Project Fund Request: Ultra-Sound Training for Matibi Doctors
2015/05/03
Created by: Antony Chengahomwe (Medical Superintendent, Matibi Hospital)
and Adnos Chikomo (FFM Projects Coordinator)
Address: Matibi Mission, Mwenezi District, Masvingo Province, Zimbabwe
Phone: +263-772-454-759 (Antony) / +263-772-694-124 (Adnos)
E-Mail:
adnoschikomo@gmail.com
/
cantony2008@yahoo.co.uk
/
friendsformatibi@gmail.com
1. Management summary
Matibi Mission hospital has been operating with a number of challenges with one of the major
challenges being of aligning the hospital to the technological advances in the area of patient care.
Recently the hospital got a new Ultra-Sound Scan machine through our all-weather partners Friends
for Matibi. The main target for the donation of the machine was to assist the Maternity Department. An
ultra sound plays a major role to detect complications or abnormalities while the baby is still in utero.
This tool would aid in the day to day management of patients particularly inclined to the Maternity
patients. Zimbabwe still has a long way to reduce the Maternal Mortality Rate which currently is sitting
at more than 700/100 000 population. The still-births rate at the institution is also relatively high. The
hospital has had Maternal Deaths which could have been preventable if the right tools including use
of Ultra-sound scan could have been used. The ability to pick complications using an Ultra-Sound
Scan is user dependant and hence the call to train the Medical Doctors there with the skills to use and
interpret Ultra-Sound images.
2 Total estimated costs of the project
Accommodation for 2 trainees
Food for the 2 trainees
Fuel for travel of the 2 trainees
Training fees for the 2 trainees
Total
3 Funding
Cash from FFM
Loan granted
Switzerland
Local funds
Government
Local
Others
Total
from
Friends
for
560 USD
588 USD
250 USD
200 USD
1 598 USD
Matibi
1598 USD
0
0
0
0
0
1598 USD
4 Time plan for realisation of results
The doctors will get the training in the nearest convenient time circumventing the commitments at the
hospital. The training will be a 14-day programme at Masvingo Provincial Hospital, so the doctors will
get the training one after another. The attachment will be in the Radiographic Department under the
mentorship of the Chief Radiographic Technician who will introduce the mentees to the use of Ultrasound imaging and subsequent follow up on the progress made. A certificate or letter of attendance
will be given at the end of the attachment from the Hospital Medical Superintendent or the mentor.
5 Financing plan
We consider that the most feasible plan is to have the budgeted 1,598USD deposited into the Matibi
Hospital Account by mid September 2015. It is only with this money at hand that we can know the
training schedule. Thus, the targeted Masvingo General Hospital discloses a training schedule to a
candidate who has already paid up the training fees.
6 Person(s) in charge
The Medical Superintendent is responsible for securing the training dates for the two doctors. He has
to scrutinise the situation and do appropriate timing for the training in consideration of the day-to-day
duties at Matibi Hospital. A radiographer at Masvingo General Hospital shall be the trainer. Reporting
for this activity shall be primarily the responsibility of the Medical Superintendent and the Projects
Coordinator while the Masvingo Diocese Health Coordinator is the representative of the church as the
responsible authority at Matibi Mission.
7 Detailed information about the project
7.1 Detailed project description
This project is quite essential in making Matibi Mission Hospital an effective health delivery hub. It is a
most realistic response to the prevailing problem where the medical officers are lacking necessary
skills to operate the 2 ultrasonic machines that FFM donated. Yet the operation of these machines is
important to reduce maternal mortality. Besides that, the project gives our hospital a competitive edge
above other hospitals. For example, it aligns the hospital with the technological advances in the
medical fraternity and brings convenience to the wide clientele base that we serve. Matibi Hospital
serves a sphere of influence of 60 kilometres radius. The maternity clients typically face the problem
of poor terrains when travelling to the hospital and this is one of several other causal factors for
maternal issues. In light of this, the requirement of ultrasound scans is unquestionable.
7.2 Project goals
We are a hospital with a current catchment area of 8818 people but with clients coming from
Mwenezi, Chivi and Mberengwa districts. The hospital has a capacity of 125 beds that cater for
maternal, paediatric, medical and surgical patients as well as AIDS and TB patients. The Antenatal
care clinic caters for patients close to 120 a month and the institutional deliveries are an average of
76 per month with a Caesarean Section rate of 12,5 % of all the deliveries. The table below shows the
workload of the Maternity Unit from the beginning of the year 2015.
MONTH
Total live deliveries
Normal Deliveries
Caesarean Sections
Still births
Macerated
Fresh
Maternal deaths
January
59
53
6
1
0
1
0
February
72
61
11
2
2
0
1
March
77
68
9
1
1
0
0
April
84
73
11
2
1
1
0
May
88
77
11
0
0
0
0
June
The general outcome of the deliveries is good but use of an Obstetric Scan can make the Antenatal
care be more comprehensive and be able to pick maternal and foetal complications earlier to institute
life-saving management. It also compliments hugely the clinical acumen of the medical officers.
To obtain Ultra-sound services the patients have to go to Masvingo a distance of about 100km by the
shortest route or to Zvishavane which is about 80km from Matibi hospital. Equipping the hospital with
such services would provide the best convenience and satisfaction for the clients. It costs at the
minimum of about $20 USD to get an Obstetric Ultra-sound from the closest centres mentioned above
not factoring in the transport and other logistical costs. The majority of the hospital clientele base is
very poor or impoverished by some means and mostly live at less than a $1 a day. An affordable and
readily available imaging services can be a huge relief to this community.
7.3 Project risks
The success of this project depends highly on the trainer’s clinical competency. As far as medical
practice in Zimbabwe is concerned, this risk is minimised by the existence of standards for different
medical roles such as training. Besides that, Masvingo General Hospital is a reputable formal
institution of health governed by the Ministry of Health and Child Care. Another possible risk is limited
time to prepare the doctors adequately. The proposed timeframe for each training is two weeks. This
is potentially is too short for each trainee to grasp all the concepts about imaging. Our strategy to
meet this risk is to devise a monitoring system which makes sure that the training is intensive. The
system may include the use of a loaded timetable and a suitably designed logbook for all the
procedures done.
7.4 Negative impacts of not realising this project
The impact of losing on such a project is huge and can be looked on a clinical perspective as well as
well as a social aspect. It cannot be over emphasized the significant role that imaging in Obstetric
care can play to pick complications both for the baby and the mother. Absence of imaging delays
institution of interventions that serves the mother and perhaps the baby too. Operating without does
not reassure the mother on the possibility of a safe delivery and good delivery outcome. Clients
develop poor confidence in the health delivery system if complications are picked late leading to
avoidable losses of life.
The unavailability of imaging facilities won’t reduce the distances that clients will have to travel to get
services. This means clients incur huge cost in terms of money and time which further impoverishes
our economically poor community. The inconvenience of patients also foster client dissatisfaction
which can subsequently lead to few institutional deliveries. This will create a backdrop against our
motto of “A safe motherhood for a safe society through a safe delivery”
The machines without use will see them get redundant for an unthinkable future as has been the case
and not benefit the hospital and its clients on a wider scope.
8
Other organisations or governmental support
The project will benefit from working with other hospitals, most notably Neshuro hospital which is the
closest. The project shall also be communicated to stakeholders in maternal health. Already, Matibi
Hospital is constantly represented during maternal and perinatal mortality meetings held at district and
provincial levels. Recommendations from these forums include the need for the Doctors to undergo
Imaging training, meaning that there is a collective justification for the project among stakeholders.
The Provincial Hospital considers the project important to reduce the number of referrals from
Mwenezi and other areas served by Matibi Hospital. The government is resource constrained and is
also pleased to learn that Matibi Hopsital is planning to add its weight towards critical staff skills.
9 Additional information
The attached pictures show the two Ultra-sound machines available at Matibi.
10 Personal comments
The wide client base, the current national economic situation and the geographical location of the
hospital means that the hospital should be able to offer all comprehensible services under one roof to
provide an equitable and patient-satisfying service. Obstetric Imaging is an important panacea to
reduce maternal and child mortality. The Ultra-sound machines at Matibi Hospital are practically out of
use as if they have any fault and yet it is only about user skills. These devices need to find their way
into operation if lives have to be saved maximally.
11 Decision FFM Switzerland
Project funding request status:
New
Assessment
Ready for decision
Declined
Approved
Implementation
Board Meeting
Telephone conference
Decision made by:
E-Mail circular
Decision date:
Signatures (two necessary)
Cancelled
Oliver Müller
President
Friends for Matibi
Patrick Brazzale
Vice president
Friends for Matibi
Daniel Schmidt
Treasurer
Friends for Matibi