Utrecht University Medical Center offers students the possibility to follow a part of their electives abroad. The University collaborates with several foreign hospitals. 

The optional elective clerkship ‘primary health care’ in Machame Hospital, Tanzania is meant as a 6 to 8-weeks elective for fifth or sixth year medical students.

Essence of this elective clerkship is the amassing of knowledge about primary health care. The student improves her/his knowledge about primary care while practicing this fundamental part of medicine in a transcultural setting. Due to the language barrier the first weeks of the clerkship are predominantly observational. Most of the elective period will be spent in Machame Hospital some in dispensaries and outreach work. Since this is a primary health clerkship, the student is preferably less involved in second-line medical care (e.g. surgical theatre) but more in new admissions in medical wards and obstetrics and in the out patient department.

This course manual serves as a guideline for students preparing their elective in Machame Hospital. The manual contains both practical information about preparations and stay in Tanzania, and educational information and assignments.

Required foreknowledge

The student is expected to have gained general medical knowledge in her/his former  years of study, especially during the courses KLO, PLO, the subjects 1.5 and 3.3 ‘ Infection and immunity’ , 1.7 en 4.1 ‘ Obstetrics’  and has clinical experience of at least the third year electives internal medicine and surgery. The third year subject ‘ Healthcare in developmental countries´ and the fourth-year clerkship ‘gynaecology’ is strongly advised. A Swahili-course is compulsory (see practical information).

Educational goals

• The student gains knowledge about the organization of primary healthcare in Tanzania and can compare this knowledge to the healthcare structure in Holland.
• The student is aware of the limitations of healthcare in Tanzania and is able to practice medicine with limited diagnostics.
• The students learns about the difference in morbidity of diseases between developed and developing countries.
• The student gains insight in the basic needs and the organization of community health care.
• The student is able to overcome cultural differences and language barriers in practicing medicine
• The student has knowledge about the most common tropical diseases (epidemiology, clinical presentation, diagnostics, treatment) in Tanzania.
• The student improves her/his clinical (primary healthcare) skills by working in the Outpatient Department and in the dispensaries.
• The student is able to assess severity of disease and is aware of the difficulties faced when deciding about referral of a patient.
• The student learns the basic skills and knowledge of  mother-and-childcare and cooperates on the obstetrical ward. 
• The student is able to perform  and interpret  basic diagnostic laboratory tests.
• The student is able to share knowledge and has taught at the local clinical officer school.
• The student is aware of her/his knowledge and her/his limitations and consults others  if necessary.
• The student is able to reflect on her/his behaviour and feelings and can find help in coping with stressful events if necessary.