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This project is still pending. Due to the rejection of the project proposal through the German Ministry of Development we look for new sponsors for this important project!

Surgical Ward with three Operating theatres at St. Elizabeth Hospital, Arusha, Tanzania

New Theatres for St. Elisabeth Hospital – why?

St Elizabeth hospital is located in Arusha city in Northern Tanzania. It was founded more than 30 years ago and has ever since been providing crucial health services to the fast growing region and its people. More than 120 doctors, nurses and other medical staff are serving about 80,000 patients each year, delivering a wide range of health services. As a faith-based institution the hospital has traditionally served the poor and marginalized people, many of which are from the Massai, Arusha and Meru tribes.

Massai-Kind surgery in rehabilitation (left). Guest Prof. Dr. Clayton Kraft inspecting the results.

Especially the tradition of circumcision which is officially banned but still common practice with the Massai provokes severe problems during the delivery procedure. Disabilities of the children are often consequence. What makes matters worse, however, are the conditions of the existing operating theatres. The hospital has only two outdated theatres with no air condition and no sterile environment. The lack of a ventilation system poses severe risks of infection for all patients, particularly for the new-borns and their mothers who are already traumatized from emergency C-section procedures. Additionally, the existing facilities lack a recovery room which means that all patients are directly after their surgery transferred to the ward. This is if the ward isn’t full. Many times they end up on the corridors of the hospital for the first few hours after surgery.

After being upgraded to a ‘Council Designated Hospital’, the number of deliveries in St. Elizabeth skyrocketed from 700 in 2011 to around 3000 in 2014. In parallel, emergency Caesarean sections increased dramatically and the existing operating theatres and the existing staff are running at their limits. While these procedures, in line with the law offered at no cost to the population, are now taking up all the hospitals operating capacity, other essential cases such as traffic accidents or victims of severe burns can often no longer be treated and have to be referred to other hospitals.

 
3000 birth giving procedures and up to 900 C-sections per year have to be handled by the poorly equipped hospital

The old theatres have no sterile environment, no air-condition, crowded women wards


Planned Project: Objectives and Activities

An in-depth assessment of the situation of St. Elizabeth made matters clear: a refurbishing of the old theatres is not feasible. The way forward to ensure adequate medical services for Arusha’s most marginalized people is the construction of a new surgical ward. The two old theatres will be replaced with three new ones. The old and worn out equipment will be exchanged with new machinery. A new surgeon will be hired, in addition to the existing team, with a specialization in complex surgeries such as club foot and other orthopaedic treatments. The hospital will once more be able to serve its population with a wide range of surgical procedures, including orthopaedic procedures, circumcision as a preventive measure against HIV and C-section deliveries as a preventive measure against mother-to-child transmission. By constructing three surgical theatres, the total operating capacity of the hospital will be increased substantially.


Planned Project Budget

Based on a comprehensive feasibility study and a participatory planning process the projected budget for the rehabilitation of the surgery wards and operation theatres at St. Elizabeth has been set at 1.8 million Euros in total. The vast majority of this budget includes investment costs. The construction of the ward needs to adhere to high technical and hygienic standards according to national Tanzanian regulations and totals more than 800,000 Euros. The project also intends to procure the medical equipment for the theatres; almost 600,000 Euros are budgeted for this component alone.

The vast majority of this project will be financed by the Federal German Ministry of Development Cooperation (BMZ). However, the BMZ funding requires a 25% self-contribution of the project budget to be covered by the German NGO´s “action medeor” and “Partnership for Africa”, 460.000 EUR in total. To finance this funding gap of 460.000 Euros action medeor and Partnerschaft für Afrika are asking for your help. We are looking for committed partners who can help us fill this gap. Any help is welcome!

How you can help

  • The two bigger operation theatres will cost 140.000 EUR, dthe smaller one 95.000 EUR
     

          Sample for a new and sterile theatre

  • The orthopaedic equipment will cost 57.000 EUR

    Samples for new orthopaedic technical equipment for the new theatre

 

  • The sterilizers will cost 85.000 EUR

          Samples for sterilizers for the new theatre

  • For 55,000 Euros, your contribution could ensure that no power cut will put anyone’s life at risk. This amount would cover the 80 KVA back-up generator with automatic switch, which kicks in when the power goes off. To cover the few seconds until this happens, the hospital needs to install an UPS (Uninterruptible Power Supply) which keeps lifesaving machinery going before the generator kicks in. This system also includes a stabilizer which protects all the equipment from high voltage loads when the power comes back.
  • For 40,000 Euros, your contribution could finance the expensive, but urgently needed anaesthetic machinery. In total we need two of these.

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    Sample for anaesthetic machine for the new theatre

  • Also priced at 40,000 Euros is the ventilation system. Capable of 20 air changes per hour, this system is crucial to reduce the risk of infection, not only to the patient but also to the operating medical staff
  • You are into monitoring and supervision? For only 28.500 Euros you can contribute to the project by financing the local supervision of the construction works through a local team of architects, structural and electrical engineers. For only 6.000 Euros you can help finance the new incinerator which will have to be constructed, so that the medically contaminated material can be safely treated without any risk of environmental contamination and disease transmission.

  • The capacity building component is also a great opportunity for support. The hardware and the infrastructure alone do not guarantee a project’s success. The hospital management and financial controllers will be trained and further qualified to ensure solid bookkeeping and strategic management of the new surgical ward and the hospital in general. Additionally, the medical staff will receive tailored training in quality and hygiene management and the surgeons will be trained how to run a surgical ward at ideal capacity. This component is currently budgeted at 69.600 Euros.

 

Background information

In 2011, the reputation and outstanding work of the hospital led to an agreement with the Government of Tanzania which upgraded St. Elizabeth to a so-called Council Designated Hospital. Under this arrangement, the Tanzanian was willing to pay staff salaries and all medicines and medical supplies, while the hospital would offer services like any public hospital and thus serve all pregnant women and all children under five years free of charge. The day the agreement was signed, the amount of surgeries and medical treatments started to increase.

The Tanzanian Ministry of Health has investigated the current operating theatres in St. Elizabeth and has already highlighted the deteriorating state of the facilities. Applying existing rules and regulations, the government could close the theatres at any time. While the financial support from the government covers staff and medical supplies, St. Elizabeth has to finance maintenance and construction of the infrastructure through own funds. As the hospital is struggling to fund its day to day operations, its management team approached action medeor and Partnerschaft für Afrika to ask for support.

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