Anna Faulkner went to Tanzania and found that the reality was harsher than she'd imagined

Before I finalised my elective plans, I went to a symposium organised by my medical school. I had decided to go to Tanzania in eastern Africa, so the advice on HIV, malaria, and rabies was particularly useful for me. The lecture given by a consultant in infectious diseases firstly advised us against going anywhere—particularly sub-Saharan Africa—that had a high prevalence of HIV. We were warned that medical students were not permitted to undertake any invasive procedures on patients known to have HIV. If we went against the medical schools advice, then we were advised not to do any surgery, obstetrics, or blood taking. They suggested that we should go only to a hospital that had clear guidelines on needlestick injuries and antiretroviral medication available.

We were discouraged from taking our own post-exposure prophylaxis with us, because we were not responsible enough to self prescribe, especially when under stress. We were given a booklet that went through all the health and safety issues, and advised to see the health service at the university to make sure we had the right immunisations. After the talk, the consultant finished by saying that he had spent many months in Africa and highly recommended us going.

After getting my mefloquine, and deciding against rabies injections, I emailed the hospital I was to work in. I didnt get a reply regarding their needlestick policies. Still, I was not deterred by the medical schools advice, as I had known so many other medical students who had been to Africa and had had amazing experiences working where they really were needed.

Once I was in Tanzania, HIV became a harsh reality. After a while I decided that I wasnt going to do anything that was going to jeopardise my health and future career, especially as I didnt have any postexposure prophylaxis.

In effect, this reduced me to being a rather useless medical student again, following after consultants on ward rounds. I was lucky in that the hospital I was in was well run and didnt really need any extra hands, but had this been a more rural hospital, then I would have just been a hindrance. Incidently, I did get my own infectious disease, a little hookworm in my foot from walking around barefoot in Zanzibar. Meanwhile, I was getting emails from friends in places like Chicago, who were dealing with gun shot wound victims, or others delivering babies in Uganda.

My experience in Tanzania was wonderful, but I think I would have got so much more out of it if I had been prepared to get my hands dirty and then would have actually made a difference. Perhaps if Id had postexposure prophylaxis, I might have been a bit braver. You do have to take precautions wherever you are, whether Africa or Sheffield.

If I had my time over again, I would choose to go to a country with less risk of HIV. There I could get the elective experience I had always dreamt of, without the constant worry of contracting HIV. Of course, its for each individual to decide how much they want to risk, in order to help people who really need that help.