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Five minutes with...Dr Michael O’Donovan, Consultant Physician, Tanzania

Michael O’Donovan is a consultant physician volunteering with VSO in the department of internal medicine at a busy hospital in the south central region of Tanzania. Watch a short film and read about his work below.

Michael is one of 15 volunteers helping to improve the day-to-day functioning of a hospital that only recently became one of nine referral hospitals in the country, serving a huge population with up to 700,000 patient contacts per year.

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What are you doing in Tanzania?

I’m a consultant physician in general internal medicine and I work with medical students and doctors at St Francis Hospital helping to develop their clinical skills on the ward and their theoretical knowledge in the classroom. My role is to work with these medical professionals on how to practice medicine properly, so helping them apply their theoretical knowledge to sick patients in need of care. The teaching approach is the same as it would be anywhere in the world, but there is a huge difference between the limited resources available to doctors and medical students in Tanzania when compared with Europe.

What is the hospital like?

St Francis Hospital used to be a district general hospital, which meant it dealt with acutely ill patients presenting from the local area. It was recently upgraded so it’s now one of nine referral hospitals in Tanzania where patients are referred to from other smaller health centres. My role as a VSO volunteer is to help upgrade its services, and bring the hospital up to the level where it needs to be. St Francis serves a large part of the population, it has somewhere between 600 and 700 thousand patient contacts per year - so it’s a very busy hospital.

Can you explain how your VSO placement is a bit different?

It’s not the typical long-term VSO placement of one to two years overseas, as all of us working on this project are on short-term placements helping St Francis establish itself as a referral hospital. We are a team of 15 volunteers at the hospital with different areas of specialism and we dip in and out, returning to the hospital for two or three weeks every three months to train hospital staff and monitor progress. It is very much a concentrated effort during the time we are at the hospital – which is quite different from the usual model of building relationships over weeks and months before trying to implement any change. I think it is working well though, and this approach to volunteering in short bursts has attracted volunteers with lots of professional experience.

What is a typical day?

A typical day begins at 8:45am with a ‘night report’ which is when the on call doctors from the previous night explain the condition of patients admitted overnight and explain their provisional diagnosis. I then do wards rounds together with senior doctors, junior doctors and medical students visiting wards including the intensive care unit. Later in the day I usually conduct teaching sessions with students and young doctors working as interns at the hospital.

Do you feel you are making a difference?

I think the impact of my work will be felt in the long run...especially in terms of how patients are treated at the hospital. I’m optimistic the tutorials, x-ray and ECG interpretation skills-sharing and training in proper bed side clinical skills will leave a lasting impression on the medical students and interns. There are very few senior doctors at St Francis Hospital – especially in internal medicine – so having someone specifically here to teach on these subjects is rare for medical students in Tanzania. The students and interns are showing a lot of enthusiasm, so hopefully I can have a positive influence which will improve their medical practice in the future. Even if it is just simple things that stay with them – like using the hand washing facilities and proper use of patient monitoring forms – it can and will make a big difference to patient care at this large and important hospital in Tanzania.

What is it like working alongside local people?

Before I started my placement I knew most of the staff and students I’d be working with would be Tanzanian. I’ve been particularly struck by the enthusiasm and positive attitude of the students and interns. They are fully aware of that I’m here to help enhance their skills and they appreciate that – so it’s been very encouraging for me. It is also key for long-term change– as they will be the ones making the difference to the quality of healthcare when they begin to practice their profession. There is a hope that many of the students and interns I’m working with will stay and work as doctors in the region or at the very least remain in Tanzania, because the country needs Tanzanian doctors to stay in Tanzania.

Any final thoughts?

Hospitals in most African countries are resource-poor so for me it’s been a real experience stepping aside from the usual environment of conducting lots of investigations, having access to lots of medication and facilities to treat patients.  On a personal level, trying to share skills effectively in a poor rural hospital with aspirations to serve an enormous population has been a real experience.

We are urgently recruiting a radiologist to accelerate the reduction of maternal and neonatal mortality in southern Tanzania for six months.

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