A Few Things To Know About Travel To East Africa

The East Africa Medical Assistance Foundation can direct you to the appropriate agencies for organizing a trip to East Africa. However, here a few things to know:

What are the best times to travel?

If your travel plans would be affected by the weather, you may want to consider that East Africa has two main rainy periods. Heavy rains occur between March and May. During this time, the area receives the bulk of the water it will get over the coming year. The "short rains" are much smaller in quantity and occur from October to November.

What kind of clothing should I bring?

Lightweight, tropical clothing is worn year-round. In the cooler season (June to September), a light jacket may be needed in the evenings. Due to cultural sensitivities, conservative dress is recommended.

How do I get there?

Travel to Tanzania is actually quite simple. The easiest, most direct route is to fly KLM Airlines directly to the Kilimanjaro International Airport, which is located between Moshi and Arusha. Although more convenient, it will be more expensive than less direct routes.

Another option involves flying to Nairobi, Kenya, and taking public transportation to Moshi, Tanzania. One foundation volunteer flew to England, and then took an Air Kenya flight to Nairobi, followed by a DHL (the international shipping company) bus directly to Moshi. He felt that this route was safe, and was less expensive than a direct flight to Kilimanjaro. A third option involves flying into the city of Dar es Salaam, and then taking an Air Tanzania flight to Kilimanjaro.

Do I need a visa?

Visas are required for all Americans entering any East African country. If you plan to also travel to Kenya, a visa must be acquired for both Kenya and Tanzania. Most travel agents booking your flight have a visa service which can be more convenient than trying to go through embassies in Washington, D.C. Note that embassies can be quite slow -- you should begin preparation for visas at least four to six weeks in advance of your departure.

What immunizations do I need?

Since immunization recommendations can change, you should contact an International Clinic near you for specific information. However, current recommended immunizations include yellow fever and cholera. Recommended vaccines include a tetanus booster, hepatitis B, and meningococcus. In addition, malaria prophylaxis is recommended. Malarone, probably the recommended form of prophylaxis, is taken once a week, and should be started at least two weeks before visiting Africa, and continued one week after returning.

What about lodging?

Lodging can be arranged in the medical compound at the Kilimanjaro Christian Medical Center. If you plan on staying in the Tanzanian capital, Dar es Salaam, book your hotel early, as the city seems to be booked solid much of the year.

What kinds of transportation are available?

The frank answer is that, unless you own your own vehicle, transportation in Africa can be difficult. Public transportation is probably the best alternative. There are very convenient forms of public transportation between major cities. Tour agencies can provide transportation, but it can be expensive. Renting a vehicle can be very difficult.

What about communicating in and out of the country?

A letter from Tanzania takes at least two weeks to reach the United States, and about two weeks to get an answer back. Direct-dial telephone and cable services are available to the United States and other parts of the world. Phone/fax service from the United States to Tanzania is actually quite easy and relatively inexpensive. However, calling/faxing from Tanzania to the United States can be difficult. The best plan for communicating with people in the U.S. is to arrange times that they can call you. Tanzania is eight standard time zones ahead of eastern standard time in the United States, and does not observe daylight savings time.

E-mail is readily available at Cyber Cafes.

What are the prices like?

Prices in Tanzania are cheap for local residents and much higher for tourists. Therefore, you may want to consider procuring a license/work permit -- even for a short visit. This can be arranged through the foundation. Having the work permit will allow you to get Tanzanian rates, which, in many cases, are half of what you would pay as a tourist for lodging, entry fees for parks, etc. Note, however, that work permits cannot be obtained for less than two months. Also, negotiate things such as taxi fares and rates before you ride. Also, establish with tour companies what is expected as normal for tips and gratuities for their guides and porters. It is much easier to negotiate before rather than after.

Can I bring my family?

You can feel very comfortable bringing your family along. There are a large number of Americans and Europeans living, working, and volunteering around the KCMC. There are families of expatriates living at the KCMC with children from infants on up.

What are the current economic conditions?

Although it is a poor country, Tanzania is fairly successful at feeding its people, and hunger is not a significant problem. The economy is heavily dependent on agriculture, which employs about 90 percent of the work force. Topography and climate, however, limit cultivated crops to only about 5 percent of the land area. However, recent growth has featured a rise in industrial production and a substantial increase in output of materials. Recent banking reforms have helped increase private sector growth and investment. Agricultural production consists mainly of coffee, tea, sisal, cotton, cashews, tobacco, cloves, corn, wheat, bananas, fruits and vegetables. Industries are primarily agricultural processing, diamond and gold mining, oil refining, shoes, cement, textiles, and wood products. The United States has historically sought to assist Tanzania's economic and social development through bilateral and regional programs administered by the U.S. Agency for International Development (USAID). The AID program of the 1990s has emphasized improving the rural transportation network, private enterprise development, and family planning.

What are the current political conditions?

In 1991, a special commission was appointed to examine and recommend fundamental reforms of the Tanzanian political system. At the end of 1991, Tanzania began another attempt at democratic and economic reform in order to change its autocratic single-party state system. Low pay, combined with obsessive secrecy and lack of accountability had led to fraud and corruption. In early 1992, the government adopted a multi-party democracy. Legal and constitutional changes led to the registration of 11 political parties. Two parliamentary by-elections in early 1994, which were contested by most parties, were the first-ever multi-party elections in Tanzanian history. The current President is Benjamin Mkara. Tanzania is a functioning democracy with a free press. The United States enjoys cordial relations with Tanzania.

What about the work?

Working with Dr. Diefenthal is a fascinating experience. Imaging modalities include plain films, and extensive ultrasound work, including cardiac, and some fluoroscopic work such as barium and IVPs. You will undoubtedly find yourself introduced to a wide range of pathologies which you may only have read about. In addition, you will be exposed to new uses of ultrasound which are seldom, if ever, incorporated in the United States. There is a large amount of work done in cardiac echo, especially in young and pediatric patients who suffer from a variety of maladies, particularly from the effects of rheumatic heart disease as well as congenital anomalies.

Volunteer Opportunities For Radiologists At KCMC

The Kilimanjaro Christian Medical Center, (KCMC) is a 500 bed teaching hospital at the base of Mount Kilimanjaro and the site of the only Radiology residency in the country. In 1988 Helmut and Ro Diefenthal returned to Tanzania to work and teach at KCMC. Since then, many Radiologists and some Radiology residents have visited KCMC to work with the Diefenthals and contribute to the residency. There are residency programs for two year AMO (Assistant Medical Officer) residents and four year MD residents. We do not have the equivalent of AMO’s in the USA, but they function as physicians and serve in general practice and in some specialties. The majority of our AMO radiology residents provide the only radiology expertise in local hospitals. Our MD residents are becoming the leaders in Radiology in Tanzania.

How long do I visit, what do I do?

If you are traveling in East Africa, and want to stop for a day or two to see the hospital and program, please do!! If possible let us know ahead of time when to expect your visit.

If you want to volunteer, we encourage visits of a month or longer. Most visiting physicians want some time to see the sights of Tanzania. It also takes some time to get over jet lag and get used to the routine.

Visiting Radiologists cannot do final reads on studies, any more than a visiting Tanzanian Radiologist could do final reads at a hospital in the USA. If you are planning a visit of six months or longer, you may want to go through the process of getting a Tanzanian license. However there is a lot of value you can add to the day at KCMC without getting a license. The day starts with teaching rounds with the different hospital specialty services, and includes reading CT, plain film, and some mammography and fluoroscopy, but the residents spend a good portion of the day performing Ultrasound exams. Visiting Radiologists may bring prepared lectures or cases, review current cases with the residents, or spend time with the residents in Ultrasound. Sitting at the view box and analyzing a CXR or KUB with a resident is greatly appreciated. Power Point or slide presentations can be given, and at the end of the day you can have a beer with a Tanzanian resident and learn about their life!

Where do I stay?

An efficiency apartment in the Doctor’s compound a short walk from the hospital can be rented for under $200 a month and we can arrange this for visitors There are restaurants and a hospital cafeteria, but food at nearby Markets is plentiful and good. There are always many visiting physicians from the USA, Canada and Europe working at KCMC at any time giving an international flavor to the hospital. A rental car is useful but not essential.

Whom do I contact?

Because of the size of the department at KCMC, we try to space out visiting radiologists so that there is one visiting at a time. The East Africa medical Assistance Foundation can be contacted through our web site and we can answer questions and check on dates. Once you have decided to make a visit for more than a few days, a courtesy letter should also be sent to Dr. Mark Swai Director of volunteer services with the dates of your visit to the KCMC Radiology department.

Address:
Dr. Mark Swai.
“Office of International Collaboration”
Kilimanjaro Christian Medical Center
P.O. box 3010
Moshi, Tanzania.

How do I get there?

There are international flights to the Kilimanjaro Airport, which is close to KCMC. Some visitors have flown into Nairobi Kenya and taken land transportation, but we cannot recommend this at this time.

What else is there to see?

Where do we start?? You will be near to Tarangire National Park, Lake Manyara National Park, Ngorongora Crater, Oldupai Gorge, Serengeti National Park and of course, Mount Kilimanjaro. Dar es Salaam is a short flight away. Safaris can be arranged through local companies, or we can give you the name of a reliable US travel agency that specializes in Tanzanian travel.