Supporting opportunities for everyone

About the author: Catherine Shari works as an emergency physician at the Emergency Department of Muhimbili National Hospital in Dar es Salaam, Tanzania.  On top of that, she is also an honorary lecturer with the Muhimbili University of Health and Allied Sciences.  More recently Catherine became a GloCal research fellow (2017/2018).  But Catherine didn’t always consider a research-based career.  Oddly, she didn’t consider a career in emergency medicine either.  Both research and emergency medicine found her.  We caught up with Catherine so she could share her story.
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I still remember crying when I learnt that my next rota allocation will be in the Emergency Department of Muhimbili National Hospital.  It was 2012 and at the time, I was a general practitioner from a rural hospital.  My limited encounters with emergency medicine (up to that point) had exclusively been of poorly-resourced casualty rooms and its associated failings – death and suffering.  As a result, the whole notion of working there seemed pointless, hopeless, a wasted opportunity.  I was determined to go elsewhere – anywhere; just not the Emergency Department!

It seems surreal to think that I nearly missed out on this career I now hold very dearly.  I can recall impromptu meetings with the director of human resource administration nearly each day for the first few weeks, begging for a different posting.  My bias meant that I was slow to realise that something truly unique was growing in the Emergency Department at Muhimbili National Hospital. A collaboration between the Abbott Fund Tanzania, Muhimbili National Hospital, Muhimbili University of Health and Allied Sciences, and the Tanzanian Ministry of Health had resulted in a training program in Emergency Medicine at Muhimbili National Hospital. I couldn’t get a different post so I got stuck with the Emergency Department. It took less than a month for my eyes to be opened; and then I saw it: the doctors and nurses in the Emergency Department actually knew what the were doing and were saving lives for real.  It had budded into a place of hope, right under my nose.  And I wanted to spread this hope that grew inside of me across the whole of Tanzania. 

By the time I became an Emergency Medicine trainee in 2013, clinical emergency care was what excited me the most. However, part of the programme required that I conducted a research project. It was then that I realized that I could very likely make a much bigger impact, in an area that I was passionate about, through research. 

My project was simple: I objectively evaluated the practice of emergency blood transfusions for paediatric patients. I worked so hard and learned how to do good clinical research in the process. My hunch was that we were probably not doing as well as we could do.  I was right.  But something was missing. I knew I wanted to disseminate my findings, but I wasn’t really sure where to start. Very few of my seniors had published their dissertation’s research; I thought of presenting the findings at a conference, but found that I could not afford registration. I recall September 2015 as a particularly challenging time; I was struggling to get financial support to attend the 2016 International Conference on Emergency Medicine in Cape Town, South Africa. That is when opportunity found me.

When I first heard of Supadel I couldn’t even spell it! I kept on wondering, what are people saying? super-der, supa-dale, superdell? Of course Supadel is the peer-to-peer conference sponsorship scholarship from the African Federation for Emergency Medicine.  It was a fine day the day I heard my application had been successful.  The 2016 International Conference on Emergency Medicine was one of my all-time greatest experiences. The exposure, learning and networking with very successful people in emergency medicine from all over the world provided me with a rare chance to stop and rethink my career trajectory. I attended a research workshop and presented my own work. Not only that, but I also won a best poster presentation award! In 2017, I was fortunate to be awarded the Supadel scholarship for a second time.  This time I was able to attend the Emergency Medicine Society of South Africa’s annual conference.  I was humbled to again win a best oral research presentation award.  The opportunity to attend these conferences completely changed my research career prospects. Furthermore, winning these research awards had a significant effect on how I valued my own research.  

The experience that I obtained through conference presentation, made me feel fairly confident.  And so I applied for a GloCal Mentored Research Fellowship towards the end of 2016.  This came at a very challenging period for me.  I was full-term pregnant and was booked for a caesarian section four days before the application deadline! I was determined to follow it through though.  I knew better research systems could help other healthcare professionals in Tanzania do better research.  I knew that this would translate to better patient care for far more patients than I can ever see on my own in the Emergency Department at Muhimbili National Hospital. So there, in my hospital bed, before and after a caesarian section, I completed and submitted my application on time.  
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I am currently busy with my GloCal fellowship.  I plan to use the experience to prepare myself for a sustainable clinical research career, by advancing my knowledge and skills in clinical research design through the formal course work and mentorship offered.  I am as excited for my future as anyone in my position can be, and determined to make an impact in African emergency care. I pray that one day I will have the opportunity to be on the other side and help others get the support and mentorship that I got through Supadel and GloCal.

You can read Catherine’s fascinating case report on purulent pericarditis in a child published in the March issue of AfJEM here.  Catherine’s work on blood transfusion practices among anaemic children were published in the BMC Hematology and can be found here.
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Follow her on Twitter: @catherine_shari ‏