On a Tuesday morning in July 2011, at Kiunga District Hospital (KDH) in northern Tanzania, two doctors sat in the congested anteroom of the facility's humble major operating theatre, discussing the file of a preoperative patient. Three Tanzanian nurses busied themselves between the anteroom and the operating theatre, cleaning surfaces or checking equipment in preparation for surgery. In one corner of the room, three wazungu volunteers in scrubs sat on a broken cot, sharing cell phone images with each other, lingering in hopes of observing a procedure. I was in another corner, compiling a list of medical equipment lacking in the theatre. The hospital matron intended to share this list with the volunteer placement organizations (VPOs) that brought these, and dozens more, volunteers to the hospital each year, in hopes that VPOs would ask their clients to donate some of the listed equipment upon arrival.

These activities were interrupted when three additional foreign volunteers walked tentatively in. ‘Can we observe the surgery?’ one asked. They were pre-medical students from the United Kingdom. One of the Tanzanian physicians, Dr Kapiga, whom I had known since 2008, looked at me and asked in Swahili, ‘What did they say?’ I relayed the request to him. ‘Do they have any medical skills?’ he followed. ‘No,’ I replied, ‘they haven't started medical school yet.’ ‘Do any of these wazungu have any medical training at all?’ he inquired. ‘Yes,’ I responded, ‘the ones wearing scrubs have completed their first year of medical school.’ Dr Kapiga looked thoughtful, then asked me a question that echoed my own concerns with situations such as this, which by 2011 had become frequent at the hospital: ‘Would it be permitted for random guests to enter, and watch or do any surgical procedure they wanted where you live?’

The scenario of foreign volunteers entering the surgical theatre at KDH is a relatively recent phenomenon, first initiated in 2007. During eleven months of ethnographic research on a different topic there in 2008, I counted no more than thirty such volunteers. Yet from September 2012 to September 2013, KDH hosted about 100 volunteers, the majority arriving between June and August. If seeing wazungu at the hospital in 2007 was rare, today their presence in Arusha, not only within clinics, but also throughout orphanages, schools, churches, and NGO offices, is routine.