When I first stepped into Nduta Refugee Camp ten years ago, I thought I understood medicine. Yet 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 also by the diversity of conditions—skin diseases, diarrhoeal illnesses, infections, and chronic disorders, 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 were unsure would survive; elderly men who had carried their last reserves across the border; families who had escaped 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.
Read: Tanzania refugee camps ‘overstretchedMy role has evolved across critical departments. I have 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, in north-western Tanzania, was never designed to host a functioning medical facility, yet today it shelters a neonatal ward capable of saving babies weighing under a kilogram.
Our maternity unit has dramatically reduced maternal and newborn mortality. We established a fully functional clinic for chronic diseases such as diabetes and hypertension, strengthened HIV and TB care, expanded mental health services, and improved emergency response systems.
A major breakthrough came when we secured formal referrals to Kibondo District Hospital, just 20 kilometres away, replacing the exhausting 90-kilometre transfers to another camp. This change alone has saved countless lives.
Read: Burundi refugees live in squalor in Tanzanian camps, but they still prefer life thereIn Nduta, medicine is more than treatment—it is protection. A refugee patient does not only need care; they need privacy, confidentiality, and a sense of control in a life stripped of it.
The systems we built for survivors of sexual violence are among the work I am proudest of, because they protect patients as human beings, not merely 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 save more mothers and babies.
Through training with medical experts from Geneva, our skilled midwives were validated as prescribers, granting them the authority to dispense essential medications for common conditions. This fundamentally transformed maternal care and empowered our national staff.
None of this would have been 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 remain. 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 kilometres to receive care they can trust. That trust is sacred, earned through consistency, respect, and compassion—and it is something we guard carefully.
Read: UN Fund gives $11m for humanitarian aid in TanzaniaMSF 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 such as 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. 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 have 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 haemorrhaging, the team moves instinctively. When a newborn struggles 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 have 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, 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.
The true victory in Nduta lies not only 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.
Dr Motta is a field medical doctor for MSF and served at Nduta Refugee Camp, situated in the north-western region of Tanzania. Provided by SyndiGate Media Inc. (Syndigate.info).
