St. George's Church, Pontesbury,
Shropshire, England
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Pontesbury - Muheza Link.......... Improving primary health care in rural Tanzania
All the photographs on this page have a link to a larger view, mostly about 500 KB. To return to this page, use your browser's Back Button. Photographs courtesy of Dr Ian Bradley.
New Wards at Maramba Health Centre St George's church is glad to be associated with other churches and individuals in Pontesbury in raising funds to support 'The Pontesbury Muheza Link'. HistoryA charity, Community Health Care Direct, (CHCD) was conceived in May 1993 for the purpose of supporting basic health care in the Muheza District in the Tanga Region of Tanzania. In 1994 they invited Dr. Ian Bradley to visit to initiate their scheme. In 1996 Ian took early retirement from the G P Practice in Pontesbury, Shropshire, to work alongside CHCD and become involved in other ways of helping to improve the medical care in the Muheza District. During 1996 The Pontesbury - Muheza Link was formed. The objectives of the Link as stated in our trust deed are:- to enable the provision of medical services in the Tanga region of Tanzania, including education and support of medical personnel, and the relief of hardship in the region. Each year since its formation the Link has organised an evening when Ian gives an illustrated update on his work. Other fund raising events are held and many individual people, churches, schools, clubs and groups in the area raise funds or collect goods to support the work in Muheza . No member of the committee receives an honorarium and Ian pays his own travel and living expenses. Village Health Workers (VHWs)The Muheza District has a population of about 280,000. Of these 90% live in rural areas and 80% have a five hour walk to their nearest government health facility. VHWs are trained to offer help to people in their own villages. Each village selects one or two people, preferably one male and one female, who they think will be suitable to train as VHWs.
A group of 30 village health workers In 1994 the VHWs were not being supported and none were found working in their villages. VHWs are now active in over 70 villages. After initial training the VHWs receive a supply of ten basic drugs and dressings to treat the common illnesses found in their villages. Worm infestations are common and most can afford to pay for this medication but how much better to prevent the infestations. VHWs are continually reminded that health education is the most important part of their work. However they have an uphill task encouraging every household to dig its own pit latrine and ensure their drinking water is safe.
A Village Health Worker at his post Apart from employing a VHW coordinator no government money is available to help. The village is required to provide a suitable building to use as a village health post where patients can be seen Patients pay a small fee for each visit but this does not cover costs.
A Village Health Post nearing completion CHCD (operating as Medicines Education Africa in Tanzania) provides initial training and regular drug kits. As the VHWs have had only minimal training supervision and continuing education is vital. Each time the VHWs collect their drug kits their records are checked and any mistakes discussed.
A Village Health Post in use The Link supports annual refresher courses for the VHWs. In 2001 the Link raised money for a motor cycle to enable the VHW coordinator to undertake supervision in the villages. Health Centres and DispensariesThe Muheza District has four health centres and fifty four dispensaries. Dispensaries see out- patients and provide child health and maternity care. Health centres have similar facilities plus a laboratory and in-patient beds. The government is responsible for these health facilities but until recently has not provided for their upkeep. The Pontesbury-Muheza Link has raised money for repairs and sent out beds, mattresses, sheets, blankets, theatre equipment and many smaller items. These goods have been sent in shipping containers shared with support groups in Bristol and Hereford.
Ian Bradley inspecting goods from 'The Pontesbury Muheza Link' arriving at the store in Muheza Because of increasing customs scrutiny and other factors, we are no longer collecting items to send by container. Maramba Health CentreThe Maramba division of the Muheza District has a population of 62,000. For the first time there is a doctor at the Health Centre and facilities for surgery needed to be provided. The British International School of Jeddah raised funds to enable the Link to provide an operating theatre and two small surgical wards.
Maramba Operating Theatre In 2003 the Link funded the building of two new wards. Last year a garden trail in Pontesbury plus some individual donations raised enough money for ten new beds. St George's ' Friday Club' in Pontesbury raised the money for ten mattresses.
Original Maramba Women's Ward
New Maramba Women's Ward built by The Pontesbury-Muheza Link to alleviate overcrowding Unfortunately the Tanzanian Government has not come up with the promised extra staff so these facilities are not yet being used to their full potential but patients no longer share a bed. In 2005 the Muheza District was split into two with Maramba in the new Mkinga District. It is possible that the Maramba Health Centre will become the Mkinga District Hospital. This could offer an exciting challenge to the Link. Mjesani Health Centre
Mjesani Health Centre Men's Ward before refurbishment
The same ward after refurbishment Mkusi Health Centre
The Women's Ward at Mkuzi Health Centre before refurbishment
The same ward after refurbishment Mobile Clinics
The Mobile clinic The maternity and child health units at Muheza District Hospital and Maramba Health Centre visit villages which do not have easy access to a health centre or dispensary.
Judith Mkondo, 'Village Health Worker Trainer' at work in the Mobile Clinic Health education is given along with routine childhood development checks, immunisations and ante- natal care. At present the Link is supporting monthly visits to ten villages. Water SuppliesAs with so much of the underdeveloped world shortage of water is a problem. Muheza has a piped supply but it can run out in the dry season. As much as 60% was lost by leaks. A sponsored canoe event on the River Wye raised money for 110 water meters. These are now bringing in money for much needed repairs. In 2005 the Link helped purchase a motor cycle for the water department. Maramba Health Centre had massive leaks from their water supply. In 2000 the Link funded the replacement of all the external pipes. The nearest water supply for Mkuzi Health Centre was a well, one kilometre away.
Mkuzi's original water well In 1997 a rainwater collecting system was rebuilt. During the rainy season this supplied all the water needed but the storage butts held only about a week's supply.
Hygenic standards are maintained Last year the Link funded the building of large underground storage tanks which the district water engineer has calculated will provide water for all the year.
Mkuzi's new underground water storage facility and header tanks The system has only just been finished so we wait to see if his calculations were correct.
Mkuzi's new clean water supply Support for EducationA very good feature of medical training in Tanzania is a system of "upgrading". This enables someone with a basic qualification to obtain a higher qualification by taking a shorter course than a person starting from scratch. Grants have been given to sixteen people to enable them to undertake upgrading courses. Three clinical officers have upgraded to assistant medical officers, giving them the title "Doctor". Nurses, laboratory staff and health assistants have also been given grants. Other ProjectsContainers of goods have been received from Pontesbury and other areas in Shropshire and Hereford. St George's 'Friday Club' raised money and provided a bicycle for Rev Edward Haule who worked in a remote parish.
Rev Edward Haule on his bicycle As well as medical items sent out in the shipping containers, well over one hundred sewing machines have been sent to Muheza by the Link. They go to various sewing classes run by various churches.
Peter Rajabu, Director of the Kwamkono Polio Hostel checks sewing machines as they arrive
The sewing machines are quickly put to use Pontesbury Cubs raised money for torches, rechargeable batteries and solar rechargers. Groups of ladies within Shropshire and much farther afield have been furiously knitting teddy bears. These are now a sought after item by children in the Muheza District. VisitsNo description or photograph can convey the same appreciation of a situation as being there. Lasting bonds have been created by sharing time with people from both ends of the Link. We have welcomed three visitors from Muheza, two clinical officers, Grace Samba and Julius Muruma and a nursing officer, Agnes Mbwana.
Grace Samba, the Doctor in charge, Mkuzi Health Centre helping out in the kitchen
Julius Muruma, doctor-in-charge Maramba Health Centre, outside theatre wearing a suit he bought during his visit to Pontesbury.
Agnes Mbwana, district school nursing officer, with AIDS orphans who have just been given uniforms and exercise books. Our guests spent time observing how medical care is delivered here and met many people in the area. Julius Mruma learnt that in England men help with the housework! We are sure he learnt other things as well! All three of these visitors maintain contact with people they met while here.
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