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Hospitali Teule Muheza -
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To get started with this blank [[TiddlyWiki]], you'll need to modify the following tiddlers:
* [[SiteTitle]] & [[SiteSubtitle]]: The title and subtitle of the site, as shown above (after saving, they will also appear in the browser title bar)
* [[MainMenu]]: The menu (usually on the left)
* [[DefaultTiddlers]]: Contains the names of the tiddlers that you want to appear when the TiddlyWiki is opened
You'll also need to enter your username for signing your edits: <<option txtUserName>>
These [[InterfaceOptions]] for customising [[TiddlyWiki]] are saved in your browser

Your username for signing your edits. Write it as a [[WikiWord]] (eg [[JoeBloggs]])

<<option txtUserName>>
<<option chkSaveBackups>> [[SaveBackups]]
<<option chkAutoSave>> [[AutoSave]]
<<option chkRegExpSearch>> [[RegExpSearch]]
<<option chkCaseSensitiveSearch>> [[CaseSensitiveSearch]]
<<option chkAnimate>> [[EnableAnimations]]

----
Also see [[AdvancedOptions]]
<<importTiddlers>>
Pre 2010 ....

''Grand Opening of New HIV Care and Treatment Centre''
On January 15th 2009 the brand new CTC was opened at Teule. It took just four months to build and is a pleasant open plan building.  The ceremony consisted of speeches, dancing and drumming.  A Tanzanian doctor represented the US embassy in Dar es Salaam and various Aids Relief officials also attended. 
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''Christmas 2008''
This was celebrated in the usual style with a short service in the chapel followed by a procession around the wards with singing, bible readings, talks and presents being passed out to the children. The whole event was delayed a little as labour ward was quiet and the first baby of the day who always takes on the part of Jesus in the procession didn't arrive till nearly 11 am. The wards were well decorated with trees from Amani and the Good news of Christmas reached everyone.
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''New Buildings''
After much discussion GTZ agreed to build a new Reproductive and Child Health Centre and a new Theatre for Teule Hospital. As well as the new buildings the original ones were rennovated so the space available has grown considerably certainly for RCH. Lots of examination rooms and offices are now available for RCH. In theatre, the original two theatres, one of which was rather cramped has been replaced with two large, air conditioned pleasant theatres. There is an ample recovery area and CSSD has been considerably enlarged. The staff are all enjoying the new expanded and improved facilities.
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''World Palliative Care Day''
October 10th 2008 was World Palliative Care Day.  The day started off with a parade from the centre of Muheza that made its way through the town and ended up at the hospital.  The marchers consisted of Trumpeters, Nurses and Muheza Citizens.  Afterwards everyone crowded into the Diana Centre for speeches, dancing and drumming.  Later on sodas and lunch was brought out and enjoyed by all.

''John and Bridget Wood visit Muheza''
Drs John and Bridget Wood who started the Hereford Muheza link in 1985 and last visited Muheza more than 10 years ago returned to see us while on holiday in Tanzania in March 2008. They were able to meet again many members of staff who have visited Hereford over the years as well as to see the progress of various projects and discuss the ongoing future of the link, Their visit was enjoyed and appreciated by many.
{{borderless{
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''Christmas 2007''
This was once again celebrated with carol singing around the wards and gifts being given out to all the children. The procession was led by two members of staff acting as Mary and Joseph and carrying the first baby born on the 25th.
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}}}

''Children's Christmas Party 2007 to celebrate World Aids Day''
This was held at the Yacht Club in Tanga and over 70 children and their followers joined in the fun - boat trips, games, food and splashing around.
{{borderless{
|[img[going out on the Lady Diana|http://img183.imageshack.us/img183/6352/aidsparty2smbg8.jpg][http://img247.imageshack.us/img247/1051/aidsparty2bbk0.jpg]]<<imagebox>>|[img[dinner time|http://img214.imageshack.us/img214/631/aidsparty3smbh7.jpg][http://img339.imageshack.us/img339/9605/aidsparty3zt2.jpg]]<<imagebox>>|[img[playing games|http://img50.imageshack.us/img50/4203/aidsparty4smmj8.jpg][http://img247.imageshack.us/img247/8127/aidsparty4ji9.jpg]]<<imagebox>>|[img[with UK medical students|http://img88.imageshack.us/img88/7348/aidsparty7smrd0.jpg][http://img260.imageshack.us/img260/799/aidsparty7ld7.jpg]]<<imagebox>>|
}}}

''World Hospice and Palliative Care Day''
This was celebrated on October 5th 2007. A seminar for hospital workers was held to increase knowledge about Palliative Care within the hospital. It was effectively run by the Palliative Care team. A further celebration with singing, dancing and refreshments was held on the 6th October.
{{borderless{
|[img[Muheza Hospice Care|http://img525.imageshack.us/img525/9922/pallcareoli1smtj7.jpg][http://img172.imageshack.us/img172/8791/pallcareoli1bqw3.jpg]]<<imagebox>>|[img[Bagamoyo Spirits|http://img206.imageshack.us/img206/4827/pallcareoli4smlh8.jpg][http://img120.imageshack.us/img120/8901/pallcareoli4bn7.jpg]]<<imagebox>>|[img[Palliative kids singers|http://img258.imageshack.us/img258/366/pallkidssingingsmqs8.jpg][http://img171.imageshack.us/img171/5493/pallkidssinginguh4.jpg]]<<imagebox>>|[img[home based care|http://img247.imageshack.us/img247/4818/pallcareoli3smcx9.jpg][http://img524.imageshack.us/img524/4558/pallcareoli3vi4.jpg]]<<imagebox>>|
}}}

''NTS graduation 2007''
25 nurses graduated in August 2007 with a Diploma in Nursing and Midwifery. It was the culmination of four years hard work and an enjoyable celebration for all.
{{borderless{
|[img[Guests of Honour|http://img140.imageshack.us/img140/9058/bigbodssmde0.jpg][http://img176.imageshack.us/img176/1970/bigbodsqm4.jpg]]<<imagebox>>|[img[Graduating Nurses|http://img262.imageshack.us/img262/5646/nursesgradsmeg1.jpg][http://img262.imageshack.us/img262/3083/nursesgradqu3.jpg]]<<imagebox>>|[img[presenting certificates|http://img165.imageshack.us/img165/8311/certificatessmat2.jpg][http://img140.imageshack.us/img140/9036/certificatesfg1.jpg]]<<imagebox>>|[img[Family congratulations|http://img178.imageshack.us/img178/2556/congratulationssmfb7.jpg][http://img247.imageshack.us/img247/8859/congratulationsbt1.jpg]]<<imagebox>>|
}}}

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(April 2012)
On travelling in Tanzania - Matt and I flew to Dar and had a taxi ride to our hostel Jambo Inn. We used the recommended taxi driver who spoke good English and helped us immensely with getting the correct bus to Muheza the following day.
You probably could save money by using someone different but when you are new in a country I think the piece of mind is worth the little extra. Jambo inn was decent enough, safe, mosquito nets and supposedly warm showers.

The bus ride to Muheza was fine although we were a little worried about missing our stop as all the towns looked the same but it was fairly obvious when the bus pulled in. It took us about 5 hours I think.

Placement - I don't think I could have lucked into a better elective. For what I was after, Teule was perfect. While many other students on my course had what is effectively holidays for their electives I think I far more appreciated experiencing living in rural Africa. Comparatively to the locals the student hostel is luxurious, you get used to bucket showers and it's so warm that you don't need warm water. Everyone in the hospital is helpful and you will see lots. Afternoons tended to be free, but there isn't too much to do around Muheza, so every Tuesday we escaped to Tanga the built up coastal town for a swim and a nice meal at the hotel. Weekends tended to either be staying at beach resorts or hiking in Lushoto. The elective is run very well, the way the students are staggered ensures that new students are taught the ropes by the existing students.

Oh and by the way, I made it up Kilimanjaro, but vomited constantly on the summit attempt about 8 hours... It was probably the hardest thing I've ever put myself through. My oxygen saturations at the top was 64%!

Safari was great too we saw so much, including the lilac breasted roller you told me about Sally!


(February 2012)
General advice:
Language makes a difference. Learning some basic Swahili will make your time in Teule and in Tanzania much easier and more enjoyable.
Get your vaccinations early. Yellow fever is the one most people don't have.
Apply for a visa card. Lots of places in Africa don't take mastercard. 
Travel cards are usually a big waste of money. There are a new range of cards which have no international transaction fees and no exchange fees (at least in Australia) offered by a few banks: Citibank, 28 degrees, etc. 
 
Tanzania
Is really exotic, different, and people are pretty friendly and approachable.
Is safer than most people think. There are essentially a few dangerous places/activities, but it is not hard to stay out of trouble. Some simple measures include not travelling alone at night and asking locals which places to avoid. 
Most things are very cheap, by Western standards, including food, accommodation, transport and a lot of fun activities. Things to be wary of are flights, climbing Kilimanjaro and safari, which can be a huge hit to a budget. I would recommend all of these, but make sure you are aware of the price involved. 
Also, there really isn't enough time to safari/long trips on a weekend in Teule. A good safari is 4 days, which can't be squeezed into a weekend, especially when you factor in travel to and from the safari. You've spent the time and money to come all the way to Africa for medical training, paid for your placement and it just doesn't make sense to start skipping hospital days to do these activities.

 My elective:
Unless you are fluent in the local languages, be aware that you will not be able to understand the discussions between patients and doctors. It is important to be proactive and ask doctors about what they are discussing and doing for each patient. The thing I gained most from the elective was seeing how medical care is delivered in an under-resourced hospital in a developing country. It is also a small, rural hospital, which many people will not have experience in and a chance to see medical conditions you won't see at home.
Cost: Accommodation is provided cheaply, food is accessible and cheap as well. The big cost during your stay is the donation that most African hospitals expect, which is 250 pounds at this hospital (~$400Oz). Remember  that some hospitals (eg. KCMC which is popular) will expect you to get a resident's permit, which is about $500, so you might end up paying more even if the hospital donation is cheaper.

Would I recommend it - Yes, but not for everyone. I really enjoyed the placement and got a lot out of it. Be aware that you will not be able to assist in surgeries, but there are some other hospitals in Africa where you can get surgical experience (A friend went to Baragwanath hospital in Johannesburg). If you are in this for learning internal medicine or paediatrics, you will be able to see lots of signs and symptoms you have previously only read about, but in some ways the learning is limited. You will not see microbial isolates, so most patients will be given the empirical antibiotics (if they are available!) for their presenting complaint. What you WILL see is medical care in a poor country, an amazing experience in itself as well as many of the most important world-wide disease (HIV, malaria, TB, schistosomiasis) which are rare in the developed world.


(December 2011)
 Returning from Tanzania I feel like I have had one of the most exciting, eye-opening & enjoyable adventures of my life.
The country is so diverse - climbing Kilimanjaro, living in Muheza & amazing safari opportunities plus full of very friendly people. An elective at Teule was a great & unique opportunity to be in a smaller African town, rather than a big city, with only a small number of elective students (unlike KCMC or some Dar hospitals). Arriving at the hospital I feared slightly what I had gotten myself into but soon felt very comfortable, settled into the daily routine & loved my 5 weeks there. You get a lot of exposure to interesting clinical signs examining patients & doctors are used to having students. Weekend adventures to Peponi & Zanzibar, mid-week trips to Tanga for swimming & dinner, exploring Muheza markets & cooking make time fly.
If you're prepared to step slightly out of your comfort zone (limited electricity, no running water), get involved at the hospital & add on a bit of travel around Tanzania you will have a brilliant elective & a lot of fun!


(August 2011)
Teule is a fantastic hospital for any student to visit as it provides a great balance of established health care yet still demonstrates the difficult working conditions of limited resources.  Being at Teule provided a great insight into the lives of Tanzanian people partly due to the fact that working in healthcare provides a privileged insight into the lives of patients but also because members of staff and the public were very amiable and willing to discuss all areas of life, healthcare, politics and religion should you wish to do so. I was able to get into how a hospital is run in a relatively small Tanzanian town was invaluable in trying to understanding why certain health situations occur in resource poor countries, where difficulties arise in treatment and why change can be a very slow process. I was able to see a range and stage of disease that does not occur in the UK (some of which I have still been unable to fathom!) This was fascinating, puzzling and at times shocking yet thoroughly worthwhile. I would thoroughly recommend travelling out with the palliative care team to the local communities as this allows you to see some of the sickest patients as well as where people live. If you’re lucky, as we were, you may even get a trip to a local farm where we were plied with delicious local oranges plucked straight from the tree. Finally, Tanzania is a beautiful country to visit which I would say gave me the perfect introduction to Africa, and totally altered any preconceptions I had of a land frazzled by the sun (to be fair temperatures were still relatively low during my stay) as the land was green and lush. Visiting the Usambara mountain range (easily accessible by bus from Muheza) was incredible and even a little chilly at times! I spent two weeks in Zanzibar at the end of my elective which I would thoroughly recommend to anyone planning on visiting Teule as it offers a rich cultural history, fantastic architecture, food (spices), and of course beaches. One thing I didn’t manage to squeeze in was a visit to the infamous safari parks, by all accounts this is well worth doing and I would recommend putting time aside either before or after your elective as it’s not really possible to do during it on account of the long distances to travel. Whilst at Muheza there are many options for the weekends including Peponi a wonderful nearby beach resort (others are also available), exploring Tanga which has a number of large hotels with fine restaurants and pools (Mkonge Hotel, Tanga Beach Resort, Tanga Yacht club etc) and visiting the local tailor’s in Muheza where any number of exciting garments can be fashioned.

A few items I would recommend taking:
-Don’t forget your white coats, scrubs and protective glasses as there are no spares. Any extra equipment you can find is very welcome particularly  scrub caps, gloves etc.
-ALCOHOL GEL. We got through a lot.
-Take more mosquito spray (containing DEET) and sunscreen than you think you’ll need as it’s hard/ impossible to get a hold of, particularly the higher factor sunscreen.
-Remember to take lots of covering items of clothing as there are no real occasions (except for the wonderful visits to Peponi- a local beach resort) where you won’t need to be fully covered.  I constantly envied the long skirts of my friend so I would recommend these for the ladies.


(November 10)
I would encourage people to do the walk to Magaroto, even if they don't go the whole way. Its really nice to get into the countryside near Muheza. But be prepared for it to be a long day!
I also think Zanzibar is well worth doing. You can fly there for about $100 each way. We stayed at the Pyramid hotel and were able to organise a spice tour through them for only $15.
And make the most of Tanga too. Find the fruit salad shop, squashed in a side street between the food palace and some of the banks.
At the hospital, definitely do a day with the palliative care home visit group and the community visits for children's health. Really great days. Other areas might depend on your specific interest but i think its worthwhile to spend a bit of time on all the wards. Practice your Swahili before you come too, even if its just a few phrases it might help break the ice.

(September 10)
- Great mix between hospital in a smaller village (i.e. not in the city) with limited resources but feeling supported and going somewhere prepared to have students. (There is a huge mix of hospitals in Tanzania and from hearing stories from collgues
- Was very happy with the accommodation and facilities, actually really enjoyed cooking our own food (and learning how to bake bread!), may feel a bit basic if you're just arriving there first (rather than travelling around for a while) but be reassured that you soon feel  comfortable and at home. Small portable speakers are a good idea to bring and definitely a pack of cards (though may be some there). 
- Maybe take some simple recipes that you can make if you're not much of a natural cook, though can use the internet/imagination. May be enough to just think about some simple meals you could cook. 
- Taking spare/unwanted equipment is helpful - main one which may have been useful was an ophthalmoscope as in short supply (think only 1 but never used it) and a box of gloves (to use and leave behind) is warmly recieved by staff!

Not much else about the hospital placement as felt well prepared and the black book has so much information for actually getting around/finding things/what to do on the wards while you're there.


(July 10)
Doing an elective at Teule opens your eyes to medicine in the developing world and you will certainly leave with a better understanding of how hospitals funtion in the developing world and will make you appreciate the
NHS!!
I had a brilliant time and got lots of experience. Make the most of the wards and surgeries. There are plenty of people willing to teach and you will gain an insight to the different departments.
Make the most of your weekends and go exploring and if you can tag some time onto the end of your elective to do some more. Tanzania is an amazing country.


(May June 2010)
Greetings to fellow medical students planning an elective to Teule Hospital.
You will have a great experience. Its very difficult for your medical elective not to be one of the highlights of your training! Teule Hospital will give you an appreciation of medicine in the developing world and Tanzania is a wonderful country to travel around so you will get the perfect balance of an eye opening medical experience and the chance to do some sweet sightseeing too.
A few pieces of advice from when we over for 5 weeks in May-June in 2010.
There seems to be a very large spectrum of medical student’s sub Saharan medical elective experiences -  from the very much observational to the independent running of a ward. Teule Hospital is very used to having medical students and your role at the hospital is such. On one hand this is great because with no expectation that students will staff the hospital, you have the opportunity to experience different parts of Teule and over a few weeks can have gained insight into most wards/departments. The other side of the coin is that the feeling of being surplus to requirements that you are
probably familiar with from university hospitals is even in a hospital short of medics, still a reality. This is not to say you cannot play a very active role. Get out into the villages in community visits and offer to run an outpatients clinic.

There is so much more to the experience at Teule than simply the medical aspect. Living in Muheza for one is an experience in itself. Living the simple life and in fairly basic living conditions becomes something you enjoy…picking up groceries from the local fruit&veg market and returning to the hostel that without all the luxuries of western houses still feels like ‘home’ is part of what makes the experience memorable.

And a few practical pieces of advice-

Arriving into Dar es Salaam is the easier option that flying into Nairobi.

Travelling in the weekends is really easy, but having a bit of time tagged onto the beginning of your trip or the end for a safari and a visit to Zanzibar is a must.

Muheza is in the more Muslim part of Tanzania and so conservative dress is required for both hospital and around the village. Bottoms to at least the knee and tops that cover shoulders are the best way to go.

Any questions feel free to flick them through to alice.minhinnick@gmail.com

Enjoy



(May 10)
1. Don't rely travellers cheques...they were impossible to cash at any of the banks in Tanga and most of the banks in Dar. You can however use them to pay for safari with Sunny safaris which was quite handy as they charge extra for credit card payments and only accept dollars for cash.

3. Long skirts/trousers are needed..I know it says this already but is v v useful to know

4. Bring a torch

5. Bring an obstetric wheel..



(April 10)
In my 8 weeks I managed to spend time in each speciality which helped me to get a great overview of the work of the hospital. The language barrier was harder to overcome than I had anticipated. The doctors, AMOs and COs all had pretty good English but the nurses English was quite variable so having them translate for you to take histories etc was often very difficult (I never met a patient who could converse fully in English). I think taking time to learn some basic Swahili - greetings and some medical words is well worth doing before arriving as it will really help you to get more out of time on the wards and in clinics. 

The male and female medical wards are full of lots of interesting cases with 'good signs'! You can also learn a lot about HIV, TB and malaria on these wards. Paediatrics - again lots of interesting things that you don't see in the UK e.g. severe malnutrition and HIV. Obs and gynae - had an excellent week on this with Sally. She's a great teacher and we got to see and do a lot. Well worth spending a week on this even if you don't think obs and gynae is for you because looking after HIV in pregnancy and working to reduce maternal mortality is extremely important in Africa and therefore feels like an essential part of learning about the care provided at Teule Hospital.  Diana Centre/palliative care centre - good opportunity to learn lots about HIV and anti-retrovirals, most people also get to go on a community visit - an excellent experience.  Surgery - again many interesting things to see but can also be very sad. One of the surgeons - Dr Mbago is especially keen on teaching and will take you under his wing and get you to scrub in.



(Jan 10)
Firstly I had the most amazing time in Tanzania and Teule, and it is something that I will never forget. If you have a confirmed spot at Teule then congratulations you are in for a lifechanging experience!

1.) Try and learn some Swahilli before you go! If you know the basic greetings (which are vital to you getting by) and some numbers, then the rest can be picked up from the other students. My advice is to buy the Lonely Planet phrase book. Personally, I found this book to being key to not only living in Muheza but also to travelling around Tanzania.
2.) Be prepared for the power to go out, and the water to stop running for periods. I think the longest time we had was 24 hours without power and about 2 days without water. I think if you are prepared to go without a shower (bucket shower that is) for a couple of days and understand that you might have to cook on a kerosene stove for a few days, then you will be fine.
3.)Make friends with Dr Penina (she lives with you). She is lovely and an awesome knowledge guide to living in Muheza. Also if you cook for her, she might even cook you an amazing african feed if you are lucky.
4.) Nursing students are fantastic. they will try to teach you swahilli, and they will also invite you to play football or netball with them. Nasra was a student who especially liked elective students, and she will help you if she can so look for her.
5.) There are a couple of children who will come and hang out at the accommodation with you, Roberti 7-8 and Vanessa 2-3. Play with them, they are heaps of fun. 


(June 09)
We both really enjoyed our time in Muheza and got a lot out of the experience both in terms of immersing ourselves in the African culture and in hospital life. As an elective it provided a brilliant insight into medicine in rural Africa and we would encourage anyone to get involved in all aspects of hospital life even if you are going out with a specific speciality in mind. Sally and Ben were brilliant and will look after you if you have any problems - they encourage everyone to get together once a week for 'mzungu dinner'.

Most things you will need to know about what to do when you arrive are in the book in the student hostel so we will focus here on things you should know before you go. The accommodation is very basic (especially in terms of electricity and water supply) - This was not a problem for us at all but some people might like to be aware of this before they arrive. As long as you are not expecting luxury it is perfectly adequate. There is always water available from the hospital to collect in buckets. If you are travelling direct from the UK bring any food items you feel are essential as there are a lot of things that aren't available in Muheza, although most things can be purchased in Tanga (about 1 hour away by road). For the ladies make sure you bring plenty of sanitary items. A torch is essential - head torches are very useful for going to the toilet in the middle of the night. Also if you are going in rainy season it will rain A LOT  - bring waterproofs! 
In terms of bringing medical supplies ask Sally what would be useful. We took basic stethoscopes because we didn't want to lose/break ours - this was a mistake, we missed out on a lot of clinical signs and would have been fine with our proper ones. Take scrubs and face masks - apparently these are available but in very limited supply. 




(Nov-Dec 08)
I would recommend everyone has a go at learning some Swahili before coming out, or at least bringing a phrasebook! I had a very memorable elective experience!

(Nov 08)
I chose Teule for my elective based on strong recommendations from a student who had been there previously. I wanted to experience what it was like to practice medicine in a place completely different from home. Teule certainly was that.
Initially, I was disappointed that we couldn't help more. I had finals a month after I was to return home and so learning Swahili wasn't top on my list of priorities. My advice is to learn AS MUCH as you can before you go and whilst you are there because then you will be much more valuable in the hospital (and feel less stupid). I wasn't expecting to be presented with patients with such fantastic clinical signs - it was a great place to learn; especially if like me, your medical school doesn't put a lot of emphasis on tropical medicine.
From talking to my friends, my elective was quite different. We spent all week in the hospital and travelled at weekends. This was a good mix and I think that if you don't take full advantage of the medicine side of your elective at Teule, you will be seriously missing out. The staff are all keen to get you involved as much as possible and there is a great community feel - especially amongst the mzungu doctors.

(Sept 08)
I thought the placement was great, but we were lucky as we were there on our own for a lot of it so felt like we could do lots of different things which we enjoyed. I would recommend that students make the most of being able to deliver babies, insert catheters etc.. as all of these practical things are harder to achieve at home. Learning a little swahili goes a long way. especially medical words and greeting. I did obs and gynae, general medicine and a little paeditrics which I really enjoyed but I also did a day of surgery and a day in minors so it was nice not to have a fixed timetable for once. I would also advise that students make an effort with the doctors and nurses as we did and loved getting to know them. Chapati making with Dr Mmbare and ugali with Dr Masanja.

(June 08)
1) Money
Best to bring US dollars. Travellers cheques are fine as well. These will be used by safaris, Zanzibar, Peponi and Lushoto. Tanga, Muheza, Dar and Arusha all use only tanzanian shilling so don't turn up to the hospital with only USD. The only exception to this is that accommodation in Dar uses dollars. Its a bad idea to get them exchanged at the airport, banks and foreign exchange offices had good rates in Dar and in Tanga the banks were best for exchange.
2) Learn basic Swahili
Know at the very least greetings, how to ask the price and numbers. Not everyone knows english. Medical jargon is ok, you'll probably never be able to learn enough and the nurse will help you out.
3) Accommodation
The showers are cold, very cold. It has everything you need, look for the black book, I didn't get time to write in it.
4) Food
Pretty much everything can be bought in the market or in the shops near the centre, especially the supermarket near Jackson's hairdresser (the owner of the supermarket has good english). Prices are roughly (these are the only items I remember). Western food can be bought in SDs which is in Tanga.
1,000Ts per kg of rice
3,000Ts per Kg of prime cut beef
7,000Ts per whole chicken, plucked and killed
50Ts for 1 banana, orange
100Ts per potato, carrot
100Ts for cooked corn
100Ts per egg
1,000Ts for big bread, 800Ts for small bread (I think)
1,500Ts for the big massive keg o'water, 1,000 for 1 litre (I think)
1,500Ts for chipsi mayai
500Ts for Sodas most places, but there is a secret soda place in the male nurses accommodation where you can get sodas for 400Ts.
5) Places in the hospital you will really get to be part of the team and get to do loads!
In Teule you can pretty much do as much, or as little as you like. If you want to get a lot out of it. Student nurses are brilliant and can translate for you and let you know who needs what, they also like you to teach them things and will ask you lots of questions so be warned!
Jenner ward for paeds - the doctor in charge will teach you loads and more often than not let you do ward rounds solo, if you ask. Often just walking in and asking if the nurse need any help will keep you very busy. I was kept very busy on this ward following a lorry which hit a school bus. Sometimes it can be pretty hard even PICU in the hills ward. As they are lacking a lot of drugs and equipment they need and can die even though they would never die back home.
Surgery wards (especially the one opposite hills ward) and theatre - You will pretty much always be first assistant here and might even get to do some of you own surgery here with Dr Mbago he’s also super enthusiastic and can be easily found as he likes to teach and has a collection of nursing students around him.
Nightingale ward for general medicine - A lot of brilliant signs here and the chance to do lots of procedures such as chest drains, ascitic tap and lumber punctures its also great for teaching. Dr Msangi here is a really great guy with a strange fashion sense and he will teach you loads.
Those are the 3 wards I went to most but there are other good ones too - I heard minor theatre near the physio building where you have the chance to do a lot including circumcisions. In obs and gynae you have the chance to be first assistant in theatre and baby catching. The later is highly recommended if you didn’t get the chance to in med school.
6) Useful contacts
Jackson at the hairdressers is a really nice guy. Brilliant english and taxis, good places to stay or even food he can sort you out and show you where to go. He enjoys talking to you and making wazungu rafiki, he can also teach you useful Swahili. Worth talking to generally. The student nurses are all very nice with good english and will help you in anyway they can may even invite you for dinner and to play football with them!
7) Places to go (stay) and how best to get there
Peponi -  good for snorkelling trip and to chill out at the beach with good food - Best to take Taxi from Muheza (cost 35,000Tzs). 
Tanga: good for city life + shopping. Bat caves and ruins are pretty good. Avoid the hot springs (major disappointment as too muddy to go into the springs and the guy will offer you poisonous coconut wine which will make you feel very sick) best to get a guide and cycle there. You can negotiate the price to over half what they ask. Worth staying at the inn by the sea. Take a taxi from the dalla dalla stand should be no more than 10,000Ts.
Amani: Head up here with the Diana centre then stay over for the weekend. Big rainforest great for walks. Can't remember the name of the guesthouse we stayed at. But it was luxury, great double beds ensuite, hot showers and great food (breakfast, lunch and dinner) all for 30,000Ts per night. There is a bus that can take you back I think for a good price but we headed back with a bunch of drunken doctors who were hitting muheza for a night out......

(May 08)
On arrival into Dar we got a taxi with Ayoub Juma (Tel: +255 713 352 910) as per sally’s recommendation. We texted him from the UK in advance to arrange. He’s probably more expensive than one at the airport but great for peace of mind. We stayed at the Safari Inn which is basic but reasonably cheap and got a taxi to a local restaurant for dinner. Then the 7am bus with Scandinavia the next morning. 
Trips from Muheza – we went to Tanga about twice a week to relax at the Ocean Yacht Club. Great for relaxing on the floating pontoon, good showers (albeit cold), nice food & G&T’s. We went to Peponi (got a taxi there and 2 buses back) – a relaxing & beautiful hideout by the beach. We also went to Pemba for a weekend. We stayed at Jondeni’s – great accommodation, food & views & fantastic day trip to Misali island. 
Overall the 4 weeks at Teule including weekends and all transport, food and daily beer was £400.
Thing I wish I had taken:
Ipod speakers, otoscope, opthalmoscope, wound dressings, theatre shoes, snacks, small gifts to leave with staff
Things I’m glad I had:
Scrubs, gloves, alcohol gel, Oxford handbook, BNF, pen torch, stethoscope, face masks, goggles, swahili phrasebook
Glad I was warned about:
Lack of anaesthetic during procedures,
Things I wish I’d known:
All the rooms have UK sockets so yes you can take your hairdryer, straighteners, speakers etc to make you feel more normal.
- Money was a bit of a nightmare. Locally you pay in TSH but flights & accommodation you pay in dollars. Travellers cheques are a nightmare to change. ATM’s only give out TSH. Take US dollars in cash and then take out TSH from the cash machines. Often cheaper to pay in TSH than US$ when you have an option.
Communication with back home was really hard. Local sim card didn’t work in my phone as I didn’t get in unlocked in the UK before I left. So I paid £2/min for outgoing calls and £1/min to receive. Argh! 50p a text. So unlock your handset before you leave. It was also a real struggle to access the internet. The staff hospital computer didn’t work once while we were there. We used a computer about once a week at Ben & Sally’s house. It might be an idea to take a laptop to watch DVD’s and use the wifi if allowed at Ben & Sally’s. I honestly never expected to be so out of touch with people at home.
There are so many signs to see. No-one will find you so you have to seek things out. There is a black book in the hostel full of recommendations & things to do in the hospital & at weekends so give that a good read. 

(Jan 08)
I would definitely recommend it - but i think it would be important to make sure that people had some idea of what they were getting themselves into - i think the water supply dropping out here and there and collecting water in buckets was something that i hadn't really realised would be an issue - for me i didn't find it too bad but for others they would probably have found it easier if they'd been warned about it beforehand.
My expectations were exceeded - i got to do a lot more hands on stuff than i thought i would. I learnt a lot more from the people i worked with about myself and about life then i ever expected to. I mainly found it useful from a personal learning perspective rather than a medical one.
don't buy Tanzanian Shillings before getting to Tanzania - you may end up with old currency that no one else will use

(Dec 07)
* Try to learn a bit of Swahili before you get there.  Definitely bring a Swahili phrasebook.  You will need it.
* It’s a really good idea to have your own medical handbook that you can carry with you.  The British students all use the Oxford, which is highly recommended.  Pocket Medicine is too simple for what you will need.
* The hospital is extremely resource poor, and especially lacks the items necessary for sterile technique, so try to bring your own alcohol swabs, gloves, hand sanitizer, and needles if you can.  Also bring your own goggles and masks if you intend to do any procedures.
* If you intend to work with children, bring stickers or cheap toys, and they will love you!
* Bring: CDs for uploading and downloading pictures, stethoscope, food you cannot live without (ie peanut butter, soy sauce), USB thumb drive, cash in US dollars (no credit cards anywhere in Tanzania and limited ATMs—you will want to travel)
* You don’t need a white coat.
* This elective was much harder than I had anticipated.  The living accommodations were very simple, and the town was tiny...... I had one of the best experiences of my life in Tanzania. 

It was one of the best experiences I had in my life. 
I started in the RCH (Reproductive Child Health). It was nice to see so many mothers gather in the mornings, to have their child checked up. Also we went on mobile teams to give out vaccinations, other injections and weighting the children. This was really nice. 
After I did work on postnatal and antenatal where I did a lot of nursing counselling. I learned a lot about HIV and pregnancy, malaria, tuberculoses and maternity in developing countries. 
After this I went to labour ward, where I did delivered babies even by myself after two weeks. I was really excited. I went to surgery for some emergencies and saw two abnormal babies born. Live and death is in different proportions as in western countries and sometimes it is hard to cope with, but still I think it makes you a better person to realise how lucky and blessed we are with all our facilities. In Teule they do so much work with so little facilities.

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[img[Castle|http://img480.imageshack.us/img480/6435/CastleOnDanube.jpg]]
Anglican Missionaries first arrived on mainland Tanzania in the 1870's and were given land by the local chief in a rocky area at the foot of the Magoroto hill at a place called Magila where a leper colony was already established. Missionaries of that era had a life expectancy of 18 months when they arrived and they brought their grave stones with them. Thankfully things have changed. By the 1920's Magila was a thriving community with a school, hospital and convent. In time however especially with the rail and road links the nearby Muheza village became the district town. 

In the 1970's Dr Marion Bartlett recognised that both the mission hospital at Magila and the government hospital at Muheza (Ubwari) needed expanding and she persuaded various parties to come together. Eventually land on the old Muheza Sisal Estate was bought and a new enlarged combined hospital in Muheza town was built and called Teule Hospital - meaning the Chosen One. This is owned and operated by the Anglican Church of Tanzania but mostly funded by the Tanzanian government. It was opened by Mwalimu JK Nyerere in 1981.  

At the 25th anniversary celebration in 2006, there were 25 out of the original 66 staff that came to Teule from Magila and Ubwari all those years ago. 
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Hospitali Teule is the District Designated Hospital for Muheza district. It is owned and administered by the Anglican Church of Tanzania, under the Diocese of Tanga with the aim of providing Health Care for the population of Muheza District in co-operation with the District Medical Officer and according to regulations determined by the Ministry of Health.

{{textcenter{
 ''VISION OF TEULE HOSPITAL''
To provide a centre of excellence in all aspects of patient care, a good environment for patients and staff and to strive continually for higher standards. To reach these goals we are grateful to our glorious Lord Jesus Christ whose example in love and service we try to follow.
}}} 

''Contacting details'' include ...
Hospitali Teule, Private Bag, Muheza, Tanga, Tanzania
+255 27 2644121. (Hospital phone manned 7.30 am to 3.30 pm). 
office[at]teule[dot]or[dot]tz

Any comments, queries or additions to this website please contact Clare Chizazi
[[2006 Annual Report|http://www.teule.or.tz/annual%20report%202006.pdf]]
[[2007 Annual Report|http://www.teule.or.tz/annual%20report%202007.pdf]]
[[2008 Annual Report|http://www.teule.or.tz/annual%20report%202008.pdf]]
[[2010 Annual Report|http://www.teule.or.tz/annual%20report%202010.pdf]]
''USPG'' - This is one of the UK Anglican Church Mission Societies and has had a long association with Teule Hospital. It supports some staff at the Hospital (currently Dr Ben Amos and Dr Sally Edmonds with their three children Zack, Max, and Piran). It also gives a number of grants including one to the Nurse Training School and one to help fund HIV testing of blood donors and upgrading of staff.

''Hereford Muheza Link Society'' - This is a hospital link with the district hospitals in Herefordshire. It is an active group that both fund-raises and supports Teule with equipment that is being cast out of a modern western hospital but is still functional. Containers of such equipment get sent out each year to Tanzania and if you look around Teule evidence from Hereford is everywhere - trolleys, lockers, beds, surgical instruments etc etc. There is also an exchange of visitors in both directions, partly educational but also for people both in Tanzania and in the UK to learn something about another country and culture. An education fund has been developed to enable workers at Teule to go on various training courses including Clinical Officers to become MD's and Nursing Officers to become Tutors. A recent initaitive is for junior doctors in the UK to be at Teule for about 6 months to learn, work and teach.
http://www.herefordhospital.nhs.uk/HerefordMuhezaLinkSociety/tabid/145/Default.aspx

''Medicines for Muheza'' - This is a group that fund-raises to supply many things that the hospital is in need of. Some specialised drugs come through MforM and top-ups to the staff salaries are also paid by them. Many other projects such as ward renovation, new vehicles, child feeding programme etc etc are funded through MforM.

''Muheza Hospice Care''. This is not exactly a hospital supporter but a Hospice that operates alongside Teule Hospital sharing many of the facilities and staff and jointly caring for the same patients. It has a widespread programme to promote the use ot Morphine and develop palliatve care services throughout Tanga region and now extended to reach more regions within Tanzania. 
Muheza lies on the main tar road from  Dar es Salaam to Tanga and therefore enjoys a reasonable bus service which takes 5-6 hours. You can also reach us by bus from Moshi / Arusha (7-8 hours) or by plane from Dar / Zanzibar or Arusha (NOT KIA) to Tanga. 

''Taxi in Dar'' -From the airport you need to use a taxi and the cost into the centre of town or to the bus terminal is about 25,000shs. We have a friendly taxi driver called Ayoub Juma ( good English spoken) who is very good and has a mobile phone  (+255 713352910). You can text him from the UK etc to ask him to meet you at the airport. He is helpful, honest and reasonably reliable if a tad more expensive than some. He will buy on going tickets for you at request - usually quite sensible as he is aware what buses are working when. He will also (for USD 250) bring you all the way to Muheza - useful especially if there are 2 or 3 of you and you have lots of stuff.

''Staying in Dar'' - If you need to stay in Dar es Salaam, there is plenty of reasonably priced safe accommodation. Recommended is the Jambo Inn in the centre of town or with the Catholics or Free Pentecostals who both have centres rather out of town so very secure but convenient for airport and bus station. TEC (Catholics) at Kurasini (Tel no +255 22 2125751/ 2111817/ 2125865/ 2851075) does food. The Free Pentes (Tel no +255 773 116167/+255 713 787779 - both personal mobile phones, email fpctcenter at fpct.or.tz)  have a kitchen and can prepare food if given plenty of notice, and is a tad more money but both are good value at 20-25,000 per person. Juma can help you with bookings at TEC or FPCT.  

''To Muheza from Dar'' Many buses go to Muheza from Dar which lies on the road to Tanga. The main bus station is on the edge of Dar and called Ubungo. It is full of buses, touts and hassle, but a good taxi driver will help you avoid most of this.  The journey takes about 5 ½ hours - we recommend not leaving Dar any later than 3pm as traveling after dark is not recommended and arrval is more difficult. The buses cost about 12-15,000 shs per person. You may get charged extra if you have more than one bag. Juma (taxi driver in Dar - see above) is happy to drive you up to Muheza from Dar for $250. You can also fly from Dar via Zanzibar and Pemba to Tanga.  The cost one way is about 140,000shs (excess baggage charge over 15kg).  email aviation [at] coastal [dot] cc  .Then take a Dalla-Dalla (small minibus) from the end of the airport drive to Muheza.

''To Muheza from Arusha'' - Buses also come from Arusha (beyond being Naroibi) and Moshi. These are the safari and Kilimanjaro centres so you may be coming from that side if you have done some travelling first. Many buses go to Dar from there  which means you must get off at Segera and get a dalladalla the remaining 35 kms. Others go direct to Tanga. The journey takes about 7 hours.

''Muheza to Teule'' - On arrival at Muheza bus station, go towards the railway line (away from the main road). The road then goes left, along, over a little bridge, then uphill and you want the next right. Go across the railway line, and take the right fork immediately. Keep straight on and you will go up the hospital drive. It takes about 15 minutes to walk from the bus station or you can take a taxi, at cost of 2000shs but ask them to take you right to the door of the hostel near the nurses home to avoid carrying all your heavy kit through the hospital. If you get stuck, ask anyone and they will know where to direct you – just ask for Teule Hospital. 

Once at the hospital ask for Clare Chizazi or for the student hostel. The warden of the hostel (within the school of nursing) is usually around to ensure you get in OK.  Please do let us know when you expect to arrive just before you do so we can try to ensure beds are made etc. If you arrive at the weekend without letting us know, then you may find that we are all away and no-one knows about you - I'm sure you'd survive but it's a bit harder ....

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''Students'' get to stay in a hostel within the hospital grounds which is basic but better than many of the local houses. It has recently been upgraded with fans and ceilings in the rooms. It also has an oven and a fridge which usually work - folk who came a few years ago would hardy recognise the place now.  Nets and bedding are provided. Water is temperamental like in the rest of Muheza. Someone can do laundry for you at a small price. Currently this costs 35,000 shs per week.

''Other visitors'' may get to stay in ''Hillview'' - a house built by Dr Ian Bradley and up till recently occupied by Drs Karilyn and Richard Collins. This is the most luxurious house on the site with a water tank in the roof nearly guaranteeing a regular water supply. It is beautifully cared for by Juliette and also has a night guard. Availability needs to be checked with Dr Sally. Currently this costs 40-50,000 shs per week.

''Electric'' sockets and voltage are the same as the UK (supposedly) but power outages are common events and it is recommended that you bring a torch with you. 

''Clothing'' - You need to dress appropriately in both the hospital and the town. Short sleeved shirts with trousers or skirts below the knee are suggested. Ties are not needed. Sandals are recommended and unless you need walking boots for going up Kilimanjaro decrease the amount you need to bring. Shorts for girls are only OK in the tourist places (but not in Stonetown in Zanzibar) but trousers are fine. One option is to use a kanga as a wrap  and shorts to keep cool. Exposed mid riffs are not OK nor spaghetti strap tops. 

''Mobiles'' work at a price although you can easily buy a Tz sim card to use with your hand set which many have found useful unless you are “locked”into some UK system. Texting to UK costs about 4p and phone calls about £1 per minute. 

''Going out'' - the options in Muheza are not huge but "chipsy mayai" (egg n chips) at the Elephant Inn with a bottle of beer comes recommended by many. Early evening buzzes in Muheza town and it is generally safe but if you stay out late you need to be careful where and how you find your way home - no different to most towns around the world.

''Getting away'' - There are many things to do at weekends with the Indian ocean not far away and a beautiful place called Peponi (kiSwahili for paradise) to stay at as well as hiking in Amani or Lushoto within reach. This is in addition to general travelling with animal safaris (Ngorongoro crater and Serengeti or the cheaper, less well known but arguably better Ruaha or Selous) and Zanzibar to enjoy not to forget climbing Kilimanjaro for those who like a good vomit (and the view).  (See TravellingInTanzania) Please note it is not really possible to do a safari or Zanzibar properly in a weekend and taking long weekends every week will decrease your experience here as no one will both to help you in the few days you are around.

''Money'' - . You will need about Shs. 30,000 per week depending on how much western food you buy (in addition to rent) and most weekends cost about 100,000 shs all in. Beer and sodas could double your weekly expenses depending on quite how much you consume !  The current rate of exchange is about 2500 Tanzanian shillings to the £1. We now have an ATM in Muheza itself which is functional about 50% of the time (as of March 2009) - visa only - if you want to use Mastercard then you must go to Tanga. You can get money directly out of your own bank account therefore which is currently the cheapest and easiest way of getting cash here.  Pounds, dollars, and euros can be changed in Tanga. Tour operators for safaris will accept part payment with credit cards and cash (mostly dollars). There is also an ATM at the airport for when you first arrive. 

''Internet Access'' is poor in Muheza unless you have your own local dongle (how we survive). The fast cable goes past the town but we are not yet connected in. Mostly you have to go to Tanga to get connected unless you bring your own system. 3G is not accessible here yet .....

''Googles'' - we strongly recommend that you bring eye protection with you and use it whenever you carry out invasive procedures. There is some available but the supply is erratic. Leaving them here for local uasge is greatly appreciated.

''Theatre scrubs'' - Recently the suggestion has been made (by students) that it would be helpful if you brought scrubs, clogs and clean (not surgical) gloves as well as googles. These are NOT vital as we mostly have enough but you may find it useful. However eye protection is generally more scarce and I think important to bring.

''Cameras'' - You can take most photos you want although do be sensitive to taking close ups of people and remember to ask. We have recently had problems on the wards with consent not being effectively obtained – you MUST get a nurse who speaks kiSwahili to do this properly for you not just go through a mime. 

''Remember – this is Africa .... where everything takes time and what doesn't get done today may get done tomorrow or there again ......''

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[>img[view from hospital|http://img165.imageshack.us/img165/9494/viewfromhospitalsl1.jpg]]
''Climate'' - Muheza enjoys a climate that is HOT and STICKY especially between December and March. The long rains usually come between March and May and the short ones in October and November but yearly variations are ever present. From June to September it can get a bit cool – you may even need a cardigan, but not very often.

''Culturally'' - About 60% of the population are Muslims and 40% Christian of a variety of denominations. There are two main tribes in the area - Bondei and Sambaa and a number of others including Zigua and Masai but many tribes from all over Tanzania are represented. Masai remain distinctive with many members still wearing traditional blankets and many beads and often not speaking kiSwahili.

''Language'' - Kiswahili is used everywhere although everyone also speaks their tribal mother tongue of which there are many.  The hospital functions in English (notes written in English) and all qualified staff can speak it although most communication is in kiSwahili. Very few patients speak English.

''Contact details'' - Hospitali Teule, Private Bag, Muheza, Tanga, Tanzania - snail mail is effective and mostly reliable with most things taking 6-10 days from the UK although one particular Christmas parcel posted in November arrived the following July !
+255 27 2644121. (Hospital phone manned 7.30 am to 3.30 pm – GMT+3 hours). If desperate it is possible to phone or text Clare on +255 713 311852 but its probably more effective just to email - students [at] teule [dot] or [dot] tz although internet access is variable and I can't guarantee a rapid turn around.

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[>img[http://img135.imageshack.us/img135/787/ntsc.jpg]] This developed from the school that was originally based at Magila and moved to Muheza in 1981 when the new hospital was opened. Since 2004 it has been training nurses to Diploma level. Currently there are 116 students spread over 4 years. In 2009 a 2yr upgrading course from Certificate to Diploma level was started. Thus there are many student nurses on the wards of varying experience and from a variety of places.
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''Cradle'' (January 2012 - ) This is in collaboration with Kings College in the UK and is distributing digital BP machines to outlying clinics and recording the impact on referrals for Pre-eclampsia. Not directly in this study but eventually the aim is to reduce the maternal mortality rate due to hypertensive diseases in pregnancy.

''The Woman Trial'' (January 2012 - ) This is with the London School of Hygiene and Tropical Medicine and is trialling the use of Tranexamic Acid (an antifibrinolytic) in the treatment of Post-Partum Haemorrhage.  (www.womantrial.lshtm.ac.uk)

''AZCQ'' (2011-)  A trial of the standard verses a combination of azihromycin and chloroquine  for intermitant presumptive treatment of malaria in pregnancy.  See Chico, R.M., Pittrof, R., Greenwood, B. & Chandramohan, D. Azithromycin-chloroquine and the intermittent preventive treatment of malaria in pregnancy. Malaria journal 7, 255 (2008) for a justification.

''Confit'' (Jun 2011 -  )
What  is causing fever in febrile outpatient children and adults?   Malaria has declined so what is giving people febrile illness?  This is one of a number of different studies going on worlwide to attempt to  this question in developing countires that have not had the laboratory capacity to look at this. 

''Interact'' (June 2009 - )
Part of the ACT consortium (www.actconsortium.org/pages/project-10.html).  Examining the interaction of ''A''rtmisinin ''C''ombination ''T''herapy(ACT)  with ''A''nti''R''etro''V''irals (ARV).  These drugs share common mechanisms of degradation and so use of ARV's may change the effectiveness of ARV's.  Studying adults for the pharmacokinetics and effectiveness of ACT therapy. 

''FEAST'' (July 2009 - March 2011)
''F''luid ''E''xpansion ''A''s a ''S''upportive ''T''herapy (www.feast-trial.org).  A trial of treatments for impaired perfusion in severely ill children in Africa  (www.feast-trial.org).  Another large multisite study on our paediatric ward.  Now published: Maitland, K. et al. Mortality after Fluid Bolus in African Children with Severe Infection. The New England journal of medicine 110526130015056 (2011).doi:10.1056/NEJMoa1101549 

''Typhoid'' (Feb 2008 - Jun 2010 )
Surveillance of paediatric inpatients for Salmonella typhi and other basterial diseases and its relationships to malaria.  1. Mtove, G. et al. Decreasing incidence of severe malaria and community-acquired bacteraemia among hospitalized children in Muheza, north-eastern Tanzania, 2006-2010. Malaria Journal 10, 320 (2011).

''Aquamat'' (Jan 2007 - Jun 2010)
We are participating in a large multicentre trial of Artesunate vs Quinine for the treatment of severe malaria in children. The other sites are spread across much of Africa.  Published: Dondorp, A.M. et al. Artesunate versus quinine in the treatment of severe falciparum malaria in African children (AQUAMAT): an open-label, randomised trial. Lancet 376, 1647-57 (2010).

''Azithromycin'' (Feb 2008 - Jan 2009)
A trial of Azithromycin/Artesunate against Lumefantrin/Artesunate for the treatment of outpatient paediatric malaria.   Sykes, A. et al. CID (2009)  doi:10.1086/605635 

''Hib and Pneumococcal surveillance'' (Oct 2004 - )
We are a WHO Paediatric Bacterial Meningitis monitoring site and part of the Netspear group (http://www.netspear.org).  

''Severe Febrile Illness in Children'' (Jun 2006 to May 2007)
In this study all children admitted to the hospital with a fever over the course of on year (more than 3800) were examined in detail to try and determine the cause of the fever.  A detailed, structured, clinical examination was combined with ward based rapid tests, blood culture, haematology  and malaria slides.  Published:  Nadjm, B. et al. WHO guidelines for antimicrobial treatment in children admitted to hospital in an area of intense Plasmodium falciparum transmission: prospective study. BMJ 340, c1350-c1350 (2010).

''Malaria in Pregnancy'' (Jan 2004 to Mar 2005) 
This was a study looking at treatment safety of non severe malaria from 16 to 34 weeks gestation. Pregnant women with malaria were admitted to the JMP2 ward and given one of four treatment regimes. They were followed up for 28 days for the outcome of malaria and until postpartum for the outcome of the pregnancy.   Theonest K. Mutabingwa et al., “Randomized Trial of Artesunate+Amodiaquine, Sulfadoxine-Pyrimethamine+Amodiaquine, Chlorproguanal-Dapsone and SP for Malaria in Pregnancy in Tanzania,” PLoS ONE 4, no. 4 (April 8, 2009): e5138.

''MOMS'' (Mother Offspring Malaria Study) (Jun 2002 to Jul 2006.  2011-present) 
This was a study looking at placental factors related to malaria and their effect on the potential for malaria in the babies until 2 years of life.  See:  Gwamaka, M. et al. Iron Deficiency Protects Against Severe Plasmodium falciparum Malaria and Death in Young Children. Clinical Infectious Diseases 1-8 (2012).doi:10.1093/cid/cis010.   Muehlenbachs, A., Mutabingwa, T.K., Edmonds, S., Fried, M. & Duffy, P.E. Hypertension and maternal-fetal conflict during placental malaria. PLoS medicine 3, e446 (2006) and many others 
Click on any photo to see it enlarged

''10 years of Palliative Care in the Diana Centre - March 2012''
On March 30th 2012, Muheza Hospice Care celebrated its 10th anniversary. It has grown from small beginnings run by Dr Karilyn Collins with day hospice held in the meeting room, into a centre of excellence which others across Africa try to emulate. More patients each year are able to benefit from palliative care in their last often difficult days. This was celebrated with marches through town, dancing, singing, speeches and refreshments.
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''Container arrives from Hereford January 2012''
The latest container was packed and shipped in November. It arrived in January and was unloaded on Saturday morning. A useful variety of things made their way onto the wards over the subsequent few weeks.
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''New Classrooms for the Nurse Training School - 2011''
With increasing numbers of students in the NTS more classroom space is needed. This is in addition to a skills laboratory, library and computer suite which are all needed to train nurses in the 21st centuary. A big double block has had the foundations dug and half is now finished and about to be put to use.
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''Christmas 2011''
The birth of Jesus was celebrated with a procession around the hospital with carol singing between the wards,  short messages of hope delivered on each ward and gifts given to all patients.
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''NTS graduation 2011''
Over 100 nurses graduated in August 2011. The direct entrant Diploma of Nursing course had its final year of the old 4 year course finishing and the first year of the new 3 year course. As well as this the conversion from Certificate course had also been reduced from a 2 year to a 1 year course, so double lots of students from both courses were completing, The Guest of Honour was from the Ministry of Health and many friends and relationships also showed up. It was a real celebration of many hours of hard work. Of course, the results came out the week after .....
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''Sylvester leaves the NTS''
Sylvester Chizazi has been the lynch pin of the Nurse Training School for over 30 years. He has seen the institution develop through many stages and handed over as the Principal to Elizabeth Chigua a few years ago, but stayed on to help out with the teaching. However enough he said was finally enough and we said goodbye.
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''World HIV day 2010''
This is a yearly celebration of all the HIV work that is undertaken in Muheza and an outreach into the town and the district to continue to raise awareness of the virus.
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ArchiveRecentEvents
[<img[central corridor|http://img508.imageshack.us/img508/5628/corridor2tg6.jpg]] 
The traditional layout of the hospital has wards set either side of a long corridor.There are 4 Medical wards (Yohana Jumaa (Male), Imani (Female), Mwenge (Palliative care) and Chipukizi (NSSF)), two Surgical wards (Wallace (Female) and Bartlett (Male)), two Paediatric wards (Hills (with Paed ICU) and Jenner (with NNU)) and a maternity unit comprising a delivery suite (Tegemeo) and an ante/post-natal ward (Azimio with SCBU - Joseph's Unit). Specialist services include an ICU, dental, eye and physio departments and a Palliative Care / HIV centre known as the Diana centre. Xray and USS are offered as are all basic laboratory services plus a specialist microbiology service.
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[img[Rajabu|http://img444.imageshack.us/img444/1468/hospitalcarlogooi7.png]]  Hospitali Teule Muheza
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We have an active elective programme here at Teule for medical students and at times have had nursing and physio students as well. We enjoy having students and many members of staff get involved with teaching. All students pay a £250 charge which is put in a pot and used to fund Tanzanian staff doing various training courses. We have a full complement of students most of the time. If you are interested please contact Clare Chizazi on students [at] teule [dot] or [dot] tz   Please note that the internet connection is slow and doesn't cope well with attachments. A simple email applying for a place is sufficient, the most important information needed being dates.

The following is all information that you may find helpful if you are considering an elective with us or after you have been accepted ...
MuhezaFactets
WorkingInTheHospital
HowToReachUs
LivingInMuheza
YourHealth
TravellingInTanzania
StudentProjects
CommentsFromOthers

Please note that at Teule we get many applicants to do student electives and work on a first come first serve basis. We therefore have to turn many folk away as we can only accept 5 students at any one time (due to hostel limitations and the ability to offer you effective teaching). This does occasionally get stretched but as seldom as possible. Your place will not be confirmed until you have definite dates and we have received your £250 charge. If you change your mind about coming to Muheza we ask you to inform us as soon as possible so that others can get the chance instead. We accept a maximum of 3 students from any university at any one time to ensure a good mix of previous experience. We do NOT want to know the dates of your whole elective period but those that you hope to spend at Teule Hospital. Please do think about what else you want to do in Africa when sorting out your dates. Leaving early is frustrating for us and detrimental to your colleagues who also wanted to come here. Taking every weekend as a LONG weekend in order to fit in safari, zanzibar etc during your time in Muheza is also unacceptable. These places take time to get to and cannot be fitted into a weekend. We think that it is best for students to be here for 4-6 weeks to get maximum benefit from the visit.We are not accepting students for less than 4 week blocks as this gives little time for you to settle or us to get to know you and produces more frustration all round. Some medical schools have 9 week electives which some people split between two sites. You can spend that all with us if you want but then you may want a specific project to get you teeth into during the second half of your time although some folk have left after 9 weeks saying they still had things they didn't get round to doing. We get asked from time to time to sign students up for a longer period than they actually stay at Teule. I am afraid that the answer is always no! 

There are many things to do at the hospital, wards, clinic, theatre, out-reach etc etc and you can be involved in any or all of them as you wish and within the bounds of others needs. Mostly the routine of the hospital runs from 7.30 to 2.30 and the afternoons are quiet (shopping and coping with the heat time) or else you're still out on outreach or in the Diana centre. In general we find that students who are here for up to 4 weeks find just getting around everything enough and if they need a project for their medical school need to choose something small eg: a case study. If you are here for longer then you can spend the first few days getting to grips with things and then have time for something else as well.

''Realistic options''
1. ''case study'' - you will undoubtedly see cases that are interesting around which something can be discussed - often including cultural issues as well as medical - use of traditional medicine, hospital access and costs (why wait till you need a wheel barrow to get your hydrocele to hospital before attending ?), malaria etc etc
2. ''audit / research'' - some  things can be looked at closely, with questionnaires, even comparing to UK practise. eg. understanding of post natal depression, barriers to uptake of HIV testing on the ward.  

Some of these ideas will come from us but mostly from you as you have a prior special interest or notice something that intrigues you . Its a good idea to run ideas past someone beforehand as to local feasibility. On the whole it is not a good idea to start something and expect others to finish it as mostly they won't. 

There is quite a lot of research going on already here (London School of Tropical Medicine, and others). You are welcome to see what is happening but mostly we are part of data collection in large studies long term and the concept that you can "join in"  isn't possible.

''Publishing''
If you wish to publish the results of your study, or if it involves any procedures that are not normally performed then ethical clearance should be considered.  This is a long winded and difficult procedure (at least 6 months) so any "serious" projects need to be discussed well in advance of arrival. We have recently had a student who was really keen and wanted to publish her results following a questionnaire into common mental health problems in HIV positive people. These are her comments about the whole ethical approval side in Tanzania.

Below are the pearls of wisdom I have gathered on ethical approval, such as they are.

You need formal ethical approval only if you want to do an 'official project' ie one you could publish. Otherwise you can just get ethical approval from the doctors at the hospital. 

To get official approval you need two things: country research clearance and ethical research clearance.

Country clearance must be obtained from COSTECH. <http://www.costech.or.tz/research%20clearance.htm> It costs approx $350, if you get it. I have been told it is important to have a Tanzanian referee and that you will probably need to pester them to get it eg call them up, spend some days in Dar sitting in offices upon arrival. They say apply a minimum of 2 months before arrival, I have been unofficially told at least 6 months. 

To get ethical research clearance the waters are murkier but it seems there are two main ways: The national institute for medical research (NIMR) <http://www.nimr.or.tz/index.php?option=com_content&task=view&id=26&Itemid=34> Costs about $300  

Or a local ethics committee - such as the Muhimbilu University one (medical school in the capital). This is the route I am going down. I think the university has an arrangement whereby they inform NIMR of what they accept, but to be honest I haven't got a definitive answer on this. It's not a less rigorous route as the application required is still pretty comprehensive, but I thought the less big the organisation the easier to pester if necessary. 
 
If you attempted the Muhimbili Uni route <http://www.muchs.ac.tz/> you would need to apply to be an elective student with them (which costs about $300 also) and ideally find someone to supervise you there. They are happy for you to spend most of your time at a different hospital. 

So my top tips are:
1.Start planning massively in advance
2.Find a Tanzanian supervisor/sponsor/supporter 

Back to StudentElectives
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.popup hr {
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.popup li a:hover {
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.searchBar {float:right; font-size:1em;}
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.searchBar input{
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.searchBar input:focus {
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*html .titleLine {margin-right:1.3em;}

*html .searchBar .button {margin-left:1.7em;}

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.blog h2, .blog h3, .blog h4{
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.blog .excerpt {
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#tiddlerWhatsNew h1, #tiddlerWhatsNew h2 {border-bottom:none;}
div[tags~="RecentUpdates"], div[tags~="lewcidExtension"] {margin-bottom: 2em;}

#hoverMenu  .button, #hoverMenu  .tiddlyLink {border:none; font-weight:bold; background:#f37211; color:#fff; padding:0 5px; float:right; margin-bottom:4px;}
#hoverMenu .button:hover, #hoverMenu .tiddlyLink:hover {font-weight:bold; border:none; color:#f37211; background:#000; padding:0 5px; float:right; margin-bottom:4px;}

#topMenu .fontResizer {float:right;}

#topMenu .fontResizer .button{border:1px solid #000;}
#topMenu .fontResizer .button:hover {border:1px solid #f37211; color:#fff;}
#sidebarTabs .txtMainTab .tiddlyLinkExisting {
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#sidebarTabs .txtMoreTab .tiddlyLinkExisting {
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#displayArea {margin-right:1em;}

.headerShadow {
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.viewer .button {border: 1px solid #ED700B; font-weight:bold;}
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[[StyleSheetCommon]]
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.topbutton button, .topbutton{float:right;}

.note{
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.bold {font-weight: bold !important;}
Tiddler.prototype.getSubtitle = function()
{
	return(this.title);
}
/***
|''Name:''|TiddlyLightBox|
|''Date:''|Jan 1, 2006|
|''Version:''|1.0 beta|
|''Author:''|Saq Imtiaz|
|''Location:''|http://tw.lewcid.org/#TiddlyLightBoxPlugin|
|''Documentation:''|http://tw.lewcid.org/#TiddlyLightBoxDocs|
|''License:''|[[Creative Commons Attribution-ShareAlike 2.5 License|http://creativecommons.org/licenses/by-sa/2.5/]]|
|''Based on:''|DC3.LightBox<br>Light Box Gone Wild <br>Ibox|

!!Code
***/
//{{{
config.macros.imagebox ={};
config.macros.imagebox.handler = function (place,macroName,params,wikifier,paramString,tiddler)
{
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}

config.macros.divbox ={};
config.macros.divbox.handler = function (place,macroName,params,wikifier,paramString,tiddler)
{
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config.macros.tiddlerbox ={}
config.macros.tiddlerbox.handler = function (place,macroName,params,wikifier,paramString,tiddler)
{
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}

store.addNotification("TiddlyLightBoxStyles",refreshStyles);

if (!window.TiddlyLightBox)
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    createBoxWrapper : function()
        {
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            if (contentType=='image')
                setStylesheet("#lightBoxContent img{height:100%;width:100%;}","lightBoxImageSizeHack");
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    showProgress : function()
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    hideProgress: function()
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            { 
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TiddlyLightBox.createBoxWrapper();

Story.prototype.findContainingTiddler = function(e)
{
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config.shadowTiddlers.TiddlyLightBoxStyles="/*{{{*/\n#lightBoxOverlay {\n position:absolute;\n top: 0;\n left: 0;\n width: 100%;\n height: 100%;\n z-index: 90; \n background-color: #000;\n -moz-opacity: 0.75;\n opacity: .75;\n filter: alpha(opacity=75);\n}\n#lightBoxOverlay[id]{ \n position: fixed;\n}\n\n#lightboxprogress { \n margin:0;padding:0;\n position: absolute;\n z-index:95;\n}\n\ndiv.lightBox {\n background: #fff;\n color: #fff;\n border: 4px solid #525252;\npadding:20px 20px 25px 20px; position:absolute; z-index:99;\n}\n\n#lightBoxClose {text-align:right; color:#000; font-size:1.0em; position:absolute; bottom:6px; right:20px;}\n#lightBoxClose a{color:#666; border-bottom:1px solid #666;cursor:pointer;}\n#lightBoxClose a:hover {color:#111; border-bottom:1px solid #666; cursor:pointer; background:transparent;}\n\n#lightBoxContent {border:1px solid #525252;color:#000; background:#fff;}\n#lightBox .tiddler {background:#fff;}\n\n#lightBoxContent img {border:0;margin:0;padding:0;display:block;cursor:pointer;}\n\n#lightBoxTitle {padding:0px; font-weight:bold; position:absolute; left:20px;bottom:6px; font-size:1.1em; color:#000;}\n\n/*}}}*/";
//}}}
config.macros.top={};
config.macros.top.handler=function(place,macroName)
{
               createTiddlyButton(place,"^","jump to top",this.onclick);
}
config.macros.top.onclick=function()
{
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/***
|Name|TotallyTiddlers|
|Source|http://www.TiddlyTools.com/#TotallyTiddlers|
|Version||
|Author|Eric Shulman - ELS Design Studios|
|License|http://www.TiddlyTools.com/#LegalStatements <br>and [[Creative Commons Attribution-ShareAlike 2.5 License|http://creativecommons.org/licenses/by-sa/2.5/]]|
|~CoreVersion|2.1|
|Type|CSS|
|Requires||
|Overrides||
|Description|alternative stylesheet theme: show tiddler content only - use for 'kiosk mode' presentations|
***/

/***
!!!!{{big{important information - please read carefully:}}}
<<<
This stylesheet hides all TiddlyWiki standard toolbars, tags, menus, and sidebars, so that ONLY TIDDLER CONTENT is displayed.  Combined with SinglePageModePlugin, this stylesheet allows you to construct and publish your TiddlyWiki documents using a more "conventional" website appearance and interaction pattern.

''WARNING: After you select this stylesheet, you will most likely no longer have access to the "themes" droplist'' typically presented in the right sidebar options panel.  The current stylesheet selection is stored in a cookie, called "txtStyleSheet".  Each time you load the document, this stylesheet is automatically re-applied by the SelectStylesheetPlugin.  ''This makes it very difficult to select a different stylesheet.''

''To reset the stylesheet selection and restore the TiddlyWiki interface elements, you can use any of the following methods:''
* append "#TotallyTiddlers" to the end of this document URL.  This will automatically open THIS tiddler when you refresh your browser window so that you can select a different stylesheet from the SelectStylesheetPlugin droplist that has been embedded here for your convenience:
{{center{please select a theme: <<selectStylesheet size:1 width:auto>>}}}
* //or...// append "#style:~TiddlerName" to the end of this document URL, where //~TiddlerName// is the name of any installed stylesheet tiddler.  This ''temporarily overrides'' the current stylesheet selection and applies the named stylesheet ''without changing the current cookie-tracked stylesheet preference''.
* //or...// use your browser's "cookie-management" functions (if available) to manually remove the "txtStyleSheet" cookie.  The next time your document is loaded, it will revert to the default stylesheet, "StyleSheet" (if present), restoring the display of the familiar ~TiddlyWiki features and functions.

The following 'init' tiddler is processed by SelectStylesheetPlugin, and forces this stylesheet tiddler to be automatically displayed whenever it is first applied (i.e., selected from the droplist), so that the ''important instructions'' included above will be shown.  However, subsequent visits to the page are rendered without displaying the instructions again.
{{{
<<init TotallyTiddlersInit>>
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<<<
***/
[[Textures]] /* look-and-feel... */
/*{{{*/
/* hide tiddler functions, menus, and breadcrumbs */
.tiddler .toolbar, .tiddler .tagged, .tiddler .tagging, .tiddler .subtitle,
#mainMenu, #siteMenu, #storyMenu, #sidebar
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#displayArea
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/*}}}*/
This is by no means a definitive list or guide but some observations and names of companies that previous students have used and their comments - please do let me have the names of whoever you use and I can add it to the list.

People basically seem to do all or some of three things while here:-
''Safari'' - this is mostly the northern circuit - Ngorongoro, Serengeti ?Lake Manyara or Tarangire. You can pick up safaris reasonably easily in Arusha. They do custom built ones mostly with a landie, driver and cook and camp (but not necessarily that basic). It is possible to do the less well known southern parks - arguably game as good, fewer people around, not the big names and maybe fewer budget operators. You can do safaris out of Kenya which often then come into Tanzania to get the crater which seems a tad illogical but you may get a good price although will need a Kenyan visa as well.

''Kilimanjaro'' - the highest mountain in Africa and a goodly climb - it takes about 6 days (4 up and 2 down) and is NOT cheap. Most folk vomit near the top because of the altitude but everyone seems to have enjoyed it in retrospect ! There is also the close by Mount Meru which is not such a hard climb but you do get well over 4000 m and get excellent views of Kili.

''Zanzibar'' - beautiful white beaches for relaxing, snorkling, diving etc etc. Also spice tours and Stone town of slave trade fame.

There are other bits like train rides down to Malawi and the Southern highlands, Chimpanzees at Gombe river over in the west (you must be made of money), as well as the local things to do at weekends - more coast with beaches to relax on and snorkling (Peponi possibly ?!), and walking in the mountains, either near Lushoto or in Amani - but all that can be thought of once you are in Muheza.

http://www.africatravelresource.com
nice website - loads of detailed information beautiful but expensive resorts in several African countries.  Use for ideas not booking.

www.livetsresa.com is the website of a relative of one of the hospital's nurses. It is therefore very easy to organise safari's with them. They are competitive on price giving good rates to anyone with Teule connections and organise lovely safaris (we can vouch personally for them !).

What follows is lifted unedited from emails sent to me after the event by your colleagues ..... I vouch for none of it but they obviously all had a good time ....

(January 2012)
I did Kilimanjaro with Zara Tours - would highly recommend them. For the price (they are one of the relatively cheaper companies) it was all so well organised, they have a hotel just for their company outside Moshi & will pick you / drop off from Kili airport. Machame route is the best for a scenic hike. Be prepared for very cold temperatures from the 2nd day & ensure everything stays dry.
Taking the bus from Moshi - Muheza (or Muheza to Arusha - long journeys): for single travellers a good tip I was given is to buy 2 seats if you have a lot of luggage. Then for the long trip (approx 6-8 hours) you don't need to keep getting on & off to check your luggage is there when the bus stops. Simba were a good bus company.
Safari - through 'G adventures' was really good & would recommend. They included a good combination of village visits (local & Maasai to learn about culture) and game drives. Felt very safe & well organised

(September 10)
- I spent 3 weeks in Kenya and a week in Arusha before starting my 4 weeks in Muheza. Kenya was lovely and did some volunteering in Mombasa on the coast, near Diani beach which was a great way to start my trip to Africa. There are plenty of organisations that you can do this through although some can charge quite a bit of money for it so watch out for these. 
- I met friends in Arusha to do a safari and would thoroughly recommend the company we went through called Soko Adventures (http://www.sokoadventure.com/index.html) they also do kili climbs and my friend had a good experience with them. We paid around $400 (I think it was £320) for a 3 day, 2 night safari with a big group of us. They organised it when they arrived and had been recommended the company by the hospital they were working at. We went to the Serengeti and Ngorogoro Crater and had a fantastic time, saw all the big 5 including a leopard very close up! We camped in tents and had great guides who looked after us and cooked good food. Serengeti is a bit further away than some of the other parks but think it was worth it in our case as saw so many different things there and were v lucky!
There's also a hostel in Arusha called Ujamaa (http://www.ujamaahostel.com/index.html) that I stayed in for a week which is good value and offers volunteering opportunities for any length of time from a week to months (I did a few days with some of the volunteers I met there). It's owned by a lovely Australian called Carley and apart from paying your keep at the hostel I don't think they charge you anything to volunteer! Think it's gone up slightly to 21,000Tsh but this includes breakfast, dinner and free laundry and it's a great place to stay. 
- Weekends from the hospital are well described in the Black book and plenty of places to visit (I went to Lushoto and the usambara mountains, Peponi (lovely!) and Tanga). 
- Zanzibar is also a must and great place to visit at the end to relax. Also cheap flights to the UK back from Zanzibar airport via Brussels! I did the boat trip from Pangani with Wahid where a motorised dhow takes you to the north of the island (Kendwa), less hassle and can be cheaper than the ferry ($120 split between how many of you take the boat so we did $40 each between 3 of us). Great fun (we saw whales!) but do NOT do if you get badly seasick. Great places to stay on the island are Kendwa Rocks up north (can do amazing diving to Mnemba island and good beach parties) and Teddy's place in Paje down on the east coast (check it out on tripadvisor and http://www.teddys-place.com/home.html) - very reasonable, great place to relax and simple but lovely accommodation (beach bandas). 


(May 10)
1. In Dar we stayed at Al-Aruba guest house in Kariakoo district. Was really really cheap but clean and felt safe, and has a nice restaurant downstairs.

2. For safari from Arusha we used a company called sunny safaris. They were brilliant. Not the cheapest option probably but great value for money - we stayed in some really nice places.



(April 10)
Advice about travelling in Tanzania.....I had 8 weekends of travelling and didn't get bored!

Safari - I think really needs about 5 days minimum - 3 days on safari and a day either side to travel to Arusha. I was lucky and managed to do this over the Easter weekend but otherwise this trip is probably best done before/after time at the hospital. As for parks - Nogorogoro is an absolute must, Tarangire is also great - loads of elephants! Lake Manyara - nice but if you are short on time it is the one to miss out. Serengeti - would have loved to go but it needs another few days as it is a days drive from the others. The safari and guide were great but the accommodation left a bit to be desired....we opted for the "cheap" accom so it might be worth asking/thinking about the better place, we paid $30/night which is the most I ever paid in Tanzania yet was easily the poorest I stayed in!

Zanzibar - fantastic!!!!  Can be reached by ferry from Dar or boat from Pangani and also by air from Tanga. Flying is more pricy (£120 return) but is good if you are pushed for time, e.g. just a long weekend, and the views from the plane on the way over are worth paying for! On Zanzibar - plenty of decent places in Stone Town to stay, worth spending 1/2days there and doing a spice tour. For beaches - head north to 'Kendwa Rocks' - a firm favourite with travellers. It is beautiful, relaxed and if you are interested there is scuba diving, snorkling etc on offer.

Peponi - AN ABSOLUTE MUST for anyone spending time at Muheza! Peponi is a fantastic place on the beach about 1hr from Muheza where you can stay for the weekend in a Banda for ~£12/night (I think), eat great food and go snorkling. It is the perfect retreat from Muheza - very peaceful and relaxing. I went 3 times in 8 weeks and still did not tire of it!!! It is even a good location for finals revision (yuk) or writing MTAS answers if you happen to be out at these times of year.

Usambara mountains - worth heading there for the weekend to do some trekking. I went to both Amani and Lushoto. Lushoto is further away but I think it is the better option. Amani is very pretty but is tiny whereas Lushoto is a town with different options for eating, staying, shooping etc. At Amani there is only one place to stay and eat and there are no shops. Also easier to get hold of a guide in Lushoto. There are plenty of cheap places to stay that are reasonable - think we paid about £5/night.



(Jan 10)
Read the Black book when you arrive. It will have all the latest best spots to travel, and also tips and hints to make your life easier to travel in Tanzania. Peponi is awesome and a must for all students in my opinion!

After Teule I climbed Mount Meru, which can be done in 3 days and gives you an amazing view out over Kili with the sun rising behind. It was brilliant. I also did a safari. I went with Gap Adventures, which I organised from home.I wouldnt reccommend them as I think they are expensive although effiecient. You can easily organise safaris in arusha with a day or 2s notice.
Zanzibar is also awesome. Most amazing blue seas. I stayed at Kendwa rocks, and enjoyed that. Very backpacker atmosphere, if thats what you are looking for. 

(Jul 09)
The journey to Zanzibar from Pangani (Peponi) is recommended, it worked out well. Wahid took us by boat (small motorised fishing boat) from Pangani to Kendwa, northern tip of Zanzibar. It took all morning, leaving 6am and arriving 12pm (after having a passport cheque just south of Kendwa). I'm sure this can vary according to sea conditions. It was fairly choppy all the way there.. Definitely NOT recommended for the seasick! However, a fabulous way to
arrive in Zanzibar, Wahid will drop you at the shore of the resort you're staying at. It costs $120 for the journey, therefore the more people, the cheaper it is! His number is in 'The Book' at the hostel (otherwise get it from Peponi) and Wahid will help organise the nights accommodation/food in Pangani.

We stayed at Kendwa Rocks for several nights, a very popular and reasonable resort in Kendwa - the resort and area is definitely worth the visit. A great place to relax with a fantastic beach!

We moved to the east coast and stayed in Jambiani at Kimte Beach Inn resort. Not as popular or busy as Kendwa and the beaches/sea aren't as swimmer friendly. Private taxi/mini buses are more direct and reasonable if in large group compared to dalla dallas.

Finished our stay in Stone Town. We stayed in Garden Lodge which is a bit more pricey (for the budget travellers!) but good rooms and breaskfast - great location also. Just around the corner is Haven Guest House which was
cheaper and more basic, again good location. We had trouble booking accommodation and recommend that it is booked in advance if you're not prepared to walk around all hostels in Stone Town, begging for a bed! The food night market is great and even one day is enough to walk around Stone Town and do a spot of sight seeing. Also, as suggested by Lonely Planet, watch the sunset from the balcony at Africa House - beautiful! The night ferry is very reliable and cheap, just a long journey, 9pm until 6am arrival in Dar es Salaam.

(June 09)
We travelled for about a month before our placement. We didn't book anything before we left except our first night in Dar Es Sallam. This is definitely the best way to do it as when you're there it is easy to shop around for a good price and is much more flexible so if you want to spend a few extra days on the beach in Zanzibar it's not a problem. Our main advice would be take it easy - embrace the African pace of life! 
We started in Zanzibar - if you have plenty of time spend a couple of days in stone town but make sure you get plenty of beach time, that's the best bit. we went to kendwa in the north of the island and stayed at white sands. Having shopped around a bit they did the best price and it was nice and quiet. Kendwa rocks is full of loud british people if that's what you like. we then flew to Arusha which was a beautiful flight and cost around £100 - well worth it! From Arusha we went on a 4 day camping safari with Shidolya. We went to Lake Manyara, the Serengetti and Ngorongoro. This was an amazing experience and we would recommend doing at least 4 days, we thought we might get bored but didn't at all, we could have stayed another week. We arranged this in combination with climbing Kili with the same company for around £1000 which is a pretty good price for both. It's generally a bit cheaper if you do safari and kili with the same company. Shidolya were very good. If you plan to climb Kili it's easy enough to rent equipment when you get there, including sleeping bags, but the quality seems to be quite variable. It will probably be quite old but will be warm enough if you don't want to lugg loads of warm clothes around with you for the whole trip. Essential items to take with you include long johns, good gloves, headtorch, warm hat / balaclava and good walking boots that have been broken in! Also plenty of plasters! We both took Diamox and one of us made it to the top, the other had to turn back about 500m short due to altitude sickness so can't really say whether it helped or not. We managed to find other travellers to climb with but the company you go with will be able to fit you in with a group if you can't. Don't arrange kili and safari from touts on the street- some of them are good but we would advise to ask around, look in the guide book, decide who to go with and then go straight to their head office.
We found Tanzania a safe country to travel around, but did make sure we were with other people if walking around after dark. Buses are generally fine or what we expected anyway. English is pretty widely spoken in the touristy areas and we had no problems whatsoever.



(Nov-Dec 08)
I went on safari with Shidolya, I think one of the least expensive around $460 for a 4 day camping safari. I climbed Kili with Asante along the Machame route. They were both very good and I would recommend them to other students.
 
(November 08)
We sandwiched our hospital time between a week on safari at the start and a week in Zanzibar at the end. We used safari makers for our safari and they were fantastic. I couldn't have wanted anything more. On safari I was pleasantly surprised by Lake Manyara; the guide books do not do it justice. Zanzibar is fantastic - if you can, book for Kendwa rocks - although its in the north and on the west coast, the beach is phenomenal, there are a lot of young people, the sun sets over the sea (that sold it for me) and it is really good value. Book early though, they are popular.

(September-October 2008)
Places to go:
Peponi for a nice relaxing weekend which is cheap, close by and beautiful. Lovely food, beach and pool and the opportunity to go snorkelling.
Into the mountains (Lushoto): we stayed at Irente farm which was wonderful, and again quite easy to get to (3-4hours). The viewpoint is amazing and the farm makes all its own food (cheese, yoghurt, bread etc..)

(June 08)
Zanzibar: when I was here I was pretty much chilling out by the beach with snorkelling etc. Beware lots of hassle at the bus stand and ferry ports in Dar. For the ferry ticket, go directly to the offices and it should be around $30 for a fast ferry and you can ask for discount if in a group. You can then take a bus or a taxi (you can get a taxi for 35,000Ts, taking you up to kendwa rocks which is way up north. They often ask for dollars but will usually accept shillings. Good places to stay are Kendwa rocks and Nungwi village both really beautiful, lovely rooms and food - I think its worth going fully inclusive in both. Its worth going on the day trip when you are Kendwa rocks, (I think this can be organised at Nungwi village as well, through a guide so it might be cheaper to call kendwa rocks). should be $25 including food and gear.
Dar: A large city that I didn't connect with well. I stayed in South beach which you have to get a ferry to. This is near the fish market and costs 100Ts which arrives every 30mins from 5am to 8pm and you then need to get a dalla dalla to south beach 600Ts roughly. You will not be dropped directly here and it will take about 5mins to walk to following the signs for south beach. When you reach it unless you are pretty loaded, walk on down the road a bit until you reach a place called something village. Its pretty cheap at $52 for 2 people 2 nights if you opt for the bungalow. Food is quite expensive 10,000 per head. However its right on the beach and a really nice area compared to dar. You can go snorkelling and that here as well if you like. Its kind of like another Zanzibar. We only stayed for 2 nights but it might be more worthwhile to stay for longer. The other place we stayed in dar was near the airport at a place that you can walk to from Kili hotel (which is a great place to stay in if your really rich). Its best to ask for the YMCA hostel. A good cheap place to stay as well, apparently. However we stayed at a large tower place further up the road past the pizza joint (good filling pizzas at 10,000Ts) its called sophies. Nice rooms, tv hot shower air con and very secure and safe its about $80 I think for 2.
Lushoto:  Really nice place you can easily get a bus from Muheza, its a long drive but worth it. Its worth staying in Mama Mullers Mountain Lodge. Its more expensive than some other places but brilliant again great rooms, food is $10 each for a big great buffet. You will need to pay for guides if you go on walks and payments for it being a "protected area". You will have to get a taxi from the bus to the lodge.
Safari: we went with the Kelsi brothers it was really good and cost us $750 each for 5 days. Food accommodation everything included. Was worth going on. They told us we could pay with Visa and then they claimed their machine was broke and we had to pay cash. A good place to stay before you go on safari is the Buffalo lodge which is 30,000Ts for 2.

(May 08)
After Teule we got the bus to Arusha. Stayed at the Catholic Centre (need to book in advance, not the friendliest place and cost about 12000TSH pppn). We booked a Safari with Shildolya Tours, based in the ICC. Paid $650 for a 5 night camping tour to Lake Manyara, Serengeti & Ngorongoro Crater. Great company – good food, equipment & vehicle. Our guide wasn’t great at spotting animals but think that was luck of the draw – other guides with Shildolya were some of the best around so check how long they have worked as a guide.  
We pre-arranged our Kili tour with the Kessy Brothers – Machame 6 day trek, $1015 per person. We could pay park fees (about $600 on visa at the park gate so just had the $415 to pay in cash at their office). They booked us accommodation in the Buffalo hotel on the night before and after. Great route, excellent guides, equipment – provided so much warm weather stuff & sleeping bags which was great. Would definitely recommend Kessy Brothers for Kili. All 3 of us made it to the top. Tips are additional. 
Then we flew Kili to Zanzibar with Precision Air (cheaper than coastal) and stayed at Emerson & Green for a bit of luxury & then Echo Beach on the Machamvia peninsula (next to breezes). Lots of couples, but windy, not much to do except relax on the beach or by the pool. Like a 2nd honeymoon for me which was great but if you’re looking for a bit more socialising you may enjoy  Kendwa or Nungwi better.  

(Jan 08)
The CEFA hostel cefahostel@gmail.com - was by far the best accommodation we stayed in at Dar es Salaam -  they were lovely staff - looked after me when i had no bag and the incorrect currency and they were a great place to stay when first arriving in Dar es Salaam
$45 for a triple room - need to book well in advance - we tried booking our return trip to Dar es Salaam but they were booked out 8 weeks in advance. 
Sunny Safaris - they did an excellent 4 day safari but a very mediocre Kilimanjaro walk
would recommend them for the safari and best to use someone else for Kilimanjaro
Weekend Trip to Amani - this was a highlight and my favourite weekend away when in Muheza
 
(December 2007)
We took the dhow across to Zanzibar from Pangani (near Muheza) which was fine (although someone has told me since that it is illegal not to enter through stone town so it might be worth looking into that if anyone else is planning on doing the same thing, we didn't get into any trouble though!). We stayed at Kendwa Rocks and Robinson's Place in Bwejuu which were both great. We then flew to Arusha which was terrifying on the tiny Costal Aviation planes but we made it safely! When we got to Arusha we did a safari with a company called Crown Eagle Safaris - the second half was great but the first driver we had was not good and turned up on the second morning drunk, so he had to be taken back to Arusha by the police and we had to wait for another driver to come from Arusha to take us on to the Serengeti! So we missed quite a bit of time but they did refund us some money when we returned (after a bit of an argument unfortunately). The safari was amazing and we saw lots of beautiful animals and scenery but it was cold (as you told us!).

(September 2007)
We organised a four-day Safari in Arusha with Swala Safaris (tel 250 8424) which cost $800. This was a family-run company who provided excellent service, a brilliant trustworthy guide and safe vehicle. They organised accommodation for us which included a variety of tents and lodges. We visited Lake Manyara National Park, the Serengeti and Ngorongoro Crater, as well as visiting a Maasai village. I would thoroughly recommend them to any student travellers. After our safari we flew to Zanzibar with Precision Air from Kilimanjaro Airport for 168500 TZS. Once in Zanzibar we stayed in the Jambo Inn hostel which was clean and well situated. We organised a half-day tour to Prison Island with Tropical Tours and Safaris, for $20, which was a relaxing day where we could appreciate the beauty of Zanzibar and the Indian Ocean. With the same company we booked a dolphin tour and snorkelled with dolphins - an amazing experience.

(August 2007)
We went on a 4 day safari with Swala to Lake Manyara, Serengeti, ngorongoro crater and Tarangire national park. It was about $850 each but we stayed in luxury tents and a lodge and there were only 2 of us and it gets cheaper if there are more of you to share the car and driver, or if you camp. The driver/guide was exellent and so was the food and accommodation so I'd definitely recommend the company. When we were in arusha, we stayed at Mount Everest hotel, which was fine but nothing special. We then flew from Mount Kilimanjaro Airport to Zanzibar with Precision Air, which was approximately $150 each. I did a further 4 weeks on Elective in Mnazi mmjoa
hospital in Stone town (which to be honest I probably wouldn't recommend as somewhere to go for elective). In stone town, we stayed with a local family but some of the other students stayed at florida guesthouse/flamingo guest house/jambo brothers. All of which are in the lonely planet, were $10-$15 a night and seemed to be nice places to stay. If you are at a loss for what to do in Stone town one afternoon, you can use the pool (and sun terrace)at Tembo House hotel for 3000Tsh. My favourite beach on Zanzibar was at Paje, where we stayed at Crystal, and shared one of their beach huts between 3 of us ($75 a room)... its a really nice place! We also went to Kendwa rocks
($10 night dorm) and Nungwi. Both of which I would recommend a trip to. From nungwi we went on a day snorkelling trip to Mnemba island which was fantastic snorkelling if you don't fancy diving.

(June 2007)
We went on safari with Intrepid and did the Serengeti Trail (8 days) which worked out at just under £500 I think. It was a really amazing trip and we were lucky to see all the big 5! We were in tents for the majority of the time and the two nights camping in the Serengeti was nasty-no facilities whatsoever!! It would cost an absolute fortune to stay in accommodation in the park though so it's safari on a budget! We set off from Kenya so it meant travelling by bus from Tanzania. This worked out pretty cheap and easy and was actually quite fun (there was a hold up due to an overturned lorry on the way to Kenya and we got chatting to some locals!) Plus it was great to see Nairobi and we stayed in a gorgeous hotel (PanAfric). I would recommend this tour to anyone if there not too worried about leaving home comforts for a few days and mucking in with the odd bit of cooking/cleaning. The rough guide to Tanzania was my source of all knowledge-better than lonely planet in my opinion.

(June 2007)
We climbed Kilimanjaro and did a 5 day safari in the Serengeti, Ngorongoro and Tarangire.  We did both of these with Bobby's Tours who were allright but not special and we met other people who had had a lot of trouble with vehicles. Ours didn't seem to have a choke and needed bump starting which was interesting but otherwise there were no problems.  Safari cost $600 each for 5 people and Kili was $960 each for 2 people plus a massive amount in tips which made it quite expensive.  In Arusha we stayed at Monjes guesthouse which was cheap and nasty but adequate and in Dar we stayed at YMCA which was pretty good value at $10 per room.  Then we went to Zanzibar and spent a couple of days in Stonetown
before going to Paje which was beautiful and really chilled out.
  
(April 2007)
We took the Kizota line bus to Arusha, organised by Jackson for TSh10,000, on which we all had an allocated seat which was comfortable (no air-con but when the bus was travelling with the wiondows open in was not too hot) and driven pretty safely (by Tanzanian standards!). On arrival in Arusha we spent a night in Meru House Hotel. It was US$9 for a double which was noisy but reasonably secure. After that we moved to the Arusha Backpackers Lodge (the new name for Da Costa Hotel) which was US$10 for a double (there was a choice of having a window but being next to the road where it was very noisy, or having a quiet room in the centre of the building with no windows). We ate at the Masai camp, a camping place out of town (taxi ride TSh3000) which had a good bar and food but was very ex-pat orientated and not everyone's cup of tea. 
The following day we booked a combined safari and Kili climb with Jackpot Tours. We looked at three tour companies (all of whom offered pretty much the same thing) and Jackpot was by far the cheapest at US$1250 after some bargaining. Our safarin included a day in Ngorongoro conservation area with a morning on the crater bottom (more than enough time for us to see elephants, buffalos, black rhinos, cheetahs, lions, hippos and much more - although apparently we were very lucky to see all this, it doesn't always happen like that!), a day and a half in the Serengeti National Park and a day in Lake Manyara national park (in our opinion well worth going to - its a beautiful park and its not included in some of the packages). Accommodation was in tents which were confortable and dry and we had good food from our chef (althought the repertoire for vegetarians was getting a bit samey by the end of the kili climb). Our guide was very knowledgeable and had the sharpest of eagle eyes when it came to spotting the animals! 
We moved to Moshi after our safari and stayed in Buffalo hotel for US$15 for a double room, en suite with hot water and quiet, which was opposite a good restaurant serving Indian and Italian food cheaply. We took the Machame route up the mountain over 6 days. It was fairly hard work but the climb never got too steep and there was only one scary bit when we scrambled up a fairly steep cliff on the third day. It was beautifully scenic, much more so than the Marangu route according to our guides. Of our group of five, three got to the top and Fionna and I turned round 200m or so from the top because i was getting sick from the altitude. Those that did make it said that it was the most miserable experience of their lives (temp down to -15 to -20 degrees in the crater at the top, in the dark) but I'm sure they don't regret doing it now. We were able to hire equipment in moshi but it was very expensive. Essentials are: layers (it gets hot during the day so a thin waterproof windcheater is much better than a thick sky jacket for the climb), head torch, waterproof gloves, sunglasses, waterproof walking boots, a hat, SUNSCREEN (which must also go on the lips, we all got very sore lips by the top) and water bottles (preferably 3-4 litres worth as the only water available is boiled at the camp and you can't fill up during the day). 
After we got down from Kili, we bought a ticket for the plane from Kilimanjaro to Zanzibar from a travel agent by the clocktower roundabout in Moshi which cost US$120 each. We then rounded our holiday off with five relaxing days on the beach at Kendwa Rocks, just down the coast from Nungwi, a quiet stretch of beautiful beach with a few restaurants and nothing to do. Perfect! 

(February 2007)
The tour company we used for our safari was called Ecotours.  The guy who runs it is Philip Mong'ateko.  His phone no is +255 27 275 1480.  His cell no is +255 784 204 753 or +255 754 274 546.  Email him on tafet_2005 at yahoo.com or info at ecotourism-tz.com.  We did a four day 3 night
lodge safari going to lake manyara, ngorongoro crater and serengeti with drop of in north serengeti to pick up the bus to mwanza on lake vic.  The
4x4 was great - no breakdowns.  The drivers english was excellent and he was really friendly and helpful and the food was fantastic in the lodges -
buffet breakfasts, then amazing packed lunches with more than you could eat and 3 course dinners in the evening.  Far more than you need after
being in a car all day!  That cost $600 per person based on 4 people sharing the vehicle...The price was good for the lodges because we were in
low season, it would have been $550 per person if we had camped instead...
A friend of mine also climbed Kili with this company - it was him who recommended the company to me in fact.  He did a 6 day climb with a guide,
a cook and 2 porters all to himself for $800 i think.  He summitted and returned safely if knackered!  He couldn't speak highly enough of the team
who accompanied him.
We then took a bus from Mwanza to Kigoma - it was the worst journey of my entire life (28hours!) but worth it to see the chimps in the Gombe stream:)

(February 2007)
These two blokes went from Dar overland along the coast to the Mozambique border and then all down Mozambique and flew out of Jo'burg .......
I would however advise the students to fly to Mtwara rather than take the bus, after ours broke down about 3 hours south of Dar leaving us stranded for over 9 hours.  The main drawback to flying being that you miss a large chunk of the Tanzanian coast doing so.  The border crossing was an adventure in itself, and we made it across in a small boat with about 20 other people. We got to the border from Mtwara by jumping on the back of a truck that picks up people from the Chalize hotel in Mtwara (can recommend, cheap & clean) at about 5 am. The Mozambique immigration is just a mud hut, manned by 2 guys with guns.  I would definitely recommend that you have visa's for Moz before attempting this route :) 
Travelling by public transport in Mozambique is generally easier than Tanzania, as there are more tarmacd roads and better buses (especially as you head further south).  A trip to Ilha de Ibo is also well worth the effort. 

www.oneglobe.co.tz - used for both Kili and safari.  "They were very professional and thorough." (February 2007)

(January 2007)
I took the ngorika bus to Arusha (no fuss, no fleas), stayed in the Arusha Backpackers Hostel (formerly Hotel D'Acosta - really good place to stay as there is a bar with lots of people), did my safari with Victoria (also good) and then flew down to zanzibar with Costal Aviation. In zanzibar I stayed in the Pyramid Lodge, which was pretty good, though i think the atmosphere is better in the Jambo hostel. I did my tours with Mr Mitu, both were brilliant especially the spice tour. In Dar, I stayed in the Jambo Inn, which was also fine. 

(December 2006)
I went with SWISCO (Small World Initiatives for Woman and Childrens Orphanages or something, ex-Collins Safaris), an NGO based in Moshi.  As they are an NGO they offered a good price for climbing Kili and a 2 day safari.  Being a small company they tailored it to what I wanted.  They tend to add you to another company, though for the Kili trek I was in a group on my own though I shared a cook with a party of Americans.  I didn't particularly like the guide as he tended to bully the porter and was too preoccuppied with dropping unsubtle hints about tips, however I understand they use a number of guides.  The operator Tamimu Collins was very helpful. There are plenty of people to harrass you in Moshi, and I understand the prices are going up.  Pay in dollars.  I paid $1200 for the six-day Machame trek, a day in Lake Manyara, a day in Ngorongoro, a bus back to Dar and all food and accommodation.  The tents were comfortable and the food excellent. 

(November 2006)
We travelled independantly to Zanzibar, then to Kilimanjaro where we (along with my father who joined us at this stage) used the Marangu Hotel to organise a trek. They are not the cheapest operators in the area, but certainly the best in terms of experience, safety, sustainability and fairness to porters. The hotel is a wonderful place to stay too. I would highly recommend them-
Desmond Brice-Bennett (director)
Marangu Hotel Kilimanjaro
P.O.Box 40, Moshi, Tanzania
EMail:  marangu [at] africaonline [dot] co [dot] tz
EMail:  info at maranguhotel.com
Telephone:  +255 27 2756594/2756361
Fax:  +255 27 2756591
Mobile:  +255 (0)744 886092
www.maranguhotel.com
We also went on Safari with their sister company, 'Safari Images', however, although we had a great time, we felt perhaps that we had been slightly overcharged. I would recommend shopping around a bit but this company certainly is excellent in terms of experience and knowledge. 

(October 2006)
I climbed Kili with Zara. Everyone I talked to said Zara were one of the best operators to climb Kili with. They got me up and down the mountain ok, provided good food, guides and porters. I would advise to try and book with Zara direct, as I went through STA, which proved expensive, but I guess they do everything for you so its less hassle. 
I also went to Zanzibar but not with any operator or tour company. I enjoyed it and recommend it to anyone travelling in Tanzania. 

Back to StudentElectives
[>img[where is Muheza|http://img263.imageshack.us/img263/586/tzmapshowmhzio7.jpg]]Muheza is a small district town in the North East of Tanzania 40 Kms inland from the port of Tanga and about 100 kms south of the Kenyan border. It lies at the foot of the East Usambara mountains on the edge of the coastal plain. Until July 2007 Muheza District stretched from the Kenyan border to just north of the Pangani river, with a total area of 4922 km2. 90% of the 280,000 population lived in the rural areas. In July 2007 Muheza District was  split in two roughly along the line of the Zigi river with Mkinga District to the north and Muheza to the south. As yet Mkinga District does not have a District Hospital and its health care facilities continue to be supported by Teule Hospital. 



Dr Rajabu Mallahiyo (Medical Superintendant) trained in Dar es Salaam and has an MPH from Muhimbili University.
{{borderless{
|[img[Rajabu|http://img186.imageshack.us/img186/2694/rajabukn6.jpg]]|
}}}
  
Dr Leonard Mndeme trained in Dar es Salaam and works mainly in the medical wards
Dr Leonard Mbago trained in Cuba and gained a Masters in Surgery at KCMC.
Dr Mjema Mnkondo trained in Dar es Salaam and works within the Aids Relief programme.
{{borderless{
|[img[Mndeme|http://img407.imageshack.us/img407/8711/mndemesf9.jpg]]|[img[Mbago|http://img408.imageshack.us/img408/1153/mbagorg9.jpg]]|[img[Mjema|http://img507.imageshack.us/img507/6184/mjemabv5.jpg]]|
}}}

Dr Elice Bendera trained in KCMC and is working in Paediatrics.
Dr Hadija Mbaga trained in Dar es Salaam and is working in Medicine.
Dr Jessica Lebba trained in Dar es Salaam and is working in Medicine.
{{borderless{
|[img[Elice|http://img838.imageshack.us/img838/7361/elice.jpg]]|[img[Hadija|http://img402.imageshack.us/img402/3958/hadija.jpg]]|[img[Lebba|http://img140.imageshack.us/img140/6002/jlebba.jpg]]|
}}}

''Senior Assistant Medical Officers''
Dr Charles Chagonja (ENT and Anaesthetics) currently working in anaesthesia and ENT.
Dr Bashiri Mmbare (anaesthetics) currently working in anaesthesia and O&G.
Dr Jonathon Senyota (Dermatology) currently working in medicine.
{{borderless{
|[img[Chagonja|http://img176.imageshack.us/img176/2357/chagonjauj6.jpg]]|[img[Mmbare|http://img125.imageshack.us/img125/1059/mmbareeo5.jpg]]|[img[Senyota|http://img33.imageshack.us/img33/451/senyota.jpg]]|
}}}

''Assistant Medical Officers''
Dr Helga Nnko (HIV), Dr Penina Mkwema (Paeds) and Dr John Kibaja (Surgery) 
{{borderless{
|[img[Helga|http://img101.imageshack.us/img101/4207/helgaa.jpg]]|[img[Penina|http://img166.imageshack.us/img166/3896/peninalv3.jpg]]|[img[Kibaja|http://img155.imageshack.us/img155/6150/kibajacn5.jpg]]|
}}}


''Nursing Staff''
Itikija Mbaga (Matron), Anna Kimaro (Assistant Matron), Lawrence Mbezi  (Patron)
{{borderless{
|[img[Itikija|http://img515.imageshack.us/img515/2766/itikijaft2.jpg]]|[img[Anna|http://img407.imageshack.us/img407/3259/annafce.jpg]]|[img[Lawrence|http://img821.imageshack.us/img821/7109/lawrencej.jpg]]|
}}}

Chris Mselemu (Executive Secretary)  Rev Chimani (Hospital Chaplain) Elizabeth Chigua (Principle of the Nurse Training School) Clare Chizazi (Manager of the Diana Centre)
{{borderless{
|[img[Chris|http://img132.imageshack.us/img132/8479/w1zf.jpg]]|[img[Chimani|http://img339.imageshack.us/img339/7030/rogas.jpg]]|[img[Elizabeth|http://img168.imageshack.us/img168/4999/elizabethyy1.jpg]]|[img[Clare|http://imageshack.us/a/img91/4844/clare.jpg]]|
}}}
}}}
The hospital supplies medical services to a population of about 180,000 covering an area 50 kms by 50 kms.  It provides primary health care for the town and acts as a referral centre for the 27 outlying village dispensaries and two health centres. A large number of patients attend daily in the adult and Maternal and Child Health Clinics.  There are doctor lead clinics in medicine, surgery, obstetrics and gynaecology, palliative care  and paediatrics. There are currently seven doctors, six Assistant Medical Officers and 12 Clinical Officers.  At the Nurse Training School there is a 3 year diploma course in nursing and midwifery which is direct entrance and a 1 year upgrading course from Cerificate to Diploma level. There is an HIV / palliative care centre which has access to free anti-retrovirals and includes a PMTCT service. There is an X-ray department and an  ultrasound machine.  The pathology laboratory performs microscopy, haematology, some biochemistry, bacterial cultures and CD4 counts. There are dental, eye and physio services. There is always a shortage of equipment, drugs and dressings although not as bad as at some other hospitals in Tanzania due to support from the UK. 

Back to StudentElectives
''Malaria'' is common and mostly chloroquine – resistant falciparum. You should take advice before travelling here.  We recommend mefloquine, doxycycline or malarone.  Insect repellent is advised as are bed nets which are supplied. These are probably more useful than the drugs.

''PEP'' - get advice and a supply of antiretrovirals - a "starter" pack is fine.  If you do have a needle stick injury, we ask you to let us know as soon as possible, and you will be counselled and will be recommended to have an HIV test. We do have some PEP but not much with a PI so would rather you brought your own and then you can be certain of accessing it if you need to rapidly. We do have gowns, masks and gloves reasonably available but bringing some extra clean gloves is always appreciated. You can't rely on finding googles around and they are highly recommended whenever you do a procedure as splashes can occur easily

''Yellow fever'' certificate is mandatory (although we have never actually been asked for evidence or seen a case). 

Other ''injections'' - You will need the usual vaccination for tetanus, typhoid, hepatitis A+B etc.  Rabies is endemic but uncommon. Vaccination is available here but may be hard to access timeously. 

''Medical Insurance'' is of course a must with access to finance for airlifts out (easy to organise from Muheza if needed).

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