Tuele Hospital

Monday, 28 January 2019

Barriers, it’s definitely more red tape than carpet.


Coming to work in Tanzania on a voluntary basis has proved to be considerably more challenging logistically than we had first expected. A surgeon and a GP offering to come and work for free? You would have thought that the process would be made as easy as possible, that a ‘red carpet’ might even be rolled out to welcome and lure us into staying for as long as possible. Ha! It sometimes seems that the opposite approach has been taken. The processes are complicated. And expensive (for example I have subsequently found out that we have had to pay fifteen times that of a local doctor in professional registration fees – and we’re not even earning any money here!). The red tape is prohibitive and I worry greatly that it will (and probably does) put off other people from doing the same sort of things as us. 

But we made it here and are so glad that we persevered. Today we had to go to Tanga to get our Visas extended. I won’t bore with the details, but this has been on the agenda since we arrived. All in hand I was informed. But of course the expiry date crept closer and closer and my enquires became more persistent. They expire next week and I finally persuaded the team to take us to get them renewed. I was assured that it was a simple process and a formality, but I was very right to be sceptical. Those looks that you get from officials sometimes say so much more than words ever could. There have been many changes to the processes and laws here over the last few years I am told, which has made what we are doing harder to achieve. There was a lot of waiting around, but the local immigration officer was sympathetic to our cause and supports our extension. Unfortunately, this can only be for one month at a time (so we will have to return twice more) and today the person that we would need to actually complete the paperwork was absent. So we will return tomorrow. Fingers crossed it works out, otherwise we will be leaving in a hurry!

My reaction to all this is threefold. Firstly, whilst it seems bonkers, there is absolutely no point in letting it ‘get to you’. We took some good books to read and just went with the flow. I predicted it would be far from straight forward, so we were somewhat prepared at least. Secondly, it is actually quite an interesting insight into things. The complexities and detail of the various visas available is eye-opening (or perhaps it was the exemptions available for visas, I got quite confused). The rquired documents was mindboggling. Certainly, I feel that we have had another authentic African experience – and one that we’ve paid quite a lot of money for so perhaps we should enjoy it?! Finally however, I am even more resolute to try and meet with some of the leading stakeholders in such processes. I feel it is absolutely crazy to actively discourage (for that is what it overwhelmingly feels like) highly skilled visitors who wish to help train the local workforce in such a way that could rapidly raise the quality of healthcare. I absolutely support that comprehensive processes are in place to regulate such activity, but perhaps not like this.

Just give up and come home I hear you say? Certainly an option, but at the end of the day it is the patients that will suffer the most. So we will persevere and hope that we can adequately jump through the hoops to emerge successful.

We arrived back in Muheza late in the afternoon. To my delight (that might be said slightly tongue in cheek) there were a handful of patients that had been saved for my special review in outpatients. A victim of my own success?!


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