By: Kayti Baur, MSc Candidate in Community Health and Epidemiology

Samiah Alam, a student in Dalhousie’s Masters of Community Health and Epidemiology program, was the second student to be awarded one of the Queen Elizabeth Scholarships (QES) to study in Tanzania in the summer of 2019. We sat down with Samiah to hear about her goals, work, and experiences during her time in there.

Samiah entered the program with a strong desire to learn about global health in general, partially because her degree in epidemiology can be quite strongly associated with global health issues. Additionally, as a volunteer doula here in Halifax, Samiah had developed a particular interest in maternal and newborn health that she hoped to explore this during her time in Dar es Salaam. To this end, Samiah was placed at Muhimbili University of Health and Allied Sciences, a university associated with the national hospital for Tanzania, doing maternal health research.

The primary objective of Samiah’s practicum was to design and write a proposal to understand the community and the midwives’ perception of humanizing birth care. When she arrived, Samiah worked in the nursing department of the hospital and was originally intending to take on a purely qualitative study. However, because she felt she didn’t have all the background skills necessary to jump directly into a purely qualitative role, she decided work on a systematic review and as well as a mixed methods approach proposal on this topic while in Tanzania. She felt maintaining a qualitative thread throughout the work was important, as it allowed a connection with the people rather than just scientific fact, and she found it increased personal significance of project for her. Although her role changed from her initial goal once she arrived in Tanzania, she still feels she got a lot out of the experience, and that the experts at the university were able to offer considerable knowledge in her area of interest.

For Samiah, a huge part of what she enjoyed about her placement was the experience of Tanzanian culture. She found it very different from our own Canadian lifestyle, noting that it was very community oriented. Everyone was very open, accepting and friendly, even to the point where simply walking down the street could involve several greetings and friendly interactions with other members of the community.

“Everyone would always smile say hi in a very different way than we say ‘Hi, how are you?’ here. They were all involved with everyone in the community’s lives.” Samiah says.

Feeling this sense of being part of a larger community was important to Samiah and was a highly valued part of her experience.

When asked about a particular time during her trip that stood out for her, Samiah again brought up the experience of different cultures, this time surrounding Ramadan and the Muslim Eid holidays, one of which she spent in Dar es Salaam and the other in Zanzibar. Being in Tanzania during Ramadan, Samiah was able to go to nightly prayer with locals in the area and was invited to many of their homes. She went to visit three families, even spent the night with one. Moreover, the Eid was an official two-day holiday in Tanzania, leading to a much bigger and joyous occasion. However, Samiah notes that Zanzibar really came to life during the Eid. Although she didn’t get to visit any individuals, it was fun to be in a large city where the whole place was celebrating the holiday, as opposed to most places in Canada where many don’t even take the day off work. She talks fondly of seeing kids lined up at shops waiting to get treats during the festivities, and shopkeepers who knew the neighbourhood children coming to pass them out. A familiar, but unique experience of the holiday.

Overall, Samiah thoroughly enjoyed her summer spent in Tanzania, but suggests anyone going to work in the University environment make sure to have some foundation in the area or methodology they wish to work in because even having just the basics down already means you are able to absorb so much more from the experts at the university, instead of having to spend your time on things you could learn at home. “You would gain more out of the experience and make it more productive for both parties.”, she says. However, she believes that the placement directors are very helpful and will ensure you have an enjoyable and productive time during your stay.

For more information on the Queen Elizabeth Scholars Opportunities click here.

By: Kayti Baur, MSc Candidate in Community Health and Epidemiology

Chloé Blackman, a Master’s student in Community Health and Epidemiology here at Dalhousie University, was awarded one of the Global Health Office’s Queen Elizabeth Scholarships (QES) to study in Tanzania in the summer of 2019. Her QES placement offered a hands-on experience to learn about the Tanzanian healthcare system with our partner, Pastoral Activities and Services for People with AIDS Dar es Salaam Archdiocese (PASADA). PASADA is a community-based social service agency that offers healthcare services to vulnerable and underserved populations living with HIV/AIDs.

Chloé entered the program open to new learning and cultural experiences, having high hopes of soaking up as many new skills and life lessons as she could – a goal she believes she accomplished. Although wistfully talking about wanting to return to Tanzania in the future, Chloé packed a lot into her three-month adventure.

When Chloé arrived at PASADA she rotated through several areas of the clinic– from working with vulnerable populations, to the tuberculosis clinic, and to intake and registration. Ultimately, Chloé chose to work in the laboratory. Although not everyone who goes through the program is able to find an exact match between their studies and their work assignment, Chloé was able to develop a project with an epidemiology spin. For the next several months she worked on a study doing basic evaluation on the effectiveness of enhanced adherence counselling at reducing viral load among HIV-infected patients, work she says she enjoyed completing and hopes will be meaningful for the clinic. Outside of her placement, Chloé and Samiah Alam, another student from the QES program, were also able to work on a paper related to the Global Burden of Disease, which keeps them connected to Tanzania moving forward, and will hopefully be published in the future.

Chloé speaks highly of the cultural experience she had in Tanzania, having enjoyed expeditions to other places, including Kilimanjaro and Zanzibar. One memory from her trip that really stood out for her was visiting a local charity for families with children sick from cancer. She says getting to know the families and the struggles they were enduring was an experience that will stay with her for life.

Photo: Rehema & Chloé in Sawhili Lessons

When asked what advice she would give to people thinking about attending the program, she highly recommended learning to go with the flow and to laugh at yourself early on in the process. As you’re adapting to a new culture and language, things are bound to get a bit confusing for everyone – clearly those Swahili lessons are important! Chloé also recommends exploring outside your placement, engaging with the Canadian Embassy for events and experiences, and really making sure you enjoy the time you’ve been given there to explore and get to know the local culture. Overall, Chloé says the program was a unique once in a lifetime experience that she would encourage others to take part in.

“I am beyond grateful to all the amazing staff, volunteers, and patients at PASADA. Thank you for taking the time to teach me everything – from Swahili to the work you do. This experience would not have been the same without all of you.”

Photo: Michael, Zachariah, Desdore & Chloé

For more information on global health experiences please visit the Global Health Office website.

By: Beatrix Yuan,

“I should like to bury something precious in every place where I’ve been happy and then, when I’m old and ugly and miserable, I could come back and dig it up and remember.”

—Evelyn Waugh

When I grow old, I will hop on a plane to Ifakara, Tanzania, and to dig up that pot of gold that I buried in the summer of 2017. Thanks to Dalhousie Global Health Office and Universities Canada, I was very fortunate and beyond honoured to receive the Queen Elizabeth II Scholarship to work at Tanzania Training Centre for International Health (TTCIH) as a student intern. Through this experience, I learned a lot about Tanzanian culture, about conducting academic research in an international research team, and about myself and my future career goals.

The incredible view at Udzungwa National Park

Professional and academic growth

The goal of my internship at TTCIH was to learn about qualitative data analysis through working on the Focus Group Discussions (FGDs) transcripts for the Access to Save Delivery In Tanzania (ASDIT) project. Dalhousie University researchers collaborate with partners from the

TTCIH and other local institutions, explore the challenges that women face when try to access quality obstetric care in rural Tanzania. Through this work experience, I gained deeper understanding on the health systems in Tanzania, the benefits and challenges of conducting global health research, as well as efficient communication strategies among different stakeholders in international settings.

The TTCIH Compound

Thanks to the local institutes’ hospitality, I was also able to visit several nearby organizations including Ifakara Health Institute, the Kilombero District Health Centre and St. Francis Referral Hospital. I was especially amazed by the work conducted by the One-Stop

Clinic at St. Francis Referral Hospital. The One-Stop Clinic offers comprehensive health services to families that are affected by HIV/AIDS. These services include free HIV/AIDS testing, counselling services, informational sessions on HIV/AIDS, and community outreach services.

Free HIV/ADIS Testing offered at the One-Stop Clinic at the St. Francis Referral Hospital; these stripes can show results in roughly 20 mins.

Personal growth-a humbling experience

This working-abroad experience also drastically helped me with my personal growth. It forced me to leave my comfort zone and to connect with friends from all over the world. As a Chinese immigrant in Canada, I have always been self-conscious about my English not being my first language, and this self-consciousness often makes shy away from connecting with others. Through this experience, I understood that language proficiency is not a deal-breaker; as long as I treat people with kindness and an open-heart, people will always accept me for who I am. I appreciate all the amazing people with different backgrounds that I made real connections with in Tanzania. Learning about their interesting life experience was very inspiring and humbling.

I miss all the friendly faces!

While most people consider living in a resource-limited setting a challenge, I considered it a blessing. I appreciated that I finally got the chance to take a break from all my electronic devices and be a more compassionate person and a caring friend. Without having to constantly check my smartphone and laptop for news that were happening thousands of miles away, I learned to be attentive to the present moment. During weekends, I would go for hiking and bike rides with friends. One of the most exciting things that I did was going on my very first Safari trip at the Ruaha National Park. We saw many animals that we were only able to see in movies, like elephants, giraffes, monkeys and lions. At one point, a leopard were only 3 feet away from our vehicle!

At the Ruaha Park, a lion enjoys his afternoon laziness

Reverse culture shock is a real thing

Reverse culture shock hit me harder than I expected. Although I have been back in Canada for over three months, I still miss Ifakara and all the friends that I met there. I miss the simple things like buying groceries from farmers that I made friends with and going for mishkaki (barbeque meat) on the side of the streets. I cannot express my appreciation enough to Dalhousie Global Health Office and Universities Canada, for giving me this life-altering experience to work in Tanzania as a student intern for a summer.

The author attending a bachelorette party in Ifakara, Tanzania.

To learn more about the Global Health Office please visit our website.

To learn more about the Queen Elizabeth Scholars program please visit the Dalhousie QES website.

By: Justine Dol, PhD in Health

With great opportunities, come great responsibilities: Three key responsibilities for students volunteering internationally. Lessons learned from experience as a QES Scholar in Tanzania.

As a Canadian student working in a foreign country during the summer of 2017, it was essential for me to consider how my actions influence both the individuals I had the opportunity to work with as well as the community and place in which I was working. For my Queen Elizabeth Scholar (QES) placement, I worked at Muhimbili University of Health and Allied Science (MUHAS) located in Dar es Salaam, Tanzania. Based on this experience and my previous international experiences, I was reminded of several responsibilities that come along with these experiences that I would encourage other students to be mindful of before embarking on international travel. These include the need for co-operation and consultation with locals, being aware of personal motives and limitations, and enabling the exchange of information and capacity development.

The first key responsibility that I would argue that we as student volunteers have is co-operation and consultation with the local people in the area that we are working in. Communication is essential to develop the partnership mentality, where you can work together with your supervisors and peers at your placement, rather than approaching the placement with an (un)conscious bias of a ‘me versus them’ perception. Despite some of the best intentions, if local people or local organizations are not consulted, it can result in an “othering” of the people you are trying to help. It is important to work with local individuals to know the best way to help and contribute, rather than making them feel inferior or by compromising ongoing work. This will allow growth in both the host communities and the volunteers. Unfortunately, far too often this responsibility is ignored.

For my placement at MUHAS, I worked closely with my supervisor, Dr. Thecla Kohi, to assist with ongoing projects as was needed, rather than trying to complete my own agenda. When I did have the opportunity to lead my own research project, I made sure to involve my supervisor at every step and utilize her expertise in conducting research in Tanzania. Her expertise with postnatal mothers and nurse midwives advanced my project and contributed to the ongoing research in the School of Nursing at MUHAS.

The second key responsibility of being a student volunteer is being aware of our personal motives and limitations. I had to ask myself: am I going to put the experience on my CV? For personal development and growth? Because I have an autistic desire to build capacity in others?  To participate in research in an international setting? I think for me, it was a little bit of all the above. But maybe for other students, it is for some other reason. But by acknowledging where your desire to volunteer internationally comes from, it allows you to approach the trip in an honest manner. Additionally, it is important that as a volunteer, we acknowledge our limitations. For instance, why is it okay if I go build a house in a developing country when I have no house building experience in Canada and would not want to live in a house I built myself? I think that a large responsibility as a student volunteer is to acknowledge why we want to volunteer in the first place, and then acknowledging our limitations to assist the people we want to help. Rather than going into another country pretending to know all the answers because I come from a Canada, I think it is important to work alongside locals who are knowledgeable and capable of doing the work that is necessary but our assistance could lighten their load.

For instance, during my placement at MUHAS I was involved in data analysis for several qualitative projects where the data had been collected but my supervisor was over burden with other responsibilities and unable to take the lead on the analysis. As someone who has had previous experience with qualitative research and analysis, I was in the position to assist with the qualitative analysis. I did not attempt to get involved in areas where I do not have the necessary skills, such as working in a clinical setting, as I do not have the necessary qualifications. Instead, I contributed the skills I possess in a meaningful way to meet a need identified by my placement.

This leads into the third key responsibility of student volunteering internationally, which is the goal of exchanging information and building capacity. This responsibility is two-fold. First, an equal exchange of information between volunteers and locals is important, as it reflects partnership building, mentioned in the first responsibility. The goal of volunteering should be to share knowledge and empower locals to increase sustainability and capacity. I believe knowledge transfer is important in terms of volunteering because this reciprocity will build local capacity through building the tools they need to develop their own successes. It is also important that the knowledge exchange works both ways, as volunteers cannot assist in providing knowledge without knowing, from the individuals or community itself, what their needs are. The only way that proper exchange of knowledge will occur is through listening to the partners for their true needs, rather than using top down ideas to assist. Secondly, student volunteers are in a unique position to pass on knowledge of a country that other people might not know about. By having student volunteers share their experiences once they return to their home country, it could help to correct the stereotypes that people might hold.

For myself, after spending over three months in Tanzania, I have unique knowledge of the country and can share first-hand knowledge of the culture with people at home in Canada. I believe this is important as student volunteers because we should take what we learnt and continue to spread knowledge of our time away when we return home. The QES program is set up in such a way that public engagement is a requirement. This is key to ensure that exchange of information occurs and continued building capacity in Canada and internationally.

Overall, being a student volunteer in a country different than your own can offer some amazing opportunities, both personally and for the people you will be working with. However, before leaving, it is important to ask yourself some questions. Is what I am going to be doing there needed? Why am I going? How can I share about my experiences once I get home? I believe that the QES program at Dalhousie University has the right ideas, as it involves pre-training before volunteers arrive, co-operation between partners and universities as well as evaluation and public engagement afterwards. If we understand our responsibilities, it will result in the best experience not only for the student volunteer but also for our partners.

To read more about this program please review the 2017 Dal News Story or visit the QE Scholars Dalhousie website.

By: Beatrix Yuan, Bachelor of Science in Health promotion

It is hard to believe that my time in Tanzania is coming to an end soon. During my stay, I learned Swahili, explored nearby sceneries, and made some great friends. I really appreciate the opportunity to come to Tanzania and to spend time with all the amazing people that I met here.

During my internship at TTCIH (Tanzania Training Centre for International Health, Ifakara) my overarching goal is to learn about qualitative data analysis through working on the ASDIT (Accessing Safe Deliveries in Tanzania) Focus Group Discussions (FGDs) transcripts. The FGDs were conducted in the five catchment areas served by five different health facilities in Morogoro region, Tanzania. In each catchment area, three groups of participants were interviewed: pregnant women and their husbands, post-partum women and their husbands, as well as community leaders and health facility staff members. The FGDs were recorded, transcribed and translated into English. During the FGDs, the following topics were discussed: the social context for women to access obstetric care, quality of care, family norms and support related to childbirth, eighteen-and-under pregnancy, and recommendations for the public health services. Through analysing the transcripts, I was able to identify several key factors that affect women who live in rural Tanzania and their access to quality obstetric care.

A few weeks ago, I had the opportunity to shadow at the One-Stop Clinic at St. Francis Hospital. The Clinic offers comprehensive services for HIV/AIDS testing, counselling services, informational sessions on HIV/AIDS, and community outreach services. I observed the testing service and follow-up counselling services. Through this shadowing experience, I learned about facilitators and barriers of people infected by HIV/AIDS accessing health services.

(HIV/AIDS testing kit)

I also went on my first Safari trip at the Ruaha National Park, which was very exciting. We were greeted by many lovely animals, such as elephants, giraffes, monkeys, lions, and a leopard (which is very rare to see).

I really appreciate the opportunity QES and the Global Health Office gave me to conduct research and experience cultures in Tanzania. I would really love to come back sometime in the future. It is not easy to fit in to a new environment, especially in another country; but as long as you go in with patience, respect, an open heart, and a respectful and understanding attitude, you will be able to find your way in and make some true friends for life.

To read more about this program please review the 2017 Dal News Story or visit the QE Scholars Dalhousie website.