-dean-on-adjusting-to-work-in-tanzania\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[223],"tags":[138,1997],"class_list":["post-6994","post","type-post","status-publish","format-standard","hentry","category-guest-bloggers","tag-palliative-care","tag-tanzania"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.5 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>Mervyn Dean on adjusting to work in Tanzania - 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