By Juma Kindo, Healthcare Trainer, MSF Academy for Healthcare
The influx of people was relentless. It was February 2016, and I had just joined Médecins Sans Frontières (MSF) as a clinical officer in the Nduta refugee camp. 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. Senior 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’s talent, but the product of a competent, functional and supported team.
My journey from the bedside to the classroom was a natural evolution. Over several years, I transitioned from clinical officer to Nurse Team Supervisor and eventually Nursing Activity Manager, overseeing 120 staff across six health posts. These roles shifted my focus. I stopped looking only at individual patients and started looking at the systems that treat them.
I realized that the most sustainable gift I could give my country wasn’t just my own clinical skill, but the empowerment of my peers
I saw that even the most dedicated healthcare workers can only do so much without continuous professional development. In the MSF setting, we are privileged with international exposure and steady supplies. But in Ministry of Health (MoH) facilities, local staff often work in isolation, rarely receiving the mentoring they need to grow. I realized that the most sustainable gift I could give my country wasn’t just my own clinical skill, but the empowerment of my peers.
The MSF Academy: a new kind of classroom
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. Our Outpatient Care Programme is a six-month, competency-based journey delivered through side-by-side mentoring and interactive discussion.
In Liwale, we support five health facilities, focusing on mother and child health. My role is to bridge the gap between theory and reality. We prioritize the “top killers” of children: malaria, pneumonia, diarrheal diseases, and malnutrition. But we also tackle invisible challenges, such as poor clinical reasoning, the overprescription of antibiotics and infection prevention.
To make this training stick, we respect the context. We follow MoH guidelines rather than strictly MSF protocols, ensuring that when we leave, the skills remain applicable to the local system. We create a “safe learning environment.” Unlike a direct supervisor, I am a mentor. I encourage my learners to share their mistakes without fear of judgment. It is in these honest moments, confessing a missed diagnosis or a confusing symptom, that the real learning begins.
The impact in Liwale is already visible. At the Kimambi dispensary, when we started, the staff’s clinical reasoning for diagnosis sat at just 28%. By the time we finished the program, it had soared to 91%.
The change isn’t just in the numbers; it’s in the confidence of the nurses. We recently received feedback from the district hospital that patients referred from Kimambi now arrive with proper documentation and appropriate pre-referral management. Diagnoses that were once frequently missed or misidentified, such as UTIs, are now being caught accurately. We are no longer just treating symptoms; we are thinking logically through the evidence to find the cause.
Diagnoses that were once frequently missed or misidentified are now being caught accurately. We are no longer just treating symptoms; we are thinking logically through the evidence to find the cause
In Liwale, healthcare is often a dialogue between modern medicine and deep-rooted cultural beliefs. It is common for mothers to use traditional herbs to augment labor, believing it will help them avoid a C-section.
As a trainer, I don’t teach my students to dismiss these practices with judgment. Instead, we emphasize “patient-centered communication.” We train healthcare workers to ask about traditional medications with empathy and respect. By involving the patient in the decision-making process and understanding their fears, we build the trust necessary to keep them safe. We aren’t just building better clinicians; we are building better listeners.
Reflecting on my time in both refugee camps and rural hospitals, one lesson stands above the rest: teamwork is everything. No doctor is an island, and no facility can survive on equipment alone.
To the young Tanzanian healthcare workers considering this path, I tell them this: humanitarian work is a devotion. It is about more than a paycheck. It requires a level of empathy that can be exhausting, but the reward of seeing a patient walk out of a hospital recovered, or a healthcare system grow stronger through your mentorship, is extraordinary. But even now, the satisfaction of seeing an improved healthcare system and a thriving patient is a reward you will find nowhere else.
In the MSF Academy, we believe that the afterlife of a training program is found in the hands of the people we leave behind. We are not just treating today’s patients; we are empowering the healers of tomorrow. It is a slow, meticulous process of building the architecture of care, one session and one heartbeat at a time. Because when a healthcare worker is empowered with knowledge, an entire village receives a better chance at life.