Dakar


Report 1

Reporter Florence Wedmore

Contact at destination Pr. Thérèse Moreira Diop (diyarndong@hotmail.fr)

Year of visit 2013

Country Senegal

Region Dakar

Institution Hôpital Aristide le Dantec/ Hôpital Fann

Department Internal medicine (at le Dantec) and Infectious diseases (Hôpital Fann)

Work / Study undertaken

I spent 4 weeks with the internal medicine department. During my time there, I went on ward rounds, clerked new patients and performed a “daily check” on any old patients assigned to me, organised patients scans and accompanied them to any investigations they needed. I also got to try some supervised practical procedures- putting in ascitic drains and performing lumbar punctures. The last 2 weeks I spent at the infectious disease department, one week in their specialist ITU and one week on the ward. In both departments teaching formed a major part of the day so the ward rounds were all teaching ward rounds and at lunchtime students gave presentations.

Description of the service and department The internal medicine department looks after ongology, rheumatology and some gastro and liver patients. It is divided into 2 large wards- for females and males- looked after by separate teams. Le Dantec is a tertiary referral centre so patients tended to come either from Dakar’s suburbs or were referred in from hospitals across Senegal. Patients tended to present quite late and cases were often quite complex. The ward itself was quite basic. Patients must provide their own equipment (cannulas, fluids, thermometer etc) themselves. The hospital overall is well equipped with access to MRI, CT and all blood tests you’d normally be able to order in the UK.

The infectious diseases department was based at Hôpital Fann. It was formed of an 8 bed specialist infectious diseases ITU and a larger, chronic ward. It is otherwise similar to Hôpital Aristide Le Dantec (though in a much prettier location).

Description of the destination

Dakar is Senegal’s capital. It sits right at the tip of the peninsula which forms the most Westerly point of mainland Africa, so it is surrounded by the ocean on all sides. It is a large sprawling city; the centre is relatively well developed and houses the West African headquarters of many big companies and NGOs. Outside of the centre and in the suburbs there is a lot of poverty. Most patients seen in the public run hospitals of le Dantec and Fann were from these poorer suburbs or rural Senegal.

Were the local people friendly? Yes, especially the medical students. However because I was there during the summer holidays many of them were only on the wards a few days a week or for a couple of weeks.

Did you feel safe and if not why not? Yes, Dakar did feel very safe. Though obviously it is wise to take cautions in a large, unknown city

What did you do in your spare time? In the afternoons or evenings I visited the beach or went to events at the Institut Français or saw other live music in Dakar. At the weekends there are lots of other towns easily reachable from Dakar that are worth visiting, St Louis the old colonial capital up the coast, or the idyllic Ile de Gorree.

Is there anything that you would particularly recommend others to do? The Institut Français puts on a wide variety of events such as film screenings and live music.

What time of the year were you there? What was the climate like? I was there in August and September, which is the end of the rainy season. It was still very hot and humid with occasional heavy rainstorms.

What was your accommodation like? I rented a room in an apartment with a fellow student with an en-suite bathroom and shared kitchen.

Was it provided? No

If not who arranged it?Arranged myself through a family contact.

How much did it cost? About £50 a week each, with 2 of us sharing.

Did you enjoy your visit? Yes, I would recommend it.

Did you find it useful medically? If so, in what way?

Yes, Senegalese medical students are given a lot more clinical responsibility than British students. Being in charge of your own patients and expected to organise their tests and do a daily check gives lots of chance to practice clinical skills and hone knowledge. Even during the summer holidays the ward round each morning was effectively a teaching ward round so there was a lot of opportunities to have your knowledge put to the test.

Has it improved your French? Yes!

How has it increased your knowledge of French culture? Not really but I experienced a lot of Senegalese and West African culture.

If you went back would you do anything differently? The institute Francais in Dakar offer French language courses. Spending a week doing one of these may have been a good way to acclimatise to Dakar, get used to the Senegalese French accent and to meet some locals.

How did you get there? I travelled overland as far as Casablanca in Morocco (which is the closest you can get before overland travel is not safe) and flew from there to Dakar. On the way back I flew to Madrid and travelled back overland from there.

What was the approximate total cost? Rent for 6 weeks ~£300, living expenses (including travelling at weekends) £80 a week. As I travelled overland over a long period of time difficult to estimate how much travel cost for me but flights start from £500 return.

Is there any other information that you think may be useful? If you are planning to fly and to travel the region before your placement it may be worth investigating flying to the Gambia which will have more flights from the UK therefore prices may be more competitive. Travelling up the coast from the Gambia to Dakar is easy and there are lots of nice places to stop off along the way.

Also, keep an eye out for when Ramadan is. Although this shouldn’t affect your placement too much, the country is majority Muslim (~80%) a so a lot of things tend to stop during Ramadan and many people use the month to visit family.

Report 2

Reporter: Bryony Hopkinshaw

Contact at destination: Pr. Diop

Year of visit: 2012

Country: Senegal

Region: Dakar

Institution: Hôpital Aristide Le Dantec

Department: General Medicine

Work / Study undertaken: I spent 3 weeks on the female ward, and 3 weeks on the male ward.

Each day there was a meeting at 8.30am, where a senior (7th year) student from each of the general medical teams presented a case of a current patient for discussion of their management with the professors. After this there was normally a ward round, either fairly informal with the intern, or – a couple of times a week – a more formal ward round with the professor. There was often very good teaching on the ward rounds, although sometimes there were too many students there to hear what was going on. After this, I would either go around with 7th year students while they clerked & did jobs, or I would go and see patients myself (mostly reading notes & examining; history taking was often difficult, as many patients spoke limited French).

There were a wide variety of cases – mostly gastro, haematology, and endocrine, plus some infectious diseases – and a lot of really good signs (sadly – as they’re only so good because people present so late). I did actively clerk a few patients, and presented once at the morning meeting, but I was mostly just observing & doing my own thing rather than being given jobs and I didn’t do any procedures.

Generally, unless there were new admissions to clerk, the ward work would be done by 2 or 3pm, and the day would end then.

Description of destination: The hospital is a large teaching hospital at the tip of the Dakar peninsula. It deservedly has a good reputation for teaching, and is very well equipped in terms of scanners & investigations available. Unfortunately, the funding & infrastructure doesn’t match up to this – the buildings & wards are a bit decrepit, and most investigations & treatment are not state funded, so there are often delays whilst patients struggle to get money together. There are a LOT of local students at the hospital: 7th year students are essentially the same as foundation doctors and do most of the ward work and they were all really friendly and welcoming. The students come from all over Francophone west & north Africa to study there.

Dakar is a very large, busy, multicultural city on a coastal peninsula. It has a lot of wealth as well as a lot of poverty, and there is a lot going on: fantastic markets, good nightlife, patisseries, restaurants, live music, nice beaches, surfing….

Were the local people friendly? Everyone at the hospital was extremely friendly & welcoming. They were pleased I was making the effort with French, even though I’m sure I sounded pretty terrible most of the time, and they were always happy to explain things. It was a sociable atmosphere, with time to chat casually as well as work (although there wasn’t much socialising outside of the hospital, which was a shame!)

More generally, Dakar is mostly very friendly, people will constantly strike up conversation, which is great for French practice! Sometimes people are a bit tooooo friendly e.g. in trying to sell you stuff in the market, or if you are a girl alone at the beach, but it’s generally good-humoured.

Did you feel safe and if not why not? Yes, I felt safe, although I didn’t walk alone at night. If you’re a girl, men can be quite persistent in trying to get your email/number/hand in marriage, which can be exhausting, but I didn’t ever feel physically threatened.

What did you do in your spare time? If I finished early, I would go for a walk to look at the sea, go for a run, or walk into town. Otherwise I just spent the evenings at home studying or hanging out with my host family. At the weekends, go out for dinner, go to the beach, visit touristy places in/around Dakar. One weekend I went to St Louis, and another I went to Thies (other cities, a few hours away).

Is there anything that you would particularly recommend others to do? Go travelling afterwards – I went to the Casamance (South Senegal) and upriver in the Gambia, both of which were lovely!

What was the climate like? I was there November – December. For the first couple of weeks at the start of November, it was extremely hot (high 30s), but then it cooled down to a very pleasant temperature: mid twenties in the day, cooler at night/early morning. No rain while I was there!

What was your accommodation like? I stayed with a Senegalese family who have a lovely apartment near the hospital.

Was it provided? No, it was arranged privately – a very lucky connection through a friend of a friend!

How much did it cost? Nothing. (I did stay in a hostel for the first 3 nights, as my host was away, and this was about £15 a night, and not that nice! I think it’s possible to find relatively cheap commercial homestays, or you could try couchsurfing to look for housemates.)

Did you enjoy your visit? Yes!

Did you find it useful medically? Yes, especially in terms of seeing signs. I saw a lot more conditions relevant to finals (diabetes, ascites, electrolyte abnormalities) than I was expecting.

Has it improved your French? Yes, definitely. Especially for improving verbal comprehension, and my general confidence.

How has it increased your knowledge of French culture? It’s increased my knowledge of Senegalese culture! Plus some French colonial history. And I ate a lot of baguette if that counts?

If you went back would you do anything differently? I would be a bit more confident & proactive about getting involved with patients – the 7th year students manage their own patients (under supervision), and I think I would have been able to do more of this if I’d asked. I would also have arranged to do one or two nights & some clinic sessions to see a bit more variety of activities.

I wish I had learned some Wolof before I went. People on the street really appreciate it if you speak a little bit, and it would have been very helpful with patients.

If I went back, I’d also try & learn to surf!

How did you get there? Flew with Iberia (via Madrid & Gran Canaria)

What was the approximate total cost? £650 flights (you can get them cheaper, but I booked late), £90 insurance, £90 vaccines & anti-malarials, £600 spending whilst in Dakar for just over 6 weeks (inc. meals out, taxis, snacks, weekend trips & activities), £350 for 2 weeks travelling in the Gambia & the Casamance. Plus a bit extra for souvenirs & gifts for my hosts!

Is there any other information that you think may be useful?You have to wear a white coat in the hospital. White scrub tops are also acceptable, and I’d recommend bringing one of these, or getting a short sleeved coat in a light fabric, if you’re going to be there in the hot season (I was dying in my thick white lab coat for the first few weeks!)

If you want to do infectious diseases don’t go to the Dantec. They do get a few overspill patients, but the main Infectious Diseases service is at a different hospital (Fann).

If you book a long time in advance & are a confident traveller, you could get to Senegal extremely cheaply, by getting a charter flight to the Gambia and then travelling up (5-6 hours by public transport).

Couchsurfing is a great resource for meeting people in Dakar, as well as travelling.

 

Report 3

Reporter: Claire Ferraro

Contact at destination: Pr. Papa Salif Sow (Chef de Service)

Year of visit: 2010

Country: Senegal

Region: Dakar

Institution: Hôpital Fann

Department: Infectious Diseases

Work / Study undertaken – 6 week clinical placement in the department. There were a number of different sections, so rotated around and spent 2 weeks in each: Out-patient clinics, in-patient ward and intensive care. It was a mixture of purely observational, shadowing and being responsible for my own patients on the ward, though the doctor was available if you had questions.

Description of destination Dakar is the capital of Senegal and one of the busiest cities in West Africa. Lots of people, noise and pollution but also some nice beaches and all the comforts of Europe (France) if you want them and can afford them. I have travelled in Africa a few times but I found Senegal tough. I think it was partly due to the French, the Islamic culture, especially Ramadan. Nevertheless, it is a remarkable country, politically stable and progressive, struggling with corruption and poverty in similar respects to many other African countries.

Were the local people friendly? Yes and no! Most people are pleasant, especially in the hospital. However, on the streets there was quite a lot of hassle from guides/shopkeepers. It was difficult to make friendships with the local people. Its also a very Muslim country so culturally very different to anything I have experienced before.

Did you feel safe and if not why not? During the day – yes, no problem. There are reported dangers of muggings at night in the capital, and we were actually pick pocketed once late at night. So I would recommend not walking around alone after dark. Similarly in some of the more touristy beach towns south of Dakar I came across difficulties with lecherous men, mainly Rasta’s, being rather persistent!

What did you do in your spare time? Swim in the Olympic swimming pool, read, do French lessons on the internet. I also went out to nice restaurants and live music events in the evenings fairly regularly.

Is there anything that you would particularly recommend others to do? In Dakar – search out live music events and poetry slams. Explore outside of Dakar – to the nicer beaches and less chaotic towns. Casamance is definitely worth a trip too.

What was the climate like? Really hot! 35°C, 85% humidity (i.e. you basically sweat all the time). That was Aug-Oct, which is the tourist low season for that reason, though you get used to it. What was your accommodation like? I stayed in a English ex-pats house, which was arranged through family friends. It was very convenient but did mean that I spoke English in the evenings.

Was it provided? No.

How much did it cost? I paid this English lady £200 for my 6 week stay.

Did you enjoy your visit? Enjoy? No, not excessively. I’m really glad I went. I knew it was going to be tough and it was.

Did you find it useful medically? Yes, to some extent, although it was also frustrating. I only ever understood 70% of what was going on really. My ability in French limited me understanding the details of the medicine so I’m not sure how much I could apply what I learnt back in England. Also, there were 20 other French medical students at the ID dept so they often got much more involved with interesting cases than I could, just because there wasn’t the language barrier.

Has it improved your French? Yes –although not as much as I had hoped. I shouldn’t have stayed with an English family!

How has it increased your knowledge of French culture? Absolutely, though I’m still intrigued by Senegalese people. I loved the music and dance especially. Something I was not aware of before arriving was that Senegal is very Muslim. It was Ramadan during my time there so that was an interesting cultural experience.

If you went back would you do anything differently? Not stay with an English family. I would consider going to a different, smaller hospital – still in Dakar so that you can benefit from all the city has to offer but not where there would be so many other medical students.

How did you get there? Flights with TAP Portugal, London – Dakar, via Lisbon.

What was the approximate total cost? Flights about £400 return. A meal out in a nice restaurant could be £10. Daily living costs could be quite cheap if you eat street food and shop in local markets. European things at European prices. Accommodation the other big cost: see above.

 

Report 4

Reporter: Tania Longman

Contact at destination: Colonel Babacar Wade

Year of visit: 2009

Country: Sénégal

Region: Dakar

Institution: Hôpital

Department: Paediatrics

Work / Study undertaken: Was able to do as much as I felt confident at. Role similar to local final year students and junior doctors. Was responsible for daily clerking of my own patients and presentation on consultant led ward rounds in the mornings. Documented findings in notes, ordered and followed up investigations, wrote discharge summaries. Had the opportunity to sit in on outpatient clinics in the afternoons.

Also did project collecting material for a medical French e-learning resource – filmed interviews with staff, took photos of procedures / hospital life. Required extensive ethical considerations, supported by University in UK.

Description of destination:

Dakar is a big, bustling, lively city, located on a peninsula on the Western-most tip of Africa. Really marked rich/poor divide which could take some getting used to if it’s your first time in a developing country.

There are plenty of beaches around the city centre, and some nice swimming and surfing beaches just 30 min away. The entertainment scene offers regular, excellent quality live music (except during Ramadan!), really good restaurants and plenty of dance / drumming classes.

It is possible to live very cheaply if you do as the locals do – eat street food, take the bus etc. There is a strong French influence and pretty much any European luxuries are available at European prices.

Were the local people friendly?

Extremely, although at first it seems as though everyone is trying to sell you something. Most people are pretty genuine though – avoid making “new friends” in the really touristy places where all the hustlers hang out.

Did you feel safe and if not why not?

Incredibly. Violent crime against tourists is virtually unheard of in Sénégal and theft is pretty low too, although pickpockets hang out around the markets. Everyone leaves their valuables unguarded on the beach when they swim – people really seemed to look out for each other, especially in the fishing villages like N’Gor, that are small communities.

There are thousands of taxis that are very safe although they will try and charge you twice what they should if you’re a tourist. If you know the proper price stand your ground and they’ll either drive off or give in.

As a lone female I took the same precautions I’d take anywhere. I lived in a “dodgy” area, Medina, a working class quatier just outside central Dakar and had no problems whatsoever. I didn’t see another non- Sénégalese person in Medina the whole time I was there. As a non-touristy area no-one tried to sell me anything and the people that chatted to me were genuinely interested and I made some good friends.

What did you do in your spare time ?

Swim, go to the beach, dance classes, go to football matches and hang out with locals. Being 97% Muslim most people don’t drink so bar culture tends to be the expats and some wealthier Sénégalese. I went clubbing a couple of times when friends from UK visited – they start and finish pretty late – clubs open at 1am. It’s worth going to watch the locals in a dance-off, and if you’re feeling brave, to join in.

In most residential areas there are amazing dance and drumming gatherings out in the street virtually every night. Could be celebrating pretty much anything – a religious ceremony, a wedding or a football win. You’ll usually be invited to join in and I found people really welcoming and happy to explain what they were celebrating.

Is there anything that you would particularly recommend others to do?

Hang out with the locals. It can be a bit difficult at first because they all speak Wolof, the local language, and are really keen to teach you. I learned the (very) basic stuff, which definitely helped break down barriers in most situations, particularly as most of the children in paediatrics didn’t speak French. Once they’d seen I’d made an effort in Wolof they’d happily chat in French as they realized that we could have an actual conversation in French.

Learn to dance Sabar! There are loads of dance classes but also most locals are happy to show you their (usually amazing) dance skills. Helps to have a few moves if you find yourself at a drumming gathering in the street and you’re invited into the circle. People are so good-natured that they’d love it that you were getting involved, regardless of whether or not you knew what you were doing.

Visit the Cassamance region in the South. The overnight boat from Dakar is definitely the best way to get there. Lush, tropical vegetation, beautiful beaches and extremely chilled out, friendly people. And loads cheaper than Dakar.

Check out some of Dakar’s patisseries – a few are as good as the best ones you’d find in France! You can get really good seafood there too.

What was the climate like?

August and September were very wet and very hot. Avoid monsoon if you can, the South is especially wet. After the rainy season it’s really hot (over 35 degrees) for a few weeks then cools down a bit. In Dakar it’s not too bad as you’re by the coast the whole time, although sitting on a bus / car rapide is not too fun when it’s that hot. It was Ramadan for the first month I was there and I have no idea how people managed to get through the days with out drinking any water.

What was your accommodation like?

I lived with a family, who I found through friends. I had my own room and shared the rest of the house with 14 others. Very basic and in Medina, a really interesting working class quatier just 30 min walk from central Dakar. I ate with the family Senegalese style – sat on the floot, all out of the same bowl, using our hands. Was a bit disconcerting at first as there was no loo paper or soap in the house (I brought my own) but I managed not to get sick.

Was it provided? No.

How much did it cost? Worked out about £4/night inclusive, which is very cheap for Dakar.

Did you enjoy your visit? Absolutely loved it. Challenging times but I wanted that. Wish I could have stayed longer.

Did you find it useful medically?

Very. The hospital staff let me do as much as I felt confident at and I got lots of experience with tropical diseases like Malaria that I’d not encountered in the UK.

Has it improved your French?

Yes. Writing in the notes at hospital helped the most. In everyday conversations people don’t tend to correct you (like they do in France) when you make a mistake, if they’ve understood basically what you were trying to say. I think this is partly because they’re so laid back and partly because it’s their 2nd language too.

How has it increased your knowledge of French culture? Yes. Met lots of French people out there and hung out at the Institut Français www.institutfr-dakar.org a lot. It’s worth joining the institut for internet/library facilities & an active cultural program of exhibitions, films, concerts etc and their café/bar is a great place to meet people.

If you went back would you do anything differently? Avoid Ramadan. The whole entertainment scene shuts down for a month and people are less energetic. Although the end of Ramadan parties were good.

How did you get there? Eurostar to Paris then direct flight with Air France. There are no direct flights to Dakar from the UK but you could fly to Banjul in the Gambia and then go overland / get a connecting flight to Dakar.

What was the approximate total cost? Flights are about £500 if you book in advance but go down to about £300 if you book “last minute” (within about a month of your travel dates).

Is there any other information that you think may be useful?The Lonely Planet Senegal and the Gambia is excellent. I’m not usually a fan of these guide books but found this one really accurate with all their recommendations. I used it a lot.

I’d be happy to talk about my experience if you’re thinking of an elective there. Email me: tanialongman@hotmail.com

 

Report 5

Reporter: Rob Venn

Contact at destination: Pr. Nicolas KUAKUVI (chef de service and very nice man)

Year of visit: 2004

Country: Senegal

Region: Dakar

Institution: Hôpital Aristide le Dantec

Department: Paediatrics

Work / Study undertaken Two month attachment to paeds, the Dantec is a teaching hospital, so lots like being a medical student in this country. Did a short project on malnutrition. People at hospital really friendly; you could probably do as much as you feel confident at.

Description of destination Dakar is the capital of Senegal and one of the main towns in west Africa. A big town: lots of people, noise and pollution, but some nice beaches and all the comforts of Europe (France) if you want them.

Were the local people friendly? Yes, but masses of unwanted attention; it’s often difficult to distinguish between genuine friendliness and another scam, and sometimes the line is blurred. There are really lovely friendly people, but when you’re travelling it can be hard to shake off some ‘guides’, although if you don’t mind paying for the odd thing this doesn’t have to be too much of a problem. Depends how you feel about this, I wasn’t at all keen to be guided anywhere.

Did you feel safe and if not why not? Mostly, though I was very cautious in some areas, perhaps too much so after a couple of annoying encounters in the first couple of days. There are thieves and pickpockets in Dakar, but I was never robbed and while there is much hassle in town, I don’t believe there is a real threat of physical violence, although it’s probably best for a white person not to walk around alone at night.

What did you do in your spare time ? Swim, wander around Dakar and local area, sit talking outside the flats in the evenings. There are bars and clubs, mainly in town, but a disadvantage of being on your own is that you may not get much chance to do these.

Is there anything that you would particularly recommend others to do? Just explore the country: the different towns and villages vary a lot in character, take some time, find some nice places and relax. Joal and Mar Lodj could be my favourites.

What was the climate like? Hot! 35°C, 85% humidity (i.e. you basically sweat all the time) and a plague of locusts. That was Aug-Oct, which is the tourist low season for that reason, though you get used to it. To some extent.

What was your accommodation like? University immeuble (really intended for staff or visitors). V. nice room, TV, balcony, fridge, gas burner, cleaner. Good but expensive (£10 a night), you could find cheaper (& with air con.) in the private sector but don’t know how easy this would be.

Was it provided? Arranged by hospital.

How much did it cost? 10,000 CFA francs a night (F CFA is fixed at F655=€1, so F1,000~£1)

Did you enjoy your visit? Yes

Did you find it useful medically? Yes, mainly in terms of seeing lots of things and unusual pathology.

Has it improved your French? Yes – a great place to go if you don’t want to speak English!

How has it increased your knowledge of French culture? Local culture, yes. Understanding of lifestyle and attitudes to life just from living there and talking to people. Chance to meet people from across west Africa and the francophone world. As my first visit to Africa it was like a completely different world that I knew almost nothing of beforehand. It’s good to read newspapers and magazines and learn about these countries that I at least knew little of.

If you went back would you do anything differently? Spend less time on Dakar’s public transport; though it is of course an essential part of the trip, the 45-minute traffic jams are no joke: just pay the money and take taxis. Explore more of the country: after a couple of trips I wished I’d had the time to see everywhere.

How did you get there? Flew Paris-Dakar. No direct flights from this country.

What was the approximate total cost? Flights about €400 from Paris. Daily living costs quite cheap, European things at appropriate prices. Accommodation the other big cost: see above.

Is there any other information that you think may be useful? Don’t be put off by the hustlers and hassle, there’s a lovely country underneath it all, though it can be hard to see sometimes, especially in central Dakar. Read a little about the country and life before you go, so you’re not completely bemused by the marabouts, gris-gris and other weird features of life.

Get Lonely Planet (“The Gambia and Senegal”): it’s really, really useful.

Money: lots of cash machines in Dakar. If taking cash/traveller’s checks, take euros, not dollars or sterling.

They do not recognise you from the hotel/airport!

Eat lots of mangos!

Anything else you want to know, contact me at RMVenn@Yahoo.co.uk.