The Department of Obstetrics and Gynaecology in Mnazi Mmoja Hospital is quite advanced, equipped with more than 100 hospital beds. Besides Hou Shunyu from the Chinese Medical Team, there are four foreign experts from Russia, Egypt, and other countries. Hou is well-known in Tanzania. In late July, Amina Karume, daughter of the former President Benjamin Mkapa, needed caesarean section. She asked for Hou Shunyu to perform the surgery. Hou later pointed out, “This department is one of the most competent. Except for the operations of malignant tumors and minimally invasive surgery (MIS), all other surgeries can be performed here. There are MIS centers even in county-level hospitals in China, but there’s none here, though the investment may be only two to three million yuan.”

Lack of Equipment

“There are so many kidney stone patients. For minor stones, an operation is unnecessary. Taking lithagogue infusion or applying extracorporeal shock wave lithotripsy (ESWL) can get rid of stones in the body. But at this place, lack of medicines and equipment is a big hurdle. So the only thing we can do here is to advise the patients to drink more water and do more exercise. After three months, if the stones are still there, even they are small ones, we have to perform an operation.” Lu Jianlin, team leader of the 24th dispatch and doctor of the Department of Urology, shared the same regrets as many members of the medical staff.

Ma Qianjun, a Chinese cardiologist, came to offer treatments to sufferers of hypertension. Tanzania has a high incidence of hypertension. Ma noted that back in China, gentle stabilization of blood pressure is stressed, but local doctors here use Lasix to quickly decompress the patient. He is reluctant to follow suit, but is pressured by the dictum “When in Rome do as the Romans do.” When prescribing medicine, he enquires about whether the patient can afford it or not. If not, he changes the prescription drug, but tries to gain the same effect. The ratio of doctors to patients in the hospital is low – that’s another problem that worries Ma. After prescribing medicine to patients, a doctor might wait for six to seven weeks to see them again, which means he has to wait that long to see the effects and arrange followup treatment.

The first time the Chinese medical team came, it brought traditional Chinese medicine (TCM). It refers to acupuncture and moxibustion in Tanzania, and massage is categorized as a form of physiotherapy. Doctor Ouyang Basi told us, “There are many patients suffering from osteoarthritis, facial paralysis and lumbago.” It took one week of acupuncture and moxibustion treatments to cure a five-year-old victim of facial paralysis. Afterwards the child’s father came to the hospital to express his gratitude. There’s another thing Ouyang worries about – poor medical conditions. For example, the acupuncture needles are not disposable. The hospital doesn’t provide them to patients, and the patients are reluctant to buy them either. He has to sterilize the needles after every use.

According to the blog of Li Huaiqi, a stomatologist, on his first day at work he performed operations in the outpatients ward for three hours, with mosquitoes and flies bothering them all the time. He was afraid that they would infect the wounds. Before the third operation of the day, he was informed of a shortage of surgical equipment, so he had to wait till the used ones were sterilized, but the sterilization pot didn’t easily reach the high temperatures needed. The operation had to be suspended. After borrowing more surgical equipment, the operation eventually continued. To his surprise, the patient didn’t complain about the delay, and even comforted him in Swahili “pole pole,” which means “take it easy.”

Training Local Doctors

On the first day of his work all the x-ray films that had accumulated for a week at the hospital were piled on Li Xiaobing’s desk. Li, a PH. D of radiology, is one of the two doctors in the radiology department and his colleague mainly performs ultrasound checks. The medical images taken in the health stations of the island are all sent to this hospital for analysis. After the Chinese doctors read the images, these films are sent back. Every day Li Xiaobing finds himself reading for hours, usually 80-100 images per day.

“Tumors are not frequently seen at this place; infection and tuberculosis are more common. A chest X-ray is enough to check for disease. It’s time we paid more attention to prevention measures, finding signs of disease before it develops, so the health checks play a significant role. The patients here don’t get an X-ray until the situation is serious and acute, which would be too late for some fast-developing diseases, such as osteomyelitis and tuberculosis,” Li remarked.

After working at the hospital for awhile, Li found that mistakes were frequent in the sequence number of the medical images. An elder’s image was mistaken for a child’s. He recommended hospital staff print the number on the images. “Two of the machines in the Department of Radiology are quite advanced, but the technicians still need to work more precisely.” Sometimes Li would tell them how to perfect their techniques. “Precision makes the image readable and accurate,” he added.

Li sometimes helps train local doctors. The hospital suggests that he spare two hours each week to read the images with the local doctors together, and explain the details revealed, as well as teach them how to make good images.