Kilimanjaro Christian Medical Center – Tanzania
Tanzania is home to the tallest mountain in Africa, Mount Kilimanjaro. Located on its breath-taking foothills is the Kilimanjaro Medical Center – a full-service institution providing surgical, medical, obstetric, pediatric and outpatient services to are region of 11 million Africans. The medical center is also a leader in education, with medical, nursing, physical therapy, occupational therapy, and pharmacy schools.
Students from many countries study under guidance of Tanzanian and international healthcare professionals, accompanied by volunteers and full-time staff. The staff is exceptionally involved in training and in research activities. The medical center also has active public health and HIV interventions. Teaching and medical records are in English, but the majority of patients speak Swahili. Interpreter services are readily available.
Location & Community
Located on the Eastern coast of Africa, Tanzania is the largest East African nation. Kenya sits to the North and Mozambique lies to the South. The coast of Tanzania is humid and warm with frequent monsoons, while the North is mountainous and cold. Ecologically, Tanzania is culturally rich, with more than 120 ethnic groups that have a strong family-centered culture. Kilimanjaro Christian medical center, located near the city of Moshi (2,953 feet or 900 meters above sea level) in northeastern Kenya on the foothills of Mount Kilimanjaro, is an excellent location from which to experience the culture of this fascinating nation.
International flights arrive either in the capital city of Dar es Salaam (572 km southeast), located in the center of Tanzania, Kilimanjaro International Airport (46 km west), or in Nairobi, Kenya (349 km northwest). The medical center provides transportation from the Kilimanjaro International Airport for a nominal fee with a reservation prior to arrival.
For current information, please visit the Embassy website appropriate for your country. United States citizens can visit the Tanzanian Embassy in Washington, DC. Americans should request a “tourist visa” and can also purchase this on arrival in Tanzania for a fee. Additionally, the Tanzanian government requires each student to obtain a temporary residence permit once arriving at the Kilimanjaro Medical Center.
Resident and attending physicians are required to register with the Medical Council of Tanganyika in order to do clinical work in Tanzania. The cost is about $100 and takes a few months to process.
Traveler’s Health & Safety
All routine vaccinations should be current, including hepatitis A and B, MMR, DTaP. In addition, typhoid and yellow fever vaccinations should be obtained. Meningococcus vaccine should be considered. Malaria prophylaxis is recommended. Visitors should know their PPD status before coming. One should consult with their personal physician before traveling, and refer to the CDC Travel Website for the most up-to-date health information.
Most patients coming to the medical center are traditional Africans from the Chagga or Masai people groups who make a living through farming or guest services. Almost all have a very low income, cannot pay for their medical services, and continue to practice traditional healing practices. Patients suffer from diseases typical for East Africa: malaria, diarrheal diseases, rheumatic fever, and malnutrition. They commonly present late in the disease process when complications are much greater.
Most all patients speak Swahili, but the primary language of teaching and medical recording are in English. Thus, the hospital staff is fluent in English. Translation may be needed with patients but is readily available.
Medical Care Services
Kilimanjaro Medical Center is a full-service 457-bed hospital with a catchment area of some 11 million people. It was established in 1971 as an institution of the Good Samaritan Foundation and now is funded by the Tanzanian government and private donations. Annually, the hospital has approximately 20,500 admissions, 3,000 births, and 110,000 outpatient visits. Outpatient services include medicine, pediatrics, rehabilitation, ENT, ophthalmology, dermatology, and dentistry. The hospital is part of an educational center that includes a medical school, nursing school, physical therapy school, occupational therapy school, pharmacy school, and dentistry school.
HIV Care Services
Tanzania has 1.4 million people (2009, CIA World Book) living with HIV/AIDS which ranks sixth in the world. Kilimanjaro Medical Center is the home to a comprehensive HIV program that includes screening of pregnant women and prevention of mother to child transmission (PMTCT), counseling services, community-wide HIV/AIDS education, free access to antiretroviral therapy (ART), and a HIV patient medical center home for children and families living with HIV/AIDS.
International HIV Medicine students participate in the full range of HIV interventions. Activities include educational presentations in public forums, an outpatient clinic, HIV treatment with laboratory support at approved centers, and HIV/AIDS research projects in collaboration with Duke University. Medical Center researchers also collaborate with the NIH, Gates Foundation, and Baylor University in areas including HIV associated malignancies, voluntary testing and counseling, PMTCT, and vaccine immunology.
Public Health Initiatives
The Kilimanjaro Medical Center hosts a Community Health Worker (CHW) training program and supervises primary health projects in its surrounding villages. For these services, the medical center receives extensive professional support from Duke University. Public health nurses and the community health department actively provide health education, health promotion activities, and assistance with research activities.
A particular strength is the Kilimanjaro Center for Community Ophthalmology – a World Health Organization East Africa coordinating center for epidemiologic projects studying trachoma and vitamin A deficiency. INMED students participate in all aspect of the Kilimanjaro public health programs. Medical students interested in working in field must be in their final year.
Healthcare Profession Staff
Kilimanjaro Medical Center is staffed by Tanzanians of all primary care and subspecialty areas, and supported by permanent staff physicians from the United States, United Kingdom, South Africa, and Germany – all of whom are eager to mentor students. There are also excellent Tanzanian and international physical and occupational therapy faculty.
Students and residents are assigned to a clinical department of their choice (internal medicine, pediatrics, obstetrics and gynecology, otolaryngology, radiology, general surgery, dermatology, ophthalmology, pathology, orthopedic surgery, anesthesiology, pharmacology, nursing, or community health) and will be a part of all the clinical activities. They work alongside Tanzanian residents and students with immediate supervision from Tanzanian medical officers as well as international physicians. Each student or resident will participate in admissions, management plans, and take call for a particular ward (approximately 35-50 patients) with a Tanzanian resident.
There are weekly clinical conferences on a specific topic that students attend, weekly grand rounds, daily morning rounds, daily radiology rounds, and the medical center has many workshops and seminars open to students. Research opportunities are also available as there are ongoing projects through Duke University’s Global Health Institute, as well as the department of community health.
Student Lodging & Meals
Students are provided lodging at the medical center’s hostel or in a medical staff house in a single or double room ($150/month). The water at the medical center is safe to drink, each accommodation has a kitchen to make meals, and there is a staff canteen and doctor’s club that serve meals throughout the day for less a dollar.
The medical center has a new Communication Center with telephone, Internet, and fax. Each student accommodation has its own telephone that can receive incoming international calls.
INMED invites all participants to consider raising extra funds to donate to support this facility. While such efforts are not required, they will provide opportunities INMED personnel to become involved in this important aspect of international healthcare.
Moshi is located on the Kilimanjaro National Park and there are many exciting excursions that can be arranged through tour companies such as Kilele Afrika. There are also beautiful coffee plantations, waterfalls, and hiking around Moshi. Additionally, the renowned Serengeti National Park and beautiful Zanzibar beaches are a short trip from Moshi.
Behavior & Dress
Dress is conservative. Men to work should wear dress pants such a khakis, dress shirts, and dress shoes. Physicians normally wear white coats. Women to work wear skirts or dresses below the knee. Dress pants or khakis are also acceptable. Shorts or tops that show the shoulders or midriff are not permitted.
What To Pack
Visitors should bring copies of all healthcare profession licenses, diplomas, or certifications. It is recommended to also pack a carry-on bag that has essentials items just in case one’s luggage becomes lost. Snack foods and a stethoscope will be useful to bring along. Additional useful items include insect repellant, camera, books, flashlight and batteries, water bottle or canteen, battery powered alarm clock, and adapter kit for European-style electrical plugs (240V).