Nkoaranga: A world different than Canada

Since the dental students joined the rest of the team later in Arusha, and the need to sort out our work permits, we’ve only had the chance to be exposed to clinical work in the dental units for two days.

We took a trip up to Nkoaranga Lutheran Hospital, about 45 minutes North of Arusha, to spend some time in the dental unit under the supervision of Dr. Frank Akyoo. Within minutes of our arrival, he had us get to work, performing extraction procedures, draining an abscess, and even placing composite veneers. The patients that Dr. Frank typically see’s are those from surrounding communities that can afford to pay the hospital for the registration, procedure, and pharmaceutical fees. As many people would assume, this leaves a lot of the local population without dental care simply because it is not affordable, and people only seek treatment when it is emergent. Luckily, MedOutreach will be spending the next two weeks up at Nkoaranga (Meds and Nurses included), and we will be holding 4 days of “community clinic” providing dental care (costs covered by MedOutreach) to anyone who comes to the hospital from the surrounding areas. The hospital secretary has sent out a letter to close to 50 community centres, churches, and schools, to inform them of our upcoming clinic. We’re expecting long days of treatment – but are looking forward to being able to to help – one tooth at a time.

Dr. Frank Akyoo & Tara in front of the dental unit:


Even with only two days in his clinic, the differences between Canada’s dental care and that of Tanzania have become incredibly evident. More specifically, we’ve noticed how wasteful we can be in Western society, when we have so many resources at our disposal.

Comparing our clinic at school versus that of the dental unit in Nkoaranga highlights areas where we too easily waste resources that are eagerly conserved elsewhere.

At school, when we set up our cubicle for a patient, typically we grab a handful of gauze, some cotton rolls, a tongue depressor, and maybe a cotton tip applicator. We put out all of the air syringes, suction tips, and barriers as per standard set-up procedures – whether we plan to use them or not.

During the appointment, if we are using an instrument that may not be “perfect” for the task at hand, we do not think twice about picking up another, and another, and another, until you can get the job done. Most items we use are single use, and are chucked into the garbage following the appointment regardless of whether they were used.

When the appointment is over, we toss out everything disposable in our cubicles (whether it was used or not) and repackage everything into sterilization pouches (again, whether they were used or not). This is done because they are deemed non-sterile, which is valid reason to dispose of these items. We do not think twice about the fact that we did not use any of the cotton rolls, the cotton tip applicator, or that we only used one of the 15 pieces of gauze that we put onto our tray. We wipe everything down and do it all again for the next patient.

While this protocol is certainly the most sterile, and needed to maintain infection control for both patients and the student dentists, our lack of thought about what goes into our cubicles before our patients arrive creates a lot of waste.

In a place like Nkoaranga, Tanzania, where resources are scarce, we do not have the luxury of using materials in excess.

Before the patient comes in for treatment, we figure out exactly what will be needed for the procedure. For example, for an extraction we would need three (3) pieces of gauze: one to help control bleeding and saliva during the extraction (since there is no suction), one to clean up the area once the extraction has been completed, and one for the patient to bite on to achieve hemostasis. If more is needed, an assistant can retrieve an extra piece at that time. In Nkoaranga, Dr. Frank even cuts pieces of gauze that are larger than 2×2 into smaller segments because it is a waste of valuable material.

Before starting the procedure, we decide exactly which instruments will be used and try our best to ensure we only use those instruments to complete the treatment. They do not have an endless supply of instruments and the space in the autoclave (sterilization) machine is limited.

Materials are never deemed “one time use” if they can be dispensed away from the patients mouth and carried for use with another instrument (to prevent any contamination). This can make a tip of composite last for 2 – 3 patient fillings, rather than being used for just one!

When it is time for clean up, we have found we’re only left throwing out materials that have been used. We only need to sterilize instruments that were put to work and actually contaminated. Overall, there is notably much less waste produced, and were able to get the same job done and keep the patient comfortable at the same time.

While Tanzania may be behind in their access to resources, and limited income of both the clinics and the patients, there is a lot that can be learned in terms of resource management and limiting excess waste. After only a few days here, I know when we return to our school clinic in Canada we will be more aware of our use of materials, will make a conscious effort to be conservative, and avoid excess waste.

Nkoaranga Lutheran Hospital dental unit:




Nursing Reflections from Kaloleni

The last two weeks have been a great clinical learning experience for the nurses.  We’ve had the opportunity to work in several areas of Kaloleni Hospital including minor surgery, family planning, pre-natal, HIV treatment, and immunization.  At first it was very overwhelming.  One of the greatest obstacles we faced was the language barrier.  Because we could not speak Swahili, it was difficult to understand expectations and instructions, and sometimes limited our understanding of what was going on around us.  Although this is still an ongoing challenge for us, it is getting easier as we become more comfortable with the schedule at Kaloleni and as we expand our Swahili vocabulary.

At the hospital, we’ve been able to see and participate in prenatal assessments which include listening to the fetal heartbeat, measuring fundal height, and locating the fetal position.  We have also been able to help with HIV patient registration, take vital signs, and learn more about HIV diagnoses and treatment.  At the family planning clinic we attempted to record patients’ medical histories, and learned about pelvic exams and contraceptive options. We also enjoyed giving vaccines both orally and by injection. A highlight of our experience has been observing and assisting with minor surgical procedures such as circumcisions, draining abscesses, dressing wounds, and removing stitches.

Even though our experience at Kaloleni has been amazing, we are all looking forward to learning more at Nkoaranga Hospital starting next Tuesday.

Last weekend the Arusha boys took us to an amazing waterfall. It was a long and tiring hike, but we were able to see some of the rural area in Arusha.  We thought you might enjoy seeing some pictures!










Happy Canada Day!

Even though we are far from home, we still made a point of celebrating Canada Day. We had even more reason to celebrate today too because the dents arrived safely late last night. Though they are eagerly awaiting the start of their clinic time, the majority of their day was spent exploring Arusha, and getting immigration documents sorted out. They are settling in comfortably and will be starting at Nkoaranga Lutheran Hospital with Dr. Frank on Thursday. Image

Tara, Shaylan, and Shannon spent today at Nkoaranga LH meeting the staff, getting accommodations sorted out, and touring the facility in preparation for the dents’ arrival on Thursday. The meds and nurses will soon join them on the following Tuesday. While there we also had the opportunity to share some “Canadian cheer” with some of the inpatients and their families. Thank you to the office of Lois Brown in Newmarket for donating the Canada pins and flags.Image


Stay tuned for another blog post highlighting our experiences at Bondeni, Kaloleni, and Engira clinics thus far.

Bags are packed and we’re ready to go…

Finally! The dental students have made it to the end of their June clinic commitments and are eager to join the rest of the team in Arusha!

After a busy week of clinic, packing, and collecting last minute donations we are happy to say our bags are weighed and ready to be taken to the airport.  Thank you to everyone that helped us in the scramble this week 🙂

Tara was fortunate enough to squeeze in a lunch-time Skype chat with the rest of the team out in Arusha on Wednesday.  It’s easy to forget that they are 7 hours ahead of us – so finding the time where we’re all free and in one place can be quite the challenge!  It sounds like everyone is having a great time, and has enjoyed their first week in the clinic. They’ve had the opportunity to be exposed to so many disciplines of health care already!  The medical students have been exposed to a variety of cardiac conditions in addition to family medicine.  The nurses have been involved with vaccinations, family planning, HIV counseling, and even some minor surgeries!  Although the language barrier has been challenging at times, a lot of the doctors and nurses that they have been working with have been ensuring to take the time to translate important points.

The one advantage for the dental students arriving later than everyone else: we are given a heads up of what to pack! Since the weather and temperature is like Canada’s spring right now, they’ve told us to pack extra layers.  It sounds like there can be quite the climate change throughout the day – with chilly mornings, hot afternoons, and cooler evenings.  We also had a request from some of the local boys, that are friends (and translators) for MedOutreach, to bring more Nutella!

Needless to say, our bags are jam-packed but we’re excited to start off on our adventure tomorrow!

Boxes upon boxes of donated supplies from Schulich’s staff and faculty.  Jeremy is keenly modelling some of our gowns that we will be using in the clinic.

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So many boxes… thank you to everyone who contributed.  It took us a while to sort through everything and package it all, but we will make sure it all gets to Arusha! Rahul was nearly burried in ziplock bags at this point.Ipad 006

A big thank you to Tara’s roommate, Lisa, for letting us take over her basement for the last month. It quickly became the “drop spot” for many of the dental supplies and donations.

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Thank You!

We are happy to report that we have reached our fundraising goal for 2014! Heartfelt thanks to all those who have supported us this year.  Your gifts are deeply appreciated and have helped to ensure that we will be able to make meaningful contributions to the organizations that we work with in Tanzania.

Stay tuned, for more updates about the work that we are doing this year!

Sincere Thanks,

MedOutreach 2014


It begins…

How to describe? How to explain? When a thousand things have happened to you, where do you start to tell about it?
We arrived in Kilimanjaro after a twenty-hour trip, stunned and jetlagged, and were saved by Godlove, one of the Arusha CCF boys, who met us at the airport. We set ourselves up in Centre House, the traditional home base of MedOutreach in Arusha.

Arusha runs on a different clock than Canada. People take the time to look you in the eye when they say hello. They can also take two hours to fill a fifteen-minute appointment. Our first few days here were disorienting, to say the least, but we’ve accomplished what we needed to. We’ve met with Dr. Mhando and his staff, our medical hosts in Tanzania, and have had our first clinical encounters here. We’ve also dealt with the mundane work of changing money, getting work permits, and securing an Internet connection. We’ve started to turn Centre House into a home.

There have been obstacles to overcome, but so far MedOutreach 2014 has been up to the task, and we’re excited to move into our regular routine of clinical learning. This is an adventure, and there is no adventure without challenge.


With one week left to go, the meds and nurses got together last night to pack up our portion of the donated supplies. Between sorting and prioritizing the importance of the supplies, packing proved to be quite a task!







Shaylan and Shannon sorting the supplies donated by Coronna United Church.


The nurses were pretty excited to be able to wear Schulich Scrubs.


By the time we finished 7 hours later we were all thankful to finish and ready to call it a day.

Now that we have all of our supplies packed, we are able to focus on getting our personal bags ready and tying up a few loose ends before flying out. Stay tuned as we start this amazing adventure in less than 6 days! 🙂

One Week to Go!

Hujambo! (That’s Hello in Swahili)

It’s hard to believe that June has arrived already. 

This time next week our Medical and Nursing students will be doing a last “once-over” of their packed bags, making sure they have everything together for their departure on June 16th (Dents following closely behind on June 29th).  I think I can speak on behalf of everyone when I say that this date has come so much faster than we expected.  We’ve spent so much time focusing on our fundraising efforts and school commitments that the departure time really managed to sneak up on us!

This week will be spent packing last minute items, printing screening forms and information handouts, and brushing up on our Swahili!

Here are some of the phrases we’re working on remembering:

Jina langu ni … (My name is…)

Hujambo? (Hello, How are you?)

Unazungumza kiingereza?   (Do you speak English?)

Choo kiko wapi? (Where is the toilet?)

Asante sana (Thank you very much)

Tabasamu (Smile)

Hakuna Matata (No worries)

Karibu (You’re welcome)

Please stay tuned for blog updates as we embark on our adventure and be sure to wish us a Safari njema (Bon Voyage)!

– Tara & MedOutreach 2014




The countdown is on.

In 19 days from now the medical and nursing students will be on the plane flying to Tanzania, with the dental students following 13 days later!  We are all getting excited as our departure date approaches.  It is hard to believe that after so many months of planning the trip is almost here!

We have all been quite busy in the last few weeks between school, work, and trip preparations. However, now that all of us have finished exams we are able to devote more time to packing.  We have received our visas and are working on completing immunizations, getting travel insurance, and all of that other fun stuff. 🙂

Although it has been more difficult to get together after exams, we managed to meet up for a blitz packing night where we sorted through many of the donated medical supplies.  We are determined to find a way to squeeze all of the generous donations into travel bags. 

Thank you all for your continued support of our team, it means the world! 

– MedOutreach 2014

Corunna United Church Fundraising Event

On Sunday May 4th, 2014 Corunna United Church invited our MedOutreach team to visit for a fundraising event filled with good food, music, and a bake auction.  In all, $3,000 was raised in support of MedOutreach 2014 in addition to a large amount of supplies that were given.  Corunna United Church has been a faithful supporter of MedOutreach in the past, and we are overwhelmed and thankful for their generous contributions again this year.

Here are a few photos from the event: 


We enjoyed a delicious pork dinner prepared by volunteers from the church. 


And some homemade pie! 🙂



There were a lot of fantastic performers…




…of all ages! 



Baked goods were auctioned off,



and amazing supplies (many of which were hand-made!) were given to us to pass on to the people of Tanzania.


Corunna Church also sent a hand-made prayer shawl with us.


Our team at the end of the night with a few of the hard-working volunteers that made the night such a success! 

We are looking forward to returning to Corunna United Church again in the fall to share how their gifts helped those in Tanzania and to tell the story of the individual who we will pass the prayer shawl on to! 🙂