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.
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.
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.