KLIMANJARO CHRISTIAN MEDICAL CENTRE
An Institution of The Good Samaritan Foundation
Annual Report 2014
An Institution of the Good Samaritan Foundation
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
4.1 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".
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.
• 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
DEPArTmENT OF ANAESTHESiA
Head of department: Dr. Andrew Hellar
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.
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
Nurse Anaesthetist BSc. Nursing
Clinical Officers (on training)
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
Number of Patients
Other Anaesthetic Drugs
Number of patients
13 Diprivan (Propofol )
Labour ward coverage
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
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
regional Anaesthetic Complications
regional Anaesthetic Complications
Number of patients
Post Spinal Head ache
The Department has nine operating theatres equipped with modern anaesthetic machines.
Mechanical Ventilators are available in the Intensive Care Unit. Monitors (ECG, Pulse Oxiometer)
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.
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
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
14. Adolescence Clinic
Monday and Wednesday
* 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
* 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
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.
» 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 )
» Consultations rooms are not enough compared with the number of the patient and
» 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
» 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
* 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
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.
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
• To become a model of pediatric health care in Tanzania through the integration of Care
&Treatment, Training and Research.
To provide health care services for all children and their families in Northern Tanzania
with a focus on Care &Treatment, Training and research.
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.
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.
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
One pharmacist and one Social worker
* Currently the pharmacist and Social worker are on contract employment by KCMC and
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
» 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
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
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:
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/
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
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
The Department of Clinical Laboratory is one of the clinical service departments within the
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:
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
» 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
» 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
COmmuNiTY HEALTH DEPArTmENT
Head of Department: Dr. rachel manongi
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.
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
Environment Health Specialist
Public Health Nurses
Public Health Nurses
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
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.
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
» 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
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.
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.
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.
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
Table 3: Distribution of the number of treatments provided to patients attending at KCMC
Extractions Fillings Prothodon-
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.
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.
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
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
Registrar in Dermatology
Public Health Derm.
2. Nurse Staff (OPD & Ward)
3. Pharmacy Section (OPD & Sunscreen)
4. Public Health worker
Community Reh. worker
5. Laboratory Section
6. Accountant Section
7. Library Section
Senior Library Assistant
8. Transport Section
11. Others supportive staff
Warden (RDTC Hostel)
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.
• 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
• 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
• 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
• 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
• 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.
• 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
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.
The clinic has a total of 3 members of staff.
For the year 2014the following patients were attended monthly:
» 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
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
* 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.
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,
There is a general increase of 5.890% in ultrasound examinations compared with last year.
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
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
Various local, medical and non-medical students spent time in the department as part of their
fieldwork or on project assignments.
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.
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
4. Ageing facilities and equipment with frequent breakdowns.
5. Unstable and frequent power failure.
6. Lack of biomedical technology engineers.
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.
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
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).
Assistant Nursing Officers
The Total Bed capacity of the department has remained the same (107) like the last annual report
One of the important activity of the department is to provide a Quality patients care at a specialist
level both in and outpatients.
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)
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
Type of Procedure
The "Ten Top" conditions seen in the department has almost remained the same as in 2013.These
includes the following:
Upper Gastrointestinal Bleeding
Kidney Diseases (Acute and Chronic)
Congestive Cardiac Failure
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 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 .
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.
• 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
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.
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.
1. To provide safe and high standard theatre services
2. To teach students in various programs on safe, feasible and sustainable theater
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
Left retired Total at
Staff movement CSSD
Left retired Total at
Statistics for mot
Operations done from January to December 2014
Grand Total Operation 3835
List of sterilized items
NumBEr OF iTEmS
Dressing Pack drums
Labour ward bundles
Labour ward trays
Vaseline Gauze trays
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.
» Shortage of nursing staff
» Frequent breakdown of autoclaving machine » Leakage from the roof
To request for renovation of the Main Operating Theatre /CSSD
DEPArTmET OF OBSTETriC AND GYNAECOLOGY
Head of department: Dr. Gileard masenga
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.
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
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.
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
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.
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
» 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
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
Laparatomy due ruptured uterus
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
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
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
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.
To be a reputable department in maintaining an effective, efficient, holistic, client centred and
sustainable quality of rehabilitation programmes.
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.
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.
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.
Number of in and out patients attended in Occupational Therapy Department in the year 2014 is
No. of patients
General Surgery SI & SICU B
Neuro Paediatric Outpatient Clinic (NPOC)
Sub Total B
Grand Total ( A + B)
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.
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
S/N university College/ Country
Bergen University (Senior Officials) To review the fieldwork Manual
KCMUco ( Students)
Learning about Occupational therapy
Bergen University (Students)
KCMUco ( BScN Students)
Learning about Occupational therapy
University of Toronto
Learning &sharing skills in O.T
Exploring possibilities for research
University of Minnesota - USA
Umea University (Teaching staff)
Teaching exchange programme.
Neema Crafts Therapy – Iringa town. Learning & sharing skills in O.T
Umea University (students)
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"
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.
■ 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
■ 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
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.
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.
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.
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.
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
Outreach Visits DEDSO1
Surgical Outreach Visits
Numbers Screened DEDSO
Numbers Screened WESO2
Numbers Operated DEDSO
Numbers Operated WESO
1. Day Eye Diseases Screening Outreach.
2. Week-long Eye Surgical Outreach.
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
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
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
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
■ 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
■ 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.
■ 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
6. Intertrochanteric fracture
7. Supracondylar fracture
8. Fracture of humerus
10. Fracture of ankle
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
UFN Universal Femoral Nail
DHS Dynamic Hip Screw
All other procedures that are not so commonly done. To mention few these are
1. Nerve exploration
2. Contracture release
3. Bone grafting
5. Secondary suturing
7. Clubfoot surgeries
8. Pediatric surgeries
9. Foreign body exploration
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
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.
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 -
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
Knee disarticulation prosthesis
Cervicles Neck Collar
Figure 8 clavicle harness
Flexible lumbar corset
Trans Radius Prostheses
Trans wrist prostheses
Trans Humerus prostheses
Number of patients attended the department
» 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.
» 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
» 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.
» Department has collaboration with CCBRT
» Department has collaboration with CBM.
» Department has collaboration with TATCOT/KCMU College.
» Faraja primary school- SanyaJuu
Head of department: Dr. Aloyce Msaki
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.
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
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
» 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
4. Hypertrophic Allergic rhinitis
5. Aerodigestive foreign bodies
7. Nasal polyps
9. Chronic Otitis Media
10. Juvenile Laryngeal Papilomas
Number of death
Severe anemia sec to lymphoma
Foreign body in the airway
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
» 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
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
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.)
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.
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".
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.
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 outside K.C.m.C
Type of Pm
DEPArTmENT OF urOLOGY
Head of department: Dr. Frank Bright
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.
Table 1: main theatre procedures
Table 2: minor theatre procedures
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.
To train more residents in order to alleviate current shortage.
To start percutaneous endourology services
Head of Department: Mathew J. Shayo
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 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.
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.
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
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 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.
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.
Outpatient services: run 5days Adult Outpatient clinic and Paediatric outpatient clinic.
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.
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
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
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)
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.
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
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
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)
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:
* 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
■ 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
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
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.
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.
The board recommends future strategies of the Institute; it helps to foster links with other
institutions, and national and international collaborations.
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.
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.
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
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:
- 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
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
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.
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
KCmC/KCri projects 2014
Number of projects
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
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
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
Head of department: rev. Archboldy Lyimo
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.
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
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:
* 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 no. Of
Average no. Of
Food cost per
cost per person
days in a year
bites)Staff (on night
shift)Staff in Meetings
* 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.
* 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
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
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
» 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
» Fitter Mechanics-2
» Motor Vehicle Mechanics-2
» Boiler operators-3
» Incinerator operators-2
» Office attendant-1
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
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.
We continue to produce the steam for central sterile supply and Main Pharmacy with our
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
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
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.
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
* We have shortage of staff to cover the huge hospital area.
* The grass cutting machine is old which needs replacement
* To plant more trees around hospital premises.
* To increase number of gardens within the hospital by planting flowers.
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
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
During the year, the department has a total of 7 members of staff as follows:
Head of department:
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.
Head of unit: ms. Asinath minja
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.
The unit is operated by 11 staff.
In this year we experienced a regular shortage of Electricity supply in this unit causing delay in
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
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.
The department is operated with 2 legal officers in collaboration with the outsourced Legal
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.
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.
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.
Despite the aforementioned challenges, department managed to reach some of its goals and
peacefully provided services to the hospital according to the raised need.
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
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.
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
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.
■ 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
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.
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.
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.
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
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
Summary of patient granted bond from January to December 2014
No of patients
Summary of abscondee from January to December 2014
No of patients
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.
» 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.
» 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
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.
The unit has been able to maintain security and safety within the hospital, hostels and GSF
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
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.
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
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
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.
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
Dr AdinaniJuma completed his MSc. Epidemiology and Biostatistics at KCMUCo and graduated
at November 2014.
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.
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
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.
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.
There are 2 permanent teachers one attached from KCMC and one secretary.
Part-time teaching staff
No. of Staff
Nurse Anaesthetist BSc. Nursing
Nurse Anaesthetist Diploma
AMO Anaesthetistand M.Med Anaesthetist
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
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
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
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
» 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)
» 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
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
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
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
Enrollment of 16 students for certificate program
Successful collaboration with different stakeholders from within and outside the country
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
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
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
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
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.
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
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.
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.
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:-
* 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.
* 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
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
The school is managed by 6 full-time tutors, 6 part-time tutors and two supporting staff.
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.
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.
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
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).
* 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.
* 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.
* Financial constraints
* Limited training professional opportunities in the country for the graduates.
SCHOOL OF ADvANCED DiPLOmA PAEDiATriC NurSiNG
Principal- Ms. Margareth S. Kimweri
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.
Inadequate classrooms to hold large number of students.
Inadequate teaching staff with paediatric specialty.
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
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
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.
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.
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.
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
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.
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."
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
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
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
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
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.
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.
There are supporting services including Secretary and two Office Attendants attached from
TrainingThe school continued conducting short courses in collaboration withKCMCMedical Records
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
The school continue to implement the newly developed curriculum from Ministry and Social
First bench of Diploma in Health Records and Information Technology graduated in August,
Clinical coding Refresher Training was done to our teaching staff from United Kingdom Expert.
* 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
* School depending much in part time teachers which used a lot of funds for payment.
Various visitors were received from NACTE, MOH, NHIF, Treasure Moshi and from Government
TANZANiA TrAiNiNG CENTrE FOr OrTHOPAEDiC TECHNOLOGiSTS
Principal: mr. Harold G. Shangali
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
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
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.
* 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
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
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
Hospital statistics (January to December 2014) according to units - year 2014
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
OuTSiDE CATCHmENT ArEA
RE - ATTENDANCES
referral status according to regions 2014
OuTSiDE CATCHmENT ArEA
OUT PATIENT STATISTICS FROM CLININS (JAN. – DECEMBER 2014)
JUNE JULY AuG. SEPT. OCT.
OPD ATTENDANCE ACCORDING TO AGE (JANUARY - DECEMBER 2014)
OPD ‘TOP TEN' diseases general
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
1 Allergic conjunctivas
3 Other eye disorders
5 Mature cataract
6 Diadetic retinopathy
Inpatients – general 'TOP TEN' diseases
Single spontaneous delivery
Single delivery by caesarean section
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
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
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
Single sponteneous delivery
Singledelivery by caesariansection
Human immunodeficient virus (HIV)
All other external
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
Disorders of bladder
Essential (primary) hypertension
Hyperplasia of prostate
All other external
Hypertensive heart disease
"TOP TEN" disease in EYE ward - 2014
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
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
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
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)
Kilimanjaro Christian Medical Centre
P. O. Box. 3010, Moshi, Tanzania.
Tel. +255 027 27543777/80
Fax: +255 027 2754381
E-mail: [email protected]
DISEASES OF THE GASTROINTESTINAL TRACT (Notes Courtesy of Dr. L. Chris Sanchez, Equine Medicine) The objective of this section is to discuss major gastrointestinal disorders in the horse. Some of the disorders causing malabsorption will not be discussed in this section as they are covered in the "chronic weight loss" portion of this course. Most, if not all,
MEDICAL POSITION PAPER Management Guidelines of Eosinophilic Esophagitis A. Papadopoulou, yS. Koletzko, zR. Heuschkel, J.A. Dias, jjK.J. Allen, S.H. Murch, S. Chong, F. Gottrand, yyS. Husby, zzP. Lionetti, M.L. Mearin, jjjjF.M. Ruemmele, M.G. Scha¨ppi, A. Staiano, M. Wilschanski, and yyyY. Vandenplas, for the ESPGHAN Eosinophilic Esophagitis Working Group and the Gastroenterology Committee