Med Lessons from Arusha

For the near future, the MedOutreach team will be going to Nkoaranga hospital, in the countryside. Because we can’t be sure of having Internet connectivity there, blog updates might be infrequent for the next few weeks.

The medical students have been working in Arusha for three weeks, now, with our local contact Dr. Mhando, at several local clinics and a hospital.

The interview and physical exam are at the heart of the practice of medicine, and that heart beats very differently in Tanzania. General practitioners can take up to an hour interviewing and examining a single patient, a length of time unheard of in Canada. Because lab tests and imaging are less available, diagnoses often hinge on a crucial finding in the physical exam. This is an excellent environment for med students to work on their own physical exam skills. We have a chance here to take our time with each patient, under the tutelage of doctors who have perfected the skills of palpation, percussion, and auscultation.

Many of the patients in the clinics are local Maasai. They are a very tightly-knit community. “Treat one Maasai,” Doctor Mhando told us, “And five more will come.” The Maasai have maintained many aspects of their traditional lifestyle, and many local Maasai still live very closely with their herd animals. One consequence of this is frequent cases of brucellosis, a very rare diagnosis in Canada usually associated with unpasteurized milk. Brucellosis typically presents with unexplained fever and muscle pains, and in Tanzania it is important to distinguish it from malaria and typhoid fever. However, most of the Maasai we see in clinic are basically as healthy as the other patients, and always very friendly and open. We had the unique opportunity to take a history and conduct a physical exam on a quite healthy 100-year-old Maasai woman recently.

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