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Working in Tanzania: A Passion for People

The sixth and final part of a small series: FAME’s passion for making both patients and their families feel better.

​At FAME, I sometimes said “we should not practice veterinary medicine but human centred medicine”. It caused some hilarity. It was definitely not criticism of the quality of clinical care delivered at FAME, but rather a way of saying that apart from focusing on the condition of the patient, we also need to pay attention to the way the patient experiences the care. It means that you always have to ask permission to touch the patient, that you inform and need the agreement of the patient when doing whatever intervention and that you give the patient a clear insight into his or her own treatment plan and progress, as well as an explanation of every procedure. Communication with the patient can take away a lot of fear and can have a positive impact on the healing process. The patient will also collaborate better with regard to sticking to the suggested therapy and sharing relevant personal information needed to find causes and cures.

From a Western perspective, paying attention to the patient’s perspective on and perception of care is part of the general practice. Or rather, should be, since we often fail in doing that correctly. I understand that paying attention to the patient’s perception is even more challenging when working in a resource poor setting, and that maybe sometimes, practicing human centered care seems more of a luxury. That made me even happier to find that at FAME, there is an aspiration to focus on patient centered care more, and to keep reminding ourselves regularly and jokingly that at FAME, we need doctors, not vets. Unless of course when the ever so famous FAME dog Charley is concerned.

At FAME, I definitely encountered a passion for making both the patient and his family feel better. There was a situation in which a cesarean was opted for as mode of delivery. That decision caused some discussion. As often in medical practice, there were different opinions on how to go about the case at hand. However, when after some hours the newborn developed respiratory distress syndrome, everyone stopped focusing on the difference in opinion and turned to delivering the best care for the patient instead.

When the problems started, I was attending to another woman in labor. The newborn, who was in the same room, apparently had a breathing incident which was noticed right away by the nurse standing close by. Without even knowing what was going on, I was sent out of the room to get help. We got a quick response to our call for help. The nurse in the room had already started Neonatal Life Support. Thanks to the teamwork, the patient was stable again in no time, and from then on was closely and continuously monitored by a nurse. Hours of waking and praying were spent near the newborn. Experts in Arusha were consulted and after the road to Arusha had been repaired, FAME medical staff could transfer the baby in the back of a jeep ambulance, while assisting the breathing manually for hours. One of the nurses kept in close contact with the mother while the baby was treated at FAME, but also afterwards. We were all very happy to hear that after administering surfactant the baby recovered very well and could go home. I think the team and every individual involved deserve a big thumbs up for addressing the unfortunate cause of events so well.

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Want to know more about my journey to Tanzania and the Foundation for African Medicine? Check my travel diary.

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