Shadowing a DoctorMarch 28, 2012
Tanzania has a population in excess of forty million and only just over eight hundred doctors. This compares with over one hundred and seventy thousand in the UK. The patient per doctor ration is clearly very poor by world standards, but it is also amongst the worst in Africa, standing at approximately 50,000:1. Not only is the number of qualified doctors very low, but the terrain and the endemic diseases make a bad situation much worse.
Tanzania is struggling under an HIV/AIDS epidemic of frightening size. Whereas the problem in the West was never as severe as predictions made everyone fear, in Tanzania and other African countries, it is an enormous problem. HIV/AIDS is so entrenched that it will never be beaten in these areas and all that can be done is give palliative care and try to educate up and coming generations. A lot of the work in this area is being carried out by charities, who are aiming to try to reduce the percentage of children infected by their mothers at birth. This, along with better education, will hopefully reduce the toll of deaths, but it will take more than a generation to complete. Giving peripartum (at the point of birth) antiretrovirals will cut down the numbers of infected babies, as will help from trained staff with feeding and hygiene information, but this will not be one hundred percent successful. Alongside this are difficult working conditions and a chronic lack of staff.
Malaria is also endemic in Tanzania and is a major cause of death in children and pregnant women. Babies are born underweight and the mother is often severely anaemic at the time of the birth. Sickle cell anaemia, which gives a natural immunity to malaria as the parasite cannot follow its normal life cycle, also causes many deaths in children, not directly but because of the damage it does to organ systems.
It is therefore clearly obvious that Tanzania has many problems to deal with which impact severely on its successful delivery of medical care. Despite all of this, Tanzania manages to deliver free medical care to all and this has helped to cut infant mortality due to preventable diseases considerably. Tuberculosis is a major health problem in the country, but the use of reasonably cheap medicines have managed the disease well, cutting the recovery time drastically. Even so, with tuberculosis on the rise globally and with strains emerging which are resistant to treatment, even this advance is at risk.
Drug therapies are expensive in Tanzania mainly because most drugs need to be brought in – there are only a few manufacturers in the country and with so many endemic diseases needing life long medication – HIV/AIDS and malaria for example – the drug costs per patient is high. Many diseases, such as schistosomiasis and sleeping sickness, can be prevented by good practice and these systems are being taught, in many cases by volunteers, to eventually reduce the drain on the healthcare system by preventable conditions such as these.