Healthcare Among The Poorest Of The Poor

May 8th, 2013 by INMED
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Liver cyst


Its difficult to know how best to work on this problem of healthcare access among the poorest of the poor. Obviously the people should have some responsibility to pay for services but at the same time should the payment for the medical services cause their entire future livelihood to be mortaged and in the case of the masaai should they be forced to sell their future inheritances (cattle) just to pay for the hospital services. I know that I am on a tangent but the situation remains frustrating.


One extreme example is a young woman who came to the hospital with a ruptured ectopic pregnancy and was told to pay for all services beforehand. As you can imagine this created quite a stir among the doctors within the Internal medicine department but the problem is at the level of the hospital administration and must be modified so future problems like this don’t happen. On a daily basis a similar problem pervades, that all patients must pay for their hospital stay in full before being discharged…well this means that they are still charged for each additional day in the hospital (5000 shillings per day…about 2.50 dollars) while they are attempting to find the means for payment. Many of these situations have been frustrating and is one of the reasons why working in medicine among the poorest people presents such a challenge.

My Typical Weeks

April 25th, 2013 by INMED
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My typical weeks at the hospital have included participating in admissions of new patients with the medical students and residents, participating in bedside rounds and physical exam lectures. Interestingly, my experience at KCMC has not differed that much from one of my teaching hospitals in the memphis.  Most of our patients are very poor and come from the rural surrounding areas and include two primary tribal groups: the chagga and Masaai. Both of these groups are primarily reliant on agriculture with the primary crops grown being coffee and bananas. Most of these people are incredibly poor with average income being less than $1 dollar per day for over 50% of Tanzanians. Most of these people live on about a 0.5 acre of land that produces just enough fruits and vegetables for them to survive off with minimal else extra for commercial sale.


As such these people have minimal disposable income for obtaining hospital services and many are unable to afford the cost of their time at KCMC. From what I have heard secondhand many patients never even make it to the hospital but are forced to remain in their peripheral villages without access to medical care since they know that they can not afford it. Others come to KCMC but are forced to sell their cattle or crops and live with the future consequences of this to pay for the services.

Wonderful So Far!

April 15th, 2013 by INMED
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Again thanks to everyone who has been an integral part of helping me to come to Tanzania for this 8 week period of time. So much has happened over the last 2 weeks that is difficult to know where to start. My time here has been wonderful so far as I have been blessed with great friendships both from the local Tanzanian medical students and also the variety of foreign medical students from all over Europe, Australia, and United States.


The hospital I have been working in Tanzania, called Kilimanjaro Christian Medical Center (KCMC) is a tertiary referral medical center, meaning that it represents the highest level of medical care available in Tanzania. It has a referral base of over 13 million people and draws patients from all over northern Tanzania and also southern Kenya. It is also an academic medical center which means that it has a medical school and multiple post graduate residency programs on campus. This has been a wonderful addition because the language of the medical environment is English and so all of the students and residents can speak English. The language of the patients, however, is Swahili so my ability to converse with them is minimal at best. This has also limited my ability for direct patient care, of course, I was aware of this before I went. It has also shown me that for any future medical work language proficiency must be central for any meaningful ministry to occur.

My First INMED Blog Post

April 1st, 2013 by INMED
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lane-robertHello! My name is Robert Lane. I am a medical student at University of Tennessee College of Medicine, and I’m starting my INMED service-learning experience at Kilimanjaro Christian Medical Center in Tanzania, beginning in April 2013.