Thank you for your interest in Selian Lutheran Hospital and/or the Arusha Lutheran Medical Centre. If you decide to participate, we will offer you an experience in which you will be exposed to:

1) Tanzania and the Swahili language

2) Clinical tropical medicine (clinical parasitology and AIDS in particular)

3) Primary Health Care in a third world country

4) The rewards of medical missionary work

If this sounds like the kind of program which interests you, you need to apply to the Evangelical Lutheran Church in Tanzania – North Central Diocese  for acceptance into our program. Your application should be emailed to Dr. Mark Jacobson, coordinator of medical student and resident rotations. Your application should address the following points:

1. Why you want to participate in our program
   
   
2. What you expect to gain from the rotation
   
   
3. What you feel you can contribute to our work
   
   
4. Any experiences or studies that have helped prepare you for such a rotation
   
   
5. A statement of approval of the Selian externship or residency rotation from your medical school
   
   
6. Your plan to read about Africa and study tropical medicine under the supervision a faculty member of your program prior to coming to Arusha
   
   
7. Your resume or CV
   
   
8. A photocopy of the first pages of your passport

The minimum externship at Selian is eight weeks and the minimum residency rotation is four weeks. We typically have four students and one or two residents doing rotations at the same time in order to maximize and individualize the experience.

SELIAN LUTHERAN HOSPITAL AND ARUSHA LUTHERAN MEDICAL CENTRE

Selian Lutheran Hospital is a 125 bed hospital in northern Tanzania. The hospital and the affiliated Arusha Lutheran Medical Centre  serve 100,000 outpatients per year, perform 200 surgical procedures per month, and do over 30 deliveries per month. Bed occupancy averages 60 to 90 patients. Common medical and pediatric diagnoses are malaria, AIDS, TB, upper respiratory infections, pneumonia, diarrhea, and amebiasis. The Community Health Project is the community outreach and preventive component of Selian's and the Lutheran Diocese's health work. It serves in AIDS, Tuberculosis, Nutrition, School Health Education, AIDS Education, and Home Based Hospice Care (click here to see slideshow), and has a working relationship with the Traditional Birth Attendants of the surrounding villages.

Externship: The externship consists of working on the wards with a team that may include Advanced Medical Officer students, interns, residents and an attending physician. Externs may also do outpatient medicine in one of the hospitals' clinics and have opportunities in rural medicine at one of the remote dispensaries. Some students may choose to go to remote health care settings with the Flying Medical Services of the Catholic Church (click here to see slideshow).

Residency rotations: Residency rotations are similar to the externships except for an increased level of responsibility on the wards, especially teaching.
At the present time  externs and residency rotations are based at Selian with some possibilities of following consultants into the new Arusha Lutheran Medical Center.  See its website at www.almc.habari.co.tz

Visa requirements for entry into Tanzania: To do a rotation at Selian, you need to obtain a volunteer three month resident permit.   This will be obtained for you prior to your arrival and a scanned copy sent to  you.  This costs $120, payable to the hospital in cash.   If, for some reason, the permit is not ready before you arrive, you will be required to purchase a tourist visa to enter the country for $100 cash and then pay for the $120 permit when it is available.  In addition, your passport expiration date must be at least six months after your arrival even if you plan to stay just one or two months.

For health clearance, check the CDC website from the United States Center for Disease Control for current recommendations; as of March 2008 the only required immunization is YELLOW FEVER and this is only if you are planning to visit Zanzibar during your stay. As health professionals however, hepatitis A and B immunizations are recommended. The current recommendations for malaria are daily doxycycline (less expensive) or daily malarone. Weekly mefloquine is an option, but side effects can be troubling and there is moderate resistance to mefloquine here.  Mefloquine is absolutely contraindicated in anyone with any psychiatric history.

Housing: You will  live in a communal setting with other volunteers for the hospital. There are currently two furnished, three-bedroom houses with shared kitchen, dining, and sitting areas, and they have house help who clean and will do laundry for a small fee(click here to see slideshow). You will be responsible for rent of  $200 per month and your own food which most students find costs about $120 per month. There is a housekeeper available for each house and that cost is shared by those in the house. It is about 5$ per day usually for three days a week.  Water and electricity come from the rent, but the cooking gas is shared by occupants also. It is good to talk to other students who have come to learn about life and expenses in Arusha.   If you bring your laptop, it is possible to have internet (cost shared by occupants of the house) while here.  This is available 24 hours (more expensive) or at off peak hours (less) for a monthly fee.

There is a bus every day from the main road to Selian hospital. Some students and residents have liked walking or biking to the hospital, which is about 6 km on the back road, or 12 km on the main road. ALMC is just down the road in town, and a number of people go there each day from the neighborhood where you will be.

What to bring: You will need light clothes. For work at the hospital, casual clinic clothes are appropriate. Please bring a white coat and a stethoscope. A student or resident handbook of clinical medicine is also helpful.  Mosquito nets are available. Ball-point pens are always in short supply. Hand sanitizer and alcohol wipes are useful.

A raincoat is needed in February-June and October-December. Otherwise, a sweater or fleece and light jacket will suffice. Students often do a lot of walking, so bring good walking shoes. Some students who have been here during the dry season recommend tan and khaki colored clothes because those colors do not show the dust. Plan to bring some reading material, a flashlight, batteries, camera, etc.

There is a lodge with a swimming pool nearby, and there may even be time for the beach, so bring a swim suit. A laptop and/or PDA with various medical programs can be useful. Sheets and towels are provided in the houses. 

Finances: The easiest way to exchange money and get the best exchange rate is to use a VISA or Mastercard cash or debit card. If you visit a National Park on your own (i.e. not with a safari company), the entrance fees ($35-100/day, most are $35) must be paid with a debit card or credit card with a PIN number. Notify your credit card company that charges will be coming from Tanzania; otherwise charges from here will be blocked. DO NOT bring any dollar bills older than the year 2000, because they will not be accepted. Larger bills get a better exchange rate.   Most people use a credit or debit card in an ATM to get shillings. That works very well. BUT, you will need to pay safari costs in dollars, and  can use credit cards for that.

You can take a 2- 3 day safari (in fact we highly recommend it as part of your Tanzania experience) in the national parks for about $150-250 per day. Bring items you might want on safari: camera, binoculars, hat, and sunscreen.

Reading: Following is a suggested reading list either in advance of or during your time in Tanzania. Some of the books are out of print but available here.
Achebe. Things Fall Apart.
Bryant, John. Health in the Developing World.
Donovan. Christianity Rediscovered
Fadiman. The Spirit Catches You and You Fall Down.
Moorehead. The White Nile.

Student experiences:

To read from one student's experiences at Selian, click here.
To see pictures of 'match nights 2004 and 2006', click here.
And 'match night 2008', click here.
To see pictures of a medical school graduation celebration at Selian, click here.
University of Indiana fourth-year medical student Jennifer Whitaker wrote about her experiences with AIDS patients at Selian: to read, click here.
Visits to Arusha and Lake Manyara National Parks and Karatu.

Language: The Rosetta Stone Swahili language software is good, but expensive. English is spoken by all Selian and ALMC staff and charting is in English.

Click to print a PDF file with pre-arrival information (compiled by recent volunteers).

Click to print a PDF file with post-arrival information (also compiled by recent volunteers).

Click to print a PDF file with a map of Arusha.

Emergency Contacts:
Diocese in Arusha, Tel. 027-250-2088
Selian Lutheran Hospital, telephone 027-250-3726
Dr. Mark Jacobson, tel. 0754-299-306 
Arusha Lutheran Medical Centre:  027-254-8030;
E-mail: mjacobson@habari.co.tz