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UKEREWE MEDICAL MISSION (MAR 25 TO APR 12, 2020)

Location: Ukerewe Island

Dates: March 25 to April 12, 2020

Mission Lead: Marianne Surmann

Mission Cost per participant: $2,830

Estimated Flight Cost: $2,500 (approx)

Partner: Ukerewe District Council (comprised of Nansio District Hospital, 22 dispensaries, and 3 health centers)

Beneficiaries: Around 4,000 patients per mission, in a catchment area of 310,271 people.

Primary mission language: English

My name is Marianne Surmann and I will be leading a two-week medical mission to Tanzania, March 25 to April 12, 2020.  Our group is the Canada-Africa Community Health Alliance (CACHA), a non-profit, non-governmental organization that was founded in 2001 by a medical doctor from the University of Ottawa, Dr. Don Kilby who has been awarded the Nelson Mandela Humanitarian Award, the Ontario Award for Good Citizenship, and most recently the Governor General’s Meritorious Service Medal for his work with CACHA.  I am presently looking for volunteers to join our team of 15-20 people and below you can find an outline of what you might expect if you come along.

Where ever you come from, whatever your profession and background, we would be delighted to have you join our team. We work closely together as a team of Canadian and Tanzanian nurses, nurse practitioners, pharmacists, pharmacy technicians, physicians, surgeons, and logisticians* to provide the local people with free health care services including:

  • primary health care
  • eye exams and reading glasses
  • HIV, Malaria and Syphilis testing
  • dental extractions
  • surgeries
  • medications

*NOTE: logisticians are non-medical people who organize everything so that the medical people can see patients.

Here is an outline of how the mission to Ukerewe Island in Lake Victoria unfolds:

CACHA has a travel agent here in Ottawa that arranges the flights to Tanzania so that we all arrive at Kilimanjaro International Airport at the same time.  Most of us actually meet up in Amsterdam and take the same plane to Kili. After arrival, we all spend the night at a nearby guest house and in the morning we take a domestic flight to Mwanza followed by a 3-4 hour ferry to Ukerewe Island. The ferry dock is a hub of activity and is very interesting to observe as goods are loaded for transport to the island.

We get picked up from the ferry and taken to the motel that will be our home base throughout our stay. We settle into our rooms (shared accommodation) and then have dinner. All our meals are catered by the owner of a local restaurant (his restaurant is located across an alley-way from the market so the food is pretty fresh!) with careful attention to the levels of cleanliness required by our unaccustomed digestive systems J  We drink only bottled water which is supplied at a rate of 3L per day.

The next day is spent in an orientation meeting with our Tanzanian team where we share information and plan our clinic days in the field. The following day we have meetings that are divided up into groups based on our tasks and expertise.  Logistics people are trained in weighing patients, taking blood pressures with an automatic machine, and temperatures. We practice setting up shelters (for sun and rain), run through the expected routine we will see in the coming days while actually operating the clinic, and prepare the supplies we will need to bring with us every day (things like clipboards, tape, pens, rope for putting up tarps, tarps, batteries for the blood pressure cuffs, etc.). The medical and pharmacy teams hold meetings as well. We all help the pharmacy team count out medications and place pills into little bags with labels to be dispensed by the pharmacists at the clinics.

A typical day in Ukerewe from Monday to Friday of week one, and from Monday to Thursday of week two runs something like this:

7:00             Breakfast is served.

Bins of medical, pharmacy and logistics supplies are loaded onto trucks

7:30              Team departs for the rural village (looking out the window at the rural setting with friendly people

waving is part of the charm of the island!).

8-8:30           Arrival at local dispensary or school where the clinic will be held

  • Team leader assesses the location and works with the team to determine how the clinic will be set up
  • Logistics organizes clinical rooms, waiting areas and flow of traffic
  • Pharmacy sets up a dispensary and prepares kits
  • Assignment of consultants and translators
  • Consultations begin

13:00-14:00 Lunch taken in shifts (usually a short lunch 20-30 minutes)

16:30          Consultants with patients finish up. The pharmacy completes dispensing and packs up.  Everyone pitches in.

17:00           Head back to the motel, unpack bins and free time.  Some people walk 15 minutes into town to browse

the shops, some shower and just hang out at the motel bar and have a beer/soft drink, nap or read.

19:00            Dinner is served.

19:30            Daily debrief and Pill party (preparation of meds) for the next day

On any given day we treat between 300-400 patients.

The middle weekend, Friday late afternoon to Sunday dinner is time off and we offer some local activities. A visit to Lake Victoria Children which is a childcare and education centre near the motel, a visit to The Centre for Albinism where we can meet people and listen to their music and singing, a bike ride up the coast to see local sites and learn some of the history of the island and its tribes, and a fishing trip on Lake Victoria with local fishermen in their boats are some activities we have done in the past. Some people hop back onto the ferry and spend the weekend in Mwanza at high-end hotels with spas and great food. In Mwanza, you can visit the Roots and Culture group there working with street kids and selling art and jewelry. Or you can stay on the island at the motel and rest and enjoy the days as you please.

We hold an orientation session at CACHA’s office in Ottawa before we go. Since many of the team come from outside Ottawa, there is always the option to join the meeting by Skype.

Objectives: 

  1. Provide access to high-quality health care services and to support the local health care system

a) Work with local Tanzanian partners to provide quality health care in villages and within the hospital.

b) Orientation Team meeting for Tanzanians and Canadians team members

2. Promote learning and sharing of information, skills, and resources within Nansio Hospital

a) Clinician attending Hospital daily to assist hospital staff with the overflow of patients due to caravan and to share learning and skills between Canadian and Tanzanian clinicians.

b) Expanding education and exposure with hospital surgical staff

c) Increase scope of surgery within the hospital and across the island

d) Support and provide for improved surgical infrastructure

3. Provide opportunities for the sharing of information between Canadian and Tanzanian medical personnel.

a) Sharing and teaching of clinical information between TZ and CND clinicians

b) Providing emergency care training to our Tanzanian partners

c) Canadian participants are able to increase their knowledge of the people and culture of Ukerewe resulting in the development of deep and lasting relationships including using the knowledge to promote and educate in Canada.

4. Contribute to the prevention and treatment of HIV/AIDS

a) Free testing with TZ clinicians

b) Referrals to local HIV programs including counseling

c) Access to condoms that we bring as donations from Canada.

d) Health education shared with patients on Ipads

5. Offer the opportunity to mission participants to increase their knowledge in an area other than their designated mission role/profession

For example, pharmacists spend time with Logistics Team; the Clinician spends time in Pharmacy.

NOTE: We offer logistics the opportunity to sit with clinicians if they are preparing for a career in medicine. We honour the privacy of our patients and take care of maintaining their confidentiality.

6. Work with our partners to build local capacity such that they are in control of the medical caravan and able to take over any portion as needed or as they might choose.

7. Further women’s health initiative; Cervical Cancer Screening, Breast Examination & Uterine Cancer Health Teaching.

8. Increased community health education: show videos in Swahili on Ipads we bring with us on topics such as Kichocho, Malaria, Family Planning, HIV/AIDS, Safe water and Handwashing

9. Initiate greater community engagement:

a) Meet with community leaders in the villages we are serving to better understand their needs and the issues they are facing.

b) Research other organizations working on Ukerewe Island to determine opportunities for sharing of resources, building capacity and leveraging the work we are each doing. The partnership builds better capacity.

10. Build capacity and create access to statistical information using specially developed Electronic medical records

It offers better record-keeping for all patients and access to records of returning patients.

For up to date travel information, please consult the Government of Canada - Travel Advice and Advisories site: http://travel.gc.ca/destinations/ The World Health Organization has a comprehensive website on the Ebola virus. http://www.who.int/csr/disease/ebola/en/

Ukerewe March 2020

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SHIRATI INFRASTRUCTURE MISSION - Feb 22 to Mar 17 ( extended mission Jan 31 to Mar. 17), 2020.

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CACHA medical missions are non-profit and self-funded by volunteers and their donors. The mission cost  is disbursed over a variety of mission-related expenses including; accommodation, food, in-country transportation, allowances for locally engaged partners, medical and logistics equipment and supplies, communications, customs, medical treatments and referrals for patients, as well as CACHA overhead and management, CACHA membership fee, and helps to support many of our CACHA projects.

All donations submitted to CACHA toward payment of mission costs and plane tickets are tax-deductible.

To join this mission, please complete and send an application form, along with your CV to CACHA's Assistant Project Officer apo@cacha.ca, as well as to the Mission Lead, Marianne Surmann.

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Mission Leader Chris Fischer of Ottawa, left, keeps an I.V. bag raised as fellow Ottawan Kristina Krmpotic rushes the three-day-old infant to a truck en route to the nearest hospital.

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