By Emmanuel Rubagumya
WHEN primary school
examination results came out in 1993 at Ujewa Primary School in Mbeya
region, only one pupil passed, out of 35. It was sad for the losers, but
great elation to the sole winner.
That little girl was Angela Paul Muhozya.
By that time,
Angela did not know that with those results, it was the beginning of her
long journey towards becoming a medical doctor in Tanzania, and apart
from that, she was also going to become one of the few women scientists
and researchers not only in Tanzania, but in the world.
She also never knew
that some decades later she would be one of the cardiac
anaesthesiologists who would make history in Tanzania by successfully
conducting the first ever pacemaker operation in July 2016 at Jakaya
Kikwete Cardiac Institute (JKCI) at Muhimbili National Hospital (MNH).
Dr Angela (41 years) is a cardiac anaesthesiologist, and the current Director of Surgical Services at JKCI.
Born to John Paul
Muhozya and Chiku Juma Sekilasi, Dr Angela is the second born in a
family of three girls and one boy. Both parents are secondary school
teachers. After her primary school, she briefly went to Rujewa Secondary
School in Mbarali District in Mbeya before going to Zanaki Secondary
School in Dar es Salaam after her parents were transferred. She later
joined Jangwani Secondary School for her Advanced level secondary
education, where she opted for physics, chemistry and biology (PCB)
stream.
"My mother is a science teacher, and this partly influenced me towards opting for science subjects," says Dr Angela.
Her passion for
becoming a medical doctor started since she was doing her ordinary level
secondary education. Because of poor health, she regularly fell sick
while at boarding school, so trips to the hospital became frequent, but
she usually preferred to be attended to by female doctors.
"Naturally, I felt
better when a female doctor attended me. From that time I vowed to work
hard so that I can also become a doctor and serve fellow women," Dr
Angela explains.
From Jangwani
Angela went for her medical training course at the University of Dar es
Salaam (MUCHS campus), where she did her internship and later was
employed at the largest referral hospital in the country.
Embracing anaesthesia
During her medical
studies and internship, Dr Angela invested heavily in becoming a
gynaecologist, but this failed to materialise. The experience she got
during her internship influenced her to opt for a different
specialisation path.
As part of her work
during the internship period, she witnessed a lot of mothers dying or
losing their babies during delivery. The rate was high at that time, and
Angela could not bear it.
"When you help a
mother deliver successfully, you share that joy. When a baby or mother
dies, you feel the pain as well, I was not ready to continue witnessing
and sharing the pain. The experience was unbearable," she notes.
As a young trainee medical doctor, Angela had a reason to worry.
For example,
according to a paper published in BMC Pregnancy and Childbirth blog on
13 September 2014, Tanzania was among eleven countries in the world with
65 per cent of maternal deaths in 2008.
Tanzania
Demographic and Health Surveys of 2005 and 2010, indicates that maternal
mortality ratio was at 578 per 100,000 in 2005, and 454 per 100,000
live births in 2010.
The situation has
substantially improved today as a result of the government and other
stakeholders' huge investment and effort to save mothers and children's
lives in recent years.
It happened that
after her training in 2007, the government was employing and two options
were presented to Angela. She was either going to be a general surgeon
or anaesthesiologist. She opted for the latter.
She was employed
and worked for three years at Muhimbili National Hospital from 2008
until 2010, which helped her cultivate more interest in anaesthesia. In
September 2010, she went for her Master degree in anaesthesia for three
years at the same university. She did not know much about
anaesthesiology, but was attracted to it due to the fact that
anaesthesiologists deal with patients who undergo surgery, including
critical patients.
"I liked the nature
of the work. I liked taking in a patient for operation, putting them to
sleep, and at the end discharging them while they are awake and
healthy. I also loved stabilising critical patients and send them to
other departments for further treatment," she says.
When taking their
masters degree, doctors rotate in different areas, and Angela found
herself in love with offering her service to heart patients. There are a
lot of things when administering anaesthesia to heart patients in terms
of technique, medicine, equipment and management, which further
fascinated her.
Coincidentally, Dr Angela completed her course when JKCI was starting. She joined the institute where she continues until now.
Few anaesthesiologist doctors in Tanzania
There are only 40
anaesthesiologist's doctors in Tanzania, and women constitute a third of
those. This number is very minimal in a country with a population of
almost 60 million. On average, the need is at least one
anaesthesiologist in each regional referral hospital and district
hospital where these services are highly needed.
The situation,
according to Dr Angela, is more serious when it comes to cardiac
anaesthesiologists. There are currently three in the country, and she is
the first woman cardiac anaesthesiologist.
The challenge is systemic.
A medical student
has barely two to four weeks to study anaesthesia during a five-year
course, compared to three months dedicated to other specialties like
gynaecology, obstetrics and others. Worse still, no time is set for
Tanzanian medical students to practice anaesthesia during their one year
internship period.
"With the existing
training system, cultivating interest or encouraging young doctors to
become future anaesthesiologists becomes a challenge," Dr Angela
explains.
She strongly
advocates for a change for medical doctors students to have more time
for anaesthesia course and make it mandatory for medical doctors to
practice anaesthesia during their internship.
She also proposes
for opening up of anaesthesia courses for medical doctors in different
training institutions around the country. Right now, only MNH offers
such trainings at the post graduate level.
"It is through such
efforts that the country will have specialists and super-specialists
anaesthesiologists who are largely needed," she notes.
The role of an
anaesthesiologist in an operating theatre is vital. He/she is a
physician to a patient. It is anaesthesiologist who must know a
patient's medical history and social life in and out. A surgeon cannot
operate a patient who has not been declared fit for operation by an
anaesthesiologist.
A cardiac anaesthesiologist has also a lot of vital functions during surgeries for heart patients.
During such
operations, the heart must be stopped, and it is a cardiac
anaesthesiologist who is responsible of recuperating a patient at the
end of the process.
Memories
Dr Angela says the
first pacemaker operation conducted at the JKCI will always stick in her
mind. A pacemaker is a small electrical device fitted in the chest or
abdomen. It is used to treat some abnormal heart rhythms (arrhythmias)
that can cause a person's heart to either beat too slowly or miss beats.
The operation was
conducted in July 2016 to a five year old girl called Happiness Josephat
from Manyara region. Before that, such operation was referred abroad,
leading to huge foreign exchange loss.
"The operation marked the turning point for our hospital and Tanzania at large. I am glad to be part of that history," she says.
On few women scientists and researchers
Looking at the global statistics, women continue to represent only 29 per cent of researchers.
According to the
United Nations Scientific and Cultural Organisation (UNESCO), although
women are more numerous in certain disciplines, the glass ceiling
remains a reality within research as a whole.
Dr Angela thinks
the situation is caused by a number of factors, including multipurpose
duties women have to accomplish in their societies, mainly in Africa,
which limits them in terms of time compared to their male counterparts.
"We grow up
thinking of only studying hard and getting employed," she says.
Accessing finance and proper supporting system for conducting research
studies are other hurdles.
She commends the
JKCI Director, Prof Mohammed Janabi for initiating a research unit at
the Institute and encouraging doctors to conduct research studies.
"The government and
other stakeholders should put more weight into supporting and
monitoring research studies to improve the health care system in
Tanzania," she explains.
Dr Angela calls
upon parents to give equal chances to girls to access education and help
raise the number of women scientists in the future.
Advice to young girls
She calls upon girls to work hard and never accept failure at any stage of their endeavours.
"Along the way,
women may face discouragement from their fellow women or men, but this
should not be a stumbling block. When women invest into something, they
do it better," the wife to Dr Henry Swai and the mother to Neema,
Baraka, Brian and Abigail notes.
Emmanuel Rubagumya writes about science, technology and innovation. Email: innovationstz@gmail.com
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