News from Mvumi continues to give cause for concern. David McKelvey in a recent email wrote that they had a shower of rain which was the first for a month. A lot of the maize is past hope, but some may recover if the rain continues. The prospects for the region with another iminent crop failure are truly aweful. A lot of patients coming to the hospital, especially on the obstetric and children's wards, are suffering from anaemia, but the hunger fund is begining to alleviate problems for those in need. The effects of the drought in the region can be seen in this typical story from Mvumi:-

Recent letters from Mvumi continue to paint a worrying picture of the worsening famine in the region. Two very poor harvests in succession are causing a famine which is already proving to be harder than the "hunger" witnessed last year. Lack of food is driving people to extreme measures with fights breaking over the "unfair" distribution of Government food aid, an increase in food related burglaries and women are walking back from the grinding mills in groups through fear of being attacked for their food. Grain prices are spiralling upwards, but the bottom has dropped out of the cattle market as the animals lose weight and their owners run out of forage. School attendance is dropping as parents cannot afford the fees and parents are being taken to court for keeping their children at home.

The rains, which started late, stopped after two weeks and the first sowings of crops have wilted in the ground. Each new day brings more sun and cloudless skies. Even if the rains return tomorrow the harvest will be bad because the growing season will be shortened. Malnutrition is on the increase and children weakened by lack of food easily succumb to other diseases such as malaria and dysentery. International nutritional experts are becoming concerned at the levels of malnutrition in the area. There is a desperate need for external aid to provide food and medicines before the situation worsens. Thankfully, as they did last year, Tearfund have recognised this need and have already contributed £10,000 which will be used to subsidise treatment for mothers and children in the hospital. The Friends of Mvumi are continuing to collect money for the hospital hunger fund and your donations will save lives. A prayer letter from David and Liz McKelvey has been sent recently.

Later this year, Dr David McKelvey, his wife Liz and three children Grace, Tara and Isaac will be returning to England. The Mckelveys have been in Mvumi for nearly six years and David has been a key person in the hospital serving both on the management committee and as head of the Overseas Link Committee responsible for ordering drugs and liaising with the Friends of Mvumi Hospital. With their return there will be a vacancy for a Christian doctor with general medical experience who is willing to spend at least three years abroad, but preferably six. The post is being funded by the Church Missionary Society (CMS) and further information of this and other medical posts with CMS can be found here. here.

Ten months after its launch on the World Wide Web, Mvumiweb, the Mvumi Hospital web site has had over 10,000 visits. The number of "hits" per week currently runs between three and five hundred with some visitor's spending as much as 90min browsing the site. The response has been far bigger than expected and many enquiries have been made by medical and nursing students wishing to visit the hospital. More importantly perhaps, visitors to the site have donated equipment to the hospital and an American carried out a sponsored walk for the 97/98 Hungerfund. We hope the response in the next year will be equally good and that donations to the hospital increase as a result. Details of the visits to the site can be found here.

After two years of bad harvests in the Dodoma Region of Central Tanzania food shortages look set to continue with a late start to this years rains. Dr David McKelvey wrote in a recent letter "We have had only one shower of rain so far, and folk are getting rather worried...........maize is £4 per bucket compared with £2 last year. It looks like this may well be a worse year than last". In 1997 the drought led to widespread crop failure and in 1998 El Nino brought torrential rains which washed away many early crops and flooded fields, and widespread infestation by army worms and shield bugs ate the remaining crops and new shoots. After two years of dire food shortages the people have no reserves to face another year of famine, but the late arrival of the rains will undoubtedly reduce the size of this years harvest and the people will face more famine in 1999. A major fear in the hospital is that poverty caused by the famine will prevent people from seeking urgently needed medical attention. With no crops of their own the people will be hard pressed to find enough money to buy food imported into the area. With the cost of maize already double the price of last year, medical treatment will become a low priority within the community. To alleviate this problem, The Friends of Mvumi are continuing the hunger fund set up in 1997 to subsidise treatment fees for impoverished patients. In 1998, by heavily subsidizing medical treatment, drugs and food while in the hospital, unprecedented numbers of patients came for treatment. Such subsidies are however expensive. Amazingly in 1998, the fund collected over £42,000 and Tearfund contributed a further £10,000. It is likely that similar amounts of money will be needed this year. If you can help, please send a donation to the hospital via The Friends of Mvumi.

The "Relative's Camp" provides a number of buildings in which the relatives or friends of patients at the hospital are able to sleep and prepare meals while caring for their sick. The complex has needed renovation for several years and in 1998 work was begun. The first phase of the re-development has now reached completion. A major part of the re-development has been the long awaited building of a Maternity Waiting Hostel where pregnant women, particularly those known to be at risk, could await delivery. With help from The Friends of Mvumi, £10,000 was raised to build the hostel and the first bricks were cast in August 1998. The hostel soon came to completion and is now open and provides about 20 beds for women in need. Previously, pregnant women with problems would normally have waited until labour started before coming to the hospital. Now many will be able to come to the hospital before they get into difficulties and much suffering to mothers and babies will be avoided. In a recent letter to The Friends of Mvumi, however, it was noted that another £4,000 are needed to build new pit latrines, a kitchen and to renovate the old hostel area.

Following the water survey work carried out in 1998, drilling operations at Mvumi Hospital recently struck water at only 69 metres. The hospital katibu (Administrator) Vincent Chiwamba remarked " It was a wonderful sight during the reaming process to watch plenty of water shooting almost into the sky". The Chinese driller was very happy and said that it was the most successful borehole he had seen in the Dodoma area. The hydrogeologist Mr Bago for WaterAid had witnessed 20 boreholes being made in Dodoma region, but the Mvumi Hospital borehole was "exceptional" and a comparable one at Kisima cha Ndege was only successful at twice the drilling depth. Initial pumping tests suggest that the new borehole could yield up to 30,000 litres of water per hour compared to the present one which only yields 6,000 litres! Of course, pumps have to be bought and pipe laid to connect the new supply, but it looks as though the borehole, funded by a Dutch charity, will satisfy the hospital's water needs for the foreseeable future.

The Friends of Mvumi have recently become part of the Charity Card and World People schemes so that it is now possible to make a donation to the Mvumi Hospital using the Charity Card. The Charity Card also provides a secure donation page so that it is now possible to make on-line donations to The Friends of Mvumi over the internet from this website. By donating via these schemes, tax is automatically reclaimed for UK donors thus increasing the value of donations by 23 %. We hope that by joining these schemes The Friends of Mvumi will be able to raise extra funding to help Mvumi Hospital.

Population Services International (PSI) have selected Mvumi Hospital as one of their target areas in their DfID (Department for International Development) funded project for the Social Marketing of Insecticide Treated Nets (SMITN). The SMITN project aims to increase the awareness of the need to use bednets to prevent malaria and will create demand for bednets which they will supply through the hospital pharmacy and by specially trained agents in every village in the district. The agents work on a commission basis, but the nets are priced at a level which is affordable to most of the community. The SMITN team, who are based in Dar es Salaam, will visit each village and will promote the use of nets using social marketing techniques such as competitions, videos, plays, dance and music to raise awareness. The bed nets are marketed under the name NJOZI NJEMA which means sweet dreams and T-shirts and baseball caps are distributed to selling agents and during marketing drives to raise the profile of the nets. The insecticide is sold separately and is heavily subsidised so that it is affordable and is marketed under the name NGAO (shield) in individual packs which come complete with visual instructions and protective gloves. Already several hundred nets have been sold together with the NGAO. Widespread use of impregnated nets would have a major impact on health in the area. Trials in other countries have shown reductions in all causes of death in children under five by as much as 30% due to the use of such nets.

Bednets impregnated with insecticides such as Permethrin can reduce hospital admissions of children due to malaria by nearly 50% according to statistics gathered by Mvumi Hospital. Impregnated bednets, which were part of an aid initiative from the Japanese Government, were distributed to each household in Mvumi. Data from the hospital admissions showed that in the two years following introduction of the nets there was a large decrease in admissions and death due to malaria in the children of Mvumi. To continue their effectiveness the nets have to be treated with insecticide on a regular basis and a fund set up when the nets were first distributed has been used to do this. It is hoped that the nets will continue to have a positive effect in reducing malaria in the immediate area. Malaria is the primary cause of disease and death in Dodoma Rural District and the widespread use of impregnated bed nets would have a major impact on health in the region.

Two girls in the TB ward enjoying the benefit of the new bednets.

A worker from Voluntary Service Overseas while visiting Mvumi Hospital contributed £70 to equip the tuberculosis ward with insecticide impregnated bednets. Not only do the nets reduce the likelihood of getting malaria while in the hospital, they also provide valuable health education. Patients feel an immediate benefit from sleeping under a bed net because they are not disturbed by mosquitoes and see the effect of the nets by the numbers of dead insects on the floor! The patients are told how the nets work and it is hoped that they will buy them to use at home. Because impregnated bednets are not available locally, Mvumi Hospital now keeps a supply of the nets at the hospital Pharmacy, which are for sale for £4 each. The hospital also sells dipping kits complete with protective gloves, Permethrin and easy to follow instructions for re-treating the nets each year. Each kit costs only £0.30 and will provide protection for six months of the year, during the rains, when the risk from malaria is at its highest. Mvumi Hospital is trying to equip all the wards with impregnated bednets and the Matron, Mrs Ny'angulu, says that 162 nets are needed to complete the task.