Global Health Exchange Program: A Not So Tiny Story

Growing up as a young girl in Gaborone, Botswana, Tiny Mazhani, MBBCh, showed a natural aptitude for learning and was an excellent student. In her community, the ultimate career for an academically gifted individual was one in medicine. However, there was one not-so-minor problem: The country of Botswana did not have a medical school. Without a school of its own, the government would sponsor its young students to study medicine in countries like the United States, Ireland or Norway. Unfortunately, many of these students did not return once they completed their training.

At 19, Tiny found herself at Trinity College Dublin School of Medicine in Ireland. It was the first time she had travelled or lived abroad, and everything was a culture shock, starting with the weather. The short winter days and long summer ones differed vastly from Botswana, where it is generally warm year-round. However, the culture shock went both ways. She first went to Ireland in 2001, when many were still not accustomed to interacting with people from Africa. Their experience of Africans was almost exclusively with refugees

However, Tiny did not let these adjustments discourage her. She used the same determination that had propelled her to Ireland to get through medical training far from home. When she reached the clinical part of her medical training, she began to appreciate how she truly cared about helping people. She graduated in 2006 and immediately started her internship in Ireland. Tiny missed Botswana and found the working conditions and work-life balance not as she had imagined, solidifying her decision to move back to Botswana to practice. At this point she had had very limited experience in pediatric medicine.

Upon her return, Tiny worked as a general doctor and was assigned to the pediatric ward at Princess Marina Hospital (PMH) in Gaborone. There, she once again experienced a steep learning curve because although she had grown up in Botswana, her medical training in Ireland had not prepared her for many of the childhood illnesses she saw at PMH — kwashiorkor, tuberculosis, HIV and many others. Ever the fast learner, however, she was able to adapt quickly and enjoy her work. It was during that time that she first connected with the Botswana-UPenn Partnership (BUP) and Children’s Hospital of Philadelphia (CHOP) through Andrew Steenhoff, MBBCh, DCH, a CHOP pediatrician working at PMH at the time, and now Medical Director of CHOP's Global Health Center. Since Botswana still did not have a medical school at that point, BUP and CHOP’s collaboration with PMH were vital resources for Botswana’s young doctors, offering additional mentorship, training opportunities and research expertise.

Still unsure about what her medical specialty should be, Tiny left PMH in 2008 and started working in family practice at various clinics and district hospitals. Her time in family practice helped her confirm that she was passionate about pediatrics. She got back in touch with Dr. Steenhoff, who became her mentor. In 2011, Tiny joined the pediatric residency program at the University of Botswana where a medical school had finally been established in 2009. She worked closely with faculty from BUP and CHOP during her residency. Tiny notes, “I feel fortunate to have been connected with BUP and CHOP. They gave valuable input in the development of the training curriculum at the medical school and added expertise to what was then a very small faculty. CHOP’s Global Health fellows have also opened up new collaboration opportunities. Currently Tiny is a co-investigator on Dr. Matthew Kelly’s microbiome project, a former David N. Pincus Global Health fellow. With support and mentorship from Dr. Steenhoff and many others, Tiny successfully completed her residency thesis and pediatric residency.

True to character, Tiny did not only follow the path laid for her, but she forged new ones. During her residency, she started a neurology clinic at PMH. Botswana does not have a pediatric neurologist, so Dr. Steenhoff connected Tiny to CHOP’s Laura Adang, MD, PhD, who consulted on some of Tiny’s cases and travelled to Botswana for two separate monthlong stints of clinical service at PMH. Practicing alongside Laura has given Tiny invaluable experience, a new mentor, and support to pursue a field that interests her.

Tiny became an attending pediatrician in Botswana in 2016, and last year joined the faculty of the University of Botswana Medical School. Presently, Tiny has been accepted into the University of Pretoria’s Pediatric Neurology program in South Africa and will start her fellowship in August 2018. “CHOP and BUP have been instrumental in my professional development. I feel fortunate for both the professional and personal relationships that I have gained working with them, and look forward to seeing Dr. Steenhoff as a career mentor and professional support to me for many years to come,” says Tiny. “Batswana doctors are now able to get further training here at home to benefit our people … and its training of high caliber that teaches us about locally relevant diseases, and makes us want to further transform our Botswana health system.”