HM Medical Clinic

Kcmc.ac.tz

KLIMANJARO CHRISTIAN MEDICAL CENTRE
An Institution of The Good Samaritan Foundation
Annual Report 2014
KILIMANJARO CHRISTIAN
An Institution of the Good Samaritan Foundation
ANNUAL REPORT
TABLE OF CONTENTS
1.0 Clinical departments.1

1.1 Department of Anaesthesia.2 1.2 Casualty/Outpatient Department.6 1.3 Care and Treatment Clinic (CTC) & Child Centred Family Care Clinic 1.4 Clinical Laboratory Department.18 1.5 Community Health Department.20 1.6 Dental Department.24 1.7 Dermato-venereology Department.26 1.8 Diabetes Clinic.30 1.9 Department of Diagnostic Radiology and Medical Imaging.31 1.10 Department of Internal Medicine.34 1.11 Main Theatre and Central sterile Supplies Department.38 1.12 Departmet of Obstetric and Gynaecology.41 1.13 Occupational Therapy Department.46 1.14 Ophthalmology Department.49 1.15 Department of Orthopaedics.52 1.16 Department of Orthopaedics Workshop.56 1.17 Otorhinolaryngology Department.58 1.18 Department of Pathology.61 1.19 Department of Urology.63 2.0 Paramedical departments.68

2.1 Department of Physiotherapy.69 2.2 Medical Records department.73 2.3 Kilimanjaro Clinical Research Institute (KCRI).74 3.0 Hospital Supporting Deparments.80

3.1 Chaplaincy Department.81 3.2 Catering Unit.82 3.3 Department of Engineering.84 3.4 Housekeeping Unit .87 3.5 Information Communication Technology (ICT) Department.88 3.6 Laundry Unit.90 3.7 Legal Department.91 3.8 Procurement Management unit.92 3.9 Department of Social Welfare.93 3.10 Security Unity .97 3.11 Telephone Unit .97 4.0 Schools.98

4.1 Assistant Medical Officers General school.99 4.2 School of Anaesthesia.101 4.3 School of Nursing.104 4.4 School of Occupational Therapy.107 4.5 School of Optometry.110 4.6 School of Advanced Diploma Paediatric Nursing.111 4.7 School of Physiotherapy.113 4.8 Training Centre for Health Records Technology.114 4.9 Tanzania Training Centre for Orthopaedic Technologists.116 5.0 HOSPiTAL STATiSTiCS.120
6.0 FOrmuLAS/DEFiNiTiON OF TErmS.127
7.0 LiST OF ABBrEviATiONS.128
Kilimanjaro Christian Medical Centre (KCMC) was established in 1971 as a Zonal Referral Consultant hospital owned by the Evangelical Lutheran Church of Tanzania (ELCT) under the Good Samaritan Foundation (GSF). The aim was to create an independent legal body which nevertheless is to be permanently linked to the ELCT and Christian Council of Tanganyika. The immediate purpose of the foundation was to a body capable of establishing the Kilimanjaro Christian Medical Centre. The referral hospital was established in order to serve the northern, eastern and central zone of Tanzania. It is one among the four Consultant hospitals in Tanzania.Its record in Medical Services, Research, and Education has significant influence in Tanzania, East Africa and beyond. In 2014, KCMCcontinued to carry out its services to people according to the mission statement, "To render God's healing services to set mankind free from the bondage of sickness, suffering and sin", "To reflect Christ's character of love, mercy, compassion and faithfulness in the course of fulfilling the call to care and heal the sick" and "To share God's grace and love through the power of the Holy Spirit in the course of treating and caring for the sick".
GENErAL ADmiNiSTrATiON
During the year 2014,KCMC under its Management Team continued to carry out its role of
management of patients, teaching and research with collaborators, other stakeholders and foreign institutions.In the year, the Management Team in place was: Prof.Raimos M. Olomi Ag. Executive Director (KCMC) & Executive Secretary (GSF) Dr. Mark G. Mvungi Ag. Director of Hospital Services Mr. Essy S. Mmbaga Director of Human Resources Management & Administration Prof. Egbert Kessi Provost of KCMU College Mrs. Hilda Mungure Director of Finance Prof. Gibson Kibiki Director of Research In2014, the Management Team worked under the guidance of the Board of Trustees, Board of Governors and GSF Council. Membership of the boards and council were as follows:- Board of Trustees:
• Rt. Rev. Dr. Alex G.Malasusa
• Rt. Rev. Dr. Martin F. Shao • Dr.Geofrey G.Sigalla • Dr. Adeline Kimambo • Rev. Dr. Leonard Mtaita • Mr. Brighton Killewa • Mr. Reginald Mawalla • Prof.Raimos M.Olomi Ag. Executive Secretary - GSF.
Board of Governors:
• Rt. Rev. Dr. Alex G. Malasusa
• Rt. Rev. Dr. Martin F. Shao • Mr. John Haule • Mrs. Hilda Gondwe • Dr. Adeline Kimambo • Mr. Brighton Killewa • Prof.RaimosM. Olomi Ag. Executive Director –KCMC.
GSF Council:
• Rt. Rev. Dr. Alex G. Malasusa.
• Rt. Rev. Dr. Martin F. Shao • Rt. Rev. Simon Makundi • Mr. Brighton Killewa • Prof. Ester Mwaikambo • Mr. Reginald Mawalla • Prof.RaimosM. Olomi CLINICAL
DEPArTmENT OF ANAESTHESiA
Head of department: Dr. Andrew Hellar
introduction
The Department of Anaesthesiology is always active and keen in providing safe anaesthetic services
to the patients undergoing minor or major operations like Thoracotomy, Laminectomy, Endoscopic operations, Phoeachromocytoma and Open Heart Surgery. AMREF outreach anaesthetic services are as well provided by the department. Staffing
In the year 2014 has been fruitful to the department to celebrate to mark the graduation of the
MMed graduate who had been mentored by our Anaesthesiologist. One Medical Officer (Registrar) and three clinical officers were posted to the department.
Number of Staff
AMO Anaesthetists Nurse Anaesthetist BSc. Nursing Nurse Anaesthetists Clinical Officers (on training) Activities
Casualty - Staff Rotation in Anaesthesia department
Three clinical officers fromcasualty were scheduled to rotate for three months in department of
anaesthesia in order to acquire basic knowledge and skills on how to manage critically sick patient. Anaesthesia department appreciates for the steps taken by the administration.
Teaching - Students (Rotation in the Department)Lecture discussion sessions were conducted in the class and hand on patient procedures were demonstrated to students.
Workshop to Medical studentsSurgical and Anaesthetic skills Workshop was conducted to Medical students(These are MD III and MD IV and AMO general students) The practical and teaching activities are listed below:
Total under 5
KEY: EL = Elective = 5949; EM = Emergency = 2,067
Common regional Techniques
Number of Patient
1 Spinal nerve block 2 Epidural nerve block 3 Saddle nerve block 4 Axillary nerve block 5 Supraclavicular nerve block Drug utilization
General Anaesthetics
Number of Patients
Other Anaesthetic Drugs Number of patients
13 Diprivan (Propofol ) Labour ward coverage
Caesarean Section
Nature of procedure
Number of patients
Caesarean Section: General anaesthesia (GA) and Regional anaesthesia (RA) Nature of procedure
Number of patients
General Anaesthesia C/S Regional Anaesthesia C/S Comments
Majority of the operations are obstetric emergencies. Ninety two percent of all Caesarean sections
are mainly obstetric emergencies. The common anaesthetic technique is spinal (Regional) anaesthesia. From the above obstetric situation, the Department has set a shift system; morning, evening and night shifts. to ensure that there is prompt response to the Obstetric Emergencies. Number of patients
Reversed Cardiac arrest Number of patients
Difficult Intubation regional Anaesthetic Complications
regional Anaesthetic Complications
Number of patients
Post Spinal Head ache Achievements
Equipment
The Department has nine operating theatres equipped with modern anaesthetic machines.
Mechanical Ventilators are available in the Intensive Care Unit. Monitors (ECG, Pulse Oxiometer) are available.
Constraints
Equipment
The Department is requesting for more endotracheal tubes as the number of operations is
increasing, a set of Fiber Optic Laryngoscope for difficult Intubations, pediatric ventilator (preferably Evitadura ventilator which can be used in the neonates) because the number of under- five operation is relatively high. requests
Drugs: We had aconstant supply of Isoflurane this year denoted from Bugando Hospital. We
request for our own supply because BMC has no more supply. We request for Ephedrine, protocol, Dopamine and Fentanyl Equipment:1. The Department is requesting for more endotracheal tubes and Oropharyngeal Airways2. A set of Fiber Optic Laryngoscope for difficult Intubations3. 2 ventilators for both Paediatric, infants and Adults 4. Two Cardiac monitors for labor ward and one cardiac monitor for Urology Theatre.
Way forward The department is planning to discuss with the administration to train more nurse anesthetists and AMO anesthetists to join the department. This will alleviate anaesthetist workload in operating theatre, Intensive Care Unit, Casualty and cannulation in the wards. Year 2014 the department has trained three clinical officers from Casualty department. The department has planned to discuss with the heads of the departments, on critical care management since will soon get an emergency department which is now being built.
Head of department: Dr.isaria maruchu
introduction
Casualty/Outpatient department is the entry point to KCMC. In other words, it is the face of
this famous institution, and perhaps the busiest department. All patients, emergencies and non- emergencies, referrals and self-referrals must pass through this department which operates for 24 hours. The department receives emergencies, either brought in directly or referred from other health units within and outside the catchments area of KCMC, and from the neighbouring countries. Referrals for specialized services pass through casualty/OPD.
The goal has always been to attend all patients regardless of their colour, faith, race, economic status, etc. at all times. The spirit of team work, sharing knowledge and ideas has made the unit stand.The vision is to make the department a centre of excellence in emergency medical care. The department receives an average of 80 to 100 patients a day. In spite of the very small space, it has been possible to attend all these patients.
Activities: * Attending to all emergencies brought in * Consultations to either referred or self-referred patients and to those coming for follow up.
* Interdepartmental consultations * Counseling and testing services done by trained counselors within the department * Teaching to medical students,nurse studentsand visiting foreign students * Collection of samples from patients and sending them to the laboratory.
Clinics in the Department
1. Medical Clinic
Monday and Friday 2. Surgical clinic Tuesday and Thursday 3. Orthopaedic clinic Tuesday and Thursday 4. Obstetrics and Gynaecology Clinic - Mondays, Wednesday and Fridays Tuesday and Thursday 6. Diabetic Clinic Wednesday and Friday 7. Dental Clinic Daily except Mondays Mondays, Wednesday and Fridays Mondays, Wednesday and Fridays 10. Occupational Therapy 11. Reproductive Health Tuesday, Wednesday and Thursday 13. Cardiac Clinic Wednesday monthly 14. Adolescence Clinic Monday and Wednesday Staffing:
* 1 Principle Medical Officer – Head of Department
* 4 Register Medical officers
* 1 AMO
* 3 Clinical Officers
* 2 Nursing Officers
* 17 Assistance Nursing Officers
* 2 Enrolled Nurses
* 12 Medical attendants
Staff movements:
* 1 Doctor joined Emergency medicine
* 3 clinical Officer went for short course on anaesthesia
* 1 Nursing Officer Resigned
* 1 ANO on BSc. training Course
* 1 ANO went for Anaesthesia courses
* 1 Enrolled nurses retired on March 2014
Staff requirements:
1. Doctors
At least 14(One to be responsible for the staff clinic) 3. Medical Attendants - With the proposed Emergency Medicine department, the following will be required: Radiographer, ultrasonographer, anaesthetist and nurseswith experience in emergency medical care and doctors interested and hopefully trained in Emergency Medicine. Equipment:
» In the present emergency room there are2working monitors and 2 working suction
machines which are not enough. The following equipment are needed: » Monitors at least 3 more » Suction machine at least two » Portable suction machine » Oxygen delivery heads » Blood Pressure machine digital at least 10 » Thermometers, wheel chairs at least 10 » Stretchers. The presently used stretchers are too old » Extra chairs for patients, the available chairs are not enough for the number of patients attending the unit.
» Screens or partitioning the emergency room with curtains.
» Scales for weighing patients ( paediatric and adult scale ) Challenges:
» Consultations rooms are not enough compared with the number of the patient and
Doctors(No Privacy) » Lack of instruments i.e. enough suture sets and cut down sets » Stretcher by needs to be worked out. During the rainy season the place in slippery.
» The department doesn't have a tea room » A room for a medical records attendant and cashier is really needed in the department » In times of emergency it takes too long to get patients file and to the patients it takes time for them to pay their bills especially in the afternoons.
» The Department has no internet connection » No renovation especially in Toilet Achievements:
» One nurse graduated in Enrolled Nurse
» 2 Medical Officers employed at Department
» 1 Medical Attendant employed
» 3 clinical Officers went for short course in Anesthesia
» 1 Assistance Nurse Officer joined anesthesia
» Customer care services started at Department
» We received enough chairs for Doctors and patient
Way forwards:
* To train more human resource on emergency medicine (Doctors and Nurses and
* To prepare enough equipment for emergency department.
CArE AND TrEATmENT CLiNiC (CTC) & CHiLD CENTrED FAmiLY CArE
reported by: Sr. Zawadi Hillu
introduction
Kilimanjaro Christian Medical Centre (KCMC) is among the first four sites in Tanzania to offer free
Anti-retroviral Therapy (ART) since September 2004. The existing Care &Treatment at KCMC is focusing on increasing the number of people on ART and linking PLHIV to the community. From the beginning provision of services for adults and children was harmonized so that parents could receive services at the same time as their children and the number of children on ART was around 20% of all patients' right from the start. The centre has been receiving funds from Elizabeth Glaser Pediatric Foundation (EGPAF) to implement Care & Treatment services for adults and children. Goal
To provide comprehensive care and treatment services to adults, adolescents and children living
with HIV, within the catchment's area and beyond. The centre established Child Centered Family Care clinic [CCFCC] in October 2006 and official inauguration was done on 6th December 2007. The aim is to link the care and treatment of children and their families including primary and specialty medical care, social services, prevention of mother to child transmission (PMTCT) and home based care. Further it supports improvement of care and treatment in Continuous Pediatrics Education Program [CPEP] sites in Kilimanjaro and Arusha Regions.
Based on the special needs for adolescents the centre has established adolescents/youth clinic since November 2007 .The clinic is done once per month on the last Saturday of the month. To date there are 59 adolescents and 61 youths attending clinic. (Total 120)
vision & mission of CCFCC
Vision
• To become a model of pediatric health care in Tanzania through the integration of Care
&Treatment, Training and Research.
Mission • To provide health care services for all children and their families in Northern Tanzania with a focus on Care &Treatment, Training and research. Objectives • Strengthen quality of Care and treatment services to children and their families living Update knowledge and skills to service providers including PLWHIV. Scale up Continuing Pediatric Education Program (CPEP) in Kilimanjaro and Arusha Strengthen linkage between CCFCC/CTC and other HIV /AIDS program. Strengthen internal and external community linkages within Kilimanjaro region and beyond through CHBC. Strengthen clinical laboratory services for PLHIV to care and treatment sites in the Northern zone and beyond Strengthen Monitoring and Evaluation system on care and treatment services. Staffing
The CTC/CCFCC operated with one overall coordinator, one administrator, one training
coordinator, one community linkage Nurse and two clinics Nurse in charges. Other members are CCFCC Clinic: * 1 Pharmacist * 1 Social worker * 2 Assistant Nursing officers * 2 Medical recorders * 1 Data clerk * 2 Medical attendants * 1One office attendant CTC: * One Assistant Nursing officer, contract ended in Feb 2014 * Received one Assistant Principle Nursing officer from ENT clinic * One Medical attendant was transferred to Medical two * Received two medical attendants from medical one and Pediatric two * Two Medical recorders were employed on one year contract basis from 2014. Staff movements
Two Assistant Nursing officers, one contract ended in October 2013 and the second one retired.
One Assistant Nursing officer, contract ends in Feb. 2014Two medical recorders resigned in October 2013 Staff requirements:
One pharmacist and one Social worker
* Currently the pharmacist and Social worker are on contract employment by KCMC and
EGPAF
Activities
CTC: » Adult's clinic on every Mondays, Wednesdays and Fridays.
» ART adherence counseling to all new enrollees to Care and treatment » Ongoing group/individual counseling on every clinic days » Proper documentations of monitoring and evaluation tools » Internal & eternal linkages » Youths clinic on one Saturday every month » Provider initiated counseling and testing (PITC) CCFCC:Eligibility to the family clinic is 2 members and above, the entry point is a child » Pediatric CTC on Mondays » Family clinics on Mondays, Wednesdays and Thursdays.
» HIV Exposed babies and their mothers are seen on Wednesdays.
» Adolescent clinic on one Saturday every month » Proper documentations of monitoring and evaluation tools » Internal & eternal linkages » Continuous pediatric education program (CPEP) to support quality of C&T in other sites (Arusha and Kilimanjaro regions ) » Clinical attachments.
» Provider initiated counseling and testing (PITC) » Outreach services to two orphanage centre's on monthly basis Services provided to all family members includes:
» Counseling and testing
» PMTCT
» Care and treatment » Antiretroviral treatments (ART) » Physical examinations » Family planning » Home-based care and external linkages » Cervical cancer and TB screening.
» Psychosocial support.
Key CTC performance/achievements
Capacity building through seminars/ Mentoring and coaching:
1. CPEP seminar was conducted in March 2014 for two days with the theme "What is new

in paediatric 2014" Several topics were discussed such as, PMTCT, HIV in children,
Diabetes/DKA, Hypoglycaemia in Children, Malaria, Care for premature baby, Neonatal sepsis, Pneumonia, TB in children and Meningitis management.The seminar was attended by 18 service providers from CPEP sites.
2. The second CPEP seminar was conductedin October 2014 with the theme, "Quality in Neonatal Care", with the following topics, Neonatal examination, How to handle neonatal emergencies and Common Drug Dosage in paediatrics, Neonatal feeding, Prematurity, Birth injury, Kangaroo Mother Care, Neonatal meningitis, Neonatal Jaundice, Birth asphyxia, Care for HIV exposed Child. The seminar was attended by 16 service providers (10 from outside and 6 from KCMC). The expected outcome is to improve podiatric care within the Centre and beyond. 3. Two service providers (Nurses) attended TB/HIV care experience sharing meeting organized by the Moshi municipal Council for 3 days. 4. Four participants (social worker & 3 adolescents) attended psychosocial support in ARIEL camp activity in Arusha for six days. The activity was organized by EGPAF Continuous Paediatric Education program (CPEP):The Continuous Paediatric
Education Program (CPEP) visits were conducted to 9 hospitals in Kilimanjaro region & 4 hospitals in Arusha region, whereby members of the Paediatric department from KCMC provided formal lectures (mainly HIV related), case review and bedside teaching.
The clinic for adolescents is conducted once per month on the last Saturday of each month. To date there are 60 adolescents and 92 youths attending Care and treatment
services at KCMC (Total 152). Among them 4 were transferred to Adults CTC.
Outreach to Orphanage centres ( Kalali & Light in Africa)
The program is supporting 2 orphanages centre: Outreach was conducted as planed to Light in Africa and 32 HIV infected children were attended (27 children on ART and 5 on care). Kalalicentre, 40 children were attended with different health problems .Among them one is HIV infected and on ART.
Clinical attachments: -
During the period of Jan - December We managed to receive fifteen groups ( 30 service
providers ) for clinical attachment from Arusha (St. Elizabeth), Kilimanjaro (Kilema), Tabora (Goweko and Kigwa B dispensaries) and NachingweaLindi (Liwale District Hospital), Tabora region (Town clinic dispensary), Tabora (Kaliuwa and Uliyankulu Health Centre) and Lindi (Kilwa District hospital) regions, MwangaDistct - Usangi District hospital, Arusha region - Dream CTC Holy Ghost Father USA RC Health Centre and Usariver Health Centre (Government), Same, Arusha (Kaloleni Health Centre), .
Tabora (Igunga District), Lindi (KinyongaDistct Hospital –Kilwa), Kilimanjaro (Karanga Prisons CTC & CCP HC) From January to December 2014, a total of 59 visits were conducted, 48 visits were conducted in Kilimanjaro and 11 in Arusha. The attachment program was of benefit to them as they were mentored to gain knowledge and skills on pediatric HIV/AIDS management, Pediatric conditions, Adults CTC, PMTCT option B+, and DBS sample collection and packing procedures. The total number of 667 service providers and 122 students were mentored. Conduct outreach services at St. Joseph hospital in Moshi Urban district:
Comprehensive care and treatment at St Joseph hospital is going on well. During the period 35 clients were seen at Care and treatment. The team of service providers from KCMC provided formal lectures (mainly HIV related), clinical mentorship/coaching and bedside teaching. Provide TB/HIV integration services at CTC/CCFCC:
All clients attended CTC for both adults and children (2,494) were screened for TB on each visit. Throughout the year a total of 47 clients (adults 42 and 5 child) were found to have Tb. All confirmed were provided TB treatment and further management. Improve Internal and external linked activities:
Tracing of clients (235) through phone conversation with the outcomes of 189 clients being re-enrolled to CTC and self-transfer out were 15 clients. Expert patients (PLHIV) were involved in Group and individual counselling adherence at CTC and participated in tracing of LTFU (235 clients). Provide family planning services integration at CTC.
The services are integrated at CTC/CCFCC .Counselling on Family planning was provided to 2694 clients attending CTC (Male 851 and female 1843).
Conducting meetings to improve quality of services provided.
The following meetings were conducted during the period of Jan – December 2014.
Quality improvement (QI) team meetings were conducted on monthly basis. Clinical issues discussed in the meetings wereon QI performance indicators e.g. cervical cancer screening to all women of reproductive age who are HIV +ve attending CTC and this is done on every Monday;quality of data and use of client's appointment tools andintegration of family planning to CTC and proper filing of family planning information in CTC 2 cards. The clinical issues were discussed and plan for action were made. Meetings with Health Care Workers living with HIV (Huduma group A -a group of KCMC 18 health care workers)The purpose: Experience sharing on use of ART, adherence to treatment, stigma reduction, strategies and disclosure process. The outcome was strategies on adhering to appointment, treatment and Meeting with youths (PLHIV) Adolescents /youths (120) attended; they share success stories on use of ARV's; reminded on CD4 Cohort checkup, income generating activities; Self-care, religious and beliefs. Few members complained they got difficult time to take drugs when they travel and meet with people who are unaware of their sero-status. The challenge was discussed among the members and possible solutions made.
CTC/CCFCC staff meetings Proper documentation of CTC2 cards reminded, service providers were provided on job training on use of appointment register, discussion done on CD4, internal linkage, follow up, tracing of clients lost to follow up. Difficult issues were discussed and actions were made. The expected outcome is to improve quality of care & treatment services for both adults and children.
Meetings with people living with HIV (PLHIV)The meeting was conducted to 50 PLHIV attending clinic at KCMC. The purpose: Experience sharing on use of ART, testimonies and adherence to treatment. The outcome was stigma reduction strategies and disclosure of sero-status. CTC and PMTCT service provider's (49) Multi-disciplinary team meeting The purpose: experience sharing on challenges, review of TB infection prevention policy, new updates and review of checklist. Expected outcome is to improve quality of care to PLHIV Supportive supervision and monitoring of the program activitiesSupportive supervision/mentorship on documentation to all service providers working at the CTC/ CCFCC was conducted on every clinic days, identified weakness such as PITC in paediatric wards, cohort CD 4 check-up, Clients lost to follow up, disclosure of sero status to Adolescents living with HIV & improper documentation in CTC2, were discussed and actions were made. Reports /data was presented during QI team meetings for sharing, planning and ordering etc.
*Source of data: KCMC Quarterly Facility-based reporting to the MoHSW
major challenges and the way forwards:
Way forward
Inadequate knowledge on filing Conduct on job training and clinical mentorship to IPT form for TB. service providers working at all key sections Self-referrals to nearby CTC Conduct meetings/ ongoing education /counseling Clients resist to use IPT for TB Ongoing treatment counseling and H/education on importance of IPT and conduct meetings with clients to discuss the advantages of IPT for TB.
High demand in treatment Conduct ongoing group adherence counseling/ adherence counseling Involve expert clients in treatment adherence coun- Planned activities for the year 2015:
» Provide ongoing comprehensive HIV Care and treatment services at KCMC and beyond.
» Continue to Provide CPEP activities in Kilimanjaro and Arusha regions
» Conduct ongoing Supportive supervision and monitoring of the program activities
» Hold and attend different meetings.
» Conduct quality improvement team meetings
Acknowledgement
All these achievements have been made possible through support from the management of KCMC
in collaboration with EGPAF. The CCFCC/CTC team of service providers appreciates for the support given to the unit and other health facilities. CLiNiCAL LABOrATOrY DEPArTmENT
Head of Department: Dr. Baltazar Nyombi
introduction
The Department of Clinical Laboratory is one of the clinical service departments within the
Activities
KCMC Clinical Laboratory has the following activities:
Clinical DiagnosticsKCMC Clinical Laboratory support the patient's care by conducting investigations on patient's specimens in different sections including Haematology, Clinical Biochemistry, Microbiology, Serology, Blood Transfusion, Parasitology and Molecular diagnostics (DNA PCR for HIV Early Infant Diagnosis-HEID and viral load). During the year 2014 a total of 83,243 specimens were received and on which, 144,676 laboratory investigations were conducted as compared to 129,537 investigations conducted in 2013. The main reasons for the increase in the number of investigations (15,139 – 11.7%) were due to improved maintenance and operation of the laboratory equipment, improved stock management and reduced incidence of stockouts of reagents as well as hiring of more technical staff. TeachingScientists and technical staff in the department were involved in teaching various programmes at KCMU College. Students from different programmes conducted their Clinical rotations in the department. These included Medical Doctors, Bachelor of Science in Health Laboratory Sciences and Diploma Health Laboratory Sciences. Furthermore, students from other Health Laboratory Schools in the country spend some time in the laboratory during their field practical attachments. Laboratory Management and Staffing
The leadership of KCMC Clinical Laboratory is comprised of the Head of Department assisted by
the Laboratory Manager, Quality OfficerandSafety Officer as well as their Deputies.Support staff include laboratory attendants, data clerks and a secretary. The department continues to experience shortage of trained technical staff and in addressing this problem, KCMC and in collaboration with EGPAF, six laboratory technical staff were employed in 2014. One laboratory Scientist was transferred from KCRI Biotechnology Laboratory as well as two staff, one Laboratory Scientist and Laboratory Technologist,completed their studies and joined the Clinical laboratory. Three staff left for further studies, two for MSc and one for BSc. Efforts are being made to recruit more technical staff to support and sustain the laboratory services. In comparison of the number of staff required for a zonal laboratory, by the end of 2014 the staff in the department comprised of: KCmC Clinical
Zonal Laboratory
Laboratory Scientists Specialist Technologists General Technologists Laboratory Technicians Laboratory Attendants Progress/Achievements:
The following achievements were noted during the year 2014:
* Improved performance of most laboratory investigations as per request, and remarkable
reduction in turnaround time of investigational reports to clinicians.
* Continuous reviewing of quality manual, safely manual and sample collection manual as well as implementation of the quality management system in the department in compliancy to ISO15189:2012.
* The laboratory continued to perform well on proficiency testing (External Quality Assessment) on all enrolled tests that were performed in Clinical Biochemistry, HIV DNA PCR and Serology. * Regular departmental meetings to discuss technical, infection prevention and control as well as quality improvement issues were conducted * In October, 2014, the department continued to receive Medical Laboratory Scientist Interns who graduated their BSc degree course. The interns were expected to be supervised for one year * Most of the equipment were under service contract and Planned Preventative Maintenance (PPM) was conducted * In October 2014 we were joined by new six technical staff Problems faced:
» Inadequate number of trained technical staff
» Not all tests done in the clinical laboratory could be enrolled in EQA
» Long equipment down time (Elecsys 2010), sporadic stockouts of some of the reagents
and supplies as well as long lead times » Insufficient supply of blood transfusion units from NBTS to meet the demand Efforts made to solve problems
» Strengthening stock management by forecasting, timely ordering of reagents and
supplies from competent suppliers.
» Service contracts were made between EGPAF and equipment suppliers to support implementation of PPM of equipment » Continuous education and sensitizing staff to adhere to Good Clinical Laboratory Practice (GCLP).
» Review of Laboratory documentationand implementation of ISO 15189:2012 » Implementation of 5S and IPC principles Future plans to ensure efficiency in service delivery:
» Enhancement of Laboratory Accreditation process ready for initial assessment
» Identification and hiring more technical staff and creation of conducive environment for
» Replacement of current haematology analyzers and installation of new clinical biochemistry laboratory equipment (Blood gas, Protein and Haemoglobin » Enroll all laboratory investigations conducted in the laboratory into EQA programme by credible bodies.
COmmuNiTY HEALTH DEPArTmENT
Head of Department: Dr. rachel manongi
introduction
The Community Health Department (CHD) is located in the third floor of the KCMC main
building. The department activities are based on the three pillars of KCMC which are Services, Teaching and Research. The CHD has the vision "to see a working whole system that actively facilitates learning, research, as well as provision of community services that fulfill the KCMC vision" and the mission "to send for mighty hope, and work together to heal the world."
CHD Department has the following objectives:
•
To promote the concept of sustainable health promotion.
To conduct family health mobile clinics.
To compile available health information and development indicators.
To carry out medico-social action research.
To facilitate University campus-community partnerships.
To provide creative and competent life-long learning health workforce.
To enhance and build nutritive collaborative links.
To carry out consultancy work.
Staffing
Department of CHD is understaffed as shown below:
Staffs at the Community Health Department
The below number of staff available includes two Public Health Nurses who are also serving as
Zonal RCH coordinators in the Northern zone and four staff who are on training (three undertaking PhD and one Masters).
Staff needed Staff available DoctorsSenior Public Health Promotion Basic science
Senior statistician
Senior Nutritionist Community Development Environment Health Specialist Public Health Nurses
Public Health Nurses
Activities
A) Services
in the Hospital
CHD is known for its efficiency in conducting health education within the hospital for both in and
out patients. The Health education given varies according to current issues globally; nationally and locally. This year we had opportunity to use Radio FM in Moshi and SautiyaIinjili to educate surrounding communities about Ebola disease. Within the hospital, we have managed to give health education at various departments in regular basis as follows: OG Department: Health education to pregnant women who are admitted in OG1 and OG2
before and after delivery. Topic covered ranged from importance of early clinic attendance with their partners, danger signs, anemia in pregnancy ,and importance of breast feeding and how to handle the baby during breast feeding, how to express milk and safe storage of the milk for the babies for working mothers. Also postnatal mothers were educated on the importance of giving immunization and different types of vaccine to their babies. At the Antenatal clinics additional topic of family planning was given.
Paediatric Department: Health education to postnatal mothers was provided. This included-
post natal care, counseling on nutrition, young infant feeding and importance of mother's milk, how to position the baby during breastfeeding, good attachment, immunization for mother and the baby and also family planning.
OPD: Outbreak Diseases [Dengue, Ebola, etc.], Hypertension, Obesity and diabetic lifestyle
predisposing factors were taught. This including facilitating the diabetic clinic.
In total, a total of 6000 patients and clients received health education during the period of infectious Control at KCmC Kitchen and nearby restaurants: At KCMC Kitchen, 41 staff
handling food for in-patients, students, and staffs were assessed for their health status. Routine medical examination was done as per KCMC infectious control guidelines (three times per year).
Urine and stool was checked. This exercise is considered important in order to avoid transmission of the infection (a detailed report is available in the department and the Matrons' office). For the nearby hotels, we have conducted environmental and sanitation checkups. Problems were identified (poor cleanness and medical check-up for staff not done) and discussed with hotel Community services:
In collaboration with the collage we managed to conduct outreach activities training the"
tomorrows" doctor on how to work with the communities ; We took them to the dispensaries to learn the role of dispensaries' committees in relation to communities they are serving. The students were also taken to CCBRT, sewage system and we visited people with disability. The aim for all this community outreach it to make the students aware of the community needs so that they can from their early career development plan to work in rural areas. Supervision of mNCH in the Northern zone: In total 26 health facilities were visited (Kilimanjaro
region 12; Arusha region 14). Challenges found were mainly lack of skilled staff; readiness of the health facilities to tackle MNCH issues and monitoring indicators for MNCH are not documented (a separate detailed report is available in the department).
Zonal rCH meeting
Zonal RCH Meeting was conducted from 3rd to 5th December. Regional participants from Arusha,
Kilimanjaro and Tanga attended plus Zonal level and stakeholders from EGPAF AND Engender health attended the meeting. The major aim was to discuss on how to improve quality of MNCH services in the zone. Zonal and Regional RCH Reports were presented showing the achievements and challenges. Other educative topics were presented i.e. sharpened one plan and score card to show regional and district performance were presented, RCH live serving commodities, ILS Gate way and report format for RCH Services. (Summary report of the meeting is available in the Youth Friendly reproductive Health Clinic: We conduct Youth Friendly Reproductive Health
Clinic daily but specific on Tuesday and Thursday. Youth from various Colleges in Moshi city, Secondary school students From Moshi Municipal and Moshi Rural District, and other adolescents from various communities attended this clinic. Health education and counseling of HIV testing, STI plus provision of condoms are part of the services provided. The total number of youth attended since January to December 2014 were 249.
B) Training and students' supervision
Training is one of the major activity the CHD department is involved. We train Research
Methodology, Epidemiology, Biostatistics and Health Promotion to all undergraduates and Post graduates within the KCMU College as per planned timetable. Teaching methodologies includes class lectures, Team Based learning-TBL, Problem Based Learning-PBL, and rotational blocks mainly at different hospital departments like OPDs, Occupational Health, and Physiotherapy which enabled students to acquire the theoretical and practical skills of the subject course contents. C) research
The department conducted the following research funded by MEPI - Medical Education Partnership
Initiative an independent organization that works in partnership with the KCMU College:"Module Village for Medical Students at KCMC College" – We have received all the equipment needed and data collection phase ended on 15thDecember 2014. Six hundred households were visited and different variables collected plus GIS mapping of the model village done.
Assessment of school policies and environment in promoting physical activity and nutrition toward prevention of non-communicable diseases among school age children in Moshi Municipality, Research on knowledge and practice on physical activity and nutrition on non-communicable diseases among health care workers in Kilimanjaro region NIH R21 Grants funded research on development of mental health treatment for Obstetric fistula patients in Tanzania Challenges
» Lack of equipment to conducting health education i.e.TV, Loudspeaker, digital cassette,
video camera to facilitate training activities.
» Lack of laptop and projectors for presentations and training.
» Congestion of patient in OPDs due to limited space.
» Limited staff to facilitate training and provision of health education at the OPD and » Inadequate knowledge on infection prevention among some of the staff.
» Parents not responsible in educating their youth.
» Youths coming at a late stage, on the issue of treatment of STI diseases. » Some of the mothers do not want to breastfeed their babies.
» Owner to renovate KCMC restaurants which are under his custodian » Funds to conduct research for evidence based practice within the hospital Head of Department: Dr. Deogratias S. Rwakatema
introduction
Dental department is among the outpatient departments located on the ground floor near to GSF
pharmacy. The department is comprised of two dental units and one dental laboratory located in room 8, 7, and 6 respectively. Notwithstanding the department smallness in terms of infrastructures and staffing, it is valuable on catering for most of the oral health care needs at KCMC.
Staffing
The department is staffed by one dental specialist, two dental registrars, one nursing officer,
one nurse attendant and a dental laboratory technician. One of our Dental registrar and a dental laboratory technician were on study leave for the whole of this year. Activities
KCMC, from outpatient clinics at KCMC and inpatients from various wards. Concomitantly
with this, academic activities were as well sufficiently run. Most of dental patients admitted in the wards had orofacial trauma and few with orofacial dental abscess. These were admitted to surgical, paediatric and orthopaedic wards.
Statistics
Table 1, 2 and 3 below summarizes the annual return of Dental Outpatient Department statistics.
Table 1: Distribution of the number of patients attended at KCMC Dental Outpatient Clinic by months in 2014 Table 2: Distribution of the number of the diagnosed conditions in patients attending at KCMC Orofacial
Table 3: Distribution of the number of treatments provided to patients attending at KCMC Extractions Fillings Prothodon- Achievements
Most of the patients who came to us were successfully treated throughout the year. ‘Malocclusion
in our set up' topic was presented to the clinical conference audience by one of our colleague. Proper recording, uninterrupted procurement of dental materials and upsurge of patients footing bills using National Insurance have made us to restore a good number of teeth in this year.
Through donation we have managed to receive a second hand operative dental unit. Already installed and in use.
Limitations
Lack of replacement for a dental laboratory technician (they are hard to come) so far has created
a deficiency in that aspect of oral health services at our institution.
Future plans
The department is engaged into modernization of dental units' rooms and possibly establishment
of Oral and maxillofacial Surgery Centre.
We are also planning to start fixed orthodontic appliance services but initial capital investment is a stumbling block.
Head of Department: Prof. Elisante J. Masenga
introduction
RDTC has since 1992 to date trained a total of 242 Dermato-Venereology Officers from 17
African countries (65 come from Tanzania the host country). The MMed programme started in the year 2000. It has so far trained 19 MMed Residents from Kenya (3), Ethiopia (2), Ghana (1), Rwanda (3), Botswana (1), Malawi (2) and Tanzania (7). We are currently having a total of 12 M.Med Residents. The Centre is highly appreciative to IFD for sponsoring majority of our ADDV students. We also appreciate the support from the MoHSW to the Tanzanian MMed candidates.
RDTCStaffing situation and the projections(Dermatology Wards) include Actual Required Variation 1. Doctor
Senior consultant Specialist Dermatology Registrar in Dermatology Public Health Derm. 2. Nurse Staff (OPD & Ward)
Medical Attendants 3. Pharmacy Section (OPD & Sunscreen)
Pharmaceutical Assistant 4. Public Health worker
Occupational Therapist Community Reh. worker 5. Laboratory Section
Laboratory Assistant 6. Accountant Section
7. Library Section
Senior Library Assistant Librarian Assistant 8. Transport Section
11. Others supportive staff
Office Assistants Warden (RDTC Hostel) Doctors
This is one of the critical areas RDTC is facing:
• The current 2 Senior Consultants working at RDTC are retired. Prof Grossmann has
kindly volunteered his services at RDTC but not throughout the year and Prof Masenga's two years contract ends July this year.
• Entirely dependent on volunteers especially for the MMed programme
• We have only 2 Specialists (Drs.Mavura and Mshana) – heavy load for the increasing
• Thanks for the MoHSW for allocating us the General Pathologist
• Dr ConsolataSwai who was our Registrar 2 years ago is now on MMed programme. We
are still hopeful she will join us upon completion of the Course • The Centre is highly appreciative to the sixVolunteers in the year 2014: Michael
Diggelen (Netherlands), Mafalda Valdes (Pharmacist Spain), Catherine Balestra (USA), Lonneke Franken (The Netherlands), RoudHorlings (The Netherlands), and Jennifer Gwazadauskas (USA – data for PWA) • Our previous Board Chairman had advised RDTC to develop a strategic plan
("road map") for future developments. A sub-committee was formed to deal with this issue which I believe will shade light to the acute shortage of Human Resource at RDTC. I welcome Dr.DaudiMavura to present their work.
Laboratory
• We have one GSF sponsored technologist, one Molecular Biologist on part-time basis
and a Laboratory Assistant • Mr. Moses who was once with us has again been offered (by the Government –
Utumishi) another one year effective 1st June 2014 a leave without pay. We request the MoHSW to give us replacement since he has not effectively rendered any services at Nurses
• If we combine the OPD and In-patient activities, we have a shortage of 6 Nurses and 5
Medical attendants. We request the MoHSW/GSF to help us in this area Pharmacy Section
• RDTC needs a Pharmacist for the sunscreen Unit. We are still negotiating with the
• RDTC needs 3 Pharmaceutical Technicians; 2 for the compounding and 1 for the
• A back up of 2 Pharmaceutical Assistants needed for both Units
Library section
• The current Senior Librarian Assistant is retired and shows no interest to continue. Extra
help from MoHSW/GSF is requested in this area RDTC has no Librarian only one retired Librarian Assistant (Ms.Silayo) who is under contract. She may not sign another contract next year. We request the MoHSW/GSF to help in this problem.
Secretary and Account Sections
• With these expanding activities, RDTC needs a strong back up of a qualified Secretary to
man her duties properly. The current two ones are too junior to cope.
• Equally needed is a Cashier to help in the account Section
Drivers:
• Thanks to GSF for seconding one driver (Mr. Fred Komba) to RDTC. The Second one
(Mr.Shayo) is still paid by RDTC despite increasing financial constraints. We request GSF/MoHSW to employ Drivers to RDTC.
Other Supportive StaffOther shortages as reflected under table 4.2 need close attention as RDTC work load increases with the decreasing Human Resource.
Building Progress
• The Herbert Stiefel Dermatology Wards and Burn Unit are all complete
• The Theatre and the connecting walk way are now complete
• KCMC Library modifications now complete
• We started moving our patients to one Dermatology Wing since 3rd October 2014
• We are highly thankful to Charles Stiefel who initiated the support and specifically
appreciative to Barbara Stiefel for her generous support for completing the Dermatology wards, initiating and completing the Burn Unit and the modification of the Library. These big Projects have involved huge money amounting to around 3 billion Tanzanian shillings. Thanks so much Barbara and may God richly bless you • The new Care Unit for People with Albinism (CUPWA) is running smoothly. Sincere
thanks go to Canadian NGO - Under the Same sun, "Africa directo" of Spain, BASF in Head of Clinic: Dr. Isack Lyaruu
introduction
The diabetes clinic started operating since 1996. It has been a very busy clinic. Since the Wednesday
clinic was overcrowded, we decided to open Friday clinics for more education and services to our diabetic patients and Monday clinic for children. This started over the past 2 years.
We are running diabetes clinic 3 times in a weeki.e. Monday, Wednesday and Friday. Wednesday clinic is a large clinic with a big team of specialty doctors, residents and medical students. Staffing
The clinic has a total of 3 members of staff.
Statistics
For the year 2014the following patients were attended monthly:
S/N mONTHS
Wednesday clinic
Challenges
» We have only one room which is shared between doctors, nurses and patients.
» Lack of confidentiality due to small consultation room.
» There is shortage of trained staff we need 3 trained nurses 2 doctors stationed at the
DEPArTmENT OF DiAGNOSTiC rADiOLOGY AND mEDiCAL imAGiNG
Head of department: Dr. Clemence F. Kalambo
Department overview/Composition
Diagnostic Radiology and Medical Imaging is the use of X-rays, high frequency sound waves,
magnetic resonance and other techniques of imaging to diagnose disorders not visible from outside of the human body.
The Department of Diagnostic Radiology and Medical Imaging came up immediately with the inauguration of KCMC in 1971. It is located on the ground floor of a three – floored hospital building close to the Casualty Department and the outpatient's clinics. In 2006 services were extended to the OPD/Casualty building whereby X-ray, mammography and ultrasound services are being provided mainly to outpatients.
The mission of the Diagnostic Radiology and Medical Imaging Department is to carry out the functions of health care, teaching, research and consultancy in Christian principles in a dignified, sustainable and affordable manner and facilitate efficient medical imaging development collaboration with all stakeholders.
Plant and Equipment: The list of the equipment, which is in good condition and working, is as 1 Phillips Fluoroscopic Unit (Duo Diagnostic);2 Phillips MRS radiographic units;1 General electric radiographic unit;1 portable radiographic units;1 Mobile radiographic unit;2 mammograhy units;1 Automatic film processor;6 Ultrasound units including a portable one, all with Doppler capabilities.
Specific year objectives
1. To recruit and increase the number of qualified and competent human resources by 10% by
31st December 2014.
2. To spear-head the acquisition of a multidetector CT by 31st December 2014.
3. To train more students in Ultrasonography by increasing the intake capacity by 20% by Staffing
* There are 2 consultant radiologists, 1 registrar, 6 radiographers, 2 nurses, 3 medical
attendants, 1 office attendant and 1 secretary.
* 8 MMed Residents and 16 AMO radiologists' trainees make the complete human resources inventory in the department.
* Currently the registrar is pursuing Masters Degree in Diagnostic Radiology in Kenya.
* Staff attrition is the major challenge to us due to the competitive labour market.
Activities
1. Clinical activities
I. X-Ray examinations
Type of examination
There is a general increase of 39.49% in X-ray examinations compared to last year. This is mainly due to skull films in the absence of CT in cases of head injuries, extremities films mainly following MTA and fluoroscopic investigations after the repair of the fluoroscopy machine.
II. Ultrasound examinations
Type of examination
Ultrasound is by and large being used as a cross sectional imaging modality in the absence of CT, MRI etc.
There is a general increase of 5.890% in ultrasound examinations compared with last year.
2. Training
We continued with training activities parting knowledge in Anatomy and Diagnostic Radiology to
short and long courses students and residents, in various certificates, diplomas, advanced diploma, degrees and post graduate degree courses.
39 Sonographers, 7 AMO Radiologists and 2 MMed Radiologists graduated from our department 3. research
Research activities in the department included Point of Care Sonography in pneumonia in
children, The Role of Ultrasound in Intestinal Obstruction and Radiation Doses in Pediatrics X-ray examinations.
Collaboration
Various local, medical and non-medical students spent time in the department as part of their
fieldwork or on project assignments.
Progress/Achievements
1. One registrar was employed and one attendant transferred in.
2. A multidetector CT has been purchased and will be installed early 2015
3. Thirty one Ultrasonography students graduated in 2013 an increase of 14.5% over last year.
Problems
1. Shortage of human resources.
2. Erratic supply of suitable consumables from MSD.
3. Inadequate existing infrastructure: Lack of an office for radiological personnel, lack of MMed
residents' room, lack of a tea room, changing room, bigger viewing room and examination
rooms.
4. Ageing facilities and equipment with frequent breakdowns.
5. Unstable and frequent power failure.
6. Lack of biomedical technology engineers.
recommendations
1. To be competitive in the labour market so as to be able to employ and recruit more staff
and have capacity building plans for existing staff. GSF should have its own salary scheme.
2. To employ or contract suitable biomedical engineers to service and repair breaking down equipment and also have service contract agreements for newly bought equipment.
3. To have reliable availability of consumables.
4. Improvement of existing facilities in terms of replacing old and worn out equipment plus the infrastructure. Planned preventive maintenance exercise should be reinforced.
5. To have the stand-by generator supply power to all examination rooms. 6. Improvement and progress in providing new services such as Screening Mammography and Interventional Radiology singly or on collaboration with other stakeholders local or international.
7. Furtherance of training in Medicine in Diagnostic Radiology8. Introduction of the Digital Imaging and PACS.
9. To have Magnetic Resonance Imaging services available.
10. To purchase a multidetector CT scanner utilizing the 16 years savings from the CT account.
Conclusion
Based on the existing laid down strategies, the department in collaboration with other stakeholders
has been implementing its mandated responsibilities of improving health services and social DEPArTmENT OF iNTErNAL mEDiCiNE
Head of department: Dr. venance P. maro
introduction
The Department of internal medicine is one the clinical departments at Kilimanjaro Christian
Medical centre located in the main building at the first floor. The main activities of the department is to provide quality Patients care, Teaching and Research. For administrative purposes, the department is divided into 4 main sections which are Medical Intensive care (MICU), Endoscopy, Medical I(MI),Medical II(general and private).
Total number
Consultant Physicians Specialist Physicians Assistant Nursing Officers Health attendants Bed capacity
The Total Bed capacity of the department has remained the same (107) like the last annual report
Bed Capacity
Patients care
One of the important activity of the department is to provide a Quality patients care at a specialist
level both in and outpatients.
inpatients activities
The patients are usually admitted in our wards through outpatients department and they receive the
clerkship as soon as possible by the team on call which consists an intern, Registrar/Resident and a specialist. The same will plan for the management of the patient which will include additional laboratory tests and Medication. All serious patients who are admitted must be discussed by the panel of specialists during morning reports. Every day the ward rounds are been conducted from 9.00 am to 1.00pm.However, Tuesdays and Thursdays are for the major ward rounds on which teachings and large decisions are made by Specialists. Endoscopies and ECGs are done every day and bookings continue as usual while emergencies been attended on spot.
Every last Wednesday of the month Care and Treatment Centre(HIV/AIDS) Neurology Clinics Child Centered Family Clinic Care Mondays and Wednesdays Care and Treatment Centre (Adolescents) Every last Saturday of the month Other activities of the department
Outreach Programs continues as usual which consists of Flying doctors services coordinated by
AMREF, St. Joseph CTC, and Community outreach program (KNCU health plan) coordinated by Pharm Access in collaboration with the Department of Internal Medicine.
Out patients' statistics
Number of patients
Transfer in
Transfer out
Type of Procedure
Number 2013
Number 2014
The "Ten Top" conditions seen in the department has almost remained the same as in 2013.These includes the following: Condition
Upper Gastrointestinal Bleeding Diabetes Mellitus Diabetes Ketoacidosis Kidney Diseases (Acute and Chronic) Congestive Cardiac Failure Teaching activities
The Department continues to be involved heavily in teaching and couching/mentoring activities
.The following cadre of students rotate in our department to receive bed side teachings (BEST) and tutorials. The Teaching is usually conducted by the assigned academic staff. However in every major ward rounds students have to attend to receive extra practical teachings.
The following cadre rotates in our department: Diploma in Nursing Diploma in Physiotherapy Advanced Diploma (Clinical Officer) Degree in Nursing (BSc) Degree in Physiotherapy Degree in Doctors of Medicine Masters of Medicine in Internal Medicine Elective Students outside the country Intern Doctors (Inside and Outside the country) research activities
Research activities are ongoing to find out areas of improvement and to compliment the trainings
of the Undergraduates, Post Graduates and PHDs as they collect data for their thesis. We still continue collecting data on Bacterial Zoonosis, Renal diseases, Tuberculosis/HIV, and resistant partner on antiretroviral drugs. We have by this year written a proposal on the Burden of Morbidity and Mortality on febrile illness at KCMC which will hopefully been sponsored by Medical Education Partnership Initiative (MEPI).This will have a heavy involvement of faculty members and Undergraduate students ,to strengthen their capacity in research .
Achievements
1. Two Residents graduated for their Master's degree in Internal Medicine and they were
awarded their degree in November 2014.One is our member of department and will strengthen our specialist care 2. Two Nurses Graduated in Bachelor of Nursing and they were awarded their degree in BSc in November 2014.These will strengthen nursing care in our department 3. Dr.KajiruKilonzo who went for specialization of Nephrology is now back and graduated in the field. He is expected to start nephrology services at this centre as soon as it is feasible. The department wishes to thanks the sponsors who made it possible.
4. We continue getting specialist advises/Teachings from experts from outside the country(USA/Netherlands,Australia,UK et).This has been very useful to the academic staff students and KCMC at large 5. Three young doctors who are still in master's program graduated in Diploma in Tropical Medicine been offered by London's School of Hygiene.The department wishes to congratulate them very much 6. Patients with skin conditions (Dermatology) who were been nursed in Medical two ward have been transferred to their new wards. This will give us more space. We congratulate Professor Grossman, Professor Masenga, Dr. Mavura and the entire management of KCMC for making this possible.
Challenges
• Shortage of staff-We continue facing a challenge of staff shortage particularly in nursing
cadre. It is believed that nurses are not so many in the market, but in the other way the newly employed staff is also faced with motivation challenge. The management continue to look at this challenge critically.
• Inadequate diagnostic facilities-For a physician to practice a quality medicine diagnostics
are very crucial. We are often faced with shortage of reagents and machine errors. Computerised Tomography machine has not been working for Three years. The Endoscopy unit has not been working because the machine/scopes need replacement. The hospital is working on it very aggressively despite of the scarcity of • Shortage/unavailability of medicines. We still experience severe shortage and
unavailability of some essential medicines. Many times patients have to buy these medications on their own outside KCMC which heavily affects patients care. We continue looking for the solution which includes carefully collecting more money from our National Health Insurance and cost sharing, and allocating more funds for medicine • Working equipments-Shortage of working medical equipmentslike Monitors,
Pulsoxymeters, Oxygen cylinder heads etc. continues to strike patients care.
mAiN OPErATiNG THEATrE / CENTrAL STEriLE SuPPLY
Theatre superintendent - Sr. Margareth Msoma
introduction
The Department is located at the second floor in the main hospital building. It has two units
mainly, the Main Operating Theatre (MOT) and Central Sterile Supply, Department (CSSD).
MOT: - Is an important department of the hospital where major surgical operations are performed.
It receives its clients from all departments including General Surgery Orthopedic, Dental, Gynecology, Pediatrics and sometimes direct form Casualty. It consists of 5 operating suites - 4 for clean cases and 1 for septic cases.
CSSD: - Is where processing of used (dirty) professional instrument is performed;
(Decontamination, cleaning, packing, sterilization) and supply of sterile packs / trays.
Philosophy
We believe that all patients have the right to be attended with dignity according to their specific
needs regardless of economic status, political affiliation color, race, religion.
Objectives
1. To provide safe and high standard theatre services
2. To teach students in various programs on safe, feasible and sustainable theater
techniques
Staffing
The department is still managed by inadequate number of trained nursed. This includes; one floor
coordinator and 2 unit in charge Staff movement in mOT
Transfer
Left retired Total at
Officer Enrolled Staff movement CSSD
Transfer
Left retired Total at
Statistics for mot
Operations done from January to December 2014
Department
Grand Total Operation 3835 List of sterilized items
NumBEr OF iTEmS
Dressing Pack drums Labour ward bundles Labour ward trays Orthobands trays Vaseline Gauze trays Achievement
The department still collaborates closely with partners from various institutions in the world:
* Northumbria NHS in UK ( Laparascopic Surgeries)
* AMREF reconstructive surgeons
* Northumbria Burn Team
We successfully task force to perform 35 operations and we have been observing good outcome.
Constraints
» Shortage of nursing staff
» Frequent breakdown of autoclaving machine » Leakage from the roof Future plan:
To request for renovation of the Main Operating Theatre /CSSD
DEPArTmET OF OBSTETriC AND GYNAECOLOGY
Head of department: Dr. Gileard masenga
introduction
Gynaecological and obstetric department is located at the third floor in KCMC main building.
This Department is divided into three units, which includes Delivery unit (Labor Ward), Obstetric, and Gynaecology unit. The department also runs two outpatients clinics, i.e. the GOPD and Reproductive Health Clinic (RHC) Obstetric unitThe unit has 59 beds, and admits mothers waiting for delivery or with pregnancy complications and post delivery.
Gynaecological unitIt has bed capacity of 52 beds, receives all patients referred with gynaecological problems.
Labour unitIt has 4 delivery cubicles and two theatre rooms.
Philosophy
The department believes that every human being is an individual with unique needs, and problems
which must be addressed individually irrespective of race, age, educational status, religion, political or social status. Therefore our responsibility is to give quality care to every woman and maintain good harmony and team spirit among the staff. Thus will make us work more comfortably and maintain cheerfulness among clients, our relatives and us. It's also the goal of the department to assist medical students, assistant medical officer students and nursing students in their clinical rotations teaching.
Objectives of the department
» Maintain good interpersonal relationship, team spirit and good harmony among the
staffs, students, clients and relatives in order to promote conductive working atmosphere.
» To provide quality services to all patients admitted to the department and identify patients at high risk and act promptly.
» Prevent and manage obstetric complications so as to reduce maternal/neonatal morbidity and mortality rate.
» To provide practical oriented clinical teaching to students and staff as continuing » To conduct evidence based clinical research.
Staff situation
1. Head of department
Sr. Beatrice Saritha 3. Obstetrician and Gynecologist 4. Resident 4th year i. Resident 3rd year ii. Resident 2nd year iii. Resident 1st year Other staff
1. Graduate Nurse Officer
2. Assistant Nurses Officer 3. Enrolled Nurse 4. Medical Attendants 5. Temporarily Employed Nurses 6. Office Attendant 7. Personal Secretary Seminar /workshop » We have conducted 8 Advanced life support in Obstetrics(ALSO) courses in various districts in Tanzania, as follows:- * Iringa regional hosp- 2 courses * Dodoma- Mpwapwa/Bahi - 2 courses * Tanga – 1 course * Dareda – 1 course * KCMC (nurse and residents) - 2 courses » We had 20 outreach programmes in various hospitals in Tanzania in Collaboration with AMREF flying doctors.
» One workshop was conducted in Lindi district on basic surgical skills in obstetric fistula » We provided training on Structured Obstetrics Operative Procedures (SOO) to all AMO – Students in 2014.
» We also conducted 2 training cervical cancer screening, where by 6 postgraduate students and two nurses were trained on screening for cervical cancer.
Achievements
1. In the year 2014, about 1227 women were screened for cervical cancer in our RHC
clinic, of which 56 were diagnosed to have cervical carcinoma, while 92 were diagnosed to have precancerous lesions. A total of 78 women of those with precancerous lesions, needed treatment, of which 36 had Cryotherapy and 42 had LEEP been done.
2. The department also continues with Laparoscopic procedures and in the year 2014, a total of 27 diagnostic Laparoscopic procedures were done.
3. We have managed to establish collaboration with the University of Southern Denmark, Odense university hospital. This will enable the members of our department to obtain more exposure in different areas of subspecialty such as Gynecological Oncology, endocrinology and Infertility, plus urogynecology through the established exchange 4. We have strengthen the collaboration with the Duke University, where by two senior consultant members of faculty from Duke have been visiting us and provide teaching to the residents and medical students. In addition our partners from Duke are assisting the department in advancing medical care in area of laparoscopy, gynecology oncology and fetal medicine.
5. DiafamPharmacetical in Tubingen Germany; Through this collaboration which started in 2011, we have been receiving regularly a donation of cytotoxic drugs for all patients with Gestational trophoblastic neoplasia. In addition Diafam supply us with Misoprostol for treatment of Postpartum Haemorrhage Constraints
» Inadequate number of nursing staff.
» Lack of delivery beds that can accommodate mother and her new born baby.
» A working CTG machine in the Labor Ward, and a Doppler machine for the Antenatal
» The constant stock-out of essential drugs like parenteral Hydralazine has been a great set back in management of patients with severe pre eclampsia.
» The newly established ICU in the department is lacking the necessary equipment for intensive care: pulse oxy-meter, ventilator, ECG monitor Suction machine (electrical) » The labor ward theater rooms are lacking a working suctioning machine, and anesthetic Machine ( only one available for the 2 rooms) » The Labor Ward theater rooms are also lacking A/C, making the atmosphere very hot.
» The patient's toilets in OGI and OGII are very old and they need major renovation.
» Private rooms toilets are not functioning properly and they need major repair Future plans
To develop subspecialty among the consultants working in the department in areas of gynecological
oncology, maternal – fetal medicine, endocrinology and infertility and urogynaecology.
Conditions admitted in the department
1. Normal pregnancy and complicated pregnancy with medical conditions such as Pre-
eclampsia, Eclampsia, Antepartum and post-partum haemorrhage, anaemia in pregnancy, malaria in pregnancy, diabetic mellitus in pregnancy and UTI in pregnancy, BOH and those in need of cesarean section.
2. Gynaecological conditions like – benign conditions (uterine fibroids, abortions, infertility, dysfunction uterine bleeding and puerperal sepsis. malignant conditions: cancer of cervix, ovarian and endometrium tumours, surgical cases; ectopic pregnancies, vesico- vagina fistulas.
Statistics for obstetric
Total number of admissions Total number of deliveries Spontaneous vaginal deliver Caesarean section Vacuum extraction Laparatomy due ruptured uterus Gynaecological operation
In the gynaecology unit we had a total number of 456 surgeries, performed of which 455 were
major and 1 was minor surgery.
Cervical and breast cancer screening program
In this unit we have been able to screen 1227 women coming from areas surrounding KCMC and
other referred from various hospitals from North Eastern zone of our country.
"Top ten" obstetric conditions
1. Pre eclampsia
2. Twins pregnancy
3. Anaemia in pregnancy
4. Antepartum haemorrhage
5. Bad obstetric history (BOH)
6. Malaria in pregnancy
7. UTI in pregnancy
8. Diabetic mellitus in pregnancy
9. Eclampsia
10. HIV in pregnancy
"Top ten" gynaecological conditions
1. Cervical Cancer
2. Uterine Fibroids
3. Threatened Abortion
4. Incomplete abortion
5. Ovarian Cyst
6. Ectopic Pregnancy
7. VVF/RVF
8. PID
9. Malaria in Pregnancy
10. Ovarian Tumor
research activities in the department
1. Five researches were successfully done in our department or in collaboration with
faculty's members and published in peer's reviewed journals , the titles are as follows:- Prevalence of Multiple Pregnancies and Fetal Maternal Outcomes at KCMC Prevalence and Risk Factors of Abruption Placenta at KCMC between 2000 to 2. Ongoing research activities at the department Prevention and control of Surgical Site of Infection. A hospital base study, MEPI mentored research Grant A pilot study on Development of an Intervention on Mental health among obstetric fistula patients admitted at KCMC Burden on cervical cancer Disease in Kilimanjaro region 3. Upcoming research Cervical cancer screening using smart phone WHO HPV test/ Vaccine trial OCCuPATiONAL THErAPY DEPArTmENT
Head of department: Mr. Peter Mashaka
introduction
The department is within the Orthopaedic Rehabilitation Unit since October 2014.The department
has been given two rooms for therapy. We moved from the OPD building to give space for the construction of the "Remodelling of the emergency medicine Department". The department gives services for in and out- patients both adults and children with various conditions /disabilities. The aim of the Occupational therapy is to assist patients/clients to achieve optimal participation in their valued activities of daily living (World Federation of Occupational Therapists, 2004)The OT works with the patient to improve or maintain their ability to perform activities of daily living that are meaningful to that individual at home, at work and in the community. The OT assists patients and their families in efforts to adapt to disruptions in lifestyle.
vision
To be a reputable department in maintaining an effective, efficient, holistic, client centred and
sustainable quality of rehabilitation programmes.
Staffing
The department has a total number of 8 employees. 6 Occupational therapists employed by GSF
and 2 Medical attendants. Currently, the department has 1 full – time occupational therapist. 3 OT's are on study leave. We are grateful that one Of the Occupational therapist who was on study leave for 3 years, successfully completed his studies and joined colleagues in the department. Conditions seen
Adults with physical disabilities:
* Common Conditions: Spinal cord injuries, Stroke (CVA), Brain injuries, Hand
injuries + brachial plexus injuries, arthritis, fractures and Neuropathies.
* rare Conditions: Epilepsy, Cerebellar ataxia, Guillain – Bare Syndrome (GBS),
Leprosy, amputations, Transverse myelitis, Rheumatoid arthritis and Dystonia.
Children with disabilities
* Common Conditions: Cerebral Palsy (CP), Delayed milestone, Microcephaly,
Developmental and learning disabilities, Intellectual impairment, Autism, Hydrocephalus, Spinal Bifida and Others.
Activities
-
In –patient skills training in and outside the wards Out -patient performance skills training in the OT Clinical department Workshop activities, fabricating assistive and protective devices Home visits and environmental adaptations Teaching and clinical supervision of local and international students.
Statistics
Number of in and out patients attended in Occupational Therapy Department in the year 2014 is
In-patients
No. of patients
General Surgery SI & SICU B Neuro Paediatric Outpatient Clinic (NPOC) Sub Total B
Grand Total ( A + B)
Home Visits:
In order to prepare some of our people with disabilities for everyday life at home, school or at
work, our intervention necessitates visits to home/school/ work-places/community. Most clients seen in our department would require one such visit. Last year we were able to carry 20 visits to the homes, schools, institutions, community and work–places.
visitors
The department has had 98 (local and International) visitors who visited the department as from
January 2014 to December 2014 for the purpose of learning and sharing different skills in the clinical aspect.
S/N university College/ Country
Bergen University (Senior Officials) To review the fieldwork Manual KCMUco ( Students) Learning about Occupational therapy Bergen University (Students) Clinical Placement KCMUco ( BScN Students) Learning about Occupational therapy University of Toronto Clinical Placement Duquesne University Learning &sharing skills in O.T Exploring possibilities for research University of Minnesota - USA Familiarization visit Umea University (Teaching staff) Teaching exchange programme.
Neema Crafts Therapy – Iringa town. Learning & sharing skills in O.T Umea University (students) Familiarization visit Events
The department moved from the Extension of OPD and given 2 therapy rooms at the Orthopaedic
Rehabilitation Unit. This building is behind the paediatric wards. The management has promised to identify a new premise for the Occupational Therapy department before June 2015.
Collaboration, training and research
The department Continues supervising International and local students from different programmes
at KCMC, including occupational therapy, Medicine and Nursing. The department enjoys networking with other stakeholders who are working with different groups of people with disabilities in the Northern Zone. The department has strengthened the ongoing collaboration with the University of Bergen (Norway), University of Toronto (Canada) and Oslo University (Norway). The department has collaborated in a project with the University of Toronto on "Inclusive Playground for Children at KCMC" and we look forward into implementation of
this project before June 2015. The department did present a scientific paper in the OTWORLD 14 Congress which was held in Leipzig 13th – 16th May in Germany 2014. The title of the paper reads "The importance of Home – visits, home Modifications and the use of assistive devices to
people with compromised mobility in a less resourced setting"
Achievements
Despite the critical shortage of staff, the department has managed to achieve the following -:
■ Creating awareness to the KCMC Community on issues pertaining to services to the
people with disabilities and thus enabling them to lead productive life.
■ Continuing our role in advancing our profession by regularly giving clinical supervision to students at KCMC.
■ Continuing creating an environment for mutual learning by hosting international students, visitors and volunteers.
■ Facilitating teaching and procurement of a multi-functional work –bench for woodwork as well as other handy-crafty ■ Securing donation of reference books, digital Camera, thermoplastic materials, a Multi – Media Projector, additional toys and Equipment to be used in the Paediatrics unit.
Challenges
■ Critical shortage of staff.
■ There's still a circle of mind of confusing the difference between occupational therapy
and physiotherapy among other health professionals ■ Lack of Annual departmental Budget ■ Lack of printing facilities ■ Limited transport/fund for conducting home visits.
■ Failure to perform scheduled home -visits Future plans
■ To have improved home – visit schedule
■ To improve the working environment by the use of 5's
■ To recruit more Occupational therapists
■ To initiate interdepartmental meetings with the Multidisciplinary Team members whom
we work with in the Rehabilitation field ■ To establish an Inclusive playground for children at KCMC. Head of department: Dr. William Makupa
introduction
The Eye Department KCMC is a 68 bed tertiary eye healthcare facility located within the
Kilimanjaro Christian Medical Centre. The department is composed of three units, namely the Eye Clinic, Eye Ward and Eye Operating Theatre. It is staffed by six ophthalmologists, 12 ophthalmology residents, two assistant medical officers ophthalmology, 15 AMOO trainees, 25 nurses, five optometrists and 15 medical attendants. Goals Achieved
1. The department had established an Eye Department Development Plan (EDDP) in June 2011,
and currently we are entering the fourth year of implementation of this 10 year plan.
2. We have managed to recruit one ophthalmologist, Dr ElisanteMuna who has been posted to the AMOO School by the Ministry of Health.
3. We managed to acquire two Inami L-0189 Slit Lamp Biomicroscopes with financial support from ChristoffelBlindenmission. 4. An Ophthalmic Operating Table was acquired from Deepak India, increasing our operational capacity.
5. The laundry facilities were finished, we now have a fully operational laundry service, this has reduced the loss of eye specific theatre garments.
6. Our Oculoplastic Surgeon, Dr Honest Maro had hands on training in the Netherlands, improving KCMC's capacity to deal with orbital diseases.
7. The Pediatric Ophthalmology Fellowship Programme has recommenced, with two fellows having being trained this year, Dr AboubakrSidik Domingo and Dr EmebetGirmaTigeneh8. A team of three (W. Makupa, H. Philippin and E. Mgaya) from the Eye Department attended the Scientific Conference of COECSA in Livingstone Zambia.
impact
1. Improvement in the quality of eye healthcare provided at KCMC by the development and
consolidation of Oculoplastic Services.
2. Raising the profile of KCMC as a training centre by recommencement of Paediatric
Fellowship Programme that had been suspended in 2011.
3. Removal of barriers to accessing eye healthcare by children, women, the poor, handicapped
and the elderly through Eye Outreach Programme.
Constrains
1. Lack of sub-specialist for Cornea and Uveitis.
2. Insufficient number of nursing staff.
3. Limited availability of certain types of ocular pharmaceutical products.
Didactical Activities and research
In the year 2014, some five MMed Ophthalmology residents graduated as well as six Assistant
Medical Officers Ophthalmology. Moreover some 149 Medical Students did their clinical ophthalmology through the eye department.
General Information Total Consultations New Consultations Children (< 16 years) Top Ten Diseases1 Conjunctiva Disorders 7 Retina Diseases 4 Other Disorders of Eye 5 Refractive Errors 10 Cornea Opacity Top Ten Diseases Children1 Conjunctiva Disorders 2 Other Disorders of Eye 3 Refractive Errors Eye Outreach
Outreach Visits DEDSO1
Surgical Outreach Visits Numbers Screened DEDSO Numbers Screened WESO2 Numbers Operated DEDSO Numbers Operated WESO Outreach
1. Day Eye Diseases Screening Outreach.
2. Week-long Eye Surgical Outreach.
Collaborations
1. ChristoffelBlindenmission.
2. Light for the World – Austria.
3. University Hospital Birmingham.
4. Eye Care Foundation – Netherlands.
5. College of Ophthalmology for East Central and Southern Africa.
6. Dr Hans Joachim Miertsch
DEPArTmENT OF OrTHOPAEDiCS
Head of department: Dr. Elifuraha G. maya
introduction
The Orthopaedic department is also known as surgical two. This name originates from historical
background. It used to be a unit of general surgery until 1986 when it became an independent department. It is located in second floor of the main hospital building.
Sections in the department
The department has three sections thus:-
1. General wards i.e. Room 6, 7, 8, 9, 10 and 11
2. Private wards i.e. Room 12, 13, 14 and 15 which are shared with surgical department
3. Orthopaedic Rehabilitation unity Staffing
The department organogram consist of:
■ Head of Department
■ Nurse of coordinator
■ Nurse in charge of department
■ Nurse in charge of ORU
Other staffing: ■ Graduate nurse officers ■ Assistant nurse officers ■ Enrolled nurse ■ Medical attendants ■ Orthopaedic surgeon ■ Orthopaedicthietre nurses ■ Orthopaedic plaster technician Staff development
•
EriminaKimbion BSc Nursing Course - KCMC Dr. Honest Massawe on orthopaedic surgery – KCMU CO Dr. Pallangyo on orthopaedic surgery – KMCU CO Workshop and seminars
•
Tuesday and Wednesday conference attended by all nurses One nurse attended 5 days seminars on palliative care One nurse attended I day seminar on PMTCT One nurse attended 5 days workshop on KAIZEN Achievements
■ The department was able to provide high quality care despite of shortage of staff and
overcrowding of patients.
■ The department succeeded to transfer some of spinal cord injury of patients to rehabilitation unit. ■ The department achieves to get, heater for hot water which is available in the kitchen ■ All old mattresses were exchanged ■ Some old blankets were exchanged.
Constraints
■ Shortage of staff
■ Hospital beds are old, new one are needed
■ Shortage of non-human resource i.e. suction machine private patient utensils, curtains,
and patients uniforms ■ Working C – ARM in theater IV Future plan and recommendations
■ Recruit more nurses and medical attendants.
■ Reduce the number of patients on fraction to reduce hospital staying, the cost of
treatment and Borden to the nursing staff.
■ Expand orthopedic department to allow for more beds, more theater rooms and large rooms for lectures and morning repots.
■ If possible allow nurses to specialize on orthopedic and trauma management Top ten diseases
1. Fracture of femur
2. Fracture of tibia/ Fibular 3. Cervical + Spinal cord injuries 4. Fracture of radius / ulna 5. Osteomyelitis 6. Intertrochanteric fracture 7. Supracondylar fracture 8. Fracture of humerus 10. Fracture of ankle Killer Disease
1. Cervical injuries
2. Open fracture tibia / fibula, femur
3. Intertrochanteric fracture in old age
4. Spinal cord injuries with bed sore
1007 408 1415 952 430 1382 Operations/ procedures performed in 2014.
NAmE OF PrOCEDurES
Austin Moore prosthesis External fixation Surgical debridement UFN Universal Femoral Nail DHS Dynamic Hip Screw NB:
All other procedures that are not so commonly done. To mention few these are
1. Nerve exploration
2. Contracture release
3. Bone grafting
4. Revisions
5. Secondary suturing
6. Talectomy
7. Clubfoot surgeries
8. Pediatric surgeries
9. Foreign body exploration
10. Darackoparation
11. Excisions
Collaboration
1. Health volunteer overseas of America
2. Stokemanda-ville hospital of United kingdom
3. Nijmegen university of Netherland
DEPArTmENT OF OrTHOPAEDiCS WOrKSHOP
Head of department: mr. Prosper Kaaya
introduction
Orthopedic Workshop located adjacent to TATCOT. The department received patients who came
from all corners of Tanzania and the nearby Countries. All people living with physical disabilities were attended accordingly. Staffing
Still we have shortage of staff due to the increase of the number of Clients who are in need of our
Up to December 2014 the department was maintained by the following staff:ProsthetistOrthotist Orthopaedic Technologist - Orthopaedic Technician - Office attendant - Orthopaedic attendant - Orthopaedic Shoe maker - Wheel chair Technician - Activities
Department managed to offer services to all clients who came for orthopedic devices. The
department used to receive students from TATCOT and KCMU College for field work and research. Some of the staffs are involved in teaching of student at TATCOT and KCMU College.
The following devices were delivered to the people living with physical disabilities.
Trans tibial prostheses Trans femoral prostheses Knee ankle foot orthoses Ankle foot orthoses Orthopaedic Sandals Knee disarticulation prosthesis Cervicles Neck Collar Orthopaedic boots Figure 8 clavicle harness Different repairs Flexible lumbar corset Trans Radius Prostheses Trans wrist prostheses Trans Humerus prostheses Number of patients attended the department No. month
Constraints
» Shortage of Orthopaedic Materials and components
» Shortage of office attendant. Currently we have two office Attendants.
» Insufficient number of Orthopaedic Technologist which are not match with increase number of patients. » Shortage of some of the machines and machines tools.
impacts
» We managed to provide services to all people living with physical disability by providing
appropriate Orthopedic devices.
» The department work hard to clear outstanding bills for materials and components and other debts.
Future plans
» To look for short and long courses for staffs in order for them to gain more knowledge
» To look for more donors, in order for them to support department so that we can produce orthopedic devices which can be affordable to the poor patients.
» Renovation of ground floor » To establish Departmental development plan.
Collaboration
» Department has collaboration with CCBRT
» Department has collaboration with CBM.
» Department has collaboration with TATCOT/KCMU College.
» MERSOL
» Faraja primary school- SanyaJuu
Head of department: Dr. Aloyce Msaki
introduction
The department continual to render services under the leadership of Dr.A. Msaki despite of
shortage of Human resources especially Doctors.
The department has three units namely:- » Ward » Clinic » Theater In 2014, the total capacity was is 24 because one Room of 4 beds was converted to tea Room » General ward 20 beds » Private room 3 beds We usually admit daily and operate daily, Monday to Friday. Furthermore there is daily ward round, bedside teaching and interdepartmental consultation.
Clinic
Clinics are conducted on Tuesday and Thursday. Wednesday is special for KCMC Staffs and
student. There is Audiology Unit which is located within the outpatient premises and it operates Theatre
We have two operating room we schedule operation from Monday to Friday Emergencies are
operated as they arrive.
Philosophy of the department
To provide quality care for the patients as professional responsibility
Staff situation and movement
There is one principal medical officerand four residents/registrars in the department.
DR'S: Principal medical officer -
NO APNO ASNO ANO EN SmA mA ATENDANT
Constraints
» Increased number of patients in relation to the number of staffs.
» Replacement of old surgical instruments which are no longer functional.
» Bed capacity
» Renovation of the department
» Changing room
Top Ten Diseases
1. Adenoid hypertrophy
2. Adenotonsilitis
3. Tonsillitis
4. Hypertrophic Allergic rhinitis
5. Aerodigestive foreign bodies
6. Tumors
7. Nasal polyps
8. Epitasis
9. Chronic Otitis Media
10. Juvenile Laryngeal Papilomas
Out patients
Number of death
Oropharyngeal tumour Severe anemia sec to lymphoma Laryngeal tumour Foreign body in the airway Anaphylactic reaction Achievements
During departmental visits by different ENT surgeon we managed to perform complicated
surgeries that were not performed in our Department, MMED and other students rotated within our department acquired knowledge and skills. Despite shortage of staff we managed to increase number of operation days from two to five days Future plans
» To train more residents.
» We need two registrar to alleviate the shortage of doctors
» We need speech therapist.
» Renovation of the department.
» To train nurses on different ENT specialties
DEPArTmENT OF PATHOLOGY
Head of department: mr. Yona Kasebele
introduction
The Department of anatomical Pathology is does offer clinical services to this hospital and
several other outreach hospitals. The Anatomical Pathology department is yet to get a resident pathologist, however the department functioned satisfactorily this is due to combined effort of GSF and Nijmegen University. We have been getting support of pathologists from Nijmegen University of The Netherlands. A total of five pathologists worked in the department at different times this year, these included Prof.Slotweg, Prof.Arrends, Dr. Van Tweel, Dr.ValeskaTepstra, and Dr. Van Beeek.We advise the administration should find a final should find a final solution to the Pathologist issue.
Staffing
One technical staff member finished her internship in October this year and joined the department
in November, and yet another technical staff member enrolled for PhD at KCMU College this academic year. The current staffing situation is as shown in the table below;5 Morgue staff: S/N Staff category
1( currently studying at Makerere university) Laboratory scientists (MSc.) Laboratory scientist (BSc.) Health attendants Morgue attendants Activities
Pathologists who visited/worked in the department also participated to teach Basic Pathology to
MD 3 students at K.C.M University College. Laboratory Technical staff continued to take part in teaching Diploma and BSc. Students for Health Laboratory Science.
The Department also supervised all students for their rotation on hands on skills.
Achievements
Dr. Patrick Amsi is the 2nd year at Makerere University as a resident in Pathology, and Mr.
George Semango has this academic year joined K.C.M. University college for a PhD degree with a research titled "Unravelling the Role of Interleukin 32 in HIV related Kaposi Sarcoma".
Workshops/Seminars
r. Y.Kasebele and G Semango attended a course on routine histotechnology methods and special
stains from 18th to 20th August 2014. The course was conducted by East Africa Division of International Academy of Pathology and sponsored by British Division of IAP.
Statistics
The following tables represent the various specimens processed and examined in the department
for the year 2014 Number of specimen
Number of specimen
*More than 82% of surgical biopsies are from K.C.M.C Hospital and the rest from other Death statistics – morgue.
From K.C.m.C
Total 1081
From outside K.C.m.C
Total 1080
Type of Pm
DEPArTmENT OF urOLOGY
Head of department: Dr. Frank Bright
introduction
Urology department is situated on top of the pathology department at KCMC. It has two operating
theatres, one major and one minor, a clinic and wards of 38 patients.
Philosophy ■ We believe that every person is an individual with needs and problems regardless of race, sex, age, religion, politics or social status.
■ We believe that every individual has the right to get optimal nursing care.
■ We believe that surgery is one technology of rendering the best well-being of an individual from diseases so best pre and post-operative care is essential.
■ We believe that we are God's instruments for caring the sick.
Objectives: ■ To maintained good interpersonal relationship between staff, students, patients and ■ To promote quality nursing care to patients.
■ Working as a team with doctors, physiotherapists, and anaesthetists so as to meet our goals concerning patients.
■ To ensure proper documentations to all activities done.
■ Monitoring ward cleanliness every day to prevent infection.
■ Utilization of nursing care process.
■ Have 5s implemented in urology department.
■ To ensure availability of supplies material and equipments.
■ To keep updated inventory of all equipments.
■ To emphasise on continuing education.
Statistics
Table 1: main theatre procedures
Procedure
Hypospadias repair Scrotal exploration Urinary diversion Colostomy closure Table 2: minor theatre procedures
Procedure
Stoma Calibration Activities
Teaching as our role and also one of the mission of KCMC: Last year our department received
students from Malawi , Kenya and Uganda. The department provides training for the student to graduate as Urologist. The students are taught according to KCMUco. postgraduate guideline, supervised for the research work, and we lastly we provide examinations under KCMUCo. Guideline. Thereafter, the student successfully graduated as Urologist. We also have more students joining the department as resident doctors from various part of continent including Tanzania, Kenya and Rwanda, who are still progressing with their studies at the department and the clinical Furthermore, we are planning to start the preparation for biannual JL Eshleman workshop which is supposed to be held on Nov 2015. We have managed to send first announcement on Dec.
It is our hope we will hold several meeting so that we can make the workshop success.
In addition, as the department we also have a role in the KCMUCo. As Lectures and Senior Lecturers to provide teaching to the undergraduates and resident doctors on the Urological conditions including: Pheochromocytoma, WilmsTumor,Bladder outlet obstruction, prostate cancer and etc. The department has a role to teach MD One and MD Four students in the First Semester of their curriculum. This was successfully done and the students were examined and all pass. Moreover, the department proceeds to provide care and treatment, support to people/ patients who cannot reach our hospital- KCMC through provision of flying doctor services. This year we manage to attend 10 trips from various hospital including: Nkinga, Berega, Itigi,NdalaMakiungu, Nzega,Kiomboi , Sikonge, Kilimatinde,Iambi and Dareda Hospital. The service provided was sufficient and the cooperation between these hospitals continued to be appreciated from both Last but not least, the department is running two days clinic in a week which is on Tuesday and Friday. The clinics are constantly busy with the average of 60 patients with different conditions attending per clinic per day, with the average of 2 consultants, 1 urologist, 1 clinic nurse, 1 nurse attendant and 3 students. The number of the experts is not enough as a result it always brought about long waiting for our patients; complains from the patients and short time spent with patients due to volume of patients. This estimate of patients number attended makes a total of 4678 patients who attended our clinic in 2014.
Lastly, the department is not working in isolation. We still proceed with our collaboration between Urolink and British Association Urology Society (BAUS). The aim of this collaboration is to have an exchange programme for our Junior and senior Doctors within the network to learn professional experience from various countries within collaboration. Currently, we have Dr.AlexzandiriaZazho from Greece a 4th year Medical doctor from the University of Alexndria Greece who is in the department for six months. She is learning different procedures and practice under supervision from the local supervisors. She completed her study period in March 2014. This became possible due to the collaboration with BAUS and Urolink.
Challenges faced by the department
•
Electricity instability which is long term problem in our hospital as well as our country. This has led to constant break down of our endoscopic equipments as well as diathermy Shortage of professional and non- professional staff such as specialist, consultants and ward attendants. The shortage have result into patients spend more time in the our clinic as specialist are few. The other problem which have come is the specialists tend to spend little time with patients so they can finish to see all patients. This has led to some patients not satisfy with our services.
Lack of quality consumables example catheters, face masks and surgical gloves. The problem has led into risking the workers safety and led to consume more materials as for example some of the gloves have holes so instead of using two pairs you end up using three or more.
Future Plans
•
To train more residents in order to alleviate current shortage.
To start percutaneous endourology services PARAMEDICAL
Head of Department: Mathew J. Shayo
introduction
Physiotherapy department is one of the clinical departments that provide services to individuals
and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan. This includes providing services in circumstances where movement and function are threatened by ageing, injury, pain, diseases, disorders, conditions or environmental factors. The aim of physiotherapy services is to maximise "functional movement" which is central to what it means to be healthy.
Physical therapy is concerned with assessment and maximising quality of life and movement potential within the domains of promotion, prevention, treatment/intervention, habilitation and rehabilitation. This embraces physical, psychological, emotional, and social wellbeing as well as enhancing active life among normal subjects in prevention of none communicable diseases.
Physical therapy involves the interaction between the physical therapist, patients/clients, other health professionals, families, care givers and communities in a process where movement potential is assessed and goals are agreed upon, using knowledge and skills unique to physical therapists.
Our Clients
Our clients are Inpatients and Outpatients, adults and children, old and young with pain,
movement and activity limitation, participation restriction resulting from physical, pathological or psychological disorders. We therefore stretched our services to 8 main areas in the hospital i.e.
• General surgery ward Obstetrics and Gynecology Orthopedic rehabilitation unit Outpatients (adult and Pediatric) With the expected expansion of the hospital our services are expected to expand to "Burn Unit" and "Open Heart surgery unit" which are on the process to be established.
Objectives
The department is focusing on the delivery of high quality physiotherapy services in Tanzania by
adhering to the international clinical guidelines for physiotherapy; Evidence based practice and Infection Prevention and Control protocol.
To provide proper education to the clients and community for prevention of diseases that threatens the individuals' lives and/or freedom of movement for physical wellbeing of our clients. Staffing
This year Physiotherapy services were provided by 11 physiotherapists and one supporting staff.
The shortage of human resources has been the main challenge; with the expected expansion of
services to "Burn Unit" and "Open Heart Surgery", the manpower will be stretched too thin for us to provide quality services. Therefore recruiting new physiotherapy staff is of priority. The table below show the areas of work, current number of staff and the proposed required number Human resource requirement for the Physiotherapy Department
Proposed
Type of staff
Area of work
required number Total
of new staff
Physiotherapist Medical I, II and MICU expecting to retire 2 (1 Out for BSc Physiotherapist Orthopaedic ward Physiotherapist ORU Physiotherapist General Surgery ward Physiotherapist SICU A and B Physiotherapist Obs & Gynae/ Urology Physiotherapist Burn Unit Physiotherapist Open Heart surgery unit Physiotherapist Planning and co-ordinat- Supporting staff Overall Total No of Staff
12 (11 PT and 1
9 (8 PTs and 1
Supporting staff) Supporting staff)
*Physiotherapist in OG is not permanently placed in that ward. S/He works on consultation basis.
Achievements
Despite the shortage of human resource we are facing, the department have worked hard to
attend clients and to run the following activities.
In-patients in Surgical, Orthopaedics, Medical, Paediatrics, Obstetrics and Gynaecology, dermatology and ORU wards.
Outpatients
Outpatient services: run 5days Adult Outpatient clinic and Paediatric outpatient clinic.
Special Clinics:
Cardiac Outpatient Clinic (once in a month) where we provide the necessary information and
training prior or post-open heart surgery. We are also involved in follow up of post open heart surgery patients in resuming the highest level of functional ability.
Neuro-paediatric clinic NPOC (once a week) where we work as part of interdisciplinary team,
Club foot clinic (twice a week).
The department is always ready to respond to on call services provided to patients who have life threatening conditions who needs physiotherapy two or three times a day.
Outreach services
The department also provides service to the community during routine home visits for the
disabled patients before they are discharged and if necessary after discharge, also as part of training activities. We also reach the community through AMREF flying doctors services
Training
The department continued to offer support to different levels of education in theoretical and
practical bedside sessions to students of different levels to local and international students; at the level of diploma, Bachelor of Science and masters. However, the department is lacking a room with IT facilities to facilitate learning. Elective Students: The department also receives and train students from different countries for
clinical skills and research. The table below shows the number of elective students in 2014
Elective students 2014
Name of university
Level of Education
Continuous Education
Three physiotherapists are on training. Of these, two are full time students for BSc Physiotherapy
KCMU College and one is on PhD studies Umeå University. One member of staff has graduated for MSc Physiotherapy from Bergen University College-Norway. This has raised the current number of physiotherapist specialists in the department from 2 to 3 (1 PT specialist in Orthopaedic and Manual Therapy, 1 PT specialist in Clinical PT in Orthopaedics and Rheumatology and 1 PT Specialist in Clinical PT in Lung and Cardiovascular conditions). There is a need for more specialities especially in paediatrics and Neurology.
Through collaboration with Bergen University College the department managed to conduct a disability workshop in December 2015, which was very successful and stimulated inter- disciplinarity in management for children with disability.
Number of patients
No of Treatments
General Surgery SI Medical I , II & MICU Paediatric I,II & III Sub Total A
Grand Total (A+B)
Collaboration
The department continued to collaborates with different institutions worldwide. There is
collaboration between Umea University-Sweden, Bergen University College Norway with School of Physiotherapy/ Physiotherapy Department KCMC. Through collaborations some members of staff have managed to pursue for further studies and one workshop was successfully conducted. We are on the way to establish collaboration with Maine in USA.
Constraints
The following issues surfaced to be the major problems of the department:
» Inadequate number of Physiotherapists to overcome the workload and supporting staff.
» The department has old equipment and has not been renovated for long time.
» No study room with ICT facilities (Clinical teaching room) for students
Future plans
In order to improve client services; the department is focusing on improving continuous
education to its staff through collaborations with other departments within the hospital, school of physiotherapy and KCMU-college. mEDiCAL rECOrDS DEPArTmENT
Head of Department: mr. Syprian S. mvungi
introduction
Medical records are essential components in the effective management of the patients' health care.
The medical records department contains information needed to plan, provide and evaluate the care given to the patient. It serves as a tool for communicating information to all health personnel who deal with the patients and contributes to the continuity of patients care.
UnitsThe department has 7 units namely:- » Census, » In-patients Coding, » Out- patients Coding, » Filling, » Master Index, » Reception, and » Admission.
Purposes of medical records department * Serves as a source of data/information for management and planning.
* Serves as a basis for planning patient's care * Serves as a basis for analysis study and evaluation of the quality of the care render the * Provide data for the clinical or for the epidemiological research and for research.
Overall/major functionsof the department * To manage and organize health records * To code and classify diseases * To store and retrieve health records * To collect, tabulate, analyze and interpret data for research, training and administrative * To capture data by using Care2x * To trainhealth records students in real practice (THRT) Staffing
The total number of staffs served the Department in 2014 were 23 of which 10 were trained
personnel (Health Records Officers), and the remaining 12 were not trained personnel(Medical Records Attendants) who are either attended the short course/training in Health Records or on job training with good experience of work in the department and 1 staff was office attendant The summary of staffing in the department is tabulated below: Available
required
Constraints:
* Shortage of skilled Staff
* Electricity fluctuations which affects data entry in Care 2x System
* Lack of enough archives for files storage
* Lack of enough space for filling system
* Instability of database software (Care 2x system), there was a collapse of network since
December 2013 up to date.
* Isolation from Health Scheme of Services
Achievements:
■ One members of staff graduated a 3 years training at Training Centre for Health Records
Technician (KCMC) and reported back at the department in 2014.
KILIMANJARO CLINICAL RESEARCH INSITUTE (KCRI)
Director of Institute: Prof. Gibson Kibiki
introduction
Kilimanjaro Clinical Research Institute (KCRI) is an academic centre for evidence based health
interventions. The institute initiates and conducts medical research to develop evidences for interventions and provide research training and necessary research logistics to collaborators and partners. It collaborates according to the four C's which are conduct, contract, coordinate and vision
The vision of KCRI is to be an internationally recognized centre of excellence in health research,
well embedded in the academic medical setting of KCMC, the Tanzanian health care system and international research networks.
mission
The mission is to create a critical mass of researchers embedded in an academic setting that is
rooted in a region with specific health problems, which is a powerful tool to develop evidence for medical interventions and health policies. It is a prerequisite for developing a research agenda, which is suitable for the recipient population in the endeavor of improving health.
Strategy
The board recommends future strategies of the Institute; it helps to foster links with other
institutions, and national and international collaborations.
meetings
KCRI has a management team. They meet weekly to discuss the general operations of the institute;
the meeting is chaired by the KCRI Director. Weekly reports covering research, training, finance and administrative issues are discussed. The Team consists of the KCRI Director, Heads of the six KCRI departments, Chief Accountant, ICT person, Administrative secretary and Human Resource Officer. The Director meets on a regular basis with project PIs, heads of departments, and programme coordinators to discuss issues pertaining to research and capacity building activities. The head of the department of research administration meets with research administrators weekly to follow up progress of research and implementation of weekly action plan.
Staffing
In 2014 KCRI was having 58 staff; Including 7 research scientists, 16 laboratory technologist &
1 laboratory technician,5 laboratory assistances, 2 research nurse ,4 research administrators, 1 Human resource officer, 2 accountants, 1 system administrator, 1 data manager and 4 data entry personnel, 1 secretary, 3 drivers, 2 laboratory attendants, 6 office assistance and 3 gardeners.
Therefore KCRI had 34 employees in permanent positions and 22 are on contract through various projects (in temporary positions). Of which 33 are women and 25 Men.
Challenges
•
Salary:-The total of 22 employees who are on contract have not been included in the government pay roll therefore the institution fail to retain staff in terms of salary thus leading to a loss of man power to the institution.
Retention: Because of the project based funds which are budgeted for a certain period of time employees are contracted for a certain period of time based on a particular project thus leading to the loss of skilled and experienced man power as well as reliable Biotechnology research Laboratory
The KCRI Biotechnology laboratory formerly called KCMC biotechnology laboratory was built
with a grant from Bill and Melinda Gates' Foundation (BMGF) under the umbrella of Joint Malaria Programme (JMP). The construction work started in 2002 and completed in 2008, and was officially opened in 2009. In March 2009, all research infrastructures at KCMC were put together to establish the Kilimanjaro Clinical Research Institute (KCRI), which became the third pillar of the Good Samaritan Foundation, the owner of KCMC and KCMUCo. Currently the KCRI-BL provides services to projects in HIV, Malaria, Tuberculosis, Diarrheal infections, Trachoma and Non-infectious diseases.
1.0. Laboratory infrastructure
1.1 New Laboratory wing
Research Laboratory has undergone administrative structure changes; this includes introduction
of unit/section and heads of respective units. Currently there are seven functional units, unit one:
Molecular biology and Immunology, unit two: Protein expression unit, unit three: Biochemistry,
Hematology and Blood Parasitology , unit Four : BSL3 and BSL2 , unit Five: Genomics, unit
Six :Bio-analytical ,Unit seven: Biorepository.
The new lab wing accommodated the following units:
(i)Unit 3
- Biochemistry, Hematology and blood Parasitology
(ii) Unit 4
-
Biosafety level-3 laboratory (MTB lab) Biosafety level-2 laboratory (microbiology other than MTB) Bio-Analytical (pharmacokinetics and Pharmadynamic studies ) NB: Unit 1, 2 and 5 are situated in the old laboratory building and these are Molecular/Immunology unit and Expression studies unit respectively 1.2 Biorepository
The biorepository measures 1290 sq feet (120M2) and has capacity to accommodate up to 30 big
-80 freezers. Currently the biorepository contains the following freezers • Fifteen -80 freezers Two -40 freezers, Fourteen -20 freezers Two LN2 freezers 8 LN2 storage tanks 1.3 Warehouse
Due to the need for a storage place for Laboratory supplies, the KCRI biotechnology Laboratory
has managed to refurbish the old freezer room into a warehouse where all research projects can securely store their supplies. Each project is provided with a key for lockable cabinets for storage of very sensitive reagents/kits.
1.4 Laboratory security
Biometric system /finger print and card reader lock have been improved to all main laboratory
accession door and surveillance (CCTV) cameras in all laboratory corridors and in the bio- 3.0 Laboratory accreditation
The KCRI-BL under support of the East African Consortium for Clinical Research (EACCR)
has entered into stars-based accreditation process i.e. Stepwise Laboratory Improvement towards Accreditation (SLIPTA) based process. A first diagnostic auditing has been completed to define the current status and non-conformities of the lab after which a second audit for accreditation will be initiated. EACCR is funded by EDCTP. There has been no progress since after the first audit this is because the sponsor i.e. EDCT is transitioning to phase two hence most of the proposed activities could not be done.
Achievements
Purchase of a new generator
With the expansion of the lab the power requirement has exceeded the current generator (100KvA)
capacity so the new generator 300KVA capacity has been purchased and installed Purchase a more powerful Power central stabilizer Due to the sensitivity of most of lab equipments to power fluctuation a central oil cooled power stabilizer with capacity of 300kva has been purchased and installed. The cost up to installation was 45,000USD.
KCmC/KCri projects 2014
Number of projects Challenges
1. TANESCO power
Power supply from the national power supply company, TANESCO has continued to be a major problem at the Biotech lab. 2. Imposition of tax on quality control/assurance materials – an impediment to quality laboratory services 3. Service contracts We have continued depending of companies from outside Tanzania for service and maintenance of equipment. This is not an effective way of operating such a facility as it is expensive and not timely Future prospects
1. Upgrading of software for lab management
2. Purchase of Laboratory Information Management System
Due to restructuring at the laboratory, there is a great need to purchase Laboratory information management system (LIMS) software. This is expected to cost 37,000usd one time investment; these funds are not available at the moment. Acquisition of LIMS at KCRI-BL is a milestone towards better management of Laboratory activities and hence an added value towards accreditation.
3. Setting up KCRI-BL as reference laboratory KCRI –BL management has agreed to improve in house quality management system, setting up research policy and custom satisfaction survey as initial plan towards setting us a reference laboratory. The plan is to make the KCRI-BL a reference laboratory in Tanzania for HIV, TB and Malaria diagnostic. 4. ISO15189 Training Since the laboratory is planning to achieve accreditation through SLIPTA scale, training and coaching in ISO 15189 is mandatory. The quotation we obtained from RAMS for this purposes was 24000USD, again funds are not available and we are still struggling to get them from our stake holders. 5. Sample archive and biobank The biotechnology laboratory management has started process of improving data base for all stored samples. Funds for this have been obtained through EDCTP under EACCR consortium. This work is ongoing and we expect to expand it and create a Biobank for all archived samples.
6. Electronic temperature Monitoring system There is great need to install a temperature monitoring system at the bio-repository. This will help to keep the temperature records of freezers and hence reduce human error in tracing temperature drop out. 7. Building of file storage room There is a great need for the institution to have enough space for keeping its file safely. This will help to keep the research file as per agreed standard operating procedure Current research programmes at KCRI/KCMC; some have been established under KCRI while others started before the establishment of the Research Institute: East African Consortium for Clinical Research (EACCR) – a collaboration between research and academic institutions of East Africa (Tanzania, Uganda, Kenya, Sudan and Ethiopia) and European countries (UK, The Netherlands, German, Sweden, Norway). Supported by EDCTP initiative for establishment of Network of Excellence (NoE). KCRI serves as a sub-HQ and the training node. KCRI Director serves as the Deputy Director of the consortium.
Pan African Consortium for Evaluation of Antituberculous Agents (PanACEA) – collaboration between institutions in Africa (Tanzania, South Africa, Uganda) and European countries (UK, The Netherlands and Germany) supported by EDCTP to evaluated antiTb agents for improvement of the Tb regime and treatment duration.
Malaria Capacity Development Consortium (MCDC) – collaboration between African Universities from Tanzania (KCMC), Uganda (Makerere), Senegal (Dakar), Malawi (CoM) and Ghana (Kumasi), and European Universities from the UK (LSHTM, LSTM) and Denmark (CMP, DBL) supported by Welcome Trust.
Optimization of Diagnosis – collaboration between KCMC and University of Virginia (USA) supported by NIH (USA) Training Health Researchers into Vocational Excellence in East Africa (THRiVE) – collaboration between Institutions from East Africa: KCMC, NIMR (Tanzania), Makerere, Gulu, UVRI (Uganda), National University (Rwanda) and ICIPE (Kenya), and The UK universities (LSHTM, Cambridge) supported by Welcome Trust KCMC – Duke University collaboration funded mainly by NIH (USA) Kilimanjaro Reproductive Health Program funded mainly by NIH (USA) through Harvard School of Public Health.
KCMC Reproductive Health Centre support from WHO, Norway and USA HOSPITAL SUPPORTING
Head of department: rev. Archboldy Lyimo
introduction
God has given us an opportunity to serve Him here at KCMC through the provision of Pastoral
Care and Counselling to patients, staff and students.
In addition to Pastoral Care and Counselling, the chaplaincy department conducts the following » Bible study and fellowship every week.
» Morning devotion to staff and students from Monday to Friday every week.
» Worship services every Sunday.
» HCF prayer meetings every Tuesday and every first Saturday in a month.
» Christian education to students and confirmation classes to children of our staff.
» Holy Communion to the patients and KCMC community.
» Holy Baptism (emergency) to adults and children admitted in the wards (when » Reconciliation and counselling ministry as need arises to KCMC community.
» A four months CPE training programme twice a year.
» Daily visitation for admitted patients.
» Services and last respects for the deceased in the mortuary/chapel.
» Sunday services, morning devotions, preaching, prayers and choir music to the patients through the public address system.
» Outreaches to Maasai Community with a special focus on HIV/AIDS awareness seminars, children's education and conservation and promotion of the environment. It also focuses on support treatments to those suffering from eye and ear diseases and deals with identifying and supporting primary education to vulnerable children and orphans. Staffing
Chaplaincy department was served by the following members of staff during the year 2014:
» Rev. A.E. Lyimo
» Rev. P Urassa
» Fr. F. Darkshen
» Rev. P. E. Hiiti
» Rev. A. Mongi
» Rev. D. Msanya
» Rev. W. Bartels » Ms. J. Lyatuu » Ms. F. Kisanga 1. Holy Communion to patients, relatives staff and students 2. Sunday services, adult and 3. Religious instruction and 4. Confirmation classes 5. Baptisms:- Infants "May God's love and grace through the power of the Holy Spirit abound on the KCMC community; in the course of treating and caring for patients and each other." Head of unit: mrs. regina mtui
introduction
Catering Unit operates with a total number of 40 staff comprising of one caterer, one nutritionist, 11
cooks and 27 kitchen mess attendants. The catering unit, daily prepares and provides nutritionally healthy, cost effective and quality food and food services to an average of between 400 and 450 inpatients, 381 to 400 students, 1,200 staff and about 47 intern doctors.
The unit prepares meals for different groups: Category
Objectives
* To prepare and provide nutritionally healthy meals to patients, students, intern doctors
and hospital staff.
* To comply effectively to standards of infection prevention control and 5s in the course to deliver clean and quality food to clients from clean cooking environment.
* To maintain cost effective and healthy high quality meals to various categories of its food consumers with minimal complaints.
* To prepare and provide meals to general and specific patients as a prescribed requirement from the sickness.
* The ensure quality supply of tendered food raw materials to reduce cooked and raw food Average food cost per year
Average food
Average no. Of
Average no. Of
Food cost per
cost per person
days in a year
PatientsPrivate Patients bites)Staff (on night shift)Staff in Meetings Achievements
* The unit maintained cost-effective and nutritionally healthy meals to various categories
of its food consumers with minimal complaints. * The unit continued providing professionally high standard hospitality meal service to their meal consumers with satisfaction throughout 2014.
* We successfully timely provided the meals in appropriate proportions and to the right consumer with minimal delay. * The unit ensured quality supply of tendered raw materials with success and greatly reduced cooked and raw food wastes from receiving, preparation and serving.
* Successfully ensured proper preservation of all raw foods and maintained standard operation procedure for issuing portions for preparations with minimal loss.
* Visited, prepared and provided individually requested meals to all private patients for the hospital per year and ensured their queries are professionally and ethically handled.
* Ensured repair and maintenance of health kitchen and its facilities according to the general guidelines and adoption of 5s.
Challenges
* The need to upgrade the working tools such as cooking pots, food trolleys, potato peeler
machine only to mention a few.
* Kitchen floor is just too old to maintain cleanliness at the expected standards apart from taking longer time for cleaning and scrubbing by our staff.
* Needs to have more trained and well-motivated cooks for professional practice, ethics and standards on top of increased quality of service and output.
* Control of preferage need to be addressed technologically by installation of CCTIV Future plans
On understanding that proper nutrition is part of the patients' treatment plans, the Catering Unit has
planned to improve Patient's menu into more palatable and nutritious dishes, apart from improving its quality of service to patients, staff, students and intern doctors at the maintained costs. This is especially important for HIV patients in various categories, obese, stroke and malnourished patients. To accomplish this plan, few items summarized in the table below might be needed or Table 2. List and justification of the required items for the future improvements.
Available Needed Justification
For all kinds of barking Heavy duty potato Highly required as manual potato peeling costs lots of staff time causing unnecessary To balance the workload to activities DEPArTmENT OF ENGiNEEriNG
Head of Department: mrs. mary A. mushi
introduction
The Department is located at the bottom floor of the main building. It operates under eight sections
namely: * Bio Medical Equipment * Electrical * Carpentry * Building-Manson * Fitter Mechanics * Motor vehicle mechanics * Plumbing * Cooling System & Refrigeration Staffing
» The department Operated with 30 staffs with different qualifications.
» Bio Medical Engineer/ Technicians- 2
» Mechanical Enginee-1
» Electrical Technicians-5
» Electronic Technician-1
» Instruments Technicians-4
» Artist/Decorator-1
» Plumbers-5
» Refrigeration/AC-1
» Carpenters-3
» Fitter Mechanics-2
» Mason-1
» Motor Vehicle Mechanics-2
» Boiler operators-3
» Incinerator operators-2
» Toilering-1
» Office attendant-1
Activities
We normally work on repair and maintenance of all medical equipment, Plants, Generators and
Motor Vehicles. Department managed to service all medical equipment, Autoclaving Machine, Laundry machines, kitchen equipment, lighting system, plumbing system, Carpentry and other break down happened in our centre which were within our ability.
Water supplyFor the all period of year 2014 we had no problem with our water pumps, but we faced a problem on the main water pipe line which was leaking and we manage to rectify the problem. But the water consumption is too high due to new buildings expansion. We have already consulted a surveyor from Pangani water basin-Moshi and we are finding a Quotation for new water bore hole. We advise the management to set aside money for a new bore hole to conquer these new buildings.
ElectricityThe Tanzania Electricity Company (TANESCO) continues to provide power supply to our centre for the whole year.
The Electricity is not yet stable. We are still facing a serious problem of power cut and power fluctuations, Correspondences have been made with TANESCO but no any improvement though we have a new power station for KCMC. We have a transformer of 800KVA which supplies electricity in our main building and few new buildings (i.e. KCRI, ORU, NEW EYE OT and KCCO). We advise the management to set aside money for a new Transformer to all new buildings. But there is ongoing project of installing a solar system to reduce the electricity bill.
GeneratorsWe have three generators of which one is 800kva and two small one of 42kva and 32kva.
When there is Black out (power cut) our hospital generators supply electricity only areas which have been identified as essential ones. We had a breakdown of our big generator. A stator motor burnt on November 2014. We advise the management for the near future to buy a bigger generator to cover the new buildings.
Steam production.
We continue to produce the steam for central sterile supply and Main Pharmacy with our Boilers.
This boilers are under-utilized it is only used in Pharmacy and Central Sterile Supply Department. The hospital is making an effort to have self-steam generated Autoclaves so as to have a backup. Laundry machinesThe year 2014 hospital run with three Washing machine, one Drier and Roller (Ironer). All these have been maintained by Hospital Engineering Department.
Kitchen The only three pressure cooking pots are working but the spare parts like heating elements they should be stored in the main store. The kitchen needs major repair which will involve replacement of kitchen equipment and terrazzo floor.
RadiologyThe Ministry of Health and social Welfaresign a contract withTanzania Philips Medical Systems to Maintain and repair our Radiology/ X- ray equipment. The hospital has made an effort to buy a new CT scan.
Lighting systemWe managed to replace bulbs and tube lights as required in the deferent Departments, Units and compound Houses.
Main theatre lighting systemThe theatre rooms needs completely replacement of ceiling fluorescent fittings with diffuser, two pin round earthed sockets and other renovations like plumbing system, carpentry and Manson PharmacyWe manage to repair pharmacy autoclave. This pharmacy Autoclave which is used for Infusion is too old. It was installed since 1971 and lots of spare parts are not available therefore we are working for new Infusion Autoclaving machine which will be self-steam generated. Collaboration outsideSince the year 2007 during the summer period we receive students from overseas under Engineering World Health which are Bio-Medical Engineers for practical training.
"We thank Almighty God for that achievement and may he continue blessing us so that we can serve better the needy ones." Head of unit: Mr. Jerome N. Mgeni
introduction
Housekeeping Unit deals with cleaning the hospital inside and outside the hospital premises. It
further deals with activities such as planting grass, shading trees and flowers etc.
Staffs
During the year 2014. Housekeeping unit served by 33 members of staff. Their distribution
according to areas of duties is as follows: A. Inside main building B. Outside main building C. Hostels and schools Challenges
* We have shortage of staff to cover the huge hospital area.
* The grass cutting machine is old which needs replacement
Future plan
* To plant more trees around hospital premises.
* To increase number of gardens within the hospital by planting flowers.
Acknowledgement
We would like to thank the hospital management for the continued daily support.
iNFOrmATiON COmmuNiCATiON TECHNOLOGY (iCT) DEPArTmENT
Head of department: mr. Hans T. Yambazi
introduction
The department of ICT is located at KCMC main building ground floor. The overall responsibility
of the department is to plan, procurement, coordinate and implementing all ICT function and to work as implementers of ICT activities assigned by KCMC management. The department is made of the following units with their objectives
1. ICT user training Coordination: Responsible for organization of day to day training activities, e.g. class teaching of KCMC staffs as well as other students from all over KCMC and outsiders In the year 2014 about 180 student have been trained. 2. Website Designing/Updating: Responsible for website development and maintenance, in the year 2014 the department manage to issue that the website is available in the web 24/7 and update most of materials in the web 3. Managing emails: The department is responsible for registration and maintenance of mail server at KCMC and in the year 2014 department issue that all users are getting smooth communication in and out of KCMC higher level of security the mail server is now having about 250 users.
4. Coordinating the Implementation of Computerization of ICT function at KCMC In the year 2014 the department manage to review process of computerization at Medical records using tailored made software (imedics) in collaboration with local company in Arusha so the implementation have now in progress at Medical record department as phase one. Then, phase 2 will be the implementation at Lab, Radiology and Pediatric ward.
5. Maintenance of computers and its accessories: The responsible of ICT department is to keep all computers in a good working condition by providing preventive maintenance quarterly and in daily bases if need arise. 6. User support for ICT clients: As part of daily routine the department is dedicated to provide user support online and in physical so in the year 2014 we gave service to more than 2000 users around KCMC. Our clients are Medical Doctors, Technicians, Accounts clerks, administrators as well as students at KCMC and allied health science schools 7. Internet Services: The department is responsible for the internet services at the hospital it has to issue that the internet is working and all security options are maintained to avoid unauthorized users and hackers, the department is also responsible to issue that all website are filtered to those usefully sites to restrict usage of strange sites Staffing
During the year, the department has a total of 7 members of staff as follows:
•
Head of department: Network Administrator: Computer Technician Database administrator Computer trainer Challenges
The department is facing the following challenges:
•
Lack of funds to finance ICT project Rapid change of Technology which affect both hardware and software The cost of ICT and its technology Lack of adequate ICT infrastructure e.g. LAN, power backup etc.
Lack of Human capacity to fill the post of fully functional ICT department Practical unforeseen events which occurs during implementation of computer software in the hospital environment.
Silence sabotage from the users. During installation we observe most of users fears to lose their job when computerization process successes so it slow down all process Change of working attitude is a challenge for the whole organization from top to bottom.
Goals and Objectives of the department for 2015
1. To issue that the implementation of imedics is completed in the following departments:
a. Medical records d. Accounts (Cash collection area) e. Pediatric ward 2. To issue that the department is sustainable and maintain all its functions in relation to overall objective of rendering good service to the patient 3. To use ICT and its technology to improve patient care.
LAuNDrY uNiT
Head of unit: ms. Asinath minja
introduction
During the year 2014, the unit was using only two washing machines and two flat presses which
are always overworked as we don't have spare units to allow minor maintenance.
Staffing
The unit is operated by 11 staff.
Constraints/Limitations
In this year we experienced a regular shortage of Electricity supply in this unit causing delay in
requirements
We have very essential needs of the following to meet our target:
•
Two washing and spinning machines Two Flat pressing machines One drying machine Enough laundry machines spares in stock to avoid delay in ordering process.
We request 3 heavy duty trolleys with Custer wheels in the drying yard outside.
Head of Department: Adv. rachel mboya
introduction
Legal department continued to provide its services in ensuring that proper procedure are followed
before performing or making any decision. Hence to make sure that any decision is reached with fair and sufficient reasons.
Staffing
The department is operated with 2 legal officers in collaboration with the outsourced Legal
Aim
To adhere with proper laws and regulations that gives guidance to our day to day activities. In
fulfilling that our responsibility is to enlighten staff whenever they are in need of clarification of any procedure. Apart from that we give assistance to the managements in interpretation of any laws that the hospital is bound to fulfil.
Challenges
1. A quite number of staff are not fully aware of the working performance procedure.
2. Some of decisions are made without seeking for legal opinion.
3. In often occasions decisions are implemented otherwise to affect the expected results.
4. Delaying of issuance of accessories and equipments.
Workshop/Seminar
A vote of thanks to the management for giving our department opportunity to attend various
workshop/Seminars that's equipping us with the current knowledge of laws. Achievements
Despite the aforementioned challenges, department managed to reach some of its goals and
peacefully provided services to the hospital according to the raised need.
Future plans
To assist management in fulfilling the need of reaching goals of performing basic employments
standards and reduce disputes in working place.
PrOCurEmENT mANAGEmENT uNiT
Head of Unit: James S. Mosha
introduction
The procurement division is staffed with procurement professionals together with the necessary
supporting and administrative staff. Currently there are18procurement staff with good qualifications and experience in Stores and Supply chain management. Activities
To provide expertise and services in procurement, storage and supply of goods and services for the
Commission. The activities of the Unit are:- ■ Advise the Management on matters pertaining to the procurement of goods and services and logistics management in the Commission; ■ Manage all procurement and disposal by tender activities of the procuring entity except adjudication and the award of contract; ■ Support the functioning of the Tender Board; ■ Implement the decisions of the Tender Board; ■ Act as a secretariat to the Tender Board; ■ Plan the procurement and disposal by tender all activities of the procuring entity; ■ Recommend procurement and disposal by tender procedures; ■ Check and prepare statements of requirements; ■ Prepare tendering documents; ■ Prepare advertisements of tender opportunities; ■ Prepare contract documents; ■ Issue approved contract documents; ■ Maintain and archive procurement documents; ■ Maintain a list or register of all contracts awarded; ■ Prepare monthly reports for the Tender Board; ■ Co-ordinate the procurement and disposal activities of all the departments of the procuring entity; and ■ Prepare other reports as may be required from time to time. ■ Procure, maintain and manage supplies, materials and services to support the logistical requirements of the Office; ■ Maintain and monitor distribution of office supplies and materials.
■ Maintain and update inventory of goods, supplies and materials; Objectives The main objectives of PMU department is to ensure availability of goods and services at the right quantity, right time, right quality and at the reasonable price Challenges
1. Most of the medical supplies are not available in the medical Store Department (MSD)
especially laboratory reagents, suture and dental supplier. This leads us to procure them from other source at higher cost.
2. Use of manual method in data processing and record keeping instead of automated (computerized) system. The software would help us accomplish our task accurately and timely as well as assurance of security of information to authorized people.
3. Delaying payment of supplier which result partial delivery of items, and Suppliers delaying delivery of goods and services. Future plans
■ We encourage PMU staff to attend number of short courses tailored to upgrade
professional knowledge and skills in various aspects and disciplines. These courses are conducted by (PSPTB) Procurement and Supplies and Technicians Board at different places in this Country. We therefore request for permission and financial support to attend these workshops/seminars ■ Also we request permit ion and financial support to attend these workshops/seminars Acknowledgement
We would like to express our sincere appreciation to Executive Director, Tender Board Member,
Directorate of Finance Inspection committee and User department for their support in purchasing of Medicine, medical supplies and equipment at different suppliers.
DEPArTmENT OF SOCiAL WELFArE
reported by: ms. Christina Haule
Social welfare is a speciality by which individual will mitigate his problems under social organization .The unit is actively involved in patients care programmes and maintaining welfare for all including the poor and the vulnerable. Identify various social problems affecting the medical team, patients, relatives and the public and give the appropriate advice.
Philosophy of social welfare
All patients have the right to get medical services and care regardless of their race, colour, and
political affiliation religious or economic status. Polite language to patients, staff and other colleagues is the first healing tool.
vision
The unit is the centreof excellence in providing guidance and counselling and problem solving
approach, thus establishingpleasant therapeutic environment to clients depending to their needs. Staffing
As from January 2014 to November 2014, the unit had 3 full –time employees, one office attendant and 2 social welfare officers. Currently, the unit has 2 full – time staff, 1 office attendant and 1 social Welfare Officer. In November 2014, 1 social welfare officer retired and her vacancy has not as yet being filled. Activities
The primary function is to provide and maintain good standards to patients, students, foreign visitors and community at large. To interview patients with social problems and identify factors which might lead to patients illness.
• To screen vulnerable patients who are in capable to access Medicare. To conduct counselling to patients according to their needs.
To conduct home visiting to spinal cord injury and other disabled patients, the Unit managed to visit six (6) homes for spinal cord injury patients before discharge in collaboration with Physiotherapist and Occupational therapist.
To trace homes/families of abandoned patients especially children and elderly, thereafter if failed plan to take them to respective places like orphanage centre or destitute homes.
To coordinate issues of unclaimed dead bodies who have stayed more than 14days in the mortuary by liaising with the police and Municipal Council.
To undertake the responsibility of Staff welfare by processing condolence contribution to staff whenever death occurs.
To Collaborate with Police on issues concerned to unknown and abandoned patients.
Burial at moshi cemetery
To prepare and arrange burials for unclaimed dead bodies left at KCMC morgue. A total number
11 of unclaimed dead bodies buried.
18 Abandoned patients Assist abandoned patients, trace their homes or relatives and if not found, arrange for accommodation at destitute camp or orphanage centre.
14Abandoned babiesWe managed to take14 babies to the orphanage centres like Kalali and upendo children's home. Summary of exempted patients from January - December 2014
No of patients
Total bill
Amount paid
Summary of patient granted bond from January to December 2014
No of patients
Total bill
Amount paid
Summary of abscondee from January to December 2014
No of patients
Total bill
Amount paid
Achievements
Despite the critical shortage of staff and poor working environment, the unit has manage to achieve
the following » Continuing tracing home/families of abandoned patient.
» Continuing tracing abscondee patients.
» Conduct counselling to patients according to their needs.
» Decrease the number of out- patients who come to seek for assistance.
» Educating patients on the importance of paying their hospital bills.
Challenges
» Inadequate number of staff.
» Limited transport/Fund for conducting home visit.
» Lack of an appropriate room for conducting counselling.
» Lack of Annual unit Budget.
» Lack of means of communication i.e. mobile phone
» Lack of privacy, due to the fact that the office is also used by photographer.
» Lack of adequate information about hospital issues/decisions made in the various
Machinery system of the hospital. Future plans
» To have a home visit schedule which will fit with the departments of OT&PT.
» To recruit more social welfare officers.
» To establish poor and underprivileged patient's Fund.
» To have a representation in the Hospital Management Team Meeting.
» To have our own car for conducting Home – visit by liaising with other departments who
we collaborate with Head of unit: mr. Benson i. ulomi
introduction
During the year 2014, the unit had a total of 64 security guards working in 33 different stations.
The staff have been operating day and night to maintain high security level around/within hospital and its surrounded compounds. Achievement
The unit has been able to maintain security and safety within the hospital, hostels and GSF
Constraints
•
Lack of equipments such as uniform, military boots, gumboot and rain coats.
No security camera for high level safety maintenance. Lack of radio-calls for proper communications between guards. Shortage of security guards Head of unit: ms. Dorothy malisa
introduction
During the year 2014, Telephone Unit operated with six (6) members of staff. One member of
staff is allocated at IDC Clinic and the rest at the main switchboard. Activities
Currently, telephone extensionsat Compound residence, Reproductive health unit, Lengai hostel
and International Collaboration offices are not working. We need to install telephone services in the newly launched buildings (orthopaedic Rehabilitation Unit) and Dermatology ward for smooth communications around the hospital. Lastly, the unit needs a computer for official uses. ASSISTANT MEDICAL OFFICERS -GENERAL SCHOOL
Principal: Dr. Levina J. Msuya
introduction
Assistant Medical Officers are frequently used interchangeably with graduate medical officers.
Because of longtraining and inadequate output of general Medical Officers, there is a need to have anintermediate, better trained cadre between Clinical Officer (CO) and graduate MedicalOfficers that is the AMOswho will be able to independently fulfill crucial functions in the delivery of health care in the urban, suburban and particularly on the rural areas.
Justification for training Assistant Medical Officers
This is based on the following facts:
1. The Doctor population ratio is still high (1: 25,000) hence the need to train AMO to
2. There is Urbanization of graduate doctors despite the fact that 80 - 90% of the population live in the rural areas. This calls for training of AMO to provide Health services to the rural population.
3. Increasing need of Primary Health Care Service and Health Sector Reforms requires highly trained Allied health personnel.
The Assistant Medical Officers School KCMC started in 1977with 40 students who were undergoing a one year course. After the first group the course was changed to two academic years on main subjects: Obstetrics and Gynecology, Internal Medicine, General surgery, Community Health and Pediatrics and Child Health.
The school is 37 years old and 985 students have graduated and most of the graduants are rendering services within Tanzania and outside the country.
Students completed first year of their studies 28 of which 12 Female and 16 Males completed successful. There was transfer of 1 student Florian Fidelis from AMO School Mbeya. 5 students were expelled from school due to forgery of certificates. Currently the school have 29 students, 12 females and 17 males. Teaching and learning activities
There are two academic years.
First academic year:
First year students start with introduction to clinical medicine for 8 weeks. The following 8
weeks students starts junior rotation at the major clinical areas namely: Pediatrics' and Child Health, Internal Medicine, General surgery and Obstetrics and Gynecology. The students achieve competence skills learning through clerkship, bedside teaching, performing procedure and Second academic year:
Students rotates in other specialized departments that is Urology, ENT, Pathology, Ophthalmology,
Radiology, Anesthesia for orientation of common conditions encountered in sub Saharan Africa.
Community medicine:The aim of community medicine course is to enable the Assistant Medical Officer to manageboth effectively and efficiently the Primary Health Care programs. This is achieved by lectures, field work and research project from each student.
Before final qualifying examination the students do senior clinical rotations in major departments 8 weeks each.
The course is conducted on adult learning/teaching methods. The following are themain teaching/ learning methods:Group discussions, lectures, seminars, demonstrations, bedside teaching, tutorials, case presentations, field visits and work, individual assignments, night duty and ward calls to practice skills supervised by tutors.
Staffing:
The school had 6 teaching staff:
Principal – Dr Levina J. Msuya
Assistant Principal – Dr Rogers Temu
Academic Master – Dr JumaAdinani
Office Attendant – Debora Lyatuu
Permanent tutors:Dr GisselaNyakunga, Dr RemigiusRugakingira, Dr NyobasiGesase are currently persuing master degree training at KCMUCo of TumainiMakumira. Part time tutors are from Pediatrics and Child Health, Obstetrics and gynecology, General Surgery, Orthopaedics, ENT, radiology, anesthesiology, Dermatology, Ophthalmology, Pathology and Internal Medicine.
Achievements:
Dr AdinaniJuma completed his MSc. Epidemiology and Biostatistics at KCMUCo and graduated
at November 2014.
Constraints
•
The school has no lecture room.
80% of academic staff are on part-time basis.
There are no supporting staffs like warden, secretary and hostel attendant.
There is no school transport, currently using shared Allied Health Schools car and hired buses from other institutions.
Heavy workload due to lack of permanent staffs.
The way forward:
•
To liaise with MOHSW regarding purchase of a vehicle for the school.
An improved infrastructure for the school is needed and this has to be discussed with Permanent academic and non-academic staffs to be employed at the school.
Collaborations
•
The school has collaboration with Canadian Network for International surgery who sponsored students for * Essential Surgical Skills.
* ALAM – Emergency Obstetrics conditions * SOO – Structure Operative Obstetrics SCHOOL OF ANAESTHESiA
Principal: Dr. Simon Kavavila
introduction
The School and The Department of Anaesthesilogy have integrated activities which have common
goal towards teaching and provision of safe Anaesthetic Services to the patients.
Historical backgroundThe School of Anaesthesia has a characteristic pattern showing chronological stages of professional Nurse Anaesthetist Training ProgramIn 1973 KCMC started Un Official short Course of Anaesthesia to the nurses (3-6 Months) later on, in 1985 the course was extended to One Year (hence One Year Course for Students Nurse Anaesthetic Officer Training Program (A.O.)Training Anaesthetic Officer started in1984 following the Lusaka meeting of Health Ministers of East and Central African Countries, 1983.
AMO Anaesthetist Training ProgramIn 1997 the Ministry of Health directed that Assistant Medical Officer should be registered for Anaesthetic Officer Course instead of Medical Assistant for the title of AMO Anaesthetist which was implemented in 1998. (The first batch started) M-Med Anaesthesiology ProgramThis programme has started in 2001 under the TumainiUniversity.
Professional cadres
The school trains the following cadres:
1. Masters of Medicine Anaesthesiology affiliated to Tumaini University.
2. Assistant Medical Officer Anaesthetists for Advanced Diploma in Clinical sciences.
3. Nurse Anaesthetist for a certificate level.
Staffing
There are 2 permanent teachers one attached from KCMC and one secretary.
Part-time teaching staff No. of Staff
AMO Anaesthetists Nurse Anaesthetist BSc. Nursing Nurse Anaesthetist Diploma Statistics
AMO Anaesthetistand M.Med Anaesthetist
Grand Total
Grand Total
Nurse anesthetist – One year course
Intake May 2013
Qualified in 2014
Total 14 candidates sat for exam, all passed the May 2013 To April 2014 Intake August 2013
Qualified in 2014
August 2013 To April Total 31 andidates sat for exam, all passed the Clinical training activities
Students and Tutors participate actively in all clinical activities of the Department as indicated in
monday to Friday
1. 7.00 am - 8.00 am Receiving Night Report and Capsule 2. 8.30 am – 2.00 pm Clinical Teaching in Operating Rooms and Intensive Care Units 3. 3.00 pm – 4.00 pm Didactic Teaching in Anaesthesia class or Anaesthesia Hostel 4. 4. 30 pm – 6 .30 am Pre Operative Patient review in the wards 5. 6.30 pm On wards Students on call will report in the Operating Theatre ready for any possible Emergency Weekend / Holidays Two students are allocated One for day time and the Other for night duty ready for emergency operations Scientific Discussion and Journal Club presented by students on Thursdays and Fridays evening respectively. Presentation is facilitated by the staff.
MD 3 and MD 4 and AMO general who rotated in the Department attended for theoretical sessions in the class and hand on patient skills in operating theatres Didactic teaching
The School experienced critical staff shortage the teaching was mainly supported by the staff from
the Department of Anaesthesia and visiting volunteers from USA under the American Overseas Training Programme (AOTP) and United Kingdom (UK).
Prof Charles Gomerall Constraints
» Shortage of teaching and supporting staff for the school.
» The Principal of the school and Academic Officer have retired and are working on
contract granted by Good Samaritan Foundation. » Few AMO generalto join for the AMO Anaesthesia Course » No Continuing Medical Education (CME) Way forward
» Suggestions to advise the Ministry of Health and Social Welfare to employ full time
tutors and plan for the CME to exchange medical experience with other colleagues » The school has strategic plan to visit Assistant Medical Officer Training School with the aim of sensitizing the AMO general to join the school » To encourage Doctors (MDs) to apply for M-Med in Anaesthesiology.
» Suggestions to advise the Ministry of Health and Social Welfare to have full sponsorship for the students who are willing to join AMO Anaesthesia school.
SCHOOL OF NuriNG
Principle: Mr. John Y. Sumaye
introduction
KCMC School of Nursing was established in March 1971to train Pre-service nursing students.
The school is located within the premises Kilimanjaro Christian Medical Centre. The school is registered by the National Accreditation Council for Technical Education (NACTE). It received full accreditation status in 2006.
The school layout includes; offices for staff, two furnished ICT rooms one for tutors and the other one for students, common room for staff, furnished library with computers, skills laboratory, three stores, two classrooms and one hostel for all students.
During the year 2014, teaching and learning activities were conducted by twelve full time tutors. One of them is newly employed by the Ministry of Health and Social Welfare. The acting Principal of the School retired in December 2014. One of the teaching staff went for further studies at UDOM, Dodoma. The school also has two full time support staff.
Staffing and Students Situation
Table 1: Number of staff in the year 2014 Nurse Tutors (Full time) Table 2: Number of students (ordinary diploma) in 2014 Level of Training
Table 3: Number of students (certificate) in 2014 Level of Training
Table 4: Number of students (eLearning up-grading) in 2014 Level of Training
Goals
1. To organize school learning activities in all settings
2. To increase the number of new students for eLearning program which was designed by
the MoHSW in collaboration with AMREF to upgrade Enrolled Nurses to Registered 3. To enroll students for certificate program Teaching and Learning Activities
Teaching and learning both in class and practicum sites were implemented in two semesters as
NTA level 4 had 24 weeks each for semester one and two NTA level 5 and 6 had twenty two weeks each for semester one and two Competence skills learning implemented were supervised by clinical mentors in each Clinical practice areas were KCMC Consultant Hospital, Mawenzi Referral Hospital and Majengo Health Centre. Community health nursing field practice was conducted at Kibosho Village by NTA Level 5 students in semester from February to March. Students for eLearning upgrading program were supervised by tutors and preceptors as Achievements
•
A total of 60 NTA Level 6 students sat for final Nursing and Midwifery examinations in August 2014. Out of them, 57 passed the examinations and 3 will sit for supplementary examination in March 2015. Three (4) tutors successfully completed their professional studies in the followingareas; Bachelor of Science in Midwifery at MUHAS, Bachelor of Science in Nursing at KCMUCo, Bachelor of Science in Nursing Education at CUHAS and Master of Science in Nursing Education at KeMU in Kenya.
One (1) tutor joined UDOM for Masters of Science in Mental Health Nursing in October Enrollment of 20 students for eLearning upgrading program for Enrolled Nurses to Registered Nurse Enrollment of 16 students for certificate program Successful collaboration with different stakeholders from within and outside the country Constraints
•
The school has no vehicle to meet the needs of transport for students and staff Warden is retired, therefore, someone is needed to cover that position Lack of hostel attendant, librarian and skills laboratory attendant Inadequate number of classrooms Students hostel is in debilitating state, it need refurbishment Collaboration
Apart from the practicum sites, the school also collaborated well with;
•
Nursing Schools in northern zone Tanzania Nursing Scholarship Program from USA who sponsor some of our female students from poor families by paying their school fees and pocket money Sannarpsgymnasiet in Sweden Bergen University in Norway visitors
The School received many visitors both from within and outside the country in the year 2014.
The following are few among many visitors;
1. Dr.Otilia F. Gowelle, Director of Human Resource from MoHSW (other officials from
MoHSW also visited the School in different periods) 2. DavidaNgilangwa together with other fourteen members from AMREF Health Africa, 3. Oliver Karabwa from Lugalo NTC and Clement Subeti from Mvumi NTC - assessors for final Nursing and Midwifery Examinations 4. Sr. Maria Asenga from Morogoro for eLearning entrance examination 5. Anthony van Werkhooven from USA for TNSP 6. Ronny Mellgren together with other 10 members from Sannapsgymnasiet, Halmstad in Sweden for the exchange program 7. Dink C. Christensen together with other 19 members from the University of Copenhagen, Denmark Acknowledgement
We earnestly recognize the following stakeholders for their outstanding contributions:
•
Ministry of Health & Social Welfare for continued support to the school The Executive Director for continued technical support and encouragement The Tanzania Nursing Scholarship Program from USA for providing financial support to some female students KCMC Consultant Hospital, Mawenzi Referral Hospital and Majengo Health Centre for supporting practical learning experience of students School of Advanced Paediatrics & Ophthalmic Nursing for working with us as one team SCHOOL OF OCCuPATiONAL THErAPY
Program coordinator: Ms. Sarah Mkenda
introduction
The Diploma course in Occupational Therapy which is the only one in Tanzania has been there for
15 years now. This programme runs under the umbrella of KCM College of Tumaini University Makumira and the Ministry of Health and Social Welfare.
Overall aim
It aims at qualifying Occupational Therapists who will appreciate the social, psychological
and physiological effects of disability by providing the intervention based on sound theoretical principles and models of the profession. Graduates will be competent communicators and motivators for continual profession development in Tanzania.
VisionThe overall vision is for the school of Occupational Therapy at KCMC, Tumaini University is, to train Occupational Therapists for Tanzania and the surrounding countries in Africa e.g. Malawi, Zambia and Europe (e.g. Germany). Mission » To train competent occupational therapist for Tanzania and other African countries, as is » To provide a training course that is appropriate to the needs of the local population.
» To empower locally trained staff to run and administer the OT school from the year » To ensure that adequate facilities are in place to execute the training of occupational Therapy students.
Staffing
The school has the following teaching staff:
1. Mr. Dominique Mshanga – Academic Officer (away for further studies in South)
2. Ms. Sarah Mkenda - Course coordinator, employed by MoHSW full time.
3. Mr. Anthony Ephraim – employed by KCMU College full time.
4. Mr. Simon Mallya - employed by GSF but currently on study leave, works in the school
as part time.
5. Glory Cuthbert – fully time tutor, employed by the MoHSW as well works part time in the clinical department.
6. Eraneus Josiah - fully time tutor, employed by the MoHSW as well works part time in the clinical department.
Supporting staff
The school has no secretary neither office attendant at the moment. According to a strategic plan
was put in place in 2005 the school needs 7 full time and 5 part time occupational therapists qualified in teaching for it to operate smoothly. There is a shortage of 3 full time tutors and 3 part time tutors, secretary/ administrator and office attendant.
Statistics
The school has a capacity of taking 20 students each year although we have never reached that
number because of lack facilities and resources.Thestudentsenrolledin2014/2015 areonly4males.
Theintakefortheacademicyears2012/2013,2013/2014and2014/2015 is asfollows:- Achievements
* The schools have managed to graduate a total number of 16 local students in the
academic year 2013/2014.
* 1 part time tutor is still on study leave doing Masters in OT in South Africa.
* The MoHSW employed 2 full time tutors who have join the OT teaching team already.
* The school has managed to maintain its collaboration with international school of Munich – German who normally donates money to support the struggling students in paying their school fees through their yearly visit, Umea University in Sweden which is 2 way teaching exchange programme, Toronto University etc. Constraints
* Following the acknowledgement of the MoHSW as owner of the OT programme in
September 2010, there has not been any financial support as promised. * Staff development is progressing very slowly and no support neither from the MoHSW, GSF nor KCMUCollege, people are taking their own initiatives and upon qualifying there is no recognition.
* Low enrollment of students due to high school fees rates, high entry criteria and poor awareness of this profession in the country 2. Recruitatleastfive(5)more full time tutors whoarealreadyinvolvedinteachingandsuper 3. Expose the present and future academic staff in teaching methodology 4. Plans are in place to develop a BSc curriculum in Occupational Therapy. 5. The school is planning to have its own building by end 2015/2016 and fund raising strat egies are place already. The land for building has been granted by Good Samaritan Foun SCHOOL OF OPTOmETrY
Principal: Mr. Julius C. B. Kamugisha
introduction
The school of optometry at KCMC started in 1979 by the Ministry of Health and Social Welfare
(MoHSW) with the assistance of the Swedish Organization for the Visual Handicapped (SHIA) and run a three year training programme in optometry. The aim of the course was to train an optometrist who will be able to manage refractive errors and refer pathological cases for further Staffing
The school is managed by 6 full-time tutors, 6 part-time tutors and two supporting staff.
Statistics
So far about 365 Tanzanian Optometrists and 20 Foreign Optometrists have graduated from the
school. About one third are working in Public Hospitals/Institutions and the rest are in NGO's, Private Institutions and outside the country.
Student Body
The school had a total of forty two students (40):- eleven (16) first year, fifteen (13) second year
and sixteen (11) third year students.
Field Work attachment
Clinical practice for third year students was conducted at different centres – Muhimbili National
Hospital (MNH) in Dar es Salaam, CCBRT in Dar-es-Salaam, Kibosho Hospital in Kilimanjaro, Mombo Hospital in Tanga and Sekou Toure Hospital in Mwanza.
Academic/Consultancy activities
Despite taught course in class and clinical settings; the school in collaboration with the eye
department continued with various outreach programme for students to acquire various community experience. All staff of the school were involved in MoHSW´s consultancy activities outside institutional/international Collaboration
The school continued to enjoy the collaboration from various Institutions. These included Synsam
of Sweden, Brien Holden Vision Institute, World Council of Optometry, International Association of Contact Lens Educators (IACLE) and Tanzania Optometric Association (TOA).
Achievement
* 15 optometry candidates successfully completed their course of study and all have been
employed in various health settings in the country.
* The school is fully accredited by NACTE and is using a competency based curriculum.
* The school completed the B.Sc. Curriculum preparation and submitted it to the college for further action. * Two optometry staff Mr. Gaspar Mmari and Mr. Kanuti Siara joined the B.Sc Programme at Mzuzu University Malawi.
Future Plans
* The school together with KCMC-College are looking forward for the establishing a B.Sc
Programme in Optometry.
* Efforts are underway to get 2 more full time tutors/lectures to assist in teaching some of the modules in the CBET Curriculum.
* To have more tutors with higher qualifications (M.Sc) or develop the current staff.
Challenges
* Financial constraints
* Limited training professional opportunities in the country for the graduates.
SCHOOL OF ADvANCED DiPLOmA PAEDiATriC NurSiNG
Principal- Ms. Margareth S. Kimweri
introduction
KCMC School of Advanced Paediatrics Nursing is the only government school which produces
Paediatrics nurses in Tanzania. The school was established in 1978 under the license of KCMC
School of nursing. In year 1994 the school got its own registration under which it operates up to date. This is an in-service school where by the students are already employed by the government and non-government organizations.
Currently the school has no students because the Government has issued directive for phasing out Advanced Diploma Awards. Therefore In 2010, the MOHSW has started developing new curriculum under requirement of NACTE (National Council for Technical Education). The program will have two levels: NTA (National Technical Awards) Level 7 which is Higher diploma and level 8 (Bachelor degree). The program will be Competence Based Education (CBET) and before was Knowledge Based Education (KBET). The curriculum is read but the program not yet started waiting MOHSW to finish administrative matters and to announce the course.
The school has two academic staff. We have also one office attendant shared by three schools: school of nursing; ophthalmic nursing and Paediatrics nursing school. Goals and activities
•
Because the school does not have students, we are working together with School of diploma in Nursing to make sure that the products produced is competent in knowledge, skills and attitude.
Constraints
•
Inadequate classrooms to hold large number of students. Inadequate teaching staff with paediatric specialty.
Statistics:
KCMC School of Advanced Paediatric Nursing has produced a number of qualified paediatric
nurses since 1994 as shown in the table below: Table 1: Students output
Collaboration
The school collaborates with the School of Nursing and Ophthalmic Nursing. We are sharing
classes, skills lab. At the moment we are teaching fully time at School of Nursing. We are also sharing supporting staff.
At the moment we do not have any collaboration from outside the country.
SCHOOL OF PHYSiOTHErAPY
Principal: PT. Egfrid M. Mkoba
introduction
During the year 2014 the school activities were conducted by seven (7) full-time and seven (7)
part-time profession tutors who were involved in carrying out academic activities. The school also continued to benefit from other external tutors from other departments including Medical, Surgical, Orthopaedics, Paediatrics, Nursing and Radiology. Student Body:
The school had a total of forty seven (47) students – thirteen (13) first year; thirteen (13) second
year and twenty one (21) third year students.
Outreach activities.
Clinical education for third year students was conducted in four different centres –Muhimbili
National Hospital (MNH) in Dar Es Salaam; Mbeya Referral Hospital in Mbeya, Saint Francis Hospital Ifakara and Teule in Muheza. During this period of time students had opportunity to gain experience in various working environments. Staff Development
One academic staff from the school completedMaster of Medical Science in Physiotherapy
(M.Med.Sci – Physiotherapy) of the University of Umeå in Sweden. Two staffs joined this sandwich program in October 2014. Two (one full-time and another one part-time staffs) have successfully completed the first year of their PhD studies on sandwich scheme in the same university. One staff who joined Master program in Mzumbe University (MU) Morogoro for Master in Health Systems Management is expecting to accomplish his course of education in June 2015 and return Staff movement
The school operated without a secretary following her retirement. Sole Office Attendant was
transferred to another department leaving the school without any, therefore, depending on interim allocation from house-keeping department.One tutor was hired by the Ministry of health and Social Welfare to join a monitoring and evaluation program for basic health services project. This person will return to school towards the end of 2015. Academic/consultancy activities
Despite taught courses in class and wards/clinical settings the school continued with various
outreach programme for students to acquire various community experience. The school continues to remain an integral part in the development of the BSc. Physiotherapy programme of the KCM- College. Four staffs of the school were involved in MoHSW's consultancy activities outside KCMC and two staffs are currently provide consultancy for the development of activities to realise country's "Persons with Disabilities Act." institutional/international collaboration
The school continued to enjoy the collaboration from various parts of the world. Owing to the
fact that there has been frequent mingling of these activities between it and the department of physiotherapy at KCMC it may be difficult to mention sole collaborations with the school. The school continued to enjoy collaborations with the Swedish Church Mission and Umeå UniversitySweden. Through these collaborations further education for all physiotherapists at KCMC continues to be Achievements
A total of twenty two (22) physiotherapy candidates successfully completed their course of study
and all have been employed in various health settings in the country. Seven candidates were referred to a six months supplementary period before they qualify. Through collaborations, the school in collaboration with the department of physiotherapy successfully developed their all diploma staffs Further plans
The school in collaboration with KCMC and KCMU-College looks forward to re-establishing
collaboration with University of Bergen.
TrAiNiNG CENTrE FOr HEALTH rECOrDS TECHNOLOGY
Principal: Mr. Joseph A. Msami
introduction
The Training Centre for Health Records Technology (TCHRT), which is the only one in the
country. It started in 1976 with the support from the Ministry of Health, KCMC administration and the Church of Sweden. It continues to collaborate and receive support from the Church of Sweden Mission (CSM) in terms of upgrading its academic staff Aims
The overall aim of the Training Centre for Health Records Technology is to prepare health personnel
who are capable of managing and maintaining health records and information systems.
Staffing
There are 2 permanent teachers one attached from KCMC. Among the permanent teachers one
went for further training at Kenyata University Kenya.
module of Training
Twenty four (24) students sat for final qualifying examination in August, 2014 for First Diploma
in Health Records Technology all students passed and awarded a Diploma in Health Records Technology. The nineteen (19) students who sat for NTA level 5 examination fifteen (15) students successful pass and continue to NTA level 6 Ordinary Diploma in Health Records and Information Technology which four (4) of them failed Health Care Data Classification and they are waiting to sit for the supplementary examination in February, 2015.
Theory Modules are performed in Class as per curriculum; Lecture/ discussions, group discussions, illustration, self-study, assignments, tutorial,project or research work.
PracticalModules are performed in Medical Record Department KCMC, in the field attachment at Manyara, Dares Salaam, Mwanza, Musoma, Tanga and Arusha regions within Tanzania mainland.
Activities
Supporting services
There are supporting services including Secretary and two Office Attendants attached from
TrainingThe school continued conducting short courses in collaboration withKCMCMedical Records Department.
Students were exposed to the nearest Hospitals and Health Centre to practise their training During the year the school conducted the training of ICD-10 staff working at Tabora, Dar es Salaam, Tanga and Iringa hospitals ConsultationThe school received consultation from various Health Care deliveries in Tanzania and Health training institutions. Future plans
The school continue to implement the newly developed curriculum from Ministry and Social
Achievements
First bench of Diploma in Health Records and Information Technology graduated in August,
2014.
Clinical coding Refresher Training was done to our teaching staff from United Kingdom Expert.
Constraints/limitations/challenges
* The school is facing shortage of academic teaching staff.
* Computers and other teaching equipments are worn out requires replacement
* The building in the school and hostel needs renovation especially at the roof because it
has never done since 1997.
* The cadre has not yet recognized as a Health Care Provider, it is combined together with non-Medical cadre. * School depending much in part time teachers which used a lot of funds for payment. visitors
Various visitors were received from NACTE, MOH, NHIF, Treasure Moshi and from Government
TANZANiA TrAiNiNG CENTrE FOr OrTHOPAEDiC TECHNOLOGiSTS
Principal: mr. Harold G. Shangali
introduction
During the year the school continued conducting the three years Diploma Course in Orthopaedic
Technology, Certificate course in Lower limb Orthotics/Prosthetics, Wheelchair Technology and short courses in Basic and Intermediate Level in Wheelchair Technology respectively.
Diploma in Orthopaedic Technology (DOT)
First Year DOT:
A total number of nine (9) students were enrolled in the first year of study in October 2013.
Distribution in terms of gender were (3) females and (6) males.
Second year DOTTotal number of (10) candidates were enrolled into the second year of training with gender distribution (1) female and (9) males.
Third Year DOT:Total number of ten (10) Candidates were enrolled into the final year of study. Genderdistribution (3) females and (6) males. All candidates successfully passed all subjects andrecommended for award of Diploma in Orthopaedic Technology Administration
The school main activities in respect to resource management, teaching, as well as staff training/
development were fairly accomplished. The 27th Advisory Committee Meeting was held on 13th January 2014 in which different reports and recommendations were presented and discussed for Staff Training and Development
Long-Term Courses
1. Mr. Aston Ndosireported to have completed his M. Phil Degree in DisabilityStudies
at -University of Cape Town, South Africa in June 2014 2. Mr. Joachim Moshyhas completed successfully Diploma course in Orthopaedic Technology and has resumed back to support the academic teaching staff 3. Mr. Aron Dilluhas postponed B.Sc Degree Course in Prosthetics and Orthotics atTumaini University due to illness. 4. Mr.ExaudKasegezyacompleted third year B.sc Degree Course in Prostheticsand Orthotics at Tumaini University. He is now in the final year of study. 5. Mr. Baraka Moshi completed second year B.sc Degree Course in Prosthetics and Orthotics at Tumaini University. He is now attending third year of study. 6. Ms.ElianasoMalisawas accepted to joint first year Bsc. Degree course atTumaini University in Prosthetics and Orthotics in October 2014. 7. Mr.L.Mtalopostponed his Master's programme to 2016 Short Courses and Seminars The following staff members attended different courses/seminars during the year 2014 as indicated below;The school conducted short courses as follows: Basic and Intermediate Wheelchair Course in Wheelchair Technology as from 4th August 2014 up to 15th August 2014 and 17th August 5th September 2014 respectively. ms. Salome Sariaattended the following courses and meetings.
1. Attended Alumni conference-Hospital Management for Health Professionals in Nairobi
Kenya as from 24th March up to 28th March 2014 2. Consultation in 5S-KAIZEN- TQM at Huruma, Machame and Hai hospitals as from 23rd April 2014 up to 25th April 2014. 3. Consultation visit on 5S-KAIZEN-TQM at Muhimbili National Hospital as from 22nd September 2014 up to 26th September 2014. 4. Facilitate 15th Progress Report on 5S-KAIZEN TQM in Dar es Salaam as from 21st October 2014 up to 26th September 2014. 5. Mr. David Shirimaattended two weeks course on Ischial Containing Socket for Trans- femoral prosthesis at CCBRT – Dar es Salaam as from 15th September to 26th September 2014 6. Mr. Servas Shiyo attended ISPO Congress in Cape Town-South Arica where he presented a paper on recycling of Plaster of Paris as from 25th September to 27th September 2014 7. Mr. Harold Shangali attended ISPO Congress in Cape Town-South Africa as from 23rd September up to 29th September 2014. 8. Ms. Jackline Mtei attended training on Quality Improvement (KAIZEN) in Dar esSalaam as from 30th September up to 3rd October 2014 9. Ms. Salome Saria, Mr. Rashid Simba and Mr. Davis Shirima conducted a Survey on Rehabilitation service care delivery in Health facilities in Tanzania in the following regions; Manyara, Arusha, Kilimanjaro, Tanga,Ruvuma, Dodoma, Mbeya, Unguja, Dar es Salaam, Mwanza and Kigoma, as from 26th September to 9th October 2014. Collaborators:
* Orthopedics rehabilitation Centers: The School continued utilizingProsthetist/
Orthotist in MuhimbiliOrthopedics Institute, Monduli Rehabilitation Centre, Regional * Workshop in Dodoma, Usa River Rehabilitation Centre, Comprehensive Community Based Rehabilitation Tanzania (CCBRT-DSM), Youth with Disability Community Programme (YDCP)-Tanga to supervise students during field work attachment rotations. * Sophie's Minde-Norway: The exchange programme between North South and
SouthNorth has continued to prosper over the four years. The project will come to an end in October 2015.
* mr.NanyaroEliupendo from Usa River Rehabilitation field work centre is onExchange
Programme in Norway for one year i.e. from October 2014 up to October 2015. (North- South Exchange Programme) * Ms. Lauren Jackline from Australia is on Exchange Programme at TATCOT for
periodof one year up to October 2015. (North-South Exchange Programme) * Cambodia School of Prosthetics and Orthotics (CSPO)
* South -South exchange programme between TATCOT and CSPO has continued well as
we come close to the end of the project by October 2015 * mr. Prosper Kaaya from Orthopaedic W/C KCMC clinical services department is onthe
fifth round of Exchange Programme in Cambodia for one year, i.e. from October 2014 up to October 2015 (South-South Exchange Programme) * ms.SrengSreyrath from Cambodia is on the fifth round of Exchange
Programmeat TATCOT as from October 2014 up to September 2015. (South-South ExchangeProgramme) visitors
During the year 2014 we were privileged to have among others a number of visitors, the purpose
of their visit was; * Attending meetings e.g. Advisory Board Meeting, Partnership meeting * Collaboration * Consultation of patients * Evaluation of programs which are run in the school * Invigilation and supervision of exams * Attending short courses conducted by the school e.g. Spinal Orthotics e-learning, Basic/ Intermediate Wheel Chair Training and Orthopaedic shoe wear course. Admission and OPD attendance in 2014
OPD Attendance
59 1465 1627 4523 5774 5988 7401 13389 51 1329 1411 4107 5600 5436 7011 12447 85 1475 1530 4277 6021 5752 7551 13303 49 1283 1381 4106 5414 5389 6795 12184 54 1345 1444 4636 6031 5981 7475 13456 59 1338 1431 4495 5774 5833 7205 13038 56 1226 1289 4107 5234 5333 6523 11856 59 1343 1378 4277 5926 5620 7304 12924 50 1258 1449 4358 5820 5616 7269 12885 53 1436 1509 4473 6044 5909 7553 13462 60 1241 1243 3990 5569 5231 6812 12043 47 1280 1246 3888 4915 5168 6161 11329 10497 13839 1037 682 16019 16938 51237 68122 67256 85060 152316
Birth at the hospital in 2014 by months
Hospital Statistics - January - December 2014
Total bed capacity Total discharges live Total number of patient days 1.Average daily in patient days 2.Average daily admissions 3.Average length of stay 4. Percentage of occupancy
Statistics
Return attendances Hospital statistics (January to December 2014) according to units - year 2014
Av.DAiLY
Av.DAiLY
Av.LEGHTH
PATiENTS
New outpatient registration according to districts
NEW OUT PATIENT RESTRATION-KILIMANJARO ACCODING TO DISTRICT-JAN.-DEC. 2014 930 948 1412 1520 Admissions and new registration/return attendance according to regions 2014
RE - ATTENDANCES
SuB TOTAL
OuTSiDE CATCHmENT ArEA
RE - ATTENDANCES
TOT(OCA )
GrAND TOTAL
referral status according to regions 2014
SuB TOTAL
OuTSiDE CATCHmENT ArEA
GrAND TOTAL
OUT PATIENT STATISTICS FROM CLININS (JAN. – DECEMBER 2014)
mArC APr.
JUNE JULY AuG. SEPT. OCT.
NOv. DEC.
OPD ATTENDANCE ACCORDING TO AGE (JANUARY - DECEMBER 2014)
GrAND TOTAL
OPD ‘TOP TEN' diseases general
S/N DiSEASES
1 Diseases of oral cavity, salivary glands and jaws 2 Dermatitis and eczema 3 Other diseases of upper respiratory tract 4 Person's encountering health services in circumstances related to reproduction 5 Hypertensive diseases 6 Protozoa diseases 7 Other anaemia's 8 Other forms of heart diseases 9 Diabetes mellitus OPD ‘TOP TEN' diseases in Eye department
S/N DiSEASES
1 Allergic conjunctivas 3 Other eye disorders 5 Mature cataract 6 Diadetic retinopathy 8 Myopia/hyperopia Inpatients – general 'TOP TEN' diseases
S/N DiSEASES
GrAND TOTAL
Single spontaneous delivery Single delivery by caesarean section Transport accident Diabetics mellitus Chronic disease of tonsils and adenoids Human immunodeficiency virus (HIV) All other external Bacterial sepsis of new born 10 Pneumonia organism unspecified ‘TOP TEN' diseases for Inpatients Under five (5) years
S/N DiSEASES
GrAND TOTAL
Chronic disease of tonsils and adenoids Bacterial sepsis of new born Disorders relatedto short gest.and lowbirth- weight not elsewhere classified.
Respiratory distress of new-born Other septicaemia Transitory disorder of carbohydrates metabo- lism specific foetus and new-born Meningitis due to other and unspecified 10 Unspecified malaria "TOP TEN" diseases for inpatients aged 6-59 years
S/N DiSEASES
GrAND TOTAL
Single sponteneous delivery Singledelivery by caesariansection Trasport accident Human immunodeficient virus (HIV) All other external Diabetes mellitus Intra cranial injury Maternal care for known or suspected abnor- mality of pelvic organs 10 Essential (primary)hypertension "TOP TEN" diseases for inpatients aged 60 years and above
S/N DiSEASES
GrAND TOTAL
Diabetes mellitus Disorders of bladder Essential (primary) hypertension Hyperplasia of prostate All other external Urethral stricture Hypertensive heart disease "TOP TEN" disease in EYE ward - 2014
Retina detarchment FOrmuLAS/DEFiNiTiON OF TErmS
Average daily inpatient census = Total number of patient day in the period (month, year) Days in the period (30,365) Average daily admission = Total admission in the period Days in the period Average length of stay (days) = Total number of patient days in the period Discharges (live + death) in the period LiST OF ABBrEviATiONS
Acquired Immune Deficiency Syndrome Assistant Medical Officer Benign Prostate Hyperplasia Congestive Cardiac Failure Child Centered Family Care Clinic Community Health Department Dysfunctional Uterine Bleeding Evangelical Lutheran Church in Tanzania Ear Nose and Throat Examination under Anaesthesia Good Clinical & Laboratory Practice Gastro-Intestinal Tract Gynaecology Outpatient Department Good Samaritan Foundation Human Immunodeficiency Virus Infectious Disease Control International Society of Prosthetic and Orthotic Kilimanjaro Christian Medical Centre Kilimanjaro Christian Medical College Lower Limb Prosthetic Technology Lower Limb Orthotic Technology Low Segment Caesarean Section Medical Attendant Ministry of Health and Social Welfare Muhimbili Orthopaedics Institute Medical Outpatient Department Main Operating Theatre Muhimbili University of Health and Allied Sciences Medical Supplies Department Motor Traffic Accident National Health Insurance Fund Online Public Access Catalogue Ophthalmological Society of East Africa Pelvic Inflammatory Disease Pregnancy Induced Hypertension Paediatric Outpatient Department Premature Rupture of Membrane Pulmonary Tuberculosis Regional Dermatology Training Centre Rectal Vaginal Fistula Surgical Outpatient Department Surgical Intensive Care Unit Spontaneous Vaginal Delivery Tanzania Training Centre for Orthopaedic Technology Tanzania Centre for Health Records Technology United States Agency for International Development Urinary Tract Infection Vesicle Vaginal Fistula World Health Organization This report has been prepared by the management of Kilimanjaro Christian Medical Centre.
This work has been compiled and edited by Mr. Damian Jeremia (Hospital statistician)
Contact Address:
Kilimanjaro Christian Medical Centre
P. O. Box. 3010, Moshi, Tanzania.
Tel. +255 027 27543777/80
Fax: +255 027 2754381
E-mail: [email protected]
Website: www.kcmc.ac.tz

Source: http://www.kcmc.ac.tz/downloads/annual_report_2014.pdf