When Ruth Oenga and Sakina Moloo started the second semester of their fourth year in medical school in Tanzania back in March, they had a basic theoretical understanding of what electrocardiograms are used for and what the readouts look like. But they had never laid their hands on an EKG machine. Nor had they ever had an opportunity to observe and practice how EKGs can be used to improve diagnosis and treatment for a variety of different cardiac patients and conditions.
Now, just three months later — thanks to the initiative of three of their faculty and a Program Support Award from Seed Global Health — Ruth, Sakina, and their classmates have all practiced using an EKG machine in their classes and applied their newly acquired skills and knowledge to help patients at the hospital.
“We had been learning how to do it theoretically,” Ruth reports. “Now we can do it practically. It has enabled us to actually understand EKG better. So now we are more confident that we know how to use it and will provide better treatment for our patients once we start working in our careers.”
The three faculty members responsible for this transformation are Dr. Raymond Mwenesano, Dr. Warles Charles Lwabukuna, and GHSP Physician Educator Bill Kovacs. The award from Seed was for purchase of an EKG machine and other diagnostic equipment and supplies needed to give students practical, hands-on training, both in campus skills labs and on the hospital wards where they round with faculty.
“We were trying to teach these guys electrocardiography,” Kovacs explained. “We had the theory lectures and we had sessions where we handed out pieces of paper with electrocardiograms on them, which is the end result. But it doesn’t really make much sense until you actually know what goes on, until you can actually see one and do one.”
Their students agreed. When asked to rate their confidence in knowledge of different topics, they ranked electrocardiography right at the bottom.
So when Drs. Mwenesano, Lwabukuna, and Kovacs heard about Seed’s new program offering awards of up to $10,000 for “resources that support the educational enterprise,” Kovacs recalls, “Electrocardiography was at the top of our list. It was something that the students wanted to learn and it was also recognized as an institutional need.”
Together, they prepared a proposal to obtain an EKG machine and other diagnostic equipment and supplies, including an ophthalmoscope, an invaluable tool for detecting and treating retinal vascular diseases, including complications of diabetes that can cause loss of vision without early detection and timely treatment. The proposal was promptly approved and the equipment acquired in time for the start of the semester.
“We were very happy to get the grant,” said Dr. Lwabukuna, who is the assistant director of the Internal Medicine Department. “Previously we were teaching EKGs without actually having those machines. It made teaching a lot more difficult for us and made it hard for students to learn how to use the machines for particular circumstances. So this is very good for us.”
“It has been good not only for our students and faculty, but for patients,” Lwabukuna added. “Especially in public hospitals where doctors sometimes want to do EKGs but the machines are not there. But if they come to us, with our machine we can demonstrate to our students how to use those EKGs and at the same time we can also serve patients and it becomes easier for doctors on the wards to treat those patients. So it benefits the Tanzanian public, not only our students but the entire public.”
Ruth and Sakina remember several patients who have already benefited from the EKG machine and the knowledge and skills they have developed using it — “including one with congestive heart failure, where we didn’t really know the cause until we did the EKG and were able to establish what was wrong,” Sakina said.
They both look forward to treating many more patients. And they both hope to be able to teach and share their knowledge with many more clinicians. “I would love to help many more in Tanzania, and in Africa generally, to be better doctors,” Ruth affirmed.
Kovacs is confident that she and Sakina will achieve those goals. “Warles [Dr. Lwabukuna] and I and this university, we want our students to be the best of the best. Ruth and Sakina are the best of the best. We want them to fulfill their potential, and others to be like them.”