Sharmila Sandirasegarane updates us on health care in Tanzania:
Compared to the Kibiti Health Center, equipped with a few consultation rooms and an operating room for minor procedures, the Lushoto District Hospital seemed to be stocked. Tanzania has a multi-tiered, decentralized health system with facilities ranging from rural dispensaries, with minimal services, to national referral hospitals, with the country’s highest level of care. Between these levels, patients can be referred to health centers and district hospitals.
We toured the district hospital’s various departments, including pediatrics, pharmacy, ophthalmic nursing, maternal health, labor and delivery, and phlebotomy. I was told about the modest patient records systems in many African hospitals, but it was definitely an experience to see the stacks of papers that filled a room. Handwritten sheets marked the numbers of each aisle, which were cross-listed with the patient names in the computer system. I was glad to learn that there was some kind of digital system in place, but the files only connected the names to the identification numbers of the patients, not their actual records. The records only existed in paper form.
We were pleased by the stocks of equipment, especially in the pharmacy, but we learned that it was fairly common for supplies to be out of stock. The medical students and the faculty emphasized their frustration about this problem, especially at a referral hospital. They thought the issue was out of their control as they blamed the lack of government funding for this issue.
This lack of funding is especially infuriating considering the corruption that the students frequently allege of government officials. For example, government officials in all districts own V8 SUVs that they use for a maximum of six years. Two of these cars can cost as much as a CT scan, while the country only had one machine in the country in recent years. This excessive spending is especially frustrating after seeing the lack of equipment in some of the health facilities. Even though the district hospital was relatively well-stocked, it could definitely have improvements in sanitation and infrastructure.
Particularity in dispensaries and health centers like in Kibiti, greater allocation of health funds could be very impactful. The methods of transportation for patients who move through the referral system is also inadequately developed; it is near impossible for patients in rural areas to move from dispensaries to referral hospitals for severe cases because of financial and infrastructure limitations. In fact, patients have to pay for the gas used in ambulances.
There are many underfunded areas in Tanzania’s health structure, even including the salaries of health professionals, which makes the lack of funding a fundamental issue in access to care. Actually seeing these issues first-hand has made me develop a deeper appreciation of the magnitude of the problem.