News from Mvumi Hospital

The McKelvey family return to UK after six years in Mvumi.

David and Liz McKelvey receiving some parting gifts in Mvumi.

David and Liz McKelvey, together with Grace, Isaac and Tara, have recently returned to the UK after working at Mvumi Hospital for the past six years. They have contributed an enormous amount to the Hospital in so many different ways during this time. As I look back, three of their gifts strike me in particular:-

Camp, the new borehole, the renovation of St Peter's Church for hospital and school use, the IV Unit and CSSD (in memory of their daughter Lydia), the pharmacy stock control system, the Hunger Fund.

- their tremendous gift of communication, not only in keeping us regularly informed of the situation in the hospital, but also helping us to understand something of the joys and hopes, the pain and anguish of life for those around them, and bringing vivid stories of some of the patients who have come to Mvumi. When they first left the UK to go to Mvumi, they said that they wished to be like a window, allowing those outside Tanzania to see in, and they certainly have enabled us to feel so much closer to those whom we support.

- their love and compassion for the people they have lived amongst and served, which shone through all that they did and wrote. The love which is felt for them by both hospital staff and village people was also very clear to me when I visited Mvumi in 1995 - they will be sorely missed!

We wish them well as they settle back into life in the UK.

Kate Goodacre

 

 Chigonela Maternity Hostel - Reaping the benefits

Expectant mothers gathered on the steps of the Chigonela Hostel.

In the last newsletter we were happy to report the opening of the Chigonela Maternity Hostel and we are delighted to report its continuing success. The hostel allows pregnant women to come to the hospital much earlier before delivery, thus reducing emergencies and allowing appropriate care if complications arise. To gauge the success of the hostel, visiting medical students compared the delivery statistics in the hostel during the first six months of 1999 with hospital deliveries in the same six months for 1998. There is a very clear difference between the two periods. Not only had the number of high risk pregnancies from distant villages, our primary target group, gone up, but in fact the number of all deliveries had gone up. Women clearly feel comfortable coming to the hospital and that is evident in the numbers attending. That is a real joy and its success is due not only to the building, but also to the efforts of the hospital staff and especially of Felista Mwano who is the supervisor of the hostel. Felista is a delightful retired midwife whose gentle spirit is without a doubt one of the main reasons for the success of the hostel.

 

Borehole completed!

David McKelvey measures the water flow from the new bore hole at Mvumi.

The new hospital bore hole is now functioning fully. It was a great day when the pump in the new bore hole was finally switched on. Fortunately, it was found that water pumps were much cheaper in South Africa and David McKelvey's brother Paul donated a pump,which he sent out to Mvumi. The pump specification was 12,000 litres/hour and when it was switched on fulfilled expectations and delivered the full amount. For their last few days in Mvumi the McKelvey's reported great water pressure from the bore hole.

Water of course will be a perennial problem in Mvumi and water conservation is still very necessary to ensure long-term sustainability of supply. With the donation of the water pump from Paul McKelvey there was still some money left in the water fund, which has allowed the hospital to continue with the other arm of water management, that is controlling its use. Each of the staff houses is now being fitted with a 500 litre storage tank. These tanks will be filled at night and during the day the line will be switched off. Thus there will be quantifiable demand, and each house can use the water as they see fit either using it, giving it away or watering the lettuce! This part of the project is still in progress

As with many things in life, there were problems in setting up the bore-hole. Unfortunately this was the case with the pump, and we have heard that due to a combination of a wiring fault and TANESCO's (the government electricity company) unreliable voltage, the pump motor has burnt out. A new one is being sought. However, it has demonstrated the strength of the system in that with the new bore-hole out of action, the old one can still be run

If you read the last new letter carefully you may be wondering why the bore hole is not pumping 30,000 litres/hr, which is the theoretical yield of the bore-hole. The reason for this is that the bore-hole was only drilled to accommodate a 12,000 litre/hour pump. In the future, should the hospital require more water, the hole can be reamed out to fit a bigger pump and further surveys will not be necessary.

 

The hunger fund - A continuing need

Patients queue for food supplied by the hunger fund in 1998.

There is no doubt that in the last 2 years of running the hunger fund that many lives, especially children's, have been saved. This has been especially so in the last year, when people were already at a low ebb from the second year of famine. One thing that was amazing was the way that Monday mornings in the outpatient's were tremendously busy and there were always many very sick children. The hunger fund meant that fees were able to be substantially subsidised, so that the children only had to pay an admission fee for treatment. At the weekends the fee was 30p compared to 5p on weekdays. The crowds on Monday mornings showed clearly that for a mere 25p people kept their sick children an extra day at home. One wonders how many patients would have been admitted if there had been no hunger fund, and the cost of outpatient treatment for malaria was the normal price of £1.50.

The rains that fell in Dodoma region early this year were very patchy. Some of the villages a in the region have got a reasonable harvest, but in Mvumi and close by it was poor again. Many of the shambas were planted 4 times over, and some were having to rely on food aid as early as July. So again it will be a year of hardship, and our thoughts and prayers are in Mvumi that as they clear the fields ready for rain, that God will bless them with a good harvest. However until that harvest next June, Bishop Mdimi Mhogolo has asked that again we give whatever help we can.

 

Computer usage at Mvumi Hospital and appeal

The secretaries, Esther and Octovia and accountant, Adam, at the Clinical Officers Training School getting to grips with information technology.

Technology is not really taking Mvumi by storm, but a number of computers have started making an appearance. The first ones on site were in the medical assistant and hospital technician's schools, where they have proved very useful, not only for letters, notes, exam results, and government returns etc., but also for wedding invitations! Since then there have been a couple provided for the admin staff, nursing and laboratory schools. The staff are very eager to use them and quick to learn and being able to use a computer adds job satisfaction.

The experience of pharmacy: David McKelvey had been in charge of pharmacy for the best part of 6 years. In that time he had used manual stock checking system, with the aid of his own computer to generate orders. When he was due to leave he thought that it might be appropriate to try and put the stock control onto the computer and teach the newly recruited pharmacy technician George Abdullah to handle the system. David's father in law helped set up the framework on a spreadsheet and George soon got the hang of it. George now puts the data from the pharmacy, general store, and X-ray department onto the computer situated in the nursing school. It is hoped that the laboratory store will soon follow so that the hospital can have an accurate valuation of the items in stock. This in turn will greatly help the monitoring of the revolving fund which encompasses all these stores.

The possibilities for records: We have a delightful young lady called Damian working in the records department. Under her leadership we have changed the numbering system of the notes so that the outpatient and inpatient records share the same number so there is only one set of records per patient. Damian while training in record keeping at Kilimanjaro Christian Medical Centre learnt to use computers to facilitate record keeping. She is very keen to get a computer to help her task at Mvumi.

Recent problems: Some months back the computer in the hospital technician's school developed a problem at the crucial moment of printing out the course exams. Although they had a back up, there was a big problem because they were not using the same software as the other computers in the hospital.... thankfully it was sorted out in time for the exam.

It would be a great boon if the hospital could get a number of computers, 486 or early pentium type PCs. Each with compatible software installed, and the staff could then be trained in their use. So are you about to upgrade your old computer? Or are you computer literate especially in Work, Excel, and Access and have 3-6 months to spare for training in Mvumi?

Mvumi Hospital plays leading role in malaria control in Dodoma region

A flyer describing the SMITN project.

Those who have visited Mvumi Hospital will realise the importance of malaria. Malaria is the major cause of outpatient consultations, admissions and deaths in Mvumi Hospital. It is still a major killer amongst children under five and is an intolerable burden on those unable to afford prophylaxis. Historically, attempts at controlling malaria have centered on mosquitoes which spread the disease, but the optimism of the sixties, when it was thought that they could be completely eradicated, has given way to a more pragmatic approach. It is now generally considered that the use of insecticide treated bed nets (ITNs) is the most effective means to reduce the disease in susceptible populations. Such nets, treated with insecticides (usually synthetic pyrethroids) kill any mosquitoes which land on the net and also reduce the number of insects in the rooms in which they are hung. In a Japanese government funded project held in Mvumi in 1994 it was found that the use of bed nets reduced malaria admissions to the children's ward by about 50%! In addition, other studies have shown that the severity of attacks is also reduced when ITNs are used.

The fruits of these studies are now being applied to villages across Dodoma Region. In conjunction with Population Services International the hospital, under the guidance of Dr Alison Talbert, is promoting the use of ITNs in the villages. The SMITN project uses social marketing techniques to sell ITNs and insecticide to the villagers at subsidised prices. The project "employs" agents in each village to sell the products on a commission basis and there are now 60 outlets in 25 of the 48 villages in the catchment area for the hospital. Each village launch is accompanied by plays, competitions and singing to put across the message and agents are given T-shirts and baseball caps, which advertise the nets and insecticide. The agents and customers are able to get their supplies from the hospital pharmacy and they are also sold by the hospital on health safaris to the local villages.

Since the launch of the Mvumi SMITN project in June 1998 to the end of August 1999 a total of 3993 nets and 4834 packets of Ngao (insecticide) have been sold. Amazingly the coverage of bed nets has increased in the target villages from 5% of households at the start of the project to 21%. At a time when most households have been struggling with famine this is a remarkable achievement. It is not all plain sailing however. Re-treatment rates are still low and people perceive malaria to be a seasonal problem. Many have little money to spare on nets and insecticide and church and village health groups lack the capital to start their own projects. It is hoped that eventually everyone in the community will be protected by a treated net at night. The project still has several more years to run and its object is to become self sustaining.

In the meantime, those with nets will undoubtedly suffer less disease and an unforeseen, but important bonus for the householders is the reduction in cockroaches, bed bugs and other insects in their houses!

More information about the SMITN project and malaria in and around Mvumi can be found here.

New developments at the eye department

The new eye department clinic nearing completion in December 1999.

The eye-department is one of the busiest in the hospital and offers everything from new glasses to laser eye surgery. Not surprisingly it is a referral eye centre for patients from all over Tanzania. Over recent years anyone trying to get into the eye ward on a clinic day will know how congested it gets. The space was just not adequate for the number of patients waiting to see the doctors let alone the students on ophthalmic courses. Christoffel Blinden Mission (CBM) agreed to fund the building of a new clinic block between the obstetric ward and nursing hostel. This is opposite the eye glass workshop and is en route from outpatients to the eye ward. It will comprise of a number of treatment rooms and stores and will be a great boon to patient flow and management in the eye department. The foundations have been laid and the clinic is nearing completion ready for the new millennium.

 

 Oxygen concentrators, other gifts and small projects:

A patient undergoes treatment using one of the new oxygen concentrators.

A whiff of fresh air: At last the new oxygen concentrators have arrived in Mvumi. How wonderful. There are now enough concentrators for the theatre and labour ward and there is a spare machine which can be moved around as needs arise. With the oxygen concentrators came 2 pulse oximeters. These measure the amount of oxygen in the blood of a patient via a probe clipped on a finger. They will also be a great boon. David McKelvey well remembers when a staff child needed oxygen and it was very difficult to work out just how much to give. Now it will be much easier.

A stitch in time..... Among the other gifts that have arrived at Mvumi has been a regular supply of gloves, plaster casts, sutures, catheters and instruments donated by Johnson & Johnson Medical with the Friends of Mvumi paying for transport. Contact was first made through the Mvumi Hospital web site and there is now a regular flow of much needed supplies going to the hospital. With AIDS in the Mvumi region increasing the availability of the gloves is especially welcomed by the doctors and nurses at Mvumi.

 

Beating the bounds: Mvumi is a growing town; there are 4 buses per day going to Dodoma and the number of houses and corrugated iron roofs grows every day. The hospital has been very aware that it's borders have been slowly encroached, and even trespassed. The only title deed the hospital had was given by the German colonial government! Mvumi Hospital together with all the other organisations of Mvumi Mission which include. the secondary school, the agricultural project, the church project (carpentry workshop and mill etc.) and St Peter's church have succeeded in getting the borders officially registered. The old markers placed near baobab trees, and now well eroded, have been replaced with new numbered posts. It is a small, but vital step in securing the future of the hospital.

Medical records: Damian, Mvumi's record clerk, has been implementing a new records system at Mvumi. This will use a unit number system and so it will be possible to combine both the in and out patient records. This will greatly simplify the record keeping process and should enable better monitoring of patients and much easier analysis of patient medical data. As part of the scheme it was desirable to start using files for each patient and so Friends of Mvumi has made a donation to enable a bulk buy of manila card to get this started off.

The hospital fundi running up the new sheets for the wards.

New sheets for the hospital: Thanks to The Friends of Mvumi the hospital can now boast some new sheets for many of the wards. The material was bought locally, which is cheaper, and the hospital "fundi" ran up the material into sheets. They certainly will brighten up the wards and make life more comfortable for the patients.

Staff training: The Robert Atkinson Memorial Training Fund

Mvumi has been a bit short of nursing staff recently, but for a good reason - several nurses have been away on upgrading courses. It will be a great boon to have them back soon. Daniel Mahundo, has trained in anaesthetics and will now be a nursing officer. He will be coming back to the post of assistant to matron and will manage the theatre. His upgrading was sponsored by The Friends of Mvumi. Dr Ng'wandu, the acting medical superintendent, was recently sponsored on a course for ultrasound scanning and has taken over that responsibility from Dr McKelvey.

There is still a desperate need for money for staff training. The hospital needs another doctor trained in ultrasound scanning and Dr Makundi, working in the surgical department, hopes to go soon. Also more of our nurses are winning places on upgrading courses, but they are held back through lack of funds. These opportunities are essential in raising the standard of care at Mvumi and also give a huge boost to staff moral and reduce staff turnover.

"A Child Called Sunday"

Keith Sibson as a medical student in Mvumi about 6 years ago was one of the ones that you didn't see much. He was often away singing with a Viwayi choir at a weddings! When David McKelvey heard that he wanted to visit Mvumi again with his wife Claire, he asked if they would help in filming a video about Mvumi. They took up an idea of Kate Goodacre's to follow a patient through their stay and so they filmed the story of a child called Sunday!

The video will be about 1/2 hour long and be ready for January 2000 to mark 100 years of mission in Mvumi and will be available from the secretary.

Mvumi - A six year perspective by David McKelvey

Mvumi has a way of getting under your skin, and, I'm sure many will agree, of sometimes getting even deeper into your heart. It's really hard to put your finger on just what it is that makes it so, but at the end of 6 years it has touched and changed us; but how has Mvumi changed?

Although Mvumi is in a quiet corner of the "underdeveloped" world, it has not been immune to change. There are more tin roofs; the buses to Dodoma are bigger and more frequent; the shops have verandas in which you can drink

your cold soda; the main church has a PA system, a fan and there is an area Bishop (Askofu wa Kanda) seated in Mvumi Makulu. On the hospital side staff have been willing to work out a 5 year plan and try to work with it, and then change to other ideas when they come along. They have shown willing to learn about new things (like treatment protocols) and see whether they could be put into practice. I believe that the hospital is managing its finances better and has a better control of stock. This has been important as, although the price of drugs in country has not gone up over 6 years, (due to liberalisation and trade and improvements in the government medical stores in Dar es Salaam,) support from the government has lessened. Mvumi too has become more attractive to patients as "cost sharing" has been introduced in government hospitals and health centres.

The Chigonela hostel and Central Sterile Supplies Unit which David helped to bring about.

There have been "hair pulling out frustration/exasperation" days in Mvumi (the plans said like THIS!... Now pull it down and start again; or "Where is staff nurse?".... "She's just gone out briefly.") There are still ever so many possibilities for improving the care and teaching at Mvumi. And it is in the teaching schools that lies the "strategicness" of Mvumi. The students from the 5 training schools in Mvumi still go to work all over Tanzania and they learn from the hospital's clinical practice. In return for learning in the clinical area of the hospital, the "mother" hospital gains tremendous support from the schools through the help that the teachers and students give with the daily work. An example of this is Dr James Ngwandu, who is principal of the medical assistant training school, but has also agreed to act as medical superintendent. The situation is being further strengthened by the diocese taking over from government the running of the medical assistant's training school. The links with the government district medical office are good, and Mvumi now shares in the supervision of their dispensaries in our area (through community health team headed by Dr Richard Ntahonsigaye). Furthermore, the DMO is backing the very exciting district wide mosquito net project being run by Dr Alison Talbert. Dr Marilyn Scudder's & Dr Isseme,s work in the eye department spreads the name of Mvumi onto the lips of politicians & Asian shop keepers at the furthest corners of the country.

In short I believe that Mvumi is in a strong position to tackle the further changes that are ahead. But I cannot underestimate the impact that The Friends of Mvumi makes on the hospital. Without it much of the structural, organisational, and educational work would not happen. In fact the Hunger Fund over the last 2 years, not only saved the lives of many children, but by bringing in patients it saved the hospital from what could have been very difficult years financially. I personally, and on behalf of the hospital, would like to thank you for all your work and especially mention Kate Goodacre as secretary who has been a wonderful person to " have on the other end". Your continued support for Mvumi will help it tackle the next millennium.

We personally are finding our feet after the shock change of coming back to UK. The western rush of cars, schools, jobs, Tesco's, and the internet is tugging us along and we are trying to put down anchors in the simplicity of life that was in Mvumi.

David McKelvey

Sponsored walk by Johnson & Johnson by Sheila Storr

The Johnson & Johnson team during their sponsored walk.

"On the 3rd October 1999 a group of ten employees of Johnson and Johnson took part in a sponsored walk to help to raise money for the Friends of Mvumi Hospital. The Sunday afternoon walk took place along part of the Pennine way from Gargrave to the Buck Inn at Malham in N.Yorks. It poured with rain and we all got soaked, but we managed to raise a total of just over £750 for our efforts!

This small band of friends first became involved with the charity about 18 months ago when a quantity of gloves were donated and shipped to Mvumi. Since this time a number of similar donations of useful medical supplies have been made including gloves, catheters, sutures and surgical instruments and the walk was aimed at helping to offset the high costs associated with shipping these goods to Tanzania.

The group are now raising money to sponsor Robert Mtachi, who is currently working in the Medical Records Department, to attend a two year Medical Records course starting in September of next year."

 

'Music for Mvumi' @ Dronfield by Walter and Christine Williams

During the past two years we have held various fund raising events in Dronfield for the Mvumi Hospital Hunger Fund. The concluding Hunger Fund event this year was the idea of one of our younger church members, Tom Owen, who is fifteen. When he heard about the famine and severe malnutrition and sickness amongst children in Mvumi, Tom asked his young musician friends at the Parish Church and in the North East Derbyshire Music Centre Clarinet Choir to help him to raise money for the Hunger Fund.

Their response, a Youth Recital of 'Music for Mvumi' given in Dronfield Parish Church on October 16th, was an entertainment brimming over with musical talents, all for our delight. All the arrangements for the evening's entertainment were made by Tom and his friends and their initiative raised a total of £390 for the Hunger Fund. Well done!

 

Mvumi Secondary School on the Web!

I am delighted to report that following the visit of the Headmaster of Eton College, John Lewis, to Mvumi last year, the college is now hosting a web site for the school. The web site is very nicely put together with lots of photographs and news of what is happening and what is planned for the school. If you would like to find out more please visit the site at URL http://www.etoncollege.com/mvumi.html).

News items urgently needed!

If you have any news items concerning Mvumi Hospital or your fundraising activities. We would very pleased to hear from you. Please feel free to drop us a line at www@mvumi.org or write to the Secretary.

 

 

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Last modified 9th December 2000.
Comments emailed to www@mvumi.org welcomed.