Tackling Cardiovascular Diseases in Tanzania

June 18, 2021June 29, 2021Leave a comment

Background

Cardiovascular Diseases (CVDs), a group of disorders that affect the heart and/or blood vessels are the leading causes of deaths and disability-adjusted life-years (DALYs) globally. In 2017, CVDs were responsible for an estimated 17.8 million deaths, with more than 80% occurring in low- and middle-income countries (LMICs). LMICs are experiencing a higher burden of CVD deaths due to rapid urbanization, aging, and health and nutrition transitions. It is projected that by the year 2030, CVDs will cause more than 23.6 million deaths with stroke and coronary heart diseases being the main contributors if no appropriate measures are taken to alleviate the problem [1].

Tanzania, like other developing countries, is also facing a higher burden of CVDs. CVDs alone account for 13% of the total deaths caused by non-communicable diseases in Tanzania with adults aged 25–64 years being affected the most [2]. Age-standardized mortality rates attributed to CVDs were reported to be higher among Tanzanian men compared to women (473 versus 382 per 10,000 population) [3].

Trends of CVD death rates in SSA, including Tanzania, are highly driven by lifestyle changes, characterized by low levels of physical activity, excessive alcohol consumption, tobacco use and unhealthy eating. Poor management of these factors has resulted in intermediate risk factors such as raised blood pressure, raised blood cholesterol, diabetes, overweight and obesity, that have direct linkage with CVDs. All these factors occur as a result of rapid urbanization, modernization, socio-economic status and increased advertisement of the Westernized food market [3].

Despite the rising prevalence of CVDs in Tanzania, knowledge about their risk factors and warning signs in the Tanzanian general population is generally low, especially among individuals from rural areas. However, even those with adequate knowledge of CVDs are subjected to the risk of developing them due to disparity between their health literacy and lifestyle choices [4].

5 Most Common Cardiovascular Diseases

Heart Attack

A heart attack, also known as myocardial infarction, refers to death or permanent damage of an area of the heart muscle which occurs when it is cut off from the oxygen it needs to operate. It is a medical emergency which happens because the blood flow delivering that oxygen has been significantly reduced or stops entirely. This is due to atherosclerosis, or the slow buildup of plaque, which includes fat, cholesterol, and other substances, in the coronary arteries. Blood clots can then form around the plaque, which tend to slow or block the blood flow and cause a heart attack. A heart attack may be severe enough to cause death or it may be silent.

Stroke

Stroke is considered a heart disease because the condition centers around blood flow. However, a stroke is due to problems with blood flow to the brain rather than the heart. Ischemic strokes account for 87 percent of all strokes and occur because of blockage in a blood vessel that delivers blood and oxygen to the brain. Without blood and oxygen, parts of the brain can suffer damage or die off if not treated quickly. Hemorrhagic strokes make up about 13% of stroke cases and occur when weakened blood vessels in the brain rupture or burst resulting in bleeding in the brain. When blood accumulates in the tissue around the rupture, it puts pressure on brain cells and damages them. Hemorrhagic strokes may have various causes such as a vascular malformation or abnormal growth of brain blood vessels.

Heart Failure

Heart failure, also called congestive heart failure, refers to the heart not pumping blood as well as it should. It does not mean the heart has stopped beating entirely, as the name might suggest. The heart continues to pump blood, but not at a high enough rate for the body to continue to function. The fatigue and shortness of breath that can result from untreated heart failure can greatly interfere with everyday activities like walking or climbing stairs.

Arrhythmia

A heart arrhythmia is any abnormal rhythm of the heart: too slow, too fast, or at an irregular beat or tempo. Without proper rhythm, the heart doesn’t work as effectively. The heart may not be able to pump enough blood to deliver oxygen and nutrients to other organs.

Heart Valve Complications

Like arrhythmias, heart valve complications can cover a variety of different abnormalities. Stenosis means the valves in the heart don’t open enough to allow blood to flow through normally. Regurgitation occurs when the heart valves do not close correctly, which enables blood to leak through. Like the arteries in your heart, the heart valves also need to operate properly to stave off life-changing complications [5].

Risk Factors

Risk factors for CVDs fall into three broad categories: intermediate, modifiable/behavioural, and non-modifiable as illustrated in the schematic below [3].

Intermediate risk factors

Intermediate risk factors are health/medical conditions that appear as a result of uncontrolled behavioral risk factors. Key intermediate risk factors for CVDs include raised blood pressure (hypertension), diabetes, raised blood cholesterol, and overweight and obesity.

1. Hypertension

Uncontrolled blood pressure can result in more health complications, including CVDs such as myocardial infarction, aneurysms, and stroke and other heart diseases. According to the 2014 WHO country profile report for non-communicable diseases (NCDs), approximately 31.6% of men and 29.4% of women in Tanzania were hypertensive. Moreover, there is a rapid increase in prevalence of hypertension in Tanzania, with significant variation between rural and urban settings that is characterized by sedentary lifestyles, urbanization and aging population. Results from prospective observational study conducted at the Cardiovascular Center of Muhimbili National Hospital in Dar es Salaam showed that, 45% of the heart failure patients were hypertensive. Despite a higher prevalence of hypertension in different areas of Tanzania, many people are not aware of the related risk factors, with low rate of diagnosis and treatment [3].

2. Raised cholesterol

It is known that raised blood cholesterol is a common risk factor for CVDs, including ischemic heart diseases, stroke and heart failure. Prevalence of raised blood cholesterol is influenced by sedentary lifestyles and rapid urbanization. Furthermore, poor dietary diversification contributes to increased blood cholesterol. Lower intake of fruits and vegetables and higher intake of red meat have been linked to increased levels of blood cholesterol. Nearly 20% of males and 24% of females in Tanzania had high blood cholesterol >5 mmol/L according to WHO estimates in 2010. Kilimanjaro region have been reported with highest prevalence of raised cholesterol (17.4% of men and 19% of women) compared to other regions of Tanzania like Morogoro (5% of men and 6.7% of women) and Mara (4.8% of men and 6.9% of women) [3].

3. Diabetes

Diabetes is a prime risk factor for cardiovascular disease (CVD). Vascular disorders include retinopathy and nephropathy, peripheral vascular disease (PVD), stroke, and coronary artery disease (CAD). Diabetes also affects the heart muscle, causing both systolic and diastolic heart failure. According to 2017 International Diabetes Federation estimates, more than 1.7 million people living in Sub-Saharan region are diabetic and Tanzania has been mentioned as among the country with the highest prevalence of diabetes. Results from the 2012 national survey showed that more than 9% (8% of men and 10% of women) of adult population aged ≥25 years were diabetic. Higher prevalence of diabetes is highly driven by rapid urbanization, sedentary lifestyles, and nutrition transition, which tend to promote overweightness and obesity [3].

Lack of diabetes guidelines, screening tools, poor reporting system, inadequate drug therapy and lack of training among healthcare providers and beneficiaries have been found to be potential reasons as to why many dispensaries and healthcare centers fail to provide valuable diabetic care in Tanzania. All these lead to the increased diabetic complications including angina, myocardial infarction, stroke, peripheral artery disease, and congestive heart failure. Despite the growing trends of diabetes in Tanzania, still there is low rate of awareness on diabetes and its complications in the population [3].

4. Overweight and obesity

Overweight and obesity are defined as a body mass index of ≥24.9 and ≥29.9 kg/m², respectively. The likelihood of chronic diseases such as diabetes, hypertension, as well as CVDs including coronary artery disease and and stroke, increases with increased body mass index (BMI ≥24.9 kg/m²). Both socio-demographic characteristics and economic factors influence occurrence of overweight and obesity in the population. However, lack of enough statistics, together with socio-cultural beliefs, create greater challenges in understanding the trends of overweight and obesity as public health challenges in African countries, including Tanzania. Findings from multi-country cross-sectional study conducted in 2016 in four SSA countries showed higher prevalence of overweight and obesity of 46% in rural Uganda, 48% in peri-urban Uganda, 68% in urban Nigeria, 75% in urban Tanzania and 85% in urban South Africa. Prevalence of overweight and obesity are still increasing in Tanzania as reported in the STEPwise survey conducted in the country in 2012, which showed 26% of the adult population aged >25–64 years were overweight and obese, with women being more affected than men (37% of women versus 15% of men). Few studies conducted in the country, especially in urban Der es Salaam, showed higher prevalence of overweight and obesity among school-age children. For example, a study by Mpembeni and colleagues reported the prevalence of overweight and obesity of 15% (10.1% boys and 19.4% girls) among primary school children in Dar es Salaam, Tanzania [3].

Modifiable risk factors

Modifiable/behavioral risk factors are most common preventable risk factors that underlie the development of CVDs. These include unhealthy eating, tobacco use, excessive alcohol intake, and physical inactivity. Poor management and prevention of these risk factors leads to metabolic/physiological changes that accelerate the development of CVDs.

Alcohol use

Alcohol consumption has been associated with increased risk of developing CVDs including atrial fibrillation (an abnormal cardiac rhythm), cardiomyopathy, acute myocardial infarction, hemorrhagic stroke, and ischemic stroke as it promotes raised blood cholesterol, high blood pressure, platelet coagulation and increased fibrinolysis. In 2012, prevalence of alcohol consumption among men and women in Tanzania were reported to range from 23–38% and 13–13%, respectively. Further results showed that 29.4% (38.3% men and 20.9% women) of the adult population were current alcohol users. Among them, 27.4% of men and 13.4% of women were binge drinkers. Moreover, 17.2% of adults aged 15–59 years were reported as current alcohol users in urban settings, and this was associated with socio-economic status of urban dwellers. Some of the chronic diseases such as hypertension, and diabetes are increasing in Tanzania due to the high number of alcohol drinkers. Higher prevalence of hypertension (50%) was reported among alcohol users compared to non-alcohol users (49.3%) in a study conducted in Mafia Island. Furthermore, alcohol consumption was related to increased CVD risk factors, such as diabetes (9.8%) hypertension (53.3%), overweight and obesity (73.3%) among study participants [3].

Unhealthy diets

Diet plays an essential role in the etiology and pathophysiology of different CVDs. Diet and nutrition have been recognized as major contributors atherosclerotic plaque formation and development of CVDs, including coronary heart disease and stroke. Unhealthy diet is linked to other CVD risk factors such as high blood pressure, elevated blood cholesterol, diabetes, overweight and obesity. According to a subnational STEP survey conducted by WHO in 2012, only 9.2% of individuals aged 25–64 years in Tanzania consumed at least less than 5 servings of fruits or vegetables on average per day. A study conducted in peri-urban Tanzania revealed the association between use of palm oil as cooking oil, inadequate consumption of fruits and vegetables and high intake of meat with increased blood cholesterol. Higher prevalence of hypertension in urban areas, especially among women, has been related to higher consumption of meat and coconut oils. Moreover, higher consumption of protein-rich foods, particularly meat, milk and blood with an inadequate intake of fruits and vegetables were associated with increased risk of hypertension among Maasai living in Simanjiro district. Higher consumption of highly processed foods, dietary salt with low levels of physical activity, and low knowledge of dietary choices were associated with increased prevalence of hypertension in different settings of Tanzania [3].

Physical inactivity

People who do not engage in regular exercise or physical activity are more likely to have hypertension, high blood cholesterol and be overweight or obese. In Tanzania, low levels of physical activity have been associated with increased body weight, diabetes, unfavorable lipid patterns and other CVD risk factors in rural and urban settings. Urban settings represent lower levels of physical activity compared to rural areas, which might be due to sedentary lifestyles adopted by urban dwellers as opposed to manual activities performed by rural dwellers. Therefore, the urban population in Tanzania faces a higher incidence of overweight, obesity, and elevated blood cholesterol levels than the rural population. A prospective cohort study conducted in Tanzania showed that migration from rural to urban areas reduced the level of physical activity by 52.9% (79.4% to 26.5%) in men and 21.9% (37.8% to 15.6%) in women [3].

Tobacco use

Smoking is a major contributor of CVDs as it can potentially cause atherosclerosis and raise blood pressure. Currently, there is no much information concerning the use of tobacco in Tanzania, however, few studies have documented higher incidence of tobacco use among men and women. In 2018, the prevalence of smoking in Tanzania was 13.30%, a 0.8% decline from 2016 [6]. This refers to the percentage of men and women aged 15 and over who currently smoke any form of tobacco product including including cigarettes, cigars, and pipes, and excluding smokeless tobacco on a daily or non-daily basis. The rates are age-standardized. Additionally, the prevalence of hypertension was observed to be higher (52%) among smokers compared to non-smoker (26.1%) in a study conducted in Dar es Salaam [3].

Non-modifiable risk factors

Non-modifiable risk factors are factors that cannot be changed which include age, sex, race or ethnicity, and family history. The more of these risk factors you have, the greater your chance of developing CVDs.

Increasing Age. The majority of people who die of coronary heart disease are 65 or older. While heart attacks can strike people of both sexes in old age, women are at greater risk of dying (within a few weeks).

Male gender. Men have a greater risk of heart attack than women do, and men have attacks earlier in life. Even after women reach the age of menopause, when women’s death rate from heart disease increases, women’s risk for heart attack is less than that for men.

Heredity (including race/ethnicity). Children of parents with heart disease are more likely to develop heart disease themselves. African-Americans have more severe high blood pressure than Caucasians, and a higher risk of heart disease. Most people with a significant family history of heart disease have one or more other risk factors. Just as you can’t control your age, sex and race, you can’t control your family history. So, it’s even more important to treat and control any other modifiable risk factors you have [7].

Tanzania is experiencing rapid growth of modifiable and intermediate risk factors that accelerate CVD mortality and morbidity rates. In both rural and urban settings, cardiovascular risk factors such as tobacco use, excessive alcohol consumption, unhealthy diet, hypertension, diabetes, hyperlipidemia (high level of cholesterol or triglycerides in blood), overweight, and obesity, are documented to be higher. Increased urbanization, lifestyle changes, lack of awareness and rural to urban movement have been found to increase CVD risk factors in Tanzania. Despite the identification of modifiable risk factors for CVDs, there is still limited information on physical inactivity and eating habits among the Tanzanian population that needs to be addressed [3].

References

[1]https://bmcpublichealth.biomedcentral.com/articles/10.1186/s12889-020-09956-z

[2]https://world-heart-federation.org/cvd-roadmaps/wp-content/uploads/sites/6/2019/08/CVD-Sc orecard-Tanzania.pdf

[3]https://jxym.amegroups.com/article/view/5361/html

[4]https://bmccardiovascdisord.biomedcentral.com/articles/10.1186/s12872-020-01648-1

[5]https://www.dignityhealth.org/articles/a-list-of-cardiovascular-diseases-the-5-most-common

[6] https://www.macrotrends.net/countries/TZA/tanzania/smoking-rate-statistics

[7]https://www.heart.org/en/health-topics/heart-attack/understand-your-risks-to-prevent-a-heart-attack

THE PRESENT STATUS OF MALARIA VACCINE

February 12, 2021June 29, 2021Leave a comment

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

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.

MALARIA VACCINE

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.

REFERENCES

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 https://academic.oup.com/jid/article-abstract/202/7/1076/837083
Bwire, George & Sanga, Anna. (2019). Malaria control in Tanzania: Current status and future prospects. 2664-8490..
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 https://ncbi.nlm.nih.gov/pubmed/30596732
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 https://sciencedirect.com/science/article/pii/s0264410x16311033
Malaria vaccine implementation PROGRAMME (MVIP). (n.d.). Retrieved February 12, 2021, from https://www.who.int/news-room/q-a-detail/malaria-vaccine-implementation-programme
Malaria in Tanzania. (n.d.). Retrieved February 12, 2021, from https://malariaspot.org/en/eduspot/malaria-in-tanzania/
White, N. J. (2011). A vaccine for malaria. The New England Journal of Medicine, 365(20), 1926-1927. Retrieved 2 11, 2021, from https://nejm.org/doi/full/10.1056/nejme1111777

Tips for medical volunteers

April 22, 2015June 30, 2021Leave a comment

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:

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.

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.

Mawenzi Regional Hospital, Tanzania – supporting many with few resources

June 3, 2014June 30, 20211 Comment

By Saara Kanula

Mawenzi Regional Hospital is a busy hospital which attends to over 300 outpatients daily and has around 300 beds in its wards but the number of patients can easily rise to almost 500. In the paediatric ward, sometimes up to four kids sleep in one bed.

Art in Tanzania is organizing donations for Mawenzi hospital in order to support its staff to continue their work supporting the people of the Kilimanjaro region in northern Tanzania.

Building of the new theatre started at 2010.

In Mawenzi you will find all of the usual medical facilities including: paediatric, physiotherapy, gynaecological and prenatal, a HIV-unit, tuberculosis clinic, X-ray unit and laboratory. Besides the in-patients, more than 300 out-patients come to the hospital each day.

Art in Tanzania has been co-operating with Mawenzi Regional Hospital for several years. They have great opportunities for medical students to undertake internships and they are constantly looking for volunteers to share their professional skills with the hospital staff.

The staff in the hospital do their very best but have few resources and outdated equipment. As a public hospital Mawenzi offers medical care to the majority of the population in the Kilimanjaro region, especially those who can’t afford private healthcare. Lack of basic equipment puts patients at risk and makes it difficult for the doctors to do their work.

Dr. Nkini

Mawenzi Regional Hospital is located in Moshi and serves a population of around 1.7 million. It was established prior to 1920 as a small military dispensary for German soldiers. In 1956 it became a hospital and has been growing ever since. Mawenzi hospital is funded by the government but since KCMC (Kilimanjaro Christian Medical Centre, a big university hospital) was opened in the 1970’s support and funds have been scarce.

Many of the hospital’s buildings are inadequate for modern medicine. There is a great need for renovation of old facilities and construction of new ones. The hospital is making efforts to find private investors to co-operate with and improve the quality of its facilities. Its management team has great plans for the future but it is desperately in need of support.

Building of the new Maternity clinic was suspended in 2009 because the government couldn’t fund the construction anymore.

Slow progress

Inside the hospital compound you can see lots of small buildings surrounded by flourishing gardens. Most of the buildings are over 90 years old and in need of renovation. The wards are quite modest inside.

Most of the buildings inside the hospital compound are from the 1920’s and in need of renovation.

Doctors office in the eye clinic is quite modest with only few basic equipment.

After walking pass different wards and through small paths you see a brand new white building which Dr Nkini (my host) points out to me. It is the new theatre building. Inside the building there are three theatres that have wash and sluice rooms, as well as facilities for the surgical staff. You can easily picture the building full of nurses and doctors, and patients waiting for surgery. However, at this point there are only empty rooms. The hospital has been waiting a long time for government funds for new surgical equipment.

The hospital has been waiting a long time for government funds for new surgical equipment.

Before the old theatre was closed in 2010 there were seven to twelve operations being performed daily—mainly C-sections, laparotomies and hernia repairs. Now the hospital send patients elsewhere, even for minor surgery. The Hospital’s administrators worry about loosing its specialists to the other hospitals because they are not using their surgical skills. By the end of July the new theatre building should be finished and the hospital is working to obtain new surgical equipment little by little.

Behind the new theatre there is another building under construction. Dr Nkini explains that it is to be the new maternity clinic. Building started in 2004 but was suspended in 2009 because the government couldn’t fund both the theatre and maternity clinic construction at the same time. Now it is uncertain when the building will be completed.

Dr Nkini also took me to the dental clinic. It has just been renovated and the practice is about to be shifted from the old department. The clinic is busy, attending 30 to 60 patients per day and has three specialists to take care of them. More up-to-date equipment is needed as they only have few basic equipment.

The old theatre was closed at the end of 2010 by the Ministry of Health because it didn’t conclude the standards anymore.

Donations from Finland and the UK

At the moment Art in Tanzania is collecting donations in Finland destined to different locations within Tanzania. If you can donate medical equipment it will be very much appreciated. Please contact Sari Vilen for a list of equipment that the hospital needs.

Also other kinds of donations are needed such as eyeglasses, school supplies, second hand computers, tools, sport equipment etc. Contact: sari@artintanzania.org.

Art in Tanzania is also planning to collect donations in the UK and other countries. If you are in the UK and want to make a donation, please contact Andy McKeegan – andy@artintanzania.org

Medical volunteering with Art in Tanzania

June 2, 2014February 11, 2015Leave a comment

By Katie O’Reilly-Boyles (Originally Published on Sep 26, 2013)

We interviewed Rosie, from the UK, about her experience as she worked on the medical project in Dar es Salaam. Here are her views:

Volunteers help to diagnose one of the patients on the female ward

As your project draws to a close, what have you most enjoyed about medical volunteering?

“I like it because it differs from place to place, and it’s also good to see how a hospital is run here compared to the system in the UK. I saw a very undeveloped clinic before coming to this [Mbweni] hospital, for example, and although it was upsetting –doctors had no soap to wash their hands with – the doctor was clearly amazing and the experience really had a big impact on me. Now I want to send over books, laptops and equipment in general from the UK, because that’s really what they need. I’ve also enjoyed the responsibility, particularly at the clinic, as I was sometimes allowed to treat patients.”

How do you think you have helped?

“We shadow the doctor here at the hospital which means we sometimes assist him, but in the clinic the doctor would sometimes leave me with some patients (who could speak English). I was allowed to diagnose and prescribe medicines, and it was very exciting when I got it right! Again, I think it would be really useful, when I get home, to set up funds so that we can send them over equipment such as an ultrasound machine, and even simple things like some papers to write patients’ records on.”

Rosie takes the blood pressure of an outpatient

We also interviewed Dr Daniel Muganyizi of Mbweni hospital who our medical volunteers have been shadowing.

How do you feel that the Volunteers help you in the hospital?

“I believe it is important to develop a field of medicine for the junior medics among us, and provide opportunities for them. The volunteers come from different parts of the world bringing with them different knowledge which they can exchange among themselves. With the medical profession, you don’t just learn things and consider it is done – you continuously gain more medical knowledge and skills throughout your career, for the benefit of the people you are saving and the volunteers.

Dr Daniel Muganyizi, Mbweni hospital

My best memory of volunteers and how they have helped us at the hospital is when some groups performed an X-ray and prepared instruments for operations, and they did it very well! All the staff at Mbweni Hospital, including the nurses, clinical assistants and porters really appreciate the volunteers and what they do.”

Justyna, from Poland, performs a Malaria test on a patient at Mbweni Hospital

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