Jessica Bauer, M.D., Reflection – Exploring pediatric global health in Tanzania

Jessica Bauer, M.D., a MUSC pediatric resident, was awarded a Center for Global Health Student & Trainee Travel Grant in late 2024 to pursue a global health project Tanzania. View more photos of her time in country in this Flickr photo gallery.

“This is now your patient. Carry her on your shoulders, take responsibility for her, and fall in love with her because if you don’t, no one else will."

We stand bedside of a teenage patient as a local Tanzanian surgeon speaks these words to his new intern. Rather than pointing out her missed morning lab work or the errors in the intern’s presentation, he instead focuses on the patient in front of us, getting to know she and her mother, ensuring his team does the same. He makes sure they understand her complex past medical history and what has led her to this hospital admission, still with more questions than answers on her condition. He also makes sure his team focuses on her as an individual rather than another task to check off on their long list of to-dos.

When I think back on my time working at Selian Lutheran Hospital in Arusha, Tanzania, it will be interactions like these, between physician and patient, that I will take with me and remember most.

Prior to our global health trip, I thought the biggest difference I would see between our American healthcare system and that of Tanzania would be in hospital resources and level of care. And while this was true, with my skills as a physician being tested regularly, it surprised me most to discover the immense focus on community and patient care that each physician in Tanzania brought to their job daily.

Staff who worked at Selian were not only doctors or nurses, but members of the hospital’s community at large. Each day in Tanzania started the same: morning chapel offered on the hospital campus, attended by the majority of physicians and trainees, followed by a physician’s meeting. Every specialty at the hospital attended this meeting and interns would present new admissions who came in overnight to the entire staff, prompting collaborative input on differential diagnoses and workups.

What was most striking about these meetings, however, was the additional presentation of patient deaths. Every death that occurred in the hospital over the past 24 hours would be presented, not only from an educational standpoint, but as a way to give one last remembrance to the patient whom had passed. This level of medical care, rooted in empathy and compassion, was something I rarely experienced during my years of training in the U.S. Not only spending time to remember each individual who passed away, but to do so as a whole hospital community, regardless of specialty, demonstrated just how much these physicians focused on their patients as an individual rather than another admission. A contrast to the sometimes impersonal healthcare that we can see during our training in the U.S.

As anticipated, my time in Tanzania expanded my medical knowledge and taught me how to treat common pediatric conditions with limited resources. The experience exceeded my expectations, however, in also teaching me how to better focus on engaging with patients on a deeper, more personal level.

Watching the surgery team connect with their patient reminded me that the best care not only comes from prescriptions and interventions, but also in understanding each patient’s needs, making them feel seen, valued and heard. Being a part of the daily physician’s meeting and hearing the stories and names of the patients who passed will also stay with me throughout my career. It will remind me to step back from the fast-paced healthcare we can fall into delivering, and instead focus on each patient as an individual. Focus not only on the patient’s symptoms, but also on their life, their struggles, and the family they have waiting for them outside of the hospital.

Throughout our global health trip we provided a lot of education to the physicians and trainees in Tanzania, but I would argue that they left us with something much more valuable – the reminder that medicine is so much more than symptoms, labs, or prescriptions. Medicine is about community, connecting with those around you, and treating the individual, rather than the disease.