Here is some news of recent projects. The support of the Friends of Mvumi in enabling these projects is gratefully acknowledged. These notes first appeared in a news letter to The Friends of Mvumi in 1997.

There has been a great deal of building activity at Mvumi in recent months. The Labour Ward and the toilets in the Children's Ward have both benefited from substantial renovation work. The Private Ward has also been upgraded: it is hoped that this will encourage more private patients to use the hospital and by increasing the income of the hospital effectively subsidise the treatment of other patients.

Work is planned for the renovation of the Operating Theatre and rebuilding of the Relatives Camp in the near future.

A new vehicle was purchased by Friends of Mvumi for the hospital earlier this year. The vehicle, a Toyota Dyna 3.5 ton truck , will undertake a variety of regular journeys, such as transporting the supplies of food and firewood needed to care for the large number of students at Mvumi, bringing the diesel for running the generator and collecting from the port of Dar es Salaam the drugs, medical equipment etc. given by Friends of Mvumi. It arrived at Mvumi in August and the management of the hospital wishes to thank FOM very much for this gift. Proceeds from the sale of the old truck will be put towards other projects.

Friends of Mvumi has provided £2600 for the purchase of tools and teaching aids for this important training school that was established in Mvumi in 1989. The School, unique in Tanzania, runs foundation courses for students from hospitals all over the country, both Government and Mission. These courses of ten weeks duration, provide a good grounding for novice technicians, and a new advanced course provides training for more complex hospital equipment. The School clearly plays an important role in the maintenance and repair of hospital equipment in hospitals throughout Tanzania. It also benefits Mvumi greatly, as the students carry out practical repair work on its equipment, and the teaching staff are involved in more complex repairs and the evaluation of new technical proposals.

As in past years, 25% of the unallocated income of Friends of Mvum (approx. £3500) has been sent to Mvumi to supplement the salaries of trained staff. This important contribution from the Friends is made to enable staff to continue working in this rural area. Salaries are inadequate even for basic survival, and many qualified staff are drawn to the towns and cities where they can supplement their income by extra private work.

Other important items of regular expenditure are drugs and laboratory items. In 1996 £6000 was spent on vital drugs for the hospital, and £1000 spent on the laboratory equipment and chemicals needed for carrying out a range of diagnostic tests.

A wide variety of medical and hospital equipment is sent to Mvumi. Items range from small pieces of equipment, such as neonatal resuscitation masks, to larger and more expensive items such as an X-Ray viewing box and four medicine trolleys. Gloves are also important but expensive purchases. With the gradual increase in the prevalence of AIDS, it is vital that hospital staff protect themselves when carrying out medical procedures. It is reported from the hospital that in the last 3 years the incidence of AIDS in the blood donating population has grown from 3% to 5%.

Over £1000 has been used to purchase a large quantity of medical books for a newly established hospital library, for the use of medical, nursing and laboratory students and staff. Further books have been ordered for the Medical Assistants Training School.

A new stock of Nursing Badges for presentation at the time of graduation has been purchased. These traditional metal badges, bearing the inscription 'Mvumi School of Midwifery' and the School logo, will be worn proudly by Mvumi trained nurses throughout their nursing careers.

The hospital has been struggling with its water supply for some years. To quote from a hospital report produced in May 1997: There are two main problems.

1. The demand is outstripping the supply, such that the hospital header tanks never fill with water.

Supply: The water from the hospital comes from its own borehole and is pumped by a submersible electric pump. This is powered by mains electricity or in the case of mains failure, by the hospital generator. This reliance on expensive mains electricity or diesel powered generator is a considerable financial burden for the hospital. The borehole was last cleaned in 1989. The yield at present is 96,000 litres for 16 hours pumping per day. Water is pumped to 2 header tanks and from there it is distributed to the main hospital buildings, staff housing, the five training schools and their hostels, the diocesan secondary school and the diocesan agricultural project. In addition, the hospital has 3 main rainwater tanks totalling 377,500 litres. These are reserved for the production of IV fluids, eye drops and for use in sterilisers.

Demand: In 1983 there was noted to be 143,000 litres per day. Since then there have been additional staff houses and hospital buildings constructed. There are plans for expanding the relatives camp, in particular to provide a maternity waiting hostel. The Mvumi secondary school is planning to double its number of houses and to build two hostels to house 240 students. We have agreed, at least in the short term, to supply them with water. In addition, the village water supply has not been working. The main pump has been out of action for some time and so a lot of the village has been relying on the hospital for its water.

2. The internal distribution is patchy because of hardness of the water causing corrosion and furring of the galvanised steel pipes. Precious water is lost through leakages, and in other areas the flow of water is completely blocked.

Work has commenced on the renovation of the water system, thanks to the proceeds of some wonderful fundraising events in both Canada and the UK. However, much more money is required if all the necessary work is to be undertaken.

Supply -The Borehole. This has been cleaned to see if yield could be improved, but unfortunately subsequent measurements have failed to show a significant increase.

Water Aid are helping to assess the present borehole and with the Deparment of Water will guide us through a hydro-geological survey. On balance at this stage it seems that a new borehole will be required.

Demand. Amongst various measures to control demand, it is proposed to install meters to the institutions and houses using the hospital water supply.

Distribution. New pipes have been laid from the main header tanks to the header tanks of all the wards and nursing school hostels. PVC pipes have been laid underground, and galvanised steel pipes above ground. New ball valves will be fitted to all the tanks. The piping from the sub-header tanks will then be checked and replaced as necessary. Finally, the supply lines to the staff houses will be checked - all as funds become available.