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WHEN should one think of healthy retirement plan?

Q. Doctor Massi, please give the readers your brief history?
A. I married in 1985 and have two children. My wife is a nurse by profession and she still serves in Morogoro regional hospital. I have two children. My first born is a graduate who holds a degree in procurement. The second born is intending to pursue a degree in medicine at a private university in the country.
My life history starts in Dodoma. I was born in Hombolo, Dodoma. I started my primary school in Dodoma and  completed in Manyoni then proceeded to Malangali Secondary school, and then joined Mkwawa High school in Iringa. I am so glad to see that later in life the Mkwawa secondary school was seen good enough to qualify to be transformed to a university.

After the national service, I was selected to pursue my Doctor of medicine degree in the former Soviet Union. After completing my studies I did my internship for one year at Muhimbili National Hospital. Later I was posted to Mtwara, Dodoma and Singida. Many in those days perceived that being posted to Mtwara was a punishment. To me it was different.

After serving for some years in these regions I was transferred to Morogoro where I worked for a period of six years.
In 2008 I was posted to Mwanza where I stayed until my retirement.
Q. As a retired doctor who served in a senior medical position (Regional Medical Officer) which of your legacies would you like to share with our readers?
A. I tried much to work in order to fulfill the government programmes and policies. I was committed to fight maternal and child mortality. I also embarked on addressing communicable and non-communicable diseases. It was my passion to create a teamwork since I believe team work spirit makes it easier for one to succeed in any endeavour.

I also tried to improve the working conditions of my subordinates. In Newala we constructed new health facilities, renovated a number of hospitals in Newala, including health centres and dispensaries. I also renovated the district hospital with funds from the former West Germany.

In Iramba district we constructed 11 new dispensaries and one health centre. But before leaving Iramba I had left funds for the renovation of the district hospital.Upon arriving in Newala and Iramba there was no electricity. I took emergency measures to purchase new generators. Even though it was in the government plan that it was soon to provide electricity through the national grid.

In Morogoro with the support of the government we constructed a new care treatment centre for HIV/AIDS for the regional hospital. Also we put up a facility for eye clinic.
In Sekou Toure hospital we did not have an integrated psychiatric unit, so we constructed one. But I think Bugando did have one.
Now Mwanza has all the specialists. During my tenure in office we had looked for the specialists and were able to deploy. When compared to other regions we are much better.
Q. What can you say about the training you undertook in the former Soviet Union?
A. You are right that there is that perception that doctors trained in the Soviet Union are inferior in quality. It is still there but we have managed to correct that misconception. The public has realized that many of these doctors are working in the same capacity like their colleagues who trained elsewhere.

The reason why we went to the Soviet Union, the selection followed the war situation in Uganda. Those who were to be trained at Makerere University could not go there because of the state of war. So we were sent to the Eastern Europe as an alternative.
Some of our colleagues had declined to take up the opportunity because of the same perceptions. But I always believed that the former Soviet Union had the expertise.

Part of this decampaigning was during the cold war. It was because of this power struggle the west was trying to say negative things about the east. For example when the Chinese committed themselves to build TAZARA it was the same criticisms in terms of standards and quality.

While in the USSR I found that there was a system in place. Their education approach was different, as it was humble method of training. There were no intimidations, the learning was student centred. It is different in most African countries, whereby some lecturers are even proud to fail their students. I think in the USSR there was no sexual harassment.

Q. As a graduate student then undergoing internship in medicine at the Muhimbili University College, did you face any problems?
A. My Internship in Muhimbili was smooth, of course someone faces language change problems but they are minor. The postgraduate in Muhimbili was not friendly in those days and many preferred to go abroad. The admission was also limited. However I did my postgraduate studies in Japan.

Maybe that is why today we still experience a shortage of specialists in the country.In the former Soviet Union we were in a foreign country. The indigenous seem not to want you around in those days. They see foreign students as  consuming their resources.
In 1996 I started using high-level forums advising the government to improve our medical services in the country.I was among other doctors who requested the Muhimbili University College to increase its intake from 50 students to 200.

Q. Who are your icons that you think are worth emulating in the medical field in the country?
 A. Dr  Aaron Chiduo was one of them. When he was the minister there was political will to improve the college admissions and introduction of the Health sector reforms spearheaded by the late Dr Aaron Chiduo. This was one of his legacies in the medical sector.
 Q. You are a household name in many regions that you worked in the country, how did you win hearts and minds of your clients?
A. One thing that made me win the hearts and minds is my language and attitude to patients and people in general. Since you are building team spirit the language ought to be friendly. It should be that one is friendly to the patients. I listened to them and reminded the others to do the same. We as professionals sometimes we think we know everything. It is always good to listen to the communities. People always analyse what they say. So if there is any scientific backing against or in favour of a medical problem explain to them.
In Newala we were able to reduce mal-nutrition. How did we go about it? We wanted to find out the reason behind malnutrition. In a meeting with the community we started looking for their problems. The main problem raised was fetching water far away from the villages. Women spend a lot of time looking for water and often men were not helping. So it was established that women do not have enough time to prepare food for their children, which left them starving.

Q. Someone was telling me you are not tired, and still active in  advising  the local organisations promoting health, what is the secret behind this energy and commitment?
A. Thanks God for this energy, health and life. If you look back a lot of colleagues are not with us today so much to be thankful to God. The secret behind good health is keeping oneself fit. Sometimes doing exercises and avoiding driving everywhere. I did not get addicted to office transport, I still went on to walk and exercise.

Q. What was the most complex situation that you once faced when handling an emergency case with limited facilities?
A. The cholera epidemic in 1997 while in Dodoma was unique. It was all over the country. It happened in that year of Elnino rains. Sometimes 100 patients were admitted in the municipal hospital in a day!. Patients were scattered in different hospital floors. When I went out of Dodoma town to supervise the emergency services when the epidemic took place, when I saw the magnitude of the crisis, I immediately joined the team of doctors to help rescue the patients. All those in my delegation joined me.
 Q. Were practitioners in your time taken to task for their action or inaction?
A. Starting in all hospitals. In these centres we had programmes or systems. You have to meet to discuss patients with serious conditions and deaths. We used to be questioned why a patient died and was everything done properly to save his or her life. Was there any negligence connected to the death?

Q. What kind of training is lacking today if you revisit your time of practice?

A. Today you find families sitting with the patient waiting for his terminal illness to end his or her life. Many medical practitioners do not apply psychosocial therapy. Consolation is not there. It is good even for the pathologists to offer consolation to those who have lost the beloved ones.
Q. What is the level of commitment in the new cadre of medical doctors?
A. The new graduates we are seeing in the medical field, in the beginning show a lot of commitment. Later they get committed to second income projects especially working extra hours in private health clinics. This is the area where the young doctors want a life style like senior doctors.
Most of the doctors are committed to helping people to alleviate their suffering, which is stipulated in the oath one takes before becoming a doctor.

Q. Some people talk of retirement plan, when should one start thinking about it?
 A. I would advise people to plan their retirement from the day of their first appointment. When you are taking a first degree you start planning how many children you should have by the time you retire. When one retires one's last born should be at the age of 18-20 years. It is also crucial to know where you will spend your last days, which shelter you will occupy, the type of medical coverage and above all a decent retirement package.How to achieve this? We always think that the government will give us a package through social security funds. But it is good to start setting aside funds or start a project to generate more income. These funds will supplement your income.



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