When I first stepped into Nduta Refugee Camp ten years ago, I thought I understood medicine. But nothing in my training prepared me for the reality of a refugee camp, where illness piles on top of trauma. I remember being struck not only by the number of sick people but by its diversity: skin diseases, diarrheal diseases, infections, chronic conditions, often all within the same family. It was overwhelming, and it changed me instantly.
People had fled with whatever strength they had left. Mothers clutching newborns they weren’t sure would survive. Elderly men who had carried their last strength across the border. Families who had fled Burundi with nothing but the will to keep walking. What struck me most was not the suffering, but the determination of people who, despite losing so much, still fought to live.
My role has evolved across various critical departments. I’ve worked in the emergency room, the maternal health ward, the adult inpatient department, and most complexly, the neonatal unit, caring for infants born as early as 28 weeks. This variety has demanded constant adaptation and continuous professional development.
Over the years, the camp’s hospital grew in ways none of us expected. Nduta was never designed to hold a functioning medical facility, yet today it shelters a neonatal ward capable of saving babies weighing under a kilogram. Our maternity unit dramatically reduced maternal and newborn mortality. We established a fully functional clinic for chronic diseases like diabetes and hypertension, strengthened HIV and TB care, expanded mental health services, and improved emergency response systems. One major shift came when we finally secured formal referrals to Kibondo District Hospital, just 20 kilometers away, replacing the exhausting 90-kilometer transfers to another camp. This change alone has saved countless lives.
In Nduta, medicine is more than treatment, it is protection. A refugee patient does not only need treatment, they need privacy, confidentiality, and a sense of control in a life that has been stripped of it. The systems we built for survivors of sexual violence are among the work I am most proud of because they protect patients as human beings, not just medical cases. Dignity is not a luxury in a refugee camp-it is a form of healing.
I was the first Tanzanian doctor hired by MSF in Nduta, and over the years I helped establish the NCD department, strengthen infectious disease services, expand maternity care, improve referrals, and develop staff health systems. One initiative I am particularly proud of is our push to elevate midwives into prescribing midwives, empowering them to respond faster in emergencies and ultimately saving more mothers and babies. Through training with medical experts from Geneva, our skilled plain midwives were validated as prescriber midwives, granting them the authority to dispense essential medications for common conditions, fundamentally transforming maternal care and empowering our national staff.
None of this would be possible without the people behind it. Tanzanian clinicians, nurses, midwives, laboratory experts, and international specialists work side-by-side in a rhythm built over years. We learn from each other, sharpen each other. Even when international colleagues leave, the skills, knowledge, and standards stay behind. That continuity is MSF’s true legacy.
Our hospital treats everyone equally; the Burundian refugee, the Tanzanian community, anyone in need. Many travel over 100 kilometers to receive care they can trust. That trust is sacred, earned through consistency, respect, and compassion. That trust is something we guard carefully.
MSF has never worked alone. Our collaboration with Tanzania’s Ministry of Health ensures our practices meet national standards while maintaining independence. Together, we respond to outbreaks like Marburg and Cholera, train health workers, and strengthen systems, proving that even in the most remote places, high-quality care is possible.
With MSF’s constant training and international mentorship, I learned to think faster, decide faster, and trust myself more. And slowly, this place shaped me not only as a doctor but as a person. Humanitarian work teaches you that time is everything. One minute can save a life or take it. It taught me discipline, empathy, teamwork, and above all, the value of serving people who have nowhere else to turn.
People often ask why I’ve remained in Nduta for a decade. My answer surprises them: impact. I stay because here, medicine means something. It changes outcomes immediately. Working with Médecins Sans Frontières (MSF) showed me what healthcare looks like when bureaucracy steps aside and humanity steps forward. When a mother is hemorrhaging, the team moves instinctively. When a newborn struggle for breath, oxygen arrives before the next gasp. It is medicine in its purest form: immediate, purposeful, deeply human. I found purpose here, but more surprisingly, Nduta found me. It shaped me into a doctor who thinks faster, trusts more, and never takes a single minute lightly. As a doctor, it is the closest thing to pure purpose I have ever known.
One of the darkest moments of my career happened in our emergency room. I will never forget the young man brought in after a neurotoxic snakebite. We had ordered antivenom long before, but due to national importation delays beyond MSF’s control, the shipment had not arrived. I watched the patient deteriorate minute by minute, second by second. We fought for him with everything we had. And I knew, painfully, that if bureaucracy moved as quickly as venom, he might have survived. That loss stays with me because it reminds me that in humanitarian medicine, the enemy is not just disease but also the systems that fail people when they are most vulnerable. Even today, it remains one of the hardest experiences I’ve faced.
Despite the difficult days, there are moments that remind me why this work matters. If there is one place in Nduta that holds my heart, it is the neonatal ward. I have held premature infants no heavier than my hand, silent, fragile, and fighting for every breath. Some weighed less than one kilogram, born to mothers who had escaped violence or endured unimaginable journeys. Watching a premature infant grow from 900 grams to 3 kilograms, open their eyes, or seeing a mother cry when her baby finally breastfeeds, or a father hold his child for the first time; these moments have written themselves onto my soul. Those babies taught me something profound: life does not need perfect conditions to thrive; it simply needs a chance.
If there is one place in Nduta that holds my heart, it is the neonatal ward.
The true victory in Nduta is not simply in the number of lives saved, but in the enduring change we have forged: a generation of Tanzanian medical professionals equipped to lead the fight against high mortality. This is the ultimate legacy of MSF, a relentless pursuit of dignity and survival, proving that even in the most remote areas, high-quality medical care is not a privilege, but an absolute human right. In the end, medicine is not just about curing disease; it is about nurturing dignity, empowering humanity, and leaving behind a world where care and compassion are not luxuries, but the foundation of life itself.
From Refugee to Responder: I Escaped War in 1996 and 2015, Now Finding Purpose in Every Delivery and Child's Smile.
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