Having recently returned in April 2017 from my second trip to Tanzania as a medical volunteer on Jubilee Hope, one of the boats overseen by the charity Vine Trust, my experience has confirmed my great appreciation of the work that they are doing to establish a link between the UK and the remote islands on Lake Victoria, some of which have no access at all to medical help. For those who aren’t aware, Vine Trust is an international interdenominational charity based in Leith, Edinburgh, that has projects both in Peru and Tanzania, and which works in partnership with local organisations to support health care and housebuilding in villages close to Iquitos in Peru and islands on Lake Victoria, Tanzania.
STARTING FROM SUNRISE
The day onboard begins with the regular 7 am meeting. This is a chance for the whole team to get together and have their say, including the volunteers, when everything from critically ill patients to a check on the food stocks is discussed. Meals are all freshly prepared on board by chef Titus, with breakfasts being a generous mix of chapatis, eggs, and toast.
Next, it’s out on the ship’s small motor boat to the island to exchange greetings with the village leads and to experience first hand the social conditions of the islanders. The majority of men are itinerant fishermen who are frequently on the move, depending on the lake fish stocks. Sadly, many of the women are sex workers who also live there temporarily, sometimes bringing their children.
RETURN TO THE SHIP — AND WORK COMMENCES
Back on the Jubilee Hope and it’s time to prepare for the patients arriving. Clinic areas are set up so all volunteer doctors and nurse practitioners get a chance to consult. This can be cosy with only a screen to separate working spaces but it allows more patients to be seen. Translators are arranged on a on-to-one basis and it’s worth spending time getting to know each other, and being taught some useful Swahili.
AN OVERVIEW OF WHAT TO EXPECT CLINICALLY
‘So what type of clinical situations are met?’ and ‘How much preparation do you need to do?’are questions I’m often asked. On our first day volunteers meet for an induction session with the clinical coordinator on board, who advises on the management and treatment of common conditions likely to present to us on board the ship. Patients are generally working-age adults who come with an array of symptoms; the most common illnesses are diarrhoea with or without blood, malaria, HIV, STIs, skin infections, UTI, chest infections, typhoid, and minor injuries.
The routine is to see patients, record their symptoms in their notebook, and refer them to the lab technician on board who is able to do a range of ‘rapid’ tests such as HIV, malaria, haemoglobin, urine dipstick, and stool microscopy. As medical staff we then review the test results and decide on possible diagnoses, management plans, and medications. Dental and eye problems are seen by the dentist and optometrist on board. The boat has its own pharmacy with a stock of over a hundred items including antibiotics, analgesics, antimalarials, creams, and eye/ear preparations.
Familiarising yourself with infectious diseases, the pre-trip medical information, and the Tanzanian medical guidelines (an electronic copy is available from Vine Trust) are all useful preparation for a trip on Jubilee Hope and the good support from the Tanzanian clinical staff. Once in Tanzania, having a chance to absorb the cultural and social differences of a people who have less materially, live more simply, but value a friendly greeting: ‘Jambo habari’ (‘Hello, what’s your news?’) helps to understand their situation.
FINALLY …
Clinics work on until the last patient leaves the boat around 6 pm when it’s time to relax or take a walk round the village. It’s a busy time onshore with small shop stalls selling anything from cassava leaves to colourful material. Fishermen are laying out their catches, either salted or dried, in the sun before they’re shipped away to the mainland.
Trips on Jubilee Hope have allowed me to experience what life is like on the islands of Lake Victoria and made me aware of the challenges people face when accessing health care. It has also reinforced for me the true meaning of working together as a team.
I’m looking forward to the next time I can say ‘Karibu’ (‘You’re welcome’).
Footnotes
If you are interested in volunteering contact Vine Trust at www.vinetrust.org or call them on 0131 555 5598.
- © British Journal of General Practice 2017