Muhimbili National Hospital in Dar Es Salaam, Tanzania
The devastating burden of reversible critical disease claiming the lives of children in impoverished nations has necessitated the emergence of pediatric critical care education and urgent resuscitation training. This burden is evident in the reality that 1 in 12 Tanzanian children die before celebrating a 5th birthday. Muhimbili National Hospital (MNH)—the center for education of nurses, ancillary health workers, and physicians—trains clinicians who provide care for patients within the capital city as well as those throughout Tanzania. However, these clinicians practice in an environment stressed by a paucity of resources and lack of instruction in critical pediatric illness. Upon my first invitation to MNH, I witnessed the challenges these providers face while attempting to treat critically deteriorating children. At the request of the providers at MNH, I began to develop a locally adapted curriculum and further resources for pediatric acute care. Over the past five years, I have had the privilege to partner through ADAPT with Tanzanian physicians in the establishment and continuation of acute care training, research, and mentorship. I hope to return to MNH in September 2015 to continue working with Doctor Mgelea, Doctor Shoo, and the providers at Muhimbili. I plan to reunite with local physicians through cultural understanding and situational awareness. I will use a validated reassessment tool to measure the current burden of disease as well as methodically prioritize the evolving learning priorities of those who provide care. I am also eager to return to morning case conferences and to again participate in practice based learning at bedside rounds in the acute pediatric care unit. I plan to persist in the delivery of structured simulation instruction using the understanding I continually adapt and develop during each onsite hospital evaluation. The evidence collected through these initiatives, I expect, will provide data for prioritizing education throughout the Tanzanian Health System and support future development of clinical research and medical advancement.