Martin Luther King very famously coined the phrase ‘I have a
dream’. He was referring to his vision for equal rights in relation to race,
skin colour, creed.
Over the weekend we have returned to Peponi for some much-needed
R&R. It is so beautiful here and the sea breeze certainly takes the edge off
the heat. We are well looked after and the chidlers have a wonderful ‘playground’
to entertain them. As well as resting and learning a bit more Swahili, my mind
always seems to drift into thinking mode. Many reading this may smile wryly at
that statement – I am well known for being a thinker!
Time certainly flies, and it seems that our time here is
rapidly accelerating. It is now little more than 6 weeks until we will be
leaving. Blimey. I could self-indulgently review all the things we have already
done, all the things we have achieved, and sit here with a sense of deep satisfaction.
However, whilst I will certainly take all those things and enjoy them, I cannot
help but think towards the future. We have come as one family and without any
doubt we have made a difference to the care provided in Muheza, both during our
time here and (I believe) after we have gone. But we are just one family, I am
just one surgeon. And, as will be so very apparent to anyone who has followed my
writings regularly, there is SO
much more that could (and indeed should) be done.
Furthermore, as my naturally inquisitive nature has led me on
my journey (both physical and intellectual) to unpick the healthcare system more
widely here in Tanzania, the more I learn, the more I see. And the more I see, the
huge potential for further work becomes quickly apparent. I confess I have dreams.
I have a dream that healthcare here in Tanzania could one day be much closer to
that provided in the West. And in my dream, that day is not just some abstract
point in the distant future, but that it might be soon and certainly within my
lifetime. It would be amazing to think that improving healthcare in countries
like Tanzania could become a catalyst for healthcare improvement more widely in
Africa, and indeed the rest of the world. But that is getting carried away. My
dream has had to ground itself on something tangible. Certainly ambitious, but
tangible.
I have met so many amazing doctors, nurses and other
healthcare workers here. What they do with what they have is absolutely incredible.
But they are lacking so much. So very much. They need financial support,
intellectual support, educational support, moral support. They need equipment, skills
and enthusiasm. They need to see a vision for the future begin to unravel and
then the progress will snowball. But my dream is that they are the ones to drive the healthcare revolution in Tanzania. What
I have seen in my time here is that there are many strategic initiatives from
NGOs that undoubtedly improve the system, but the impact on the ground is less
apparent. I have also seen lots of individuals and organisations working here,
some beavering away for years, some parachuting in and out. My dream is about
supporting the local teams to do it themselves, to drive this healthcare
revolution forward. Sure, they will need lots of support to do this. But that is
my dream.
I have given much thought to all this. My mind is awash with
ideas. I find myself in a raging torrent of possibilities struggling to make
sense of it all and to keep my ‘head above the water’, to keep myself breathing
the air of realism. But perhaps all ‘great things’ (dare I suggest that these ideas
might become such) have to start somewhere. Fortunately, I have an amazing wife
who is an incredible sounding board, tempers my enthusiasm and helps direct my
energies into something productive.
We have a place to start. Right here, right now, in Muheza
we have a working model for mesh hernia surgery that could transform care throughout
the country. It is a small cohort perhaps, for now. But hernia repair is the
most common general surgical procedure carried out in Tanzania and indeed worldwide.
If we can share this experience more widely in Tanzania and support the evolution
from suture repair to mesh repair, then that would be a massive step forward. I
have made many contacts and I have ideas. So much more work to do and I will certainly
need help. But we have made a start.
“Human progress is
neither automatic nor inevitable… Every step towards the goal of justice
requires sacrifice, suffering, and struggle; the tireless exertions and
passionate concern of dedicated individuals.“
February 10th 1961, Martin Luther King, Jnr.
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