By Mazhar Shahen – Art in Tanzania internship

In Tanzania over 90% of the population live in areas where there is risk of malaria. In Africa, Tanzania is the third largest population at risk of malaria. Most of the victims of the disease are children, with around 80,000 death annually caused by malaria. In Tanzania, the Kagera Region on the western shore of Lake Victoria has the highest risk of contracting the disease. The Arusha Region is a lower risk area. However due to climate change and people migration caused an increase in the migration of mosquitoes and caused areas that are malaria free to be exposed to the disease. 


Malaria is a life-threatening disease caused by the transmission through an infected female Anopheles mosquito. The infected mosquito is a carrier of Plasmodium parasite. The parasite is released into the human bloodstream through the mosquito bite. The parasite survives in tropical and subtropical climates. After the parasite enters the human bloodstream it travels to the liver to mature. Maturity of the parasite takes several days, then the parasite goes back to the bloodstream to travel to the red blood cells this time. Once the red blood cells are infected, the parasite starts multiplying withing 2-3 days, causing the infected red blood cells to burst. 

Malaria is an acute febrile disease, which means it shows signs of fever when infected. Symptoms appear in a non-immune person 10-15 days after the infection has occurred. Early symptoms are mild fever, chills, and headache. Since it is mild, it makes the malaria disease harder to detect early on. If not treated the plasmodium parasite can progress to severe illness, usually leading to death.

Severe malaria in children could lead to severe anaemia, respiratory distress, and/or cerebral malaria. Adults are at risk of multi-organ failure. 

In 2019 the World Health Organization (WHO) reported that half of the world’s population is at risk of malaria. With most of the cases and deaths are in the sub-Saharan Africa. This indicates that African community is in need of a malaria vaccine as soon as possible. Malaria control has been better, with the number of cases dropping significantly over the last decade, with the number of children dying from malaria being halved. 


Vaccines are a hot topic in the world we live in. Vaccines help us strengthen our immune system against specific disease which protects us from that illness. Vaccines are usually needle injections but can also be given by mouth or sprayed into the nose.

WHO claims that the malaria vaccine is capable of reducing malaria cases by 75% and put us on goal of the eradication of the illness. Malaria is responsible for 219 million cases each year with an estimated 660,000 deaths of the illness.

Tanzania has the third largest population that is at risk of the illness in Africa, with 90% of the population at risk of contracting malaria. Tanzania has 10 to 12 million cases of malaria annually, with most of them being children. The number of cases has been controlled a lot better of the decade leading to significant decrease, and number of children dying from malaria halved. However, due to climate change and the migration of people malaria cases are rising in areas that were considered low risk in the past. This is complicating the fight against malaria. 

Vaccine RTS,S acts on Plasmodium falciparum, the most deadly malaria parasite in the world and specifically in Africa. The vaccine is the first and only successful vaccine for malaria, which helped in reduction of children death in Africa. This vaccination is part of the Malaria Vaccine Implementation Progamme (MVIP), this program is established by WHO to deliver the vaccine in selected areas of Africa with the help of each country’s governments. The 3 African countries that are currently in pilot introduction are Ghana, Malawi and Kenya. The goal is to supply the whole region by 2023. Vaccine RTS,S is considered a safe vaccine, and no proven direct side effects are there. The pharmaceutical giant GSK will be conducting a number of Phase 4 studies in the 3 African countries chosen for pilot. 

In 1987 the discovery of a synthetic peptide polymer (SPf66) in Columbia enabled the development of the first vaccine candidate. Tanzania was the second country after Columbia to participate the clinical trials of SPf66. This indicates that historically Tanzania has an advantage as researchers will have a deeper pool of information in Tanzania compared to other African countries. Researcher George M Bwire states in his article that the inclusion of Tanzania in the Malaria Vaccine Implementation Program for the current RTS, S vaccine is crucial.


  1. Agnandji, S. T., Agnandji, S. T., Asante, K. P., Lyimo, J., Vekemans, J., Soulanoudjingar, S. S., . . . Abdulla, S. (2010). Evaluation of the Safety and Immunogenicity of the RTS,S/AS01E Malaria Candidate Vaccine When Integrated in the Expanded Program of Immunization. The Journal of Infectious Diseases, 202(7), 1076-1087. Retrieved 2 11, 2021, from
  2. Bwire, George & Sanga, Anna. (2019). Malaria control in Tanzania: Current status and future prospects. 2664-8490..
  3. Dimala, C. A., Kika, B. T., Kadia, B. M., & Blencowe, H. (2018). Current challenges and proposed solutions to the effective implementation of the RTS, S/AS01 Malaria Vaccine Program in sub-Saharan Africa: A systematic review. PLOS ONE, 13(12). Retrieved 2 11, 2021, from
  4. Galactionova, K., Tediosi, F., Camponovo, F., Smith, T., Gething, P. W., & Penny, M. A. (2017). Country specific predictions of the cost-effectiveness of malaria vaccine RTS,S/AS01 in endemic Africa. Vaccine, 35(1), 53-60. Retrieved 2 11, 2021, from
  5. Malaria vaccine implementation PROGRAMME (MVIP). (n.d.). Retrieved February 12, 2021, from
  6. Malaria in Tanzania. (n.d.). Retrieved February 12, 2021, from
  7. White, N. J. (2011). A vaccine for malaria. The New England Journal of Medicine, 365(20), 1926-1927. Retrieved 2 11, 2021, from

Tips for medical volunteers

Art in Tanzania works with numerous health care facilities in Tanzania, varying from big hospitals to small community clinics. Medical volunteering or interning in Tanzania is an eye-opening and educational experience for both current and future medical professionals. One of our professional medical volunteers listed some useful tips for future volunteers based on her experiences:

Medical volunteer in Tanzania

  • The roles at hospitals are the same as in the Western world, but the resources are very different. High respect for the local medical staff and their good job despite the limited resources!
  • You will see and experience a lot of things which at home you could only read from books. You will be having a hard time seeing people die of simple diseases that in Western countries could be cured with just better nutrition and hygiene. It’s very educational to realize that you can only do a small fraction and not save the whole world.
  • You will be able to participate in the hospital’s/clinic’s daily life in many ways. Depending on your level of studies and profession, one day you’ll be assisting in a surgery and the next folding bandages with nurses.
  • Patient records are kept in paper files. Therefore there is no excess paperwork or endless sitting in front of computer screen, so there will be more time left for actual work with the patients.
  • The work days involve a lot of waiting and long lunch breaks that can sometimes feel frustrating and inefficient, but that’s the way things are done here and it’s just something you will have to get used to.
  • Thoughts about a Westerner coming here to tell how things should be done should be thrown in the dustbin. The work is done together, learning from each other. What works in Western countries doesn’t necessarily work here. The most important thing is to abandon your prejudices and “everything’s better at home”-attitude and try to be open-minded towards the new culture!
  • Before your trip it’s good to determine your motives and goals, as that way it’s easier to help and learn.Medical volunteer at Mbweni hospital
  • Keep your eyes open, make observations and ask lots of questions.
  • After all, health care is always about people and their wellbeing. As a health care professional you donate the patients part of your time, knowledge and skills regardless to where in the world you are. Despite the limited resources there’s always something you can do -listen, learn and support!
  • It’s a good idea to study the basics of the local language beforehand, and you will learn more in the work.
  • If you wish to get involved in making diagnosis and treatment decisions, it’s a good idea to do research on at least the most common diseases; malaria, diarrhea etc., and also on tropical diseases in general.
  • Bring your own scrubs to wear, and if possible, bring with you disposable gloves, facemasks or other healthcare equipment to donate.