Swallows and Africans

I am not sure whether I should share such things, but I have always had an emotional vulnerability when I am tired. Many I am sure would read this as a weakness. Others might be touched by the humanity of it. I think the only person who is really aware of its existence is my wonderful wife who has of course seen me through most of the highs and lows in my life. Although I suspect there have been times even in my professional life when there have been glimpses of it. Perhaps towards the end of a particularly long day at work, or an all-nighter or one of those occasional brutal 36 hour marathons, when my eyes have misted in the face of some pretty tough situations. I’m fairly sure some of my colleagues over the years have noticed. Those moments that catch you – the arrival of a family member to the bedside of a very sick or dying relative, breaking bad news, the beauty of an elderly couple sharing their last moments together, the agony of an unexpected death….. As a doctor, your patients and their families need an empathic professional, not a blubbering wreck, so you learn to manage such things, a professional front that is as much a shield for you as it is important for them.

Out of the window

This morning, having got up at 04.30 to catch the bus, I was tired. And as I left Dodoma, watching the scenery change, I had a lot to think about. Perhaps listening to Coldplay’s ‘A head full of dreams’ didn’t help. As I stared out of the window, a solitary Mzungu in a bus full of local Africans, I looked out over the beautiful scenery (savannah with occasional iconic baobab trees rolling into the mountains in the distance), breath-taking as it was slowly illuminated by the breaking dawn. And then there were the villages, just a few kilometres out of the capital, mud huts. Beautiful in their simplicity of creation and closeness to the natural, yet also a stark reminder of the reality of life for much of the population. I was, for some reason, caught completely off guard. A wave of powerful emotions crashed over me. I found tears trickling down my face. I felt completely overwhelmed by the multitude of thoughts racing through my head. The enormity of the situation I find myself. The stark reality perhaps getting a rare outing in my tired state (we humans are, I think, very good at managing or perhaps disguising such things).

Such a beautiful country. Such a beautiful people. We have been so very warmly welcomed into the lives of those we are working with. It has been such an incredible experience. Such an amazing adventure. Such a privilege. And for all its challenge, I am so glad we came. And yet, having started to meet more and more amazing individuals and seen the highs (as well as the lows) of healthcare in Tanzania I was struck by how fleeting our visit here is. And, whilst on the one hand I have bold visions of an evolving period of amazing transformational change in healthcare here, I was also struck by the limitations, perhaps, of what we are doing. One family. Two Mzungu doctors and three young children. A speck in a vast ocean of people. Like swallows, we have come to Africa for just a short ‘season’ and then will be off again, back to our comforts in the West. Leaving behind the lives of those people who live here. Many new friends among them. The tender thread they live on, no less tender really for our time here. We have been a pleasant distraction perhaps, but has our visit really been anything more than that? Sure, we have certainly made a difference to a number of lives here, undoubtedly saved a few even, and that in itself is of course fantastic. But are we just a transient novelty, an eddy of breeze on a hot day, a glimmer of hope soon to be gone? What happens when we leave?

I completely accept that I am a dreamer, but it strikes me so very powerfully right now that so much more could be done. But how? Ideas are just ideas. Dreams are just dreams. Words just words. Aspirations just aspirations. Of course there is value in the little (I have always been a strong advocate of such notions, there is value to every action). But I have also seen glimpses of how much more could be done helping to transform lives across this country, not just in one small pocket. Collaboration is a word I have used a lot in recent weeks. Perhaps, with the right interest, enthusiasm, passion and support from both within Tanzania and without, perhaps these dreams, these glimpses of a better future might just become reality in a timely fashion. Perhaps….

….Every little helps…..

Swallows are annual migrators, right?!