Stories From the Field:

Tanzania

A Surgical Mission to Tanzania

Natalie Harris, a Registered Nurse on Ellison 6 at Mass General, was granted a Center for Global Health Travel Award to spend two weeks in Tanzania with Medical Missions for Children.

Thanks to the Mass General Center for Global Health Travel Award, I attended a 2-week surgical mission to Dar Es Salaam, Tanzania in July 2012 with Medical Missions for Children (MMFC).  MMFC, based in Woburn, MA, consists of approximately 375 international volunteers that travel to around 12 sites annually to provide services free of charge such as cleft repairs, microtia repairs, dental services, and speech therapy services depending upon the needs of each site.

Our five-member team (1 surgeon, 2 anesthesiologists, and 2 RNs) arrived with 12 pieces of luggage containing the necessary equipment and supplies to provide surgeries for 2 weeks. We were welcomed with open arms by the staff of the Comprehensive Community Based Rehabilitation in Tanzania (CCBRT) Hospital. CCBRT is a non-governmental hospital whose mission is to provide services to prevent and reduce disability, and empower the disabled to participate fully in their communities. CCBRT provides a variety of services to those suffering from visual and physical deformities. Although they provide services to all ages, the goal is to reach children early and minimize the long term physical and economic consequences of disability. All children under the age of 5 receive care free of charge. Services to all others are provided on a sliding scale.

Each morning we arrive at CCBRT by bus. As we unload, we walk through the crowds of people in the open air reception area. People patiently waiting on benches to be granted an appointment with the CCBRT staff. Our team reports to the ward assigned to our patients. The ward is an area of organized chaos. A large room with approximately 30 beds teeming with parents and children waiting to be evaluated, often times their siblings. The parents look hesitant, but hopeful. The children are running around and playing with all the other children. Most of the children have some physical deformity and are delighted to be able to play with others that are like themselves. The tea cart is at the far end of the room. Mothers stand in line, babies strapped to their back with colorful fabric, to receive an allotment of tea and buns for their families. In another corner, a group is watching a soccer match on the television. In the courtyard, families are washing their clothes and laying them in the grass and trees to dry. In the middle of the chaos, our team evaluates each potential patient for surgery. Those who are cleared are assigned a day for surgery. Previous patients are examined and given discharge orders as appropriate. As the families and children become familiar with our team, they begin to run to us each morning to get their pictures taken and to thank us.

For two weeks, Operating Theatre 4 is our home. Each day our team strives to provide as many surgeries as possible - typically 5-6 per day. Each day CCBRT surgical, anesthesia, and nursing staff participated along side our team. This joint effort allows for an exchange of ideas. Over the years, MMFC and similar teams that visit CCBRT, have provided surgical instruction to the CCBRT staff. This on-going commitment to education has resulted in a local team that can provide cleft repair surgeries year round.

At the end of the mission, MMFC provided services for 30 patients. Personally, the most satisfying are the teens and young adults. Watching them as they look in the mirror for the first time after surgery is very powerful. Although their speech will always be affected, their new hopeful outlook is contagious! Palo was 18 and arrived at CCBRT on his own. His bravery and determination were rewarded. Every morning he greeted us with a “thumbs up.” At the conclusion, MMFC left updated surgical instruments and supplies to enable to CCBRT staff to continue their commitment to their community and afford patients like Palo an opportunity to be productive.

I would like to thank the MGH Center for Global Health for sharing the vision that all people have the right to a healthy, productive life. The generous travel grant has allowed the savings to be channeled into patient care - after all cleft lip repair surgery only costs about $300/patient but the potential return on investment is immeasurable. I will be attending MMFC surgical missions in India and the Philippines in 2013.