{"id":4820,"date":"2026-05-05T13:13:18","date_gmt":"2026-05-05T13:13:18","guid":{"rendered":"https:\/\/academy.msf.org\/?p=4820"},"modified":"2026-05-05T13:13:56","modified_gmt":"2026-05-05T13:13:56","slug":"the-skill-to-save-how-clinical-mentorship-is-transforming-healthcare-in-liwale-tanzania","status":"publish","type":"post","link":"https:\/\/academy.msf.org\/fr\/the-skill-to-save-how-clinical-mentorship-is-transforming-healthcare-in-liwale-tanzania\/","title":{"rendered":"Les comp\u00e9tences pour sauver des vies : comment le mentorat clinique transforme les soins de sant\u00e9 \u00e0 Liwale, en Tanzanie"},"content":{"rendered":"\n

Par Juma Kindo, Formateur en sant\u00e9, Acad\u00e9mie MSF pour les Soins de Sant\u00e9<\/em><\/p>\n\n\n\n

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L’afflux de personnes \u00e9tait incessant. C’\u00e9tait f\u00e9vrier 2016, et je venais de rejoindre M\u00e9decins Sans Fronti\u00e8res (MSF) en tant qu’officier clinique dans le camp de r\u00e9fugi\u00e9s de Nduta. Des milliers de r\u00e9fugi\u00e9s burundais arrivaient, dont beaucoup \u00e9taient dans un \u00e9tat physique critique. En tant que jeune soignant avec une exp\u00e9rience clinique limit\u00e9e, le poids de la responsabilit\u00e9 \u00e9tait \u00e9crasant.<\/p>\n\n\n\n

Mais je n’\u00e9tais pas seul. Des m\u00e9decins, p\u00e9diatres et infirmiers exp\u00e9riment\u00e9s de MSF m\u2019entouraient. Chaque visite de service devenait une salle de classe ; chaque directive \u00e9tait un soutien vital. J\u2019ai vite compris qu\u2019en m\u00e9decine humanitaire, on n\u2019acquiert pas seulement de l\u2019exp\u00e9rience, on gagne aussi en \u00e9lan. Voir un patient arriv\u00e9 au bord de la mort sortir de l\u2019h\u00f4pital gu\u00e9ri \u00e9tait une source de motivation incomparable. C\u2019est l\u00e0, au milieu de la poussi\u00e8re et de l\u2019urgence de Nduta, que j\u2019ai compris que des soins de qualit\u00e9 ne sont pas le fruit du talent d\u2019une seule personne, mais le r\u00e9sultat d\u2019une \u00e9quipe comp\u00e9tente, fonctionnelle et soutenue.<\/p>\n\n\n\n

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Juma Kindo, Formateur en sant\u00e9 Acad\u00e9mie MSF Tanzanie \u00a9 Mildred Wanyonyi\/MSF<\/sub><\/figcaption><\/figure>\n\n\n\n
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Mon parcours, du chevet du patient \u00e0 la salle de classe, s’est fait naturellement. Au fil des ann\u00e9es, je suis pass\u00e9e d\u2019officier clinique \u00e0 superviseur d\u2019\u00e9quipe infirmi\u00e8re, puis \u00e0 responsable des activit\u00e9s infirmi\u00e8res, supervisant 120 membres du personnel r\u00e9partis dans six postes de sant\u00e9. Ces r\u00f4les ont transform\u00e9 ma perspective. J’ai cess\u00e9 de me concentrer uniquement sur les patients individuels pour m’int\u00e9resser davantage aux syst\u00e8mes qui les prennent en charge.<\/p>\n\n\n\n

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J’ai compris que le don le plus durable que je pouvais faire \u00e0 mon pays n’\u00e9tait pas seulement mes propres comp\u00e9tences cliniques, mais aussi le renforcement des capacit\u00e9s de mes coll\u00e8gues<\/p>\n<\/blockquote>\n\n\n\n

J’ai constat\u00e9 que m\u00eame les soignants les plus d\u00e9vou\u00e9s ne peuvent pas tout faire sans un d\u00e9veloppement professionnel continu. Au sein de MSF, nous avons la chance de b\u00e9n\u00e9ficier d’une ouverture sur l’international et d’un approvisionnement r\u00e9gulier. Mais dans les structures du Minist\u00e8re de la Sant\u00e9, le personnel local travaille souvent de mani\u00e8re isol\u00e9e et re\u00e7oit rarement l’accompagnement dont il a besoin pour progresser. J’ai compris que le don le plus durable que je pouvais faire \u00e0 mon pays n’\u00e9tait pas seulement mes propres comp\u00e9tences cliniques, mais aussi le renforcement des capacit\u00e9s de mes coll\u00e8gues.<\/p>\n\n\n\n

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L’Acad\u00e9mie MSF : une nouvelle fa\u00e7on d’apprendre<\/strong><\/h6>\n\n\n\n

Aujourd\u2019hui, je travaille avec l\u2019Acad\u00e9mie MSF pour les Soins de Sant\u00e9 \u00e0 Liwale, un district o\u00f9 les d\u00e9fis sont aussi vastes que le paysage. Nous sommes confront\u00e9s \u00e0 des infrastructures de r\u00e9f\u00e9rence insuffisantes, \u00e0 une manque de personnel qualifi\u00e9 et \u00e0 l\u2019absence de formation continue. Nous n’utilisons pas l\u2019approche traditionnelle du \u00ab professeur au tableau \u00bb. Notre programme de Soins Ambulatoires est un parcours de six mois ax\u00e9 sur les comp\u00e9tences, dispens\u00e9 \u00e0 travers du mentorat individualis\u00e9 et de discussions interactives. <\/p>\n\n\n\n

\u00c0 Liwale, nous soutenons cinq structures de sant\u00e9, en mettant l’accent sur la sant\u00e9 maternelle et infantile. Mon r\u00f4le consiste \u00e0 faire le lien entre la th\u00e9orie et la r\u00e9alit\u00e9. Nous priorisons les principales causes de mortalit\u00e9 chez les enfants : le paludisme, la pneumonie, les maladies diarrh\u00e9iques et la malnutrition<\/strong>. Mais nous abordons \u00e9galement des d\u00e9fis moins visibles, tels que les lacunes en mati\u00e8re de raisonnement clinique, la surprescription d’antibiotiques et la pr\u00e9vention des infections.<\/p>\n\n\n\n

Pour que cette formation porte ses fruits, nous tenons compte du contexte. Nous suivons les directives du minist\u00e8re de la Sant\u00e9 plut\u00f4t que strictement les protocoles de MSF, afin de garantir que les comp\u00e9tences restent applicables au syst\u00e8me local apr\u00e8s notre d\u00e9part<\/strong>. Nous cr\u00e9ons un \u00ab environnement d’apprentissage s\u00fbr \u00bb. Contrairement \u00e0 un sup\u00e9rieur hi\u00e9rarchique, je suis un mentor. J’encourage mes apprenants \u00e0 parler de leurs erreurs sans craindre d’\u00eatre jug\u00e9s. C’est dans ces moments d’honn\u00eatet\u00e9, lorsqu’ils reconnaissent un diagnostic manqu\u00e9 ou un sympt\u00f4me d\u00e9routant, que le v\u00e9ritable apprentissage commence.<\/p>\n\n\n\n

Les r\u00e9sultats \u00e0 Liwale sont d\u00e9j\u00e0 visibles. Au dispensaire de Kimambi, lorsque nous avons commenc\u00e9, le taux de raisonnement clinique du personnel pour \u00e9tablir un diagnostic n’\u00e9tait que de 28 %. \u00c0 la fin du programme, il avait atteint 91 %.<\/p>\n\n\n\n

Le changement ne se limite pas aux chiffres ; il se voit aussi dans la confiance des soignants. L’h\u00f4pital r\u00e9gional nous a r\u00e9cemment fait savoir que les patients r\u00e9f\u00e9r\u00e9s depuis Kimambi arrivent d\u00e9sormais avec une documentation ad\u00e9quate et ayant b\u00e9n\u00e9fici\u00e9 d’une prise en charge ad\u00e9quate avant leur transfert. Des diagnostics qui \u00e9taient autrefois souvent omis ou mal identifi\u00e9s, comme les infections urinaires, sont d\u00e9sormais pos\u00e9s avec pr\u00e9cision. Nous ne nous contentons plus de traiter les sympt\u00f4mes ; nous analysons les donn\u00e9es de mani\u00e8re logique pour en identifier la cause.<\/p>\n\n\n\n

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Des diagnostics qui \u00e9taient autrefois souvent omis ou mal identifi\u00e9s sont d\u00e9sormais pos\u00e9s avec pr\u00e9cision. Nous ne nous contentons plus de traiter les sympt\u00f4mes ; nous analysons les donn\u00e9es de mani\u00e8re logique pour en identifier la cause<\/p>\n<\/blockquote>\n\n\n\n

\u00c0 Liwale, les soins de sant\u00e9 sont souvent un dialogue entre la m\u00e9decine moderne et des croyances culturelles profond\u00e9ment ancr\u00e9es. Il est courant que des m\u00e8res utilisent des plantes traditionnelles pour faciliter l’accouchement, convaincues que cela leur permettra d’\u00e9viter une c\u00e9sarienne.<\/p>\n\n\n\n

En tant que formateur, je n’enseigne pas \u00e0 mes \u00e9tudiants \u00e0 rejeter ces pratiques avec jugement. Au contraire, nous mettons l’accent sur la \u00ab communication centr\u00e9e sur le patient \u00bb. Nous formons les soignants \u00e0 aborder l\u2019usage de rem\u00e8des traditionnels avec empathie et respect. En impliquant le patient dans la prise de d\u00e9cision et en comprenant ses craintes, nous construisons la confiance n\u00e9cessaire pour assurer sa s\u00e9curit\u00e9. Nous ne formons pas seulement de meilleurs cliniciens ; nous formons des personnes qui savent mieux \u00e9couter.<\/p>\n\n\n\n

En repensant \u00e0 mon exp\u00e9rience dans les camps de r\u00e9fugi\u00e9s et les h\u00f4pitaux ruraux, une le\u00e7on ressort clairement : le travail d’\u00e9quipe est primordial. Aucun m\u00e9decin n’est une \u00eele, et aucune structure ne peut fonctionner uniquement gr\u00e2ce \u00e0 son \u00e9quipement.<\/p>\n\n\n\n

Aux jeunes soignants tanzaniens qui envisagent cette voie, je leur dis ceci : le travail humanitaire est un engagement. Il va bien au-del\u00e0 d’un salaire. Il exige un niveau d’empathie qui peut \u00eatre \u00e9puisant, mais la satisfaction de voir un patient sortir de l’h\u00f4pital gu\u00e9ri, ou un syst\u00e8me de sant\u00e9 se renforcer gr\u00e2ce \u00e0 votre accompagnement, est extraordinaire. La satisfaction de voir un syst\u00e8me de sant\u00e9 s’am\u00e9liorer et des patients se r\u00e9cup\u00e9rer est une r\u00e9compense que vous ne trouverez nulle part ailleurs<\/strong>.<\/p>\n\n\n\n

\u00c0 l’Acad\u00e9mie MSF, nous sommes convaincus que l\u2019h\u00e9ritage d’un programme de formation se trouve entre les mains de ceux que nous laissons derri\u00e8re nous. Nous ne soignons pas seulement les patients d’aujourd’hui ; nous renfor\u00e7ons les capacit\u00e9s des soignants de demain. C’est un processus lent et minutieux de construction de l\u2019architecture des soins, s\u00e9ance apr\u00e8s s\u00e9ance, battement de c\u0153ur apr\u00e8s battement de c\u0153ur. Car lorsqu’un soignant acquiert les connaissances n\u00e9cessaires, c’est tout un village qui b\u00e9n\u00e9ficie d\u2019une meilleure chance de vivre<\/strong>.<\/p>\n\n\n\n

<\/p>\n","protected":false},"excerpt":{"rendered":"

Par Juma Kindo, Formateur en sant\u00e9, Acad\u00e9mie MSF pour les Soins de Sant\u00e9 L’afflux de personnes \u00e9tait incessant. C’\u00e9tait f\u00e9vrier 2016, et je venais de rejoindre M\u00e9decins Sans Fronti\u00e8res (MSF) en tant qu’officier clinique dans le camp de r\u00e9fugi\u00e9s de Nduta. Des milliers de r\u00e9fugi\u00e9s burundais arrivaient, dont beaucoup \u00e9taient dans un \u00e9tat physique critique. […]<\/p>\n","protected":false},"author":2,"featured_media":4819,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[4],"tags":[],"class_list":["post-4820","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-non-classifiee"],"acf":[],"yoast_head":"\nLes comp\u00e9tences pour sauver des vies : comment le mentorat clinique transforme les soins de sant\u00e9 \u00e0 Liwale, en Tanzanie - MSF<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/academy.msf.org\/fr\/the-skill-to-save-how-clinical-mentorship-is-transforming-healthcare-in-liwale-tanzania\/\" \/>\n<meta property=\"og:locale\" content=\"fr_FR\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"Les comp\u00e9tences pour sauver des vies : comment le mentorat clinique transforme les soins de sant\u00e9 \u00e0 Liwale, en Tanzanie - MSF\" \/>\n<meta property=\"og:description\" content=\"Par Juma Kindo, Formateur en sant\u00e9, Acad\u00e9mie MSF pour les Soins de Sant\u00e9 L’afflux de personnes \u00e9tait incessant. C’\u00e9tait f\u00e9vrier 2016, et je venais de rejoindre M\u00e9decins Sans Fronti\u00e8res (MSF) en tant qu’officier clinique dans le camp de r\u00e9fugi\u00e9s de Nduta. Des milliers de r\u00e9fugi\u00e9s burundais arrivaient, dont beaucoup \u00e9taient dans un \u00e9tat physique critique. 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Thousands of Burundian refugees were arriving, many in desperate physical condition. As a young medic with limited clinical experience, the weight of the responsibility was staggering. However, I wasn't alone. Veteran MSF doctors, pediatricians, and nurses surrounded me. Every ward round became a classroom; every guideline was a lifeline. I learned quickly that in humanitarian medicine, you don't just gain experience, you gain momentum. The sight of a patient who arrived on the brink of death walking out of the hospital, recovered, was a fuel like no other. It was here, amidst the dust and urgency of Nduta, that I realized high-quality care is not the result of one person\u2019s talent, but the product of a competent, functional, and supported team. Today, I work with the MSF Academy for Healthcare in Liwale, a district where the challenges are as vast as the landscape. We face poor referral infrastructure, a shortage of qualified workers, and a lack of continuous professional development. We do not use a traditional \\\"teacher-at-the-blackboard\\\" approach. 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Thousands of Burundian refugees were arriving, many in desperate physical condition. As a young medic with limited clinical experience, the weight of the responsibility was staggering. However, I wasn't alone. Veteran MSF doctors, pediatricians, and nurses surrounded me. Every ward round became a classroom; every guideline was a lifeline. I learned quickly that in humanitarian medicine, you don't just gain experience, you gain momentum. The sight of a patient who arrived on the brink of death walking out of the hospital, recovered, was a fuel like no other. It was here, amidst the dust and urgency of Nduta, that I realized high-quality care is not the result of one person\u2019s talent, but the product of a competent, functional, and supported team. Today, I work with the MSF Academy for Healthcare in Liwale, a district where the challenges are as vast as the landscape. 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