Tuko Pamoja: Nursing Students in Tanzania

Adrienne White, RN, WHNPBlog, Featured, Nursing, Tanzania

Adrienne White, RN, WHNP, served as a Nurse Educator through GHSP in Tanzania during the 2017-2018 school year. Adrienne reflects on working with her nursing students surrounding UN International Youth Day 2018. 

Youth represent 40 to 50 percent of the populations of most sub-Saharan African countries, with only a few other nations worldwide that have as high percentages.  Yet with fierce competition, starting at secondary school level, few young adults are able to advance to tertiary education and only a very small percentage make it to university level.  Once they do make it to university level, many students in Tanzania have large extended families who count on them, not only to excel in their studies so that they can lift the family out of poverty but also, and more immediately, to assist the family financially.  Nursing students in Tanzania report that this family dependence on them during their studies results in decreased performance because they are unable to buy basic supplies they need for school such as laptop computers, internet data, paper supplies, books or other print materials, and for the costs of transportation and other expenses.  

In spite of challenges students experience related to limited supplies, overcrowded classrooms and the pressures of competing priorities of family and academics, students in Tanzania persevere and are extremely motivated to learn.  Students without laptops use cell phones to access information and share internet bundles with their peers who run short. Students also help their classmates with other things like food, transportation, and in some instances, money to pay for needed medical care.

In Tanzania there is a common saying in Kiswahili, “tuko pamoja,” which translates as “we are together” in English.  This is the spirit I observed among the undergraduate nursing students I taught both in the classroom, in clinical settings, and in the broader community.  In this article, I will describe several instances of how students practiced this principle.

I teach undergraduate students in the classroom and clinical settings, as a GHSP visiting faculty at the a University in Tanzania. As a foreigner who was unable to speak Kiswahili, the language spoken by the majority of the population, my second-year nursing students took me under their wings.  They welcomed me not only as their instructor with a weird accent who liked to tell funny stories about growing up in “the hood” in Chicago, but also as someone with special learning needs due to cultural and language barriers. Another layer to my learning curve was that this was my first classroom teaching experience, as I had taught previously only in the clinical setting.  The students were eager to learn and helped me to feel safe comfortable in my new role.

One morning, an older man entered our classroom with one pant leg rolled up, revealing a large gaping wound on one of his legs.  One of the student leaders asked me whether I minded if he switched to Kiswahili for a few minutes, and when I agreed, he proceeded to come before the class and speak.  The students promptly began digging into their pockets, backpacks, and purses for money and took up a collection for the man. They explained to me that the man had walked with difficulty from the nearby hospital where he was denied treatment because he did not have enough money to pay.

Health insurance plans are limited and inaccessible for many people in Tanzania and many patients pay for health services out-of-pocket.  In another instance, we were in the clinical setting and students were working in the female medical ward. There was a patient writhing in extreme pain and the students were told by the nursing officer in charge that there was a shortage of medication in the ward to treat the woman’s pain.  A family member was told they could purchase the medication, but the family did not have the money. One student decided that he needed to take action and began to visit other wards in the large regional hospital to try and find the medication. He was able to find and secure the medication which was then administered to the patient.

Every day I am amazed at the initiative these young students take to help others in various settings.  A common mode of public transportation around many cities in Tanzania is in three-wheeled motorcycle taxi, called bajajis.  In large cities during high traffic times, these vehicles drive on broken sidewalks and on rough, pothole-ridden dirt roads in an effort to skirt traffic.  Accidents are frequent. One day I was with the students heading to the clinical site and there was a bajaji accident outside of their hostel.  Again, students sprung into action, assisting the passenger, who was bleeding, scared, and crying.  They assisted by calming the woman, getting her into another vehicle, and instructing the new driver to take her to the hospital.

These are just a few of the stories that illustrate the caring and compassionate leadership qualities of the student nurses whom I have had the privilege to teach and learn from in Tanzania.  Most of these students are young men and women in their early twenties. They come from poor families and have very little. They are living very far away from their families in most instances and have little support from home.  Yet they never hesitate to give of themselves in whatever way they can. As a nurse educator, I am learning how to appreciate the meaning of tuko pamoja from their actions.  I am inspired as an educator to continue working with the youth of Africa because they are indeed the future and in them, I believe there is hope.

Find out more about International Youth Day and how you may be involved here