I found the East Africa Medical Assistance Foundation on the Internet first.
The Foundation was looking for radiologists to go to the Kilimanjaro Christian Medical Center (KCMC) in Tanzania to teach and work in the radiology department. For a long time I had been thinking of doing some volunteer work so, after some short hesitation, I made up my mind to go.
The KCMC, with its 500 beds, is one of the four regional hospitals in the country of 35 million people. There are 20 permanent radiologists and 30 assistant radiologic officers in the department founded by Helmut Diefenthal, who still works 12 hours a day and manages everything, including the chores. He gives lectures every day at 5 o’clock for the residents (even on Fridays). If there is a visiting professor at the department, he or she gives the lecture in the afternoon.
There are 18 residents, eight doctors and 10 AMOs, who are mainly between 35 and 50 years old, with years of experience as internists or general doctors preparing to be specialists in radiology.
They live far away; some were from Zambia, and one was from Zimbabwe. The transportation is bad and expensive, thus most of them got to see their family two to three times annually.
The conventional X-rays take place in three rooms, on quite old but still working Siemens machines. In one of the rooms, the trauma cases are examined with a mobile X-ray. The fluoroscopy is a Philips Diagnost, with OK quality. The mammography equipment has been out of order for two years. Despite all this, the quality of the pictures is good.
There are five ultrasound machines; one to two transducers belong to each of them. The best is an Ultramark 7 machine, which is used for cardiology examinations very often and for Doppler of the limbs. The CT quality is surprisingly good; it is an eight-year-old Philips Tomoscan SR 4000 spiral.
The hospital works at full capacity, with masses of people flowing from hundreds of kilometers away. The journey takes days sometimes, and the waiting for results and the follow-up appointments take another few days. Since the patients pay for everything, only a few people can afford to go to the hospital.
An average day at the radiology department starts at 7:30 a.m. The different departments come one after another (orthopaedia, internal, pediatrics, etc.), and 60 to 70 X-rays, 50 to 60 ultrasounds and four to five CTs are taken. The patients are almost without exception very severe cases; there is barely a negative result. There is rheumatic carditis; tuberculosis; AIDS; malaria; vitiums; and extreme, untreated fractures. The ultrasound examinations are performed by residents. Besides the stomach, many small parts, the skull, the heart and the eye are examined the most.
There is the strange custom that all patients arrive in the morning. The patients from the ward are taken, too, and everybody waits until they get called. I didn’t see a single negative CT in the four weeks I was there. Brain tumors, bleeding and widespread tumors were detected a lot.
Tanzania is one of the countries most infected by AIDS, which is in the background of the large number of tuberculosis and other opportunist infections in children and adults.
The establishment of this good radiology department, with its effective way of teaching, is a huge achievement. The residents are eager to learn and should be given a lot of respect for choosing an even harder life than being a European doctor.
I gave a lot of lectures, not only for radiologists but for pediatricians, and I took part in the daily work, especially in the evaluation and controlling the US and CT.
I was met with so much love, friendliness and humanity. The students sat there day after day in a hot, sunny room without an air conditioner and asked questions and paid attention because they wanted to learn radiology.
Thanks to Ro and Helmut Diefenthal, I met a lot of nice and interesting people, even outside the hospital. The Diefenthals took me on an excursion to Tarangire, one of the most beautiful national parks in Tanzania, where I spent unforgettable days with them.Eva Kis, M.D., Ph.D., Pediatric Radiologist. First Department of Pediatrics of Semmelweis Hospital, Budapest, Hungary