“If they want to treat my people, let them treat my donkey first.”
The first Christian healthcare work in what is now the Iringa Diocese of Tanzania began in 1938 when a Swedish nurse arrived at Ilula and set up a tent to serve as a health post. Chongoma, the local chief, refused to allow his people use the modern facility. As time elapsed, the nurse began to lose hope of ever being able to reach out to the people she wished to serve. Then one day the chief’s donkey developed a large abscess on its leg. Chief Chongoma brought the animal to the nurse, commenting to his people, “If they want to treat my people, let them treat my donkey first.”
With hesitation and fear, the nurse opened the abscess, drained the pus, and packed the wound with medicine, advising the chief to bring his donkey for daily dressing changes in the following days. After a few days the donkey was fully recovered, and Chief Chongoma convened a public meeting where he ordered his people to go to the nurse’s tent for all their health problems. Many came, most were cured, and many more came.
The Ilula Lutheran Health Center has grown from its humble beginnings to its present status as a 70-bed facility situated along a busy highway in a growing town, serving a catchment area of over 100,000 people in a mostly poor and rural area of Tanzania.
The Tanzania-Zambia Highway goes through Ilula about 450 km west of Dar es Salaam and about 50 km east of Iringa. The rapid urbanization of the area in recent years has led to an alarming increase in the number of communicable diseases, including AIDS and tuberculosis.
Officially the Ilula Lutheran Health Center is registered as having 70 beds: 10 for private patients, 20 in the maternity ward, and 40 for general patients.
The Ilula Health Center is operated by the Iringa Diocese of the Evangelical Lutheran Church in Tanzania (ELCT). The Diocese also operates eight rural dispensaries (small clinics that serve several villages and are staffed by a clinical officer, with training roughly equivalent to that of a nurse practitioner). The health center receives some government funding in the form of staffing grants.
The Ilula campus includes an administration building, a building which houses outpatient services, a maternal/child health clinic with delivery room and maternity ward, a private ward, a general ward with a wing housing the infectious disease ward, and a laboratory building. Outlying buildings include kitchen facilities, laundry, and a workshop.
Current staffing includes two medical doctors, several clinical officers, nurses with varying levels of training, nine nurse midwives, lab assistants, and various administrators and accountants.
Becoming a District Designated Hospital
The Tanzanian government has expressed its willingness to designate the Ilula Lutheran Health Center as the district hospital for the new Kilolo district—and that designation would bring valuable staff and financial support to the facility.
Status as a District Designated Hospital requires the health center to upgrade its facilities in a number of ways. At a minimum, it would have to add a surgical suite complete with anesthesiology capabilities; improve its inpatient laboratory technology; add imaging capabilities such as x-ray and ultrasound; and build a morgue. In addition, a district hospital would be expected to have more beds
and patient wards, and a greater variety of specialists such as surgeons, anesthesiologists, obstetricians, and perhaps dentists.
Two Task Forces at Work
A task force in Tanzania is working with architects, builders, and government health officials to plan an orderly expansion. A task force in Minnesota is working to raise funds and to provide expertise for long range planning. The new in-patient lab, our initial project, is nearly complete. The Well Project-Saint Paul Partners are also working to establish an adequate and reliable source of safe water onsite.
MSAADA, an architectural firm based in Minneapolis that has years of experience building medical and educational facilities in developing countries, has been engaged by the task forces to create a master plan for the new hospital. Initial plans have been drawn for facilities that would cost an estimated $500,000 to build the entire proposal, including all the facilities required to attain District Designated Hospital status.