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July 2010 · Vol. 22, No. 07

Far from home and the nearest FHR monitor

Thoughts about ObGyn after practicing in Tanzania

For 2 years, we’ve helped provide basic medical services to thousands of ill and injured Tanzanian women. They’ve taught us understanding and compassion and given us a sense of usefulness.


Fast Track

“Paradoxically, both the availability of electronic fetal monitoring in resource-rich settings—and the absence of electronic fetal monitoring in under-resourced settings—lead to many unnecessary cesareans”

“Gaps in language and culture; corruption, apathy; and a shortage of nearly everything that we have come to consider necessary to practice medicine—all these make life in Moshi challenging and interesting”

IN THIS ARTICLE

Jeffrey  P.  Wilkinson,  MD; Sumera  K.  Hayat,  MD

Dr. Wilkinson is Assistant Professor in the Division of Minimally Invasive Gynecologic Surgery, Department of Obstetrics and Gynecology, Duke University, Durham, NC. Dr. Hayat is Clinical Associate in the division of General Family Medicine, Department of Community and Family Medicine and Obstetrics and Gynecology, Duke University. Both authors have served on the medical staff of Kilimanjaro Christian Medical Center, Moshi, Tanzania.

The authors report no financial relationships relevant to this article.

Two years ago, our family moved to Tanzania to help build a women’s health collaboration between Duke University and the Kilimanjaro Christian Medical Center (KCMC) in the town of Moshi, one of four tertiary referral centers in Tanzania that serves a population of nearly 14 million people. The goal of the collaboration was to expand the successful Duke-KCMC HIV/AIDS program that had been in operation at KCMC for 10 years to a broader women’s health service. Here is a synopsis of what we found in Tanzania and what we learned in those 2 years working alongside excellent local consultants and medical residents. (For ease of narration here, the word “we” expresses our individual and in-common experiences and thoughts.)

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