John Gossen
John Gossen
Tanzania 2016
I graduated from Belmont University with a B.S. in biology. I have been a certified Advanced Emergency Medical Technician for four years, working in ambulances and emergency rooms. Over three months I will use my experience in emergency medicine to volunteer in a government hospital in Dar Es Salaam, Tanzania. Read More About John →

Kuokoa Maisha


May the road rise up to meet you.

May the wind be always at your back.

May the sun shine warm upon your face;

the rains fall soft upon your fields and until we meet again,

may God hold you in the palm of His hand

Hello Everyone! I hope you are well! I appreciate all the great feedback and words of encouragement everyone has sent, know that none of it goes unnoticed. Please forgive me for being so late with this post. I have so much to share, accordingly this update is a LONG one, so I have a great deal of admiration for anyone who can make it all the way to the bottom. Additionally, this post has a couple of hospital/ medical stories, so I had some internal debates about how much I should and shouldn’t share. I have tried my best to take out most of the technical jargon and make them readable/ engaging to the everyone. That being said, I understand for some people medicine might be the most boring thing you have ever read about (though I don’t see how, I think it’s pretty awesome) so in the interest of everyone’s time (and for any family members interested in whether or not I am alive, and enjoying my time down here). I have put the fun, social, part of my adventures first, followed by the medical aspect if you are interested.

Party divemeditation

Just keep swimming, just keep swimming, just keep

As far as miscellaneous details on my personal life go, I want to thank everybody who wished me a happy birthday from thousands of miles away. My birthday was relaxed, but fantastic. I turned 23 years old in a local African coffee shop watching the sunrise, convalescing from some travelers diarrhea I had the day before. Over the past couple weekends I have gone SCUBA diving around Zanzibar and Dar Es Salaam. A Masai tribe adopted me while we danced at an African block party. I went on a biking tour around the different neighborhoods of Dar, stopping to drink local turkish coffee, eat a traditional swahili breakfast (the same thing we get every morning at home, so it must be legit), and stopped by a traditional healer’s shop. I walked around the Mwenge woodcarvers market, and watched local woodcarvers sculpt some cool souvenirs, visited the local village museum, and traveled to a local island where I swam in the crystal clear Indian ocean for the umpteenth time. So all in all I am still having an incredible time just exploring the city of Dar Es Salaam, and getting in touch with the local culture.

masai pit

A Masai barbecue, its the circle of life.

I still feel obligated to tell the internet again how great the Tanzanian people are. Now that I understand more Swahili, I appreciate more of what the locals are saying in everyday encounters. If a local sees you working while they are not, strangers frequently say Pole kwa kazi (I am sorry you have to work), then extol their admiration for you keeping you nose the grindstone. While doing some revising on this update, I was sitting in a local coffee shop. The guy who works in the store next door has come up to me three separate times; initially saying Pole kwa kazi, welcome to Tanzania, the second time saying, my brother! You work too hard!, the third he offered to pay for my coffee (even though he makes 2 dollars a day).

bongoyo viewcocobeachi

With a sea like this, why wouldn’t everyone go there?

Another example occurred while I was walking down the street. A group of traditional Swahili women walked by, nodded and said Mzungu Kaka. I must confess I did not know what Kaka meant, and assumed it was an expletive (I mean come on, doesn’t KAKA sound kinda dirty?). I went home determined to find the precise definition, and determined should I ever see them again to have a classy Swahili comeback on hand. Much to my chagrin, when asking our host mom to define Kaka I discovered it means elder brother, and is reserved as a sign of great respect within Swahili culture. Instead of telling these women off, I have to thank them. Well played locals, well played.

In conclusion.

  1. I am still so happy to be here
  2. Dar Is a blast
  3. Come to Tanzania, no seriously do it


It really does look like this

The following are some interesting medical stories from the last two weeks around Mwananyamala. Nothing is graphic so don’t worry about being grossed out, but there are some incredibly happy moments mixed with some extremely sad. A paramedic gave me a quote he referred to as the fundamental law of keeping your sanity while working in medicine, “Tell the bad stories if you learned something and make sure you always tell the good ones. In the spirit of this, I present the good and bad fortunately diluted in a 2 to 1 ratio.

anesthesiapedi resus

The surgery department. On the left,  anesthesia. On the right pediatric resuscitation, also featured a modern take on the traditional stethoscope (the metal thing)

The emergency room has not gotten any easier. There is still rampant overcrowding, questionable decisions by doctors, and a complete lack of basic resources. However, my understanding of Kiswahili has improved greatly. While I am not remotely fluent, I am able to “get by” around the city. Recently, I have been able to collect a simple patient history, determine a chief complaint, and communicate with most patients to a basic degree.

My improvement in Swahili was best exemplified around 5 o’clock last Monday. I had already changed out of my scrubs about to head home, when I saw two men wheeling in an unconscious individual into the ER. The man was hardly breathing, snoring with each breath (suggesting something partially choking his upper airway), and unable to respond to any stimulation. The rest of the staff was off with another patient (as is often the case in the crowded ER) so the patient’s initial care fell to another medical volunteer and myself. I asked the two family members Nini Shida? (What’s the problem?). The two men looked up with fear and tears in their eyes, and simply replied Sukari (sugar). I then noticed the brown sugar smeared across the patient’s lips, simultaneously forming a thick paste in his throat responsible for the obstruction in his airway. I tilted the patient to his side, grabbed a suction machine, while the other volunteer ran to grab an IV cannula and additional help. While I suctioned the viscous molasses from the patient’s airway (via a foot powered suction machine) I asked the family members for some more basic information, Amekula? (has he eaten?) dakika ngapi? (How many minutes ago?) the family responded Hapana (No) and ishrini (20 minutes).

old and newvillage 2

You save a lot on utilities out here

The patient seemed to be hypoglycemic with a blood sugar so low, his brain was hardly able to perform the necessary basic functions to support life. The situation can be easily fixed by giving the patient supplemental sugar IV (through the vein). I relayed the suspected diagnosis to the intern doc and other volunteer, who showed up with IV supplies in hand. The Intern doctor quickly spoke to the patient’s family members (in the fastest Kiswahili I have ever heard) and confirmed the man was a known diabetic who had taken insulin and forgotten to eat. The doctor returned imminently with 100 ml of Dextrose 10% (a sugar), and started an IV while I gave the patient 50 ml of D10 as soon as he finished. Giving IV sugar to a patient in hypoglycemic diabetic shock is amazing because of how quickly works. Within two minutes our diabetic friend went from choking on his own tongue, to smiling, giving us a handshake, and saying thank you.

I have obtained an entirely new understanding about the HIV/ AIDS epidemic, seeing the debilitating effects of the disease in person is something a textbook cannot provide. Of the patients presenting to the Emergency Room, I would estimate 60% are from complications associated with the disease. One of the most common complications is Tuberculosis, which easily infects the lungs of patients with a compromised immune system facilitated by AIDS. Once TB takes up residence in the lungs it spreads throughout lung tissue, interfering with oxygen transfer which if left untreated is often fatal.


In case you are wondering,  the cot cannot be removed

Such was the case of a woman transferred to Mwananyamala from an outlying hospital. The patient was transferred, due to possible HIV/ Tuberculosis complications. While assessing the patient I noted that she had an incredibly fast heart rate (160 beats per minute, anything above 100 is considered too fast), breathing quickly (once every second), and was blue in her lips, fingers, and toes. When we attached the woman to a pulse oximeter we found that her O2 saturation (a test which measure the amount of oxygen in one’s blood) was at 45%. Putting that in perspective, a human normally saturates at 97-100%, anything below 94% needs treatment, below 85% aggressive treatment, and below 70% patients have a hard time staying conscious. The woman was barely clinging to life at 45%.


Traditional Spices, and a Rocky mountain tradition (this one’s for you sports lady.)

In cases of advanced TB, low oxygen saturation can be difficult to fix. However, the most basic treatment for low oxygen saturation of any kind is putting the patient on supplemental oxygen, which increases the amount of oxygen a person takes in with each breath. Even though resources are scarce at mwananyamala, the hospital still has access to supplemental oxygen. The staff agreed to place the patient, on supplemental oxygen and I ran to grab one of the several Non-rebreather masks for the patient. Just as I was about to place the patient on a nonrebreather I was stopped by the attending physician, and told that I was doing it wrong, the appropriate device for oxygen delivery was actually a nasal cannula. While it is not my responsibility to comment on the decisions of another healthcare provider, this goes against everything I was ever taught. I was trained a mask is 4-5 times more effective than nasal cannula (delivering a potential oxygen concentration of 80-100% as opposed to a NC which delivers 22%). The doctor stated that a nasal cannula was more adequate for delivery, and even though I protested, the patient was placed on nasal cannula O2 at 4 liters per minute. The patient’s oxygen saturation was raised by 10%, a whopping 55%. The patient later died in the ward.

The basics of life support are poorly understood out here. However, another volunteer who is a Medical Doctor came up with a fantastic idea, working with the hospital to potentially change or improve their oxygen protocols. The other volunteer and I have since met with the head of their internal medicine department on ways to help address potential issues with their use of oxygen both in the ER and in the wards. The secret code word is mango. I would really appreciate if anyone has some ideas in regards to this matter, places to look for funding, innovative ideas to stabilize oxygen tanks, etc. If anyone wants to know all of the details, please email me at I cannot say how much change we will truly make in regards to improving Oxygen delivery in the hospital, but hopefully some small step can be taken in the right direction.

I would love to share a final story (and by far the most moving part of my Africa trip) that happened just the other day. A 24 year old woman came into the ER complaining of belly pain, dizziness, and general fatigue. The patient entered the emergency room early in the morning (before I arrived) and sent to ultrasound to determine the cause. The woman returned to the Emergency room from ultrasound walking and talking. The attending doctor was distracted by a cerebral malaria patient, and I couldn’t help but notice the woman was getting more and more sick. Within a few minutes she was unable to talk normally, covered in sweat, and had a highly elevated pulse (150 bpm) and respiratory rate. Speaking with her relative I learned the patient went through a late term miscarriage the day before, and had been bleeding steadily from her vulva ever since.

boxcar life

The storage in this house is spectacular

Lowered mental status (a patient’s inability to talk/ move normally, or remember who they are) and elevated vitals are all signs of hypoperfusion/ decompensated hypovolemic shock. Hypovolemic shock occurs when there such advanced fluid/ blood loss, the heart cannot pump enough fluid to keep the body functioning properly. The brain is generally the last organ to shut down (the body will shunt blood away from other organs, before letting the brain be effected), this woman’s declining level of consciousness means her body is very close to losing the fight. Simply put, the body has tried its best to keep the woman alive, but cannot maintain her current state much longer in the face of constant blood loss, and she is minutes away from dying/ bleeding out.

After inquiring if anyone had taken her blood pressure (the answer was no) I checked it, to find that her BP was 55/40. Normal BP is 120/ 80, and 90/60 requires immediate intervention/ fluid infusion. I told the ER nurse and doctor that she was not only hypotensive, but also on the verge of passing out, the response was, “the ward will deal with it.” Initial treatment of a young hypotensive patient is relatively easy, all that has to be done is replace the lost blood with IV fluid/ normal saline. In spite of the nurses laziness, I quickly started a line and began infusing IV saline as fast as possible, as I was doing this the interpretation of the ultrasound came back. The results were grave, the spontaneous miscarriage had caused bleeding within the uterus, and evidence of nearly 2 liters of blood found in the uterus alone. In America, hypotensive/ bleeding patients (like this) are given two large bore IVs (something the patient likely needs) either in the ambulance or upon entering the emergency room. This is not the case in Africa, as generally the ward (where the patient is admitted) is responsible for starting a second IV. In an attempt to avoid further stepping on the hospital staffs toes, I checked her blood pressure again and found that she had fallen to 50/30. Without emergent surgery to stop the uterine bleeding the woman would probably be dead within the hour despite our best efforts, without another IV line and more fluid the woman would never make it to surgery and be dead within minutes. I made a snap decision and started another IV.

Local home

A middle class house, with  courtyard in the middle

Scrambling to find a fresh liter of fluid to connect to the newly started IV coincided with the patient’s departure from the Emergency room and admission to the ward, where she would wait for surgery (a wait typically ranging anywhere from 2-3 hours long). Admitting a patient at Mwananyamala generally involves handing the patient’s file to family members, who then move the patient to the unit. There is no nurse handoff or doctor’s report, no one is told a current set of vital signs, only a hope that the patient’s file is read quickly enough for the attending doctor to find out about the patient’s severity. Knowing this process and that the patient was critical, I found another liter of lactated ringers, and ran to the ward. I arrived to find the patient slumped over in a wheelchair in a remote corner, completely unconscious and unresponsive, nobody attending to her.

While it is customarily rude, I burst into the ward and informed the staff that the woman had been extremely hypotensive in the ER, along with my concerns that she would die if not give fluid and taken to surgery immediately. After two doctors tried unsuccessfully to obtain her blood pressure (given it was so low) the staff doctor in the OB/ GYN ward (one of the best doctors I have seen at Mwana) recognized that this woman was a critical patient, and immediately moved her to a surgical room on the floor. While the doctor began the process of stopping the bleeding in the uterus, another nurse and I maintained fluid resuscitation in an attempt to stabilize the woman’s blood pressure. Over the next half an hour the doctor, nurses, and I battled to stabilize the woman and get her blood pressure to a normal level, in a desperate fight for the woman’s life. 45 minutes into the procedure, she “woke up,” regained consciousness, asking where she was, and was going on.

hermit crabjohn guwu

A hermit crab, and Hans taking a picture of.... Something..?

The doctor was eventually able to stabilize her bleeding, pulling out a total of 2.5 liters of blood from her uterus. The doctor thanked me for running to the unit and telling him the patient was in hemorrhagic shock. He told me two other patients had died this month from the same condition because they were not stabilized, due to a lack of nurses on staff and communication between the ER and ward. Most importantly, two days later the woman (a nursing student at a local university) was sent home to her three children where she cooked dinner for her husband that very night.


Traditional coffee, and a traditional pharmacy

Every evening the Tanzanian medical students ask me about my day. In typical polepole fashion, they expect not just a response, but a detailed synopsis of the day’s events. A great moment came from one of these conversations. Upon asking Habari za kazi? (how is work) I respond good but difficult. Naturally, the medical student asked me why, and I responded with the first part of my story about the woman with low blood pressure. When I told him that her blood pressure was 55/40 he responded, Pole Sana! (I am very sorry for you) every time I find someone with a blood pressure that low they die within two minutes. When I replied, this one lived. I was bombarded with questions about all the details of the case. How was I able to notice shock? What are the first signs and symptoms of hypoperfusion? Why does squeezing an IV bag keep people alive?

While I have been able to share a couple tips with people on this trip, nothing has ever occurred to this degree.Thanks to the Lumos foundation, 4 more Tanzanian medical students know how to identify potential hemorrhagic shock in patients, and three more children can come home to their mother’s cooking. Admittedly, It is a miniscule step forward, but it is a step in the right direction.

Thanks to the Lumos foundation for making this incredible journey possible, and in case any members of the foundation want to feel better about themselves while going to bed tonight, know they are officially responsible for helping to save a human life.

Real turtle. Courtesy Hans Tvedt

The last thing I want to say again with this post, is Thank you so much for reading! I appreciate all the people who have messaged me, shared these stories on facebook, and even just sent words of encouragement. As always, I love to any and all feedback on the blog, and advice on improvements. I would love to answer any questions about anything. If someone needs clarification on the reasoning behind some of my decisions while I have been here, let me know. Also please email me if anyone has good ideas or wants the full story about changing oxygen protocols, and making it more accessible across the hospital.

I hope everyone has a great day, and if you made it all the way down here I am proud of you!
Also since this is so long, I am going to institute a secret code word to see if anyone truly read this. Email me the secret code word, and you will get a special surprise when I return. Have a fantastic day!







Mzungu Mkasi Nzuri mbaya na mbaya

The White Guy with scissors. The Good, The Bad and The Ugly

The following poem can be read with or without the accompanying theme music.

The Ballad of Mzungu Mkasi

From the west of the west cold steel at his behest

A legend in bandage cutting

blades sing like a lark, splitting tape til they spark

he stalks around minor surgery

Who will stop this Madman!? Who can’t catch a tan

and cuts through dressings as if struck by the moon?

His Kiswhaili aint sharp, but his scissors sure are

He is known as….

Mzungu Mkasi*

*White Guy with scissors


The next hot poem... Europeans with Laundry

The Good

The best way to describe the people of Tanzania is “alarmingly friendly.” Tanzanians treat everyone like a member of their family, willing to help a stranger even at their own expense. I must admit this has been the largest source of culture shock. Locals walk right up to you and provide directions if you look lost, warn you of potential danger, and always ask about your day. Initially, (being the ever cautious traveler) I expected these interactions to end with a plea for money or a missing wallet. These fears were put to rest after ten straight days of locals yelling Karibu (welcome to) Tanzania! from across the street.

The Tanzanian lifestyle is called “polepole” meaning slowly and characterized by thriving in the present instead of stressing about the future. Life is a leisurely walk rather than a frantic run, and Tanzanians exist purely in the moment devoting their undivided attention to the task at hand.


Mosquito nets and little kids

Speaking with a local you feel as if you are the last two people on earth, basking in each others company. I must admit the welcoming, perpetually happy people of Tanzania have stolen my heart and (given my nickname is pokey “slow” joe back home) I have fallen in love with the polepole lifestyle.

The welcoming culture extends through the Mwananyamala medical staff. I officially have around 7 nicknames, including Mzungu** Mkasi, Mzungu Medic, Johnny G, Johnny Walker, Mr. John, Johnny Bravo and Jack Black. Walking around the halls of the hospital I am always shadowed by calls of Johnny Walker! How is your day? We have missed you! I am constantly loaning out my medical equipment. So far, I am the only person with a penlight (torch), Trauma shears (aka scissors, Mkasi) and I often pass my stethoscope around whatever department I am working in.

IMG_0587 (1)

When everyone speaks better English than you.

Thankfully, I am always able to find work around the different hospital departments. Now that I have gotten to know much of the medical staff, I am often able to help dress wounds, start IVs, and everything in between. I have spent most of my time in the “basic” departments like the minor surgery theater (wound dressing, abscess drainage, and stabilization), the labor/ delivery department and the emergency room. Being an AEMT makes me an interesting asset around the hospital as many routine medical procedures, like IV starts and wound dressing, are often performed by medical doctors. Accordingly, they only occur when time permits as the doctors spend most of their time attending to patients in the ward. While the skills I have are basic, being able to perform them allows local doctors to see more patients and make more diagnoses instead of being bogged down in the tedium of wound dressing. Mwananyamala is also a teaching hospital filled with Tanzanian medical students and many daktari are thankful I can take a blood pressure, so they can focus on teaching students.


I am in no way “fixing” or “saving” the Tanzanian hospital system***, but today a local doctor told me as I left, “Thank you, you were very much of a help today.” These tiny things reassure me that in a small way I am accomplishing what I set out to do. 

The Bad

While polepole is an incredible lifestyle, it is not an effective way to deliver healthcare. I have no problems dealing with the less than ideal conditions (I expected equipment and staff shortages when I came to Dar Es Salaam), but I did not expect the decisions made by local doctors. I understand providing suboptimal care due to limited equipment and availability of resources, the same cannot be used to justify poor care due to incompetence. While most doctors in the hospital are professional and extremely qualified, there are a select few attendings whom I profoundly disagree with their treatment plans and diagnosis. I often encounter this problem working in the emergency room. Emergent cases are screened and diagnosed in the ER, but physicians will wait until the patient is admitted and moved to the ward before providing treatment. The wait time to get into a ward can be measured in several hours.


The only white person you have ever seen.

The most egregious examples are pediatric patients struggling to breath and trauma patients in desperate need of transfer. One aspect of the polepole lifestyle is that when a job is done quickly, it cannot be done well. A patient presented to the hospital after a bad motorcycle wreck with numerous abrasions/ scrapes, and obvious injuries to the head and chest. Unlike trauma activations back home where the patient is immediately; assessed, stabilized, and scanned/transferred if need be, Tanzanian patients with traumatic injuries are first sent to the “minor surgery theater” to get their wounds dressed first. Afterwards the patient is moved to the emergency room for any needed scans or transferred to another hospital, should additional resources be required.

The patient entered the hospital talking, responding to verbal commands and entered the Emergency Room an hour later with wounds beautifully dressed and completely unresponsive, unable to maintain his own airway because bleeding in his brain and stomach had progressed so far. The patient was then assessed, diagnosed with a potential traumatic brain injury/ stomach bleed and a request made to transfer the patient to the large national hospital, Muhimbili. The doctor working in the ER that day did not want to do anything to treat the patient as he thought all care should be performed at muhimbili. This extended even to airway management as the doctor did not want to suction the patient’s airway when he began to vomit. Another medically experienced volunteer and myself had to manually open the patient’s airway and attempt to manually clear it. We then waited three hours for an ambulance before the patient was transferred.


Can count backwards in Swahili. Tatu... Mbili... MOJA!!!!! 

Hakuna Shida (No problems) is a great way to live your life, but taking your time with a traumatic brain injury may not provide the best outcomes.

The (not so) ugly

Working in any hospital provides a full spectrum of human life, the highest highs alongside the lowest lows. Mwananyamala has been incredibly fulfilling in so many ways, but it is the hardest thing I have ever done as a healthcare provider. Fortunately, the other volunteers have been welcoming, understanding, and a blast to hang out with. While the weekdays are occupied by work, the weekends have all been about exploring Dar Es Salaam and Tanzania. Other volunteers and I have been downtown to see the local sights, beaches, markets, and art. The last weekend culminated with a visit to Zanzibar. So while work has been a large part of my trip, there has been time for play.

Istolethis from amandaI also stole this from amanda

To Zanzibar (By Motor Car) Photocredit Amanda Arnved. Honestly. Zanzibar is this beautiful. I just need my friends to capture it.

I just want to end this post with a little conclusion.

  1. I hope you have a fantastic day.
  2. The people of Tanzania are incredible.
  3. I am beyond happy to be here.

I did the math at a local KFC (you have been there before!) and found out that the average income of a fast food worker in Tanzania is 300,000 shillings a month. 1 dollar is approximately 2000 shillings, or $150 dollars a month aka $1,800 dollars a year. The average income of a Tanzanian is $600 dollars a month, so a very good living by Tanzanian standards. I took a bujaja home (a strange moped/ carriage hybrid) and the driver was going full polepole asking me about every aspect of my life, how I liked the states, how I liked Tanzania and if there was anything he could do to make my trip better.

He was more or less one of the nicest, happiest people I have ever met.

Here is his picture….


He looks like more or less one of the nicest, happiest people you have ever met.

I do not know how much this man makes, but odds are it is around $1.64 a day, and he can still smile so big it makes me want to tell the entire world.

I am not saying everyone should quit their job and move to Africa, but I think the world would be a better place if we could all smile just a little bit more like this bujaja driver.

I have so many more stories, but I feel that if I make this post any longer by the time you finish reading this two weeks will have passed and you will be due to read another entry (if you keep reading, thanks if you do).


Thank you for taking the time to read this insanely long post. To everyone who has commented, critiqued and wished me well, thank you so much. Every kind word of support means the world to me, and I hope all of you have a fantastic day!

As always I appreciate any and all feedback, question you have, or any recommendations. Have a great day!

**Mzungu- Kiswahili for white person. Derived from Mzunguzungu to be dizzy. Refers to wandering around aimlessly, or looking like you have no idea where you are. Pretty much me no matter where I am.

*** Mwananyamala has doctors from around the world (even a mzungu from penn state) teaching the next generation of tanzanian medical professionals… They are incredible. All kudos go to them.

Karibu mtoto

“A sunlit walk in Africa” A Poem by:

John Gossen

Dimming light brings the shadows of night and relief from the African heat.

A spectrum from the sunset splashes across  pavement and among the many palm trees.

It is here that I saunter a world weary traveler on a special form of safari.

To my left walk Masai men, on my right Tanzanians, up ahead I spy the object of my dreams.

With a shout in Swahili I sprint across the serenge* arriving at the salvation I seek.

A place near to my heart (and its arterial parts) known only as...



They are shilling out money over here!

Karibuni. I apologize for taking so long to write my first post since landing in Dar Es Salaam, Tanzania but after my whirlwind orientation to the new timezone, job, language, and culture the climate kicked in with a rainstorm that knocked out power for several days. Turns out that the nearest place with sturdy internet and reliable energy is a Kentucky Fried Chicken shop (the only one in Dar) a half mile up the road.**


The merry Mzungu and Swahili signs
Here is a short list of things I have come to learn about Tanzania in my limited time here.
1. Fewer people speak English than I initially anticipated. Kiswahili is the predominant language.
2. English and Kiswahili share the same medical terminology.
3. The Tanzanian people are among the friendliest people on the planet.
4. I am so happy to be here

I have spent the past few days getting acquainted with the hospital, and the vastly different style of healthcare present in Africa. The system is plagued by shortages in equipment, and staff. I spent my first day volunteering in the labor and delivery department, where a total of 8 women gave birth within 4 hours. I was the only person with a stethoscope.

Common medical procedures such as abscess incision and drainage or wound care have to be done with a great deal of “improvising.” Patients buy their equipment for certain procedures before seeing  medical professionals. If a wound requires more than the predetermined amount, or a doctor decides an additional treatment is necessary a family member (if there is one) must run out and purchase the necessary supplies.

IMG_0573 IMG_0569

My new home, inside and out.

While Tanzania is short on supplies and resources, they are not short on kindness. Every patient provider interaction concludes with a thank you from the patient. Every... single... time... There is no pain medicine in Tanzania aside from local anesthetic and while the patient may wince, they rarely complain. While helping in the Labor and Delivery ward, one of the nurses began teaching me Swahili, and even offered to run home and bring her newborn baby so I could meet him.

The hospital staff, fellow medical volunteers and my host family have been incredibly welcoming. Showing me the ropes of a vastly different style of healthcare, while providing  a family and home despite being several thousand miles away from my own.
I have already learned so much from Tanzania yet I am only a couple days in.
Please excuse the brevity of this post, but I am worried about losing internet access again, and I want to let my family know that I am safe, sound and loving life in Africa.
I will try to provide a more complete report via my next update.


P.S. I still welcome any and all feedback good or bad. This whole blogging thing is very new to me.

* Tanzanian street.
** Dear mom and dad I am safe and ok.


A first time for many things

My Grandmother is 100% Irish.  As an ardent Catholic, she goes to church every day, reads during mass, and even has a rosary with shamrocks on every bead. Naturally, I have to start off my Lumos blog with a confession; I have never blogged. In fact, my grasp on the term is so tenuous that I turned to google for a more precise definition.

Blog: A Web site on which someone writes about personal opinions, activities, and experiences. *

Sounds pretty straight forward to me. Thank you for taking the time to read this blog!

I cannot believe my Tanzania trip is just around the corner.  The last 9 months have led up to this moment. I recently received my hospital placement, and will be volunteering at Mwananyamala Regional Hospital (hereafter called MWR) in Dar Es Salaam. The flights are booked, my Visa stamped, and vaccinations almost completed. However, it wasn’t until recently that my departure seemed imminent. I think all the good byes have helped in this realization; from saying “goodbye” to my wonderful co-workers in the SMC Emergency Room in Nashville, as well as telling my extended family to “have a nice 4 months”, and my friends to enjoy their last semester of college.


From SMC to Tanzania.

All the farewells pale in contrast to my excitement. Part of what initially attracted me to the medical field was the ability to experience a myriad of cultures, standards of living, and a diversity of people. For many years, volunteering abroad has been a dream of mine, and I cannot thank the Lumos Program enough for this incredible opportunity. I am already reading up on tropical diseases and their clinical presentations. I cannot wait to bring my experience as an Advanced Emergency Medical Technician (AEMT) to MWR, while understanding that with an entirely new set of diseases, available resources, and languages, there will be a very steep learning curve.

Most importantly, I feel a profound sense of gratitude. Truly there are too many “thank you’s” to go around; Thank you to Lumos for funding this amazing adventure, the professors at Belmont University, my friends at the SMC Emergency Room for teaching me some of the intricacies of Emergency medicine, and most importantly, my family and friends for their continued support and care. None of this would be possible without all of your help, camaraderie, and support

.IMG_3659IMG_3661 (1)

The fam with the plan.

I am still unfamiliar with this whole blogging thing, but my gut is telling me to say another goodbye. So good bye until next time dear reader! The next time you hear from me, I’ll have completed a mere 38 hours of travel, and blogging live from East Africa!

Have a great day!


John Gossen


P.S. I would appreciate any and all feedback to make this a more enjoyable experience. So post any recommendations you have. More colors? More talking? Less talking? Let me know. Thank you so much! Have a great day!