St. Walburg's Hospital in Nyangao is the only way for its 90,000 patients a year to receive medical care. But the state-approved hospital in southern Tanzania is struggling with many challenges. The financial resources are barely sufficient. The staff is often not sufficiently qualified and the energy supply is very unreliable.

Nevertheless, thanks to the tireless efforts of the approximately 200 outpatient and inpatient staff, many patients are treated there every day. The hospital takes special care of pregnant women and infants, because far too many mothers and children still die of preventable diseases.

Challenges of a bush hospital

Health care in large and important cities like Daresalaam is comparatively good, but the further one gets into the countryside, the more the quality decreases. Even in the larger regional hospitals, there is a clear disparity and the number of patients per doctor is increasing. In the district hospitals, such as St. Walburg's Hospital, there are about 1,000 patients per hospital bed and 1 doctor per 100,000 inhabitants. The poor infrastructure of the country, the lack of roads and the inadequate communication facilities from the remote regions to the cities are enough to prevent the provision of good care throughout the country. The uneven distribution of financial resources is also problematic. Only 15% of the financial resources are available for the care of 90% of the population. An additional problem of the Tanzanian health system is the lack of staff in the clinics. There are enough trained specialists, but the Tanzanian state lacks the means to employ them. Since 2015, there has been a hiring freeze - with no end in sight.

St. Walburg's Hospital also has to cope with many difficulties and limitations. In the rural south-east of the country, it has a central function in providing health care and is the only access point for about 1 million people. The Artemed Stiftung supports the hospital in this important mission in the best possible way.

A hospital for all

The specialities of internal medicine, surgery, gynaecology, obstetrics, paediatrics, dentistry and ophthalmology are represented at St. Walburg`s Hospital. HIV and tuberculosis are also very common diseases in Tanzania, which are cared for at St. Walburg`s Hospital.

X-ray and ultrasound equipment as well as a laboratory are used for diagnostics. The on-site pharmacy supplies all patients with medication and a physiotherapy practice is also available for the treatment of physical ailments.

Close exchange with the M.A.T.E.s

The availability of a hospital does not automatically imply good medicine. Our Tanzanian team wants to help where help is needed, but the knowledge is often lacking. Good work processes are also indispensable for sustainable good medicine. And the technical infrastructure needs great improvement.

Darum kümmert sich unser deutsches M.A.T.E.-Team im Einsatz vor Ort, durch Webinare oder auch Konzile aus der Ferne. Medizinische, administrative, technische Unterstützung sowie der Ausbau einer ressourcenschonenden Arbeit wird so sichergestellt. Durch den regelmäßigen Austausch und ein monatliches Reporting sowohl im medizinischen Bereich als auch in finanzieller Hinsicht, können wir eine transparente Steuerung des Projektes garantieren.

The abject poverty of the people in Nyangao is omnipresent. Families often do not know how to feed their children. So one day, little Sam came to St. Walburg`s Hospital with his parents. He had already been suffering from severe breathing problems for two days. His oxygen saturation was below 70%. For comparison: In a healthy person, no matter what age or sex, the value is usually between 95 and 100%. If it falls below 80%, the function of organs such as the brain and heart can be impaired - in the long run, there is a risk of cardiac or respiratory arrest.
The boy was in a very bad condition, the doctors had already written him off and thought it best to take him to the ward to die. If it hadn't been for a team of a German doctor and an anaesthesia nurse who insisted on having another look in the operating theatre with a laryngoscope - a kind of small mirror. The African team agreed. When the little boy was asleep and stopped breathing completely, they noticed that even under high ventilation pressures, hardly any air could be forced into the two-year-old - the airways must have been blocked by a large object. And indeed: stuck deep in the trachea was the gnawed-off lower jaw of a rat. Complete, still with three pointed teeth. Because Sam's parents couldn't give him anything else to eat.
After the removal, two tracheotomies under inadequate conditions due to lack of material and technique, many days and hours of trepidation, renewed poor oxygen saturation, a second operation, a team that did superhuman things to give the little boy a chance to survive and heal, soon a small, smiling boy walked through St. Walburg`s Hospital. He was discharged, leaving behind a completely exhausted but deeply relieved and happy hospital team. Without their tireless efforts, resourcefulness and courage, the child would not have survived.

A narrative based on Elena Terwilliger, Medical Assistant & Intensive Care Nurse