Polish aid

These are people who have received medical training but no higher medical education. As long as a surgical intervention is a simple one, the result is usually positive, but when a case is difficult things get complicated.

Many people in Tanzania die from acute medical conditions which can only be addressed by proper surgical treatment. Uterine fibroids requiring surgical removal are an extremely common condition among middle-aged women. Perinatal complications are a major cause of death for women and newborns. Malnutrition, which causes acute anaemia in pregnant women, results in haemorrhages during childbirth which are often impossible to stop. Women often struggle for the rest of their lives with the consequences of bad maternity care. In addition, babies are born prematurely, with low birth weight and medical problems. Sometimes newborns require urgent surgery because of congenital defects.

A separate problem is a rising number of injury cases, caused largely by the rapidly growing motorised traffic. Road accidents are the main cause of death for young people aged 15-29. Pedestrians and motorcyclists account for half of those killed on the road.

Besides the shortage of well-educated and experienced doctors, another problem with Tanzanian hospitals is that they lack basic equipment, medicines, and medical materials. Local hospitals are often in need of equipment, tools, and even basic medical materials (e.g. surgical threads, anaesthetics). When fractures need to be treated even plaster often turns out to be in short supply.

In response to these problems, the project “Improving the quality of surgical treatment and mother and child care in Lindi and Mtwara in Tanzania” was launched, implemented since 2018 by the Polish Medical Mission with Polish Aid funding.

The organisation supports St. Walburg’s Hospital in Nyangao. It is a medium-sized missionary hospital with 220 beds and six basic wards, located in Tanzania’s underdeveloped south-eastern part. The hospital provides services for an area of 200,000 inhabitants. As the hospital has a good reputation and offers a higher level of treatment than elsewhere in the region, its practical area is much larger. Many patients come here from towns 250-300km away, and even from Mozambique. Hospitals with a similar level of healthcare are located in the country’s capital, 800km away. 

Over the past two years of the project, the Polish Medical Mission has built a new surgical clinic and renovated the surgery and maternity wards, three operating rooms, a delivery room, and an outpatient’s clinic.  The Mission has also provided the facility with necessary medical equipment. In 2019, it opened a new neonatal intensive care unit with 12 beds. In 2020, the unit received two incubators, a resuscitator, an ECG monitor, an infusion pump, an oxygen concentrator, phototherapy lamps, and a stable supply of disposable medical materials.

 

An important element of the project are also courses and seminars for hospital surgeons as well as nurses and midwives from nearby village health facilities. The courses and seminars allow them to raise their qualifications and generally improve the quality of medical services provided in the Lindi and Mtwara regions.

The surgical training programme includes so-called acute surgical cases, mainly traumatic ones, such as open and closed methods of bone immobilisation, dressing extensive wounds, performing surgery of internal organ injuries, but also treatment of non-traumatic cases like obstetric fistula surgery in women. The program also features breast cancer and cervical cancer diagnostics and treatment.

Volunteer medical staff from Poland worked at the hospital in September 2020. Justyna Szumicka, a neonatal nurse, introduced modern standards of care at the neonatal unit and trained its staff in sanitary procedures, which are crucial in preventing infection. Urology surgeon Piotr Taborowski shared his knowledge and experience with the local staff of the surgical ward during joint procedures. His presence at the hospital enabled treatment of urological patients for whom it had not been previously possible in Nyangao owing to the lack of specialist urologists among the facility’s staff.

Together with the local hospital staff, the Polish Medical Mission also organises medical team visits to nearby villages, as their residents often do not have the opportunity and money to reach the hospital for consultations. During the visits, the medical team measures the weight and height of children, vaccinates them, and, upon noticing any worrying symptoms, refers them to hospital. A midwife and doctor examine pregnant women while a social worker offers health education for the residents. They are made aware of how to look after hygiene, what a diet for pregnant women and children should look like, and learn how to prevent infectious diseases.

As a result of these actions, the maternal and perinatal mortality in the hospital has gone down by 30%.  Compared to the national average of 16 deaths per 1000 births, the hospital’s rate is 11. Together with the Polish Medical Mission, the hospital authorities aim to ensure that the rate does not exceed 8 in the coming years.