Dodoma. Tanzania’s capital, Dodoma, has had a bad history in the health care for many years.
The wellbeing of women, children and the aged have so far been affected big time.
Pregnant women have invariably faced do-or-die situations when it came to maternity issues because of severe lack of the requisite facilities, services and other amenities at the so-called health care centres.
It is a grim revelation that, as of 2013, some 186 out of 402 primary health care facilities within the Dodoma administrative region had no water supply at all – a situation which caused varied health-related difficulties, including maternal and newborn deaths.
Despite deliberate efforts by the government to effectively resolve the situation, most health facilities in the region remain in poor hygienic conditions, largely due to lack of, or poor, financial investments in water, sanitation and hygiene, among others.
Antenatal health services were very poor at many health centres in the region due to limited access to clean water – as well as lack of other key sanitation facilities like toilets, placenta pits, waste water pits and hand-washing facilities.
Such poor hygienic conditions at nearly all the health facilities in the region forced expectant mothers to carry their own water whenever they attend health centres for delivery.
Sadly enough, a more dangerous scenario was that workers at most of the health centre were forced to provide health services to the needy in the region without having the use of standard bathrooms, pit latrines, hand washing basins, placenta and gravel pits.
In that regard, the Agency for Development & Cooperation (SDC) felt obliged to disburse $8,397,392 to finance implementation of a five-year ‘Maji kwa Afya ya Jamii’ Project (Mkaji), which is intended to upgrade water supply, sanitation and hygiene in Dodoma, aiming at minimising infections.
The project is being implemented by a Netherlands-based International NGO, Simavi (Steun Inzake Medische Aangelegenheden Voor Inheemschen’).
Since its inception in April 2014, the project managed to uplift the water supply, sanitation and hygiene status of more than 50 primary health care facilities in the region.
Speaking in an exclusive interview with The Citizen in Dodoma recently, a Medical Attendant at the Mahoma-Makulu Dispensary, which is located within Hombolo Ward, Ms Diana Ngoi, said: “Before the introduction of the Mkaji project, the health care situation here was very poor.
Most women in the rural areas suffered a lot. Some lost their lives or lost their babies due to infections related to the poor hygienic situation in those days.”
In those early days before Mkaji, Ms Ngoi recalls: “The situation was pathetic. Pregnant women who delivered children here could not even take bath after delivery because there was neither water nor bathrooms.
She added: “Also, we had no recommended means of managing placentas from the women who delivered here.”
She disclosed that the Mahoma-Makulu Dispensary receives an average of 17 antenatal women a month.
Ms Ngoi said the placentas after delivering were just thrown into the nearest dustbin, which is not right.
“The situation posed diverse challenges. For example, poor management of placentas from delivery operations was unhygienic, leading to uncontrolled infections,” she stated.
The situation has somewhat improved at the Hombolo Health Centre with the Mkaji Project playing a significant role in improving health services at the place – especially for expectant mothers and their newborn.
Commenting on the matter, Ms Tupokigwe Masako – another woman found by The Citizen working at the place said: “When I came to for delivery here for the first time, the requisite services were not available.
“Clearly, there have been some laudable improvements. There is a bathroom now, a working water system and placenta pits,” she said.
The ongoing Mkaji Project is being implemented by a consortium of partners, which include ‘Ufundi na Uhandisi Kongwa’ (Ufundiko); Pamoja Tujenge Tanzania (Patuta), Community-Based Health-Care Council (CBHCC) and Witteveen Bos, an international engineering consultancy.
Speaking in an exclusive interview with The Citizen, the MKAJI Programme Manager, Ms. Thea Bongertman, said the project has already managed to impart key hygiene and sanitation knowledge to different health workers and held training on operation and maintenance, and water and financial management to villagers.
This was meant to ensure sustainability of the project’s gains after it is phased out in March, 2019.
“Water and Sanitation (Wash) is one of the most important social determinants of health,” Ms Bongertman explained.
“Upon request of the Local Government Authorities of Dodoma region, SDC, working in partnership with Simavi, took action to improve the quality of public health services provision by reducing the potential risks of transmission of communicable diseases and infections during routine patient care and treatment so as to improve health services delivery – specifically maternal health care and services – by improving access to water, sanitation and hygiene.”
For his part, the Dodoma Regional Medical Officer (RMO), Dr Charles Kiologwe appreciated the contribution of the project in improving the status of hygiene in many of the centres in the region.
“To be honest, Mkaji is among the few health projects in Dodoma that have to a great extent played a key role in elevating the regions’ health delivery status, especially for mothers and children,” he said.
The Mkaji Project in Dodoma region can be traced to the research in 2013 by the Health Project Systems Strengthening (HPSS) programme, which was also under the auspicious SDC, and which established that most health facilities in Dodoma were in poor sanitation and hygiene conditions, mainly due to lack of water supply.
Simavi was founded in 1925 by two Dutch medical doctors, Dr John Van der Spek and Dr H. Bervoets. Their aim was to provide medical assistance for health institutions in the former Dutch East Indies.
Ever since, Simavi has been working to improve standards of health in developing countries across the globe.