ugando Medical Centre is one of four major hospitals in Tanzania, an east African country of 32 million people. With only 1,200 doctors, Tanzania depends on international help, especially in anesthesiology. I spent a month of my CA-3 resident training in Bugando. It was a valuable experience, an incredible adventure and something I will remember forever.

I found the position through Health Volunteers Overseas, which assists anesthesiology programs in several countries, and the Society for Education in Anesthesia (SEA), which sponsors instructors for Bugando. I also received a SEA/Ronald L. Katz Traveling Fellowship from SEA. My department chair, medical school dean and American Board of Anesthesiology administrators approved the month as part of my residency training.

Figure 1. Bugando Medical Centre Anesthesia Department, with Dr. O’Bannon in front.

Bugando is located in Mwanza, a city of 600,000, on the eastern shore of Lake Victoria. Mount Kilimanjaro, the Seregenti Plain and the Olduvai Gorge, site of the earliest humanoid skeletons, are nearby.

Bugando lists 800 beds, and I saw as many as four infants in one bed. The need for health care at Bugando is great, and the capacity limited. During my time there, two anesthesiologists, several assistants and a dozen students provided the anesthesia. Figure 1 shows this collegial group. General, trauma and gynecologic surgical procedures predominated, reflecting the specialists present during the month.

My typical day started at 7:30 a.m. with morning report. Call personnel reported on overnight activities, and nurse anesthesia students presented their cases for the day. After morning report, I either worked in the operating theatres or attended intensive care unit rounds. After lunch I prepared lectures that I gave at 3 p.m. to the anesthesia or medical students.

Our primary anesthetic drugs were thiopental, ketamine, halothane and ether. I learned to use draw-over vaporizers, the Epstein-Macintosh-Oxford for ether and the in-line Oxford Miniature for halothane.

The overseas training month required planning. In addition to program approvals, I needed a visa and immunizations. I received meningococcal, yellow fever, hepatitis A and typhoid vaccinations as well as polio and tetanus boosters. I took prophylaxis for malaria and carried medicines for amoebic dysentery. Reviewing reports of recent trainees, I learned that men wore slacks and short-sleeved collared shirts. I would advise good walking shoes and a small backpack.

The ASA Web site provides information about the ASA Overseas Teaching Program at <www.ASAhq.org/OTP/homepage>. Links are available here to Health Volunteers Overseas as well as Interplast and Operation Smile. The Web site also shows the two draw-over vaporizers.

The author thanks Robert E. Johnstone, M.D., for his assistance in preparing this article.

Robert T. O’Bannon III, M.D., is Anesthesiology Chief Resident, West Virginia University, Morgantown, West Virginia.