Sr. Dr. Ullamariam Hoffmann and Angelika Hartmann had been waiting a long time for this: After a year without traveling to Tanzania, the two were finally able to set off again in January 2022 for a mission to St. Walburg’s Hospital, Nyangao.

Sr. Dr. Ulla-Mariam Hoffmann, senior physician and head of the palliative care unit at the Benedictus Hospital in Tutzing, already spent some time during her residency in a hospital in Tanzania. Since then, she has felt a strong connection with the country and the people there and has already supported the Artemed Stiftung on missions in the past.

It was also not the first time that Angelika Hartmann was on site with us: the specialist nurse for hygiene, anaesthesia and intensive care from the Hospital zum Heiligen Geist (Kempen) was able to make a decisive contribution to improving the hygiene concept in Nyangao in October 2019, among other things, through her expertise.

Despite the experience of the two women, an assignment in Tanzania is always associated with many challenges and the current situation due to the pandemic situation has brought further uncertainties. It is all the more remarkable to see that, in addition to the daily support of the medical staff on site, the two succeeded in making a comprehensive analysis of the prevailing situation in the areas of hygiene, oxygen supply and internal medicine. Our team members Antonie Deucker and Axel Schmidt, who were primarily concerned with the condition of the laboratory, also played a significant role in this.

The area of hygiene includes not only the conditions in operating and treatment rooms, but also, for example, the handling of the laundry that is produced. It sounds banal, but laundry that has not been sufficiently boiled poses great risks for the transmission of diseases. It is also hard for us to imagine that there could be problems with the laundry, it is enough to put it in the washing machine and set it to 90 degrees. Not so, however, in a country like Tanzania, where it is difficult to heat water to this temperature and to find washing machines with appropriate features. In addition, there is a lack of knowledge about the consequences of insufficient laundry hygiene. Together with the Tanzanian colleagues, the problems were identified and are now being remedied bit by bit.

Not only since Covid-19 has the issue of oxygen supply played a major role in medical care. Since the pandemic, however, it has become clear to all of us that the supply of oxygen can be life-saving. In this area, too, it is much more difficult to have and maintain enough good equipment in Tanzania. Our mission participants used the time on site to take an extensive inventory together with their Tanzanian colleagues. Broken and damaged equipment was disposed of. A Standard Operating Procedure (SOP) was developed together with the local doctors and implemented in a striking manner. With additional instructions and training, the correct handling of the various oxygen devices should be guaranteed in the future. The question of how to ensure sufficient oxygen on site in the future is complex and will keep us busy for a while, but there are already some ideas on what a solution might look like.

The fate of a young Tanzanian man was a heavy blow to the participants. The strong young man was brought in with initially unclear health complaints. The laboratory analysis finally showed acute kidney failure. There was no chance to save the young man with the possibilities on site. Unfortunately, kidney failure seems to be an increasingly common problem in the population, which is probably due to pesticides in food and the intake of supposed herbal remedies, among other things. A specialist group is now considering how this development can be counteracted in order to avoid fates like that of the young man in the future.

A very nice side effect of the work in January was the intensification of cooperation with the local medical staff and our German helpers. The joint development of strategies and measures on an equal footing is the basis for a long-term improvement in care at St. Walburg’s Hospital.