MEDICAL UPDATE

Medical scene in Tanzania and Selian

• HIV/ AIDs -1.4 million people in Tanzania with HIV
  One of the primary causes for dropping the average life expectancy from approximately 60 to 45 years of age in the last 20 yrs
• It is estimated that less than 4000 (total) medical doctors have been trained in Tanzania. 
  Today there is about one doctor per 50,000 people – about one surgeon per 125,000 people.
• Medical personnel
  • Clinical Officers
    • 3 years training
      Able to diagnose medical and surgical conditions and initiate treatment
  • Assistant Medical Officers
    • Clinical Officers with an extra 2 years training in areas like anaesthetics, radiology and surgery
  • Medical Students
    • 5 years training at one of the three medical schools in Tanzania
    • Plus 1 year internship
      Work at Selian on roster – diagnose and treat medical and surgical conditions
      Currently Selian Hospital has six interns
  • Specialists
    • At Selian
      Surgeons – 4
      (note: there are only 5 surgeons in Arusha – a city with a population of approximately one million people and growing rapidly)
      • Dr Paul Kisanga – Head Surgeon – Tanzanian trained and has also spent some time in USA.
      • Dr Murila, a Kenyan orthopaedic surgeon, who has been employed for 3 years to set up the orthopaedic unit.
      • Dr Kibera, a Tanzania general and orthopaedic surgeon, just started at the hospital
      • Jenny – General Surgeon, trained in NZ
    • Obstetrics and Gynaecology – 3
    • Physicians – 2
    • Opthalmologist – 1 – part–time at Selian
    • Dentist -2
  • Patients are admitted by an intern or clinical officer, who is on-call at the hospital for 24 hours. The patient is admitted under the appropriate department and the admitting consultant is told about the patient that day or the next. The next day they are seen by a consultant. On the wards they are looked after by an intern or clinical officer, not necessarily the one who admitted them.
  • In the case of an emergency, the on-call specialist will come into the hospital as required. Otherwise, the case will be handled by the Clinical Officer.
• Nursing
  • Registered Nurses / Nursing Officer
    • 3 years
  • Bachelor of Nursing
    • If they have completed ‘form 6’ they can go straight into this programme for 3 years or Registered Nurse can do an extra 3 years of bachelors study
    • There are currently no nurses who have a Bachelor of Nursing degree at Selian
• Patients pay for their health care
  • Examples of approximate charges at Selian Hospital
    • Contribute the full cost of the following types of services eg:
      • Blood test for malaria Tsh1,000 (NZ$1.11)
      • Overnight stay in ward Tsh5,000 (NZ$5.55)
    • Provide a token amount towards the cost of more expensive procedures eg:
      • Gastroscopy Tsh55,000 (NZ$61)
    • Selian funds the balance of the service costs.  This equates to about 40% of a patients bill and this is provided by donations of money and items, mostly from overseas sources
  • The need to pay for health care often leads to people refusing to be admitted despite being unwell, as they simply do not have the money.  35% of the population are below the poverty line and 57% of the population earn less than US$1 per day (2006 UN statistics). 
  • Selian is opening a second hospital in Arusha (January 2008), placing significant strain on finances, especially due to the need for employing additional staff already but without earning corresponding income.  This has lead to us having a limited supply of equipment eg shortage of IV cannulas.

Read More:

Doing Surgery at Selian, Tanzania

Interesting Cases