HSA Rehabilitation Project, KCMC, Moshi, Tanzania

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1 HSA Rehabilitation Project, KCMC, Moshi, Tanzania November 2010 Report Russell Clark There has been no major action for this project for 2010, and no meetings by the steering committee, but action has been happening! This is a brief report to give some news about KCMC and then to report on two important areas. The current situation at KCMC Prof Shao, the Executive Director (EDR) has retired from this position and his replacement is Dr Moshi Ntabaye. To date he has not been briefed on the project by us.. I will do this in the near future, and show him the documents we have been working with. I think Prof Shao is around in some capacity eg vice chancellor of Tumaini University, but as he does not answer s, we cannot make further progress with him. Haleluya (see below) has met Dr Ntabaye and has explained the situation to him. Haleluya has reported that he is pleased to discover that Haleluya is being sponsored by HSA. I have heard from other local sources that the three major building projects, one including the extended orthopaedic ward, have not progressed this year, meaning there is little more than foundations. It s possible to see something of KCMC according to its website ( kcmc.ac.tz). Both the Director of Hospital Services( Mark Swai) and the Director of Nursing ( Redempta Mamseri) continue and know something of the project. More importantly, Harold Shangali, The Dean of the Faculty of Rehabilitation (Haleluya s immediate boss) and Director of the Tanzanian Centre for Training in Orthopaedic technology ( TATCOT) is both present and active. It is worth looking at the website to get a sense of how important Tatcot is. Next year it hosts the sixth International Conference for ISPO (International Society of Prosthetics and Orthotics), a considerable honour.. Mr Shangali is a strong supporter of the project. It is my recommendation, that we do little towards the project until Haleluya returns to KCMC in 2012 working in some position in Physiotherapy Haleluya Moshi He is our sponsored, KCMC- trained, physiotherapist from KCMC Haleluya is coming to the end of his second semester and first year at Western Cape University. He performed well in the first semester and is currently doing exams. He has worked hard and is grateful for this opportunity to study Physiotherapy at an advanced level in an internationally recognised prestigious university. He has one year to go, and we have been informed by the university that the year after ( 2012) he will need to return for a short visit to defend his thesis. The inflation rate in South Africa has been 10%, but is now down to 3.2% Despite this the University has charged 20% more than anticipated back in 2007 when budgeting estimates were made, and has increased charges again for next year. With the payment to Ridley Smith for the architectural drawings and these costs for Haleluya, the pot will be completely empty by July 2011, and all up ( including two air tickets), this has cost around A$20,000 for not a cheap course!. So, to date we have produced a good plan, good drawings and, God willing will produce a good leader for clinical rehabilitation.

2 Zacharia Massawe and FOP (Friends of Paraplegia) Zacharia is a remarkable man. He became paraplegic from an undiagnosed and untreated epidural abscess when aged 17. He tells his story as follows I was born in Mweka village in Moshi Tanzania 44 years ago. In 1983, I developed an abscess in the spinal cord, which caused me paralysis from chest down. I got married in 1999 and have two sons (Michael aged 7, Emmanuel born 2010). My wife is a real blessing to me, as she has been at my side despite all the difficulties and without complaining! Since I have experienced most of the complications that come with spinal cord injury, I have decided to dedicate my efforts to finding solutions to these problems, for myself and others. I have attended various workshops; training and seminars regarding disability and life after spinal injury, both locally and internationally. For a living, I teach Kiswahili (the local language) to foreigners and English to the local people. I also do translation from time to time I used to collect Zacharia, his wife Marianne and son Michael and take them to the KCMC chapel, and Zacharia helped Kay with her advanced Swahili. Zacharia is one of the success stories of KCMC. Last year Zacharia established Friends of Paraplegia ( FOP) with the help of a Dutch occupational Therapist and an Irish doctor. It is an inspiration to read the webpage at The aim is to help fellow paraplegics to live in some sort of home The UNSW medical school at St Vincent s hospital, Sydney, have taken on a project to help Zacharia and FOP. This starts with learning about paraplegia in Sydney, and then hopes to develop a buddy system with paraplegics in Tanzania through Zacharia. It is in the beginning phase but the following extract from the students written following the first visit to Paraquad shows their enthusiasm Reflection by the students following the visit to Paraquad, Sydney Our team was very privileged to spend quality time at ParaQuad, NSW. Prior to this visit, we had negligible experience with non-hospital-affiliated facilities. We realised within minutes how fortunate we were as we found out how busy they usually were. For example, a team of 4 had visited and assessed over 300 homes last year, and 1 person usually has about 35 clients at any one time under their care. Hence, we were very honoured to be in the company of 3 valuable members a board of director of a peer-support group (also a paraplegic), a social worker, and a public relations manager. Through our time with them, we were awed and grateful toward their hospitability as they graciously offered their assi stance to our project. We were also exposed to the widening gap between hospital and community services provided to patients, and unfortunately, some fall in between these cracks and are denied important services and management. We realise how important community-based rehabilitation is to ensuring patients stay at home comfortably and safely. However, some may be denied services that are actually available due to disjointed systems between the hospitals and these facilities. It would be simpler and more effective for both patients and hospital if transitions from hospitals to homes were seamless - provided that patients were organised with appropriate community-based services. This experience definitely taught us how vital community-based

3 rehabilitation is in providing quality all -rounded health care, and our roles as future doctors in ensuring that patients receive appropriate management even when they leave hospital. Further action Paraquad have invited Zacharia to write a column about being paraplegic in Tanzania for the next Paraquad magazine. This is produced four times a year and circulates to several thousand members The students will continue with this project next year, producing educational material suitable for Tanzania in an electronic format. Also they will facilitate the development of a buddy system. Between Paraquad and FOP.

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