Piece 22: What Am I Doing Now?

It has been 2 years since I used this blog to share my experiences as a Junior Fellow, working in Malawi with Engineers without Borders (EWB).  Fast forward to Sunday… and I am now a second year medical student at the University of Calgary on a clinical elective in Mwanza, Tanzania.  I am here with a group of three physician preceptors (all of whom have extensive experience in Global Health both in Canada and abroad) and seven fellow students.  As a member of U of C’s Global Health Concentration (GHC) I will be spending 4-weeks doing a clinical elective at Bugando Hospital and Aga Khan Medical Centre, with whom the school has developed a longitudinal partnership.

The goal of the GHC is to increase the exposure of U of C medical students to under-served populations, while developing global health competencies. I was keen to join the GHC for the opportunity to be involved in longitudinal shadowing at community clinics that work with vulnerable populations in Calgary.  I was initially less keen on the international elective component of the GHC, because my learnings related to sustainable change when I worked with EWB had raised potential ethical concerns for me about short-term projects (such as medical electives).  While my concerns remain, I am hopeful that my attitude towards the elective and this well structured program will help to mitigate some of the negative effects.

My goal throughout this elective is to be aware of the impact of my presence at both the hospital and at the medical centre.  Given the stage of my medical training and the short time frame of this elective, I know I will not be “making a difference” or “saving lives”; rather, the benefits will be personal. By bringing Canadian preceptor physicians with experience in Global Health, we hopefully will not be taking supervisory staff away from Tanzanian medical students or reducing the productivity, efficiency, and effectiveness of the clinical teams working here.  I do not want for my presence to place stress on an already poorly resourced system.  I also do not want to “do things I wouldn’t be allowed to back home”.  I am very aware of my skill level and clinical tasks or procedures that I can and cannot participate in.  If I can’t yet do a procedure at home… I won’t be doing it here!

So, I am in Tanzania to gain a better understanding of the burden of disease and to be exposed to experiences that will build my capacity and my capability to apply my emerging skills as a student physician to the challenges of serving under-resourced individuals and populations.  I am now looking forward to this experience… and will do my best to be culturally sensitive, humble, and approach this opportunity with good intentions!