1.
INTRODUCTION4
1.1
Background Information
Nyakahanga Designated District Hospital started way back in 1912 as a small first aid unit
headed by a local dresser.
In 1953 the unit was expanded into a 60-bed hospital which was again extended to 200
beds in 1965, partly with Danida assistance. Swedish, German and Danish Lutheran churches
have assisted the hospital with personnel, equipment and both minor and major improvements
over the years.
Nyakahanga started to serve as a district hospital in 1972. In 1992 an agreement was
signed to make it a designated district hospital. A board of Governors which draws members from
the Government and ELCT Karagwe Diocese was formed.
According to the agreement ELCT Karagwe Diocese retained the hospital ownership. The
hospital has a bed capacity of 200. It provides both curative and preventive services. There are 5
ELCT dispensaries which are supervised by the hospital.
ELCT dispensaries are; Ibamba,
Kayanga, Ihembe, Nyakatera and Karagwe Secondary school.
Other health centres and
dispensaries within the district belong to either the Rulenge Catholic Diocese or the district
council.
Like other designated district hospitals, the government is responsible for the recurrent
expenditure and the church being the owner of the hospital is responsible for the capital
expenditures.
1.2
Location and Profile.
Nyakahanga Designated District Hospital is located in Karagwe District. Karagwe is one
of the six districts in Kagera region in the North Western corner of Tanzania. It is found in the
North western part of Kagera region. It is bounded by Ngara district in Southern part. River
Kagera and Uganda lie in the Northern part of the district.
The Eastern part is bounded by two districts namely Muleba and Bukoba. The Western
part is bounded by River Kagera and Rwanda.
The total area coverage is 6,734 square kilometre. Land area coverage is 5534 square
kilometre. Land area coverage is 5534 square kilometre and water area coverage is 1200 square
kilometre. Karagwe district lies just below the Equator and east of 30°E [Position: 1° – 2° south
(latitude) 30.6° – 31.4° East (longitude)].
1
The district has a tropical climate. The average annual rainfall is 1040mm. Rainfall
distribution is bimodal with peak rains falling between September to December and March to
May. The period between January and February is dry. June to September is a period of marginal
or no rainfall. In general, rainfall decreases from East to West. The climate is generally
favourable for agricultural development and thus household food security is assured throughout
the year.
1.2.1
Administration
Karagwe district is divided into 4 divisions, 28 wards and 115 registered villages. There
are two parliamentary constituencies with elected members of parliament of Karagwe and
Kyerwa.
1.2.2
Communication
Nyakahanga hospital can communicate with the rest of the world by roads, water, air, post,
telephone, radio call, fax,internet and e-mail. Like most parts of the country our road
communication system is very rough. During heavy rains roads are impassable. The hospital is
125 km away from Bukoba town where the regional hospital is located.
1.2.3
Other Health Units in the District
There are two other hospitals (voluntary agencies) namely Isingiro which is about 80km
away from Nyakahanga, Nyakaiga about 45km away. The two hospitals are owned by the
Rulenge Catholic Diocese. There are three rural health centres and 46 dispensaries. Among the
three rural health centres two belong to the Government and the third health centre is owned by
the Rulenge Catholic Diocese. As regards the dispensaries, 37 belong to the government and the
rest are privately owned.
1.3
Population
Karagwe district has approximately 400,000 inhabitants. Males are estimated to be
196,000 while females are estimated to be 204,000. The natural growth rate is 2.8%, crude birth
rate is 2.0% and the crude death rate is 4.6%.
Children up to the age of five years are
approximately 80,000. About 60% of the total population make the Nyakahanga Hospital
catchment population. The major tribal groups found in the district are Nyambo, Haya, Rwandese
and Kiga.
The district was originally inhabited by the Nyambo tribe. The Hayas from Bukoba district
started to move in from 1950’s. Rwandese refugees also found their way into Karagwe in early
1960’s. These four major tribal groups have some similarities and differences culture wise.
2
1.4
Economic Situation
Agriculture is the main economic activity employing more than 90% of the population.
The major cash crops are coffee and beans. Food crops include bananas, potatoes, beans, maize,
millet, vegetables and fruits.
Livestock keeping is the second most important activity in the district. There are three
Agro-ecological zones, the North-western zone, the central zone and south-eastern zone. The
south-eastern zone experiences food shortages due to poor soils and little rainfall.
2.
GENERAL REVIEW OF THE YEAR
The provision of health care to our clients was done without much difficulties. The
hospital work load increased slightly in the year 2002. The average OPD attendance increased
to109 patients per day compared to 100 in the year 2001. The bed occupancy rate was 100%
being an increase of 15% compared to the year 2001
Like other parts of the Country, malaria continued to be a major cause of OPD attendances,
admissions and deaths as well. The HIV seropositivity among blood donors in the year 2002 was
21.1% being an increase of 4% compared to the year 2001.
The AMREF specialist outreach programme was carried out as scheduled. The hospital
received the following specialists; Gynaecologist, Urologist, ENT Surgeon, General Surgeon, and
Orthopaedic Surgeon.
Government grants were received in time except for some few occasions. The amount
received for personal emoluments was enough to cover for staff salaries and their social security
fund.
The water supply and electricity was steady.
We didn’t experience major power
interruptions.
Out partners from abroad continued to support the hospital financially, materially and
personnel.
We made all the necessary efforts to ensure continued provision of quality medical care to
our patient.
3
3.
MANAGEMENT AND ADMISTRATION
The following are the levels of hospital Management:
3.1
Board of Governors: This is the supreme body of managing the hospital, as per the mutual
agreement between the Tanzania Government and the ELCT Karagwe Diocese. The Board is
made up of 10 members; six of whom are from the Diocese and four from the Government.
The Board is responsible for policy making and the overall smooth running of the hospital.
The Board Chairperson is the Assistant to the Bishop (Dean) and the Medical Officer In Charge is
the Secretary. In 2002 the Board met once.
3.2
Diocesan Medical Board: The ELCT Karagwe Diocese being the owner of the hospital
supervises the running of the hospital through the Diocesan Medical Board. The Medical Officer
In charge and the hospital Matron are members of this Board. The Medical Board is responsible
for staffing of all workers with recognised certificates except doctors and management team who
are appointed/employed by the Diocesan Executive Council. The Executive Secretary is the
Diocesan Medical Secretary.
3.3
Hospital Management Committee: The committee is headed by the Medical Officer in charge
who is charged with the day to day running of the hospital assisted by members of this Committee.
Other members are; The Hospital Secretary, Matron, Principal of the training schools and the
Hospital Accountant. The committee is responsible for all decision-making issues. For easy
execution of the day to day issues usually a team of three i.e. the Medical Officer In charge,
Matron and the Hospital Secretary meet for immediate actions and solutions.
3.4
Hospital Advisory Committee: This committee consists of all members of the management
committee, the District Medical officer, The workers Union representative(TUGHE), the hospital
chaplain and five departmental representatives. The committee advises the Management team on
different hospital activities. The committee meets twice a year.
3.5
Departmental Meetings: In order to ensure smooth running of the hospital there are heads of
department who are responsible for day to day activities of their respective units. There are routine
departmental meetings.
4
4.
FINANCE
Like the previous year,in 2001/2002 the hospital had four sources of income. The Government
provided grants for salaries, drugs and other charges. The hospital sources of income for the year
2001/2002 was contributed as follows:
Government grants
72.3%
Health Service fund (cost sharing)
17.90%
Donations from abroad
3.7%
Local Income
6.4%
Expenditures percentagewise were as follows:
Personal Emoluments
45%
Drugs
15%
Supplies
17%
Hospital diet
5%
Electricity
4%
Plants and Vehicles
4%
Upkeep of station and minor works
3.4%
All others
6.6%
(See appendix II for Income and Expenditure Statement for the 2001/2002)
5.
STAFF
The staff situation in the year 2002 was reasonably satisfactory. There were no more observed
losses of qualified and experienced staff. The number of Key hospital staff was as follows:
1. Doctors
2 Medical Officers
1 Dental Surgeon
1 Assistant Dental Officer
3 Assistant Medical officer
2. 7 Clinical Officers
3. 15 Nursing Officers
4. 44 Grade B Nurses
5. 1 Laboratory Technologist
6. 1 Pharmaceutical Technician
In 2002 a total of 12 employees left the hospital and 13 new employees joined the hospital (See
appendices IIIIA,IIIB and IIIC)
5
6.
TRAINING
6.1
In Service Training
In 2002 a total of 15 employees were pursuing their upgrading courses in various fields. 13 were
sponsored by the Danida Supported Hospital Rehabilitation project, 2 were sponsored by
Nyakahanga Hospital (See appendix ‘IV’).
6.2
Courses offered at the Hospital
There are two courses of one year duration each.
6.2.1
Pre-Nursing School
20 ex-form four students sat for pre-entry examinations. We selected 18 students who passed
well to join the school. The school has 3 full time teachers and 2 part time teachers.
6.2.2
Laboratory Microscopists Class
Ten ex-form four students were enrolled. They were taught to perform minor laboratory tests.
The class has 2 part time teachers.
6.3
Continuing Medical Education
Daily clinical conferences were conducted for all doctors, clinical officers, Pharmacy and
laboratory staff, and senior nurses. Topics of interest were presented to all the clinical staff on
weekly basis. The hospital library was open to all clinical staff from Monday to Friday.
7.
HOSPITAL ACTIVITIES
7.1
CURATIVE SERVICES
7.1.1
Outpatient Department (OPD)
In 2002 there were 39911 attendances making an increase of 10% compared to the year
2001. The average OPD attendances per day was 109. The increase in OPD attendances in the
year 2002 is due to the increased cases of malaria in all age groups. Poverty also contributed
significantly to the increased attendance because people could not afford to seek medical services
from the private health facilities.
The top ten causes of OPD attendances were Malaria, Dental caries, Acute respiratory
infections, Urinary tract infections, Pneumonia, diarrhoeal diseases, Conjunctivitis, Diabetes,
Intestinal worms, and Hypertension. The Outpatient Department was open from Monday to
Sunday to cater for ordinary cases and emergencies as well. There was always a doctor to cater
for emergencies after working hours and weekends.
6
At OPD patients were either seen by clinical officers or doctors depending on the condition
and patient’s grade. The problem of self-referrals was still there.
(See appendices VI, VIIA, VIIB for OPD attendances)
7.1.2
Inpatient Department
The Hospital has 200 registered beds. In 2002 the bed occupancy was 100%. A total of
9873 patients were admitted with an average hospital stay of 8 days. Like OPD attendances there
was an increase of the number of patients admitted. The hospital death rate was 5.6% being a
decrease of 0.4% compared to the year 2001. Malaria was the leading cause of deaths accounting
for 23% of all deaths.
Ward rounds were done three days a week (Monday, Wednesday, and Friday). One doctor
was always available to handle emergency cases after working hours.
The nursing care was done by nurses of different cadres. We allowed relatives of very ill
patients to stay in the wards to help our nurses to look after them.
Like the year 2001, we received many patients with meningitis (122), 55% died.
(See appendices VII, VIII & IX for inpatients statistics)
7.1.3
Obstetrical Services
The maternity ward has a total of 36 beds and 6 delivery beds. It is equipped with facilities for
doing vacuum extraction, incubators for premature babies, ultrasound machine, suction machines,
oxygen concentrators etc.
In 2002 we had a total of 2037 deliveries being a increase of 73.5% compared to the year 2001.
Like previous years many deliveries were conducted at home by the traditional birth attendants.
At the hospital deliveries were conducted by qualified nurse midwives/officers and doctors.
The caesarean section rate was 21% being an increase of 2% compared to the year 2001.
Late referrals of mothers who are in labour continued to be observed in the year 2002. This
contributed markedly to the lower Apgar scores and subsequent brain damage. There were 24
maternal deaths caused by factors shown in appendix XII
Continued Medical Education was done to nurses working in the maternity ward.More
emphasis was put on the use of partogragh.
7.1.4
Surgical Operations
In 2002 we performed a total of 398 major and 1068 minor operations. Caesarean section
accounted for 51.5 % of all major operation performed. Generally there was adecrease of 19% for
major operations done compared to the year 2001. Cold cases were done on Tuesdays and
Thursdays. Other days were for ward rounds and emergency operations.
7
We still use the OMV and EMO. Ether and Halothane are the main general anaesthetic
drugs used. Oxygen concentrator machines are used for the provision of oxygen.
We have experienced anaesthetic nurses who were able to administer anaesthesia to
patients with different conditions.
All post-operative patients were admitted to the surgical ward except for obstetrical cases
who were admitted in the maternity ward.
(See appendix XIII for operations done)
7.1.5
Dental Unit
In 2002 the Unit attended 3278 patients being an increase of 7% compared to the year
2001. Dental caries accounted for 79% of all diagnoses made. The Unit has 2 doctors; Dental
Surgeon and Assistant Dental Officer.
The campaigns against the practice of extracting the so called ‘plastic teeth’ bore some
fruits. The number of people practising it has come down after taking some legal action against
the culprits. The hospital is doing everything possible to equip the dental unit to the basic
standard.
(See appendix XIV - Dental Unit statistics).
7.1.6
Tuberculosis and Leprosy
The National Tuberculosis and Leprosy treatment protocols were adhered to. The Regional and
District TB and Leprosy co-ordinators conducted regular supervisions. The DTLC office is
located within the hospital premises. In 2002 we had 179 new TB cases and 3 relapses. The
number of new cases was equal to the year 2001. No patients with Leprosy were seen.
(See appendix XV)
7.1.7
Ophthalmology
Eye services were carried out on static and outreach basis. The number of patients
attended increased significantly. However many people in the villages are not aware of the
existence of this service at Nyakahanga Hospital. The Department is planning to conduct
awareness campaigns in the near future.
(See appendix XXIII for services offered in the year 2002)
8
7.1.8
Psychiatry
In 2002 a total of 150 psychiatric patients were attended. The number of patients attended
decreased by 78% compared to the year 2001.
The diagnoses made were as follows
OPD
DIAGNOSIS
INPATIENTS
< 5 YEARS
+ 5 YEARS
< 5 YEARS
+ 5 YEARS
PSYCHOSES
0
18
0
0
NEUROSES
0
74
1
1
EPILEPSY
3
51
2
0
Patients care was done by general duty doctors and nursing officers trained in psychiatric
nursing.
7.2
PRIMARY HEALTH CARE
A five year Primary Health Care Programme funded by DANIDA through DMCDD
started in September 2001. The programme objective is to strengthen PHC services within
Nyakahnga Hospital Catchment area . It entails deliberate effort towards extension of the hospital
services beyond the hospital compound to address the root cause in collaboration with the stake
holders with ultimate goal of community empowerment and sustainability of the health services.
The PHC activities were carried out in three Wards namely; Nyakahanga, Bugene and
Ihanda.
A total of ten villages were served namely: Nyakahanga, Bugene, Ihanda, Rukole,
Chonyonyo, Kishao, Bujuruga, Omurusimbi, Bisheshe and Kashanda.
Activities, preventive and promotive services carried out were;

HIV/AIDS Control

Immunization

Antenatal service

Family planning

School health education

Weight monitoring for children up to the age of 5 years

Village health committees seminars

Eye care outreach services
9

Dental care outreach services

Traditional birth attendants training

Water and sanitation

Essential drugs programme
PHC activities were carried out on both static and outreach basis. Villages served at Nyakahanga
MCH clinic were – Nyakahanga, Bugene, Kishao, Omurushaka and Ihanda. Villages served on
outreach basis were; Kashanda, Chonyonyo, Bisheshe, Bujuruga, Cherunga, Omurusimbi and
Rukole.
(There is a detailed separate report on PHC activities)
7.2.1
HIV/AIDS Control
HIV/AIDS Control activities were carried out by the ELCT AIDS CONTROL PROJECT.
Activities done were; Counseling, Health education, HIV Screening, support to HIV/AIDS
victims, counseling services were also extended to people coming for blood donation.
Basing on blood donors at Nyakahanga Hospital the HIV seropositivity is increasing. HIV
seropositivity among blood donors for the past 5 years is as follows
YEAR
7.2.2
1998
TOTAL
DONORS
3034
HIV
POSITIVE
521
HIV
NEGATIVE
2503
PERCENTAGE
+VE
17.2%
1999
948
174
774
18.4%
2000
939
194
745
20.6%
2001
1216
208
1007
17.1%
2002
871
184
687
21.1%
Immunization
MCH Clinic carried out the Immunization programme according to the national policy. Vaccines
given were BCG, Polio, DPT, Measles and Tetanus Toxoid. The unit participated very well in the
National Immunization campaigns.
(See appendix XVIII for vaccinations statistics).
7.2.3
Antenatal Service
Antenatal services were carried out as planned. Many pregnant mothers started to attend after the
20th week of pregnancy. (See appendix XIX)
10
7.2.4
Family planning
A wide range of contraception methods were offered. The number of women who came for
surgical contraception (BTL) was 323 being an increase of 90% compared to the year 2001.
However many clients opted for injectables.
(See appendix XVII)
7.2.5
School Health Programme
School health programme was conducted in 20 primary schools within the Nyakahanga PHC
catchment area.
(Detailed report under PHC programme)
7.3
SUPPORTIVE SERVICES
7.3.1
Laboratory
In 2002 a total of 83824 tests were done being an increase of 2% compared to the year 2001.
Blood slides accounted for 25% of total tests done. We were able to perform most of the basic
laboratory tests. We experienced occasional shortages of some reagents e.g. for testing SGOT,
SGPT, Na+, K+ and Cl-.
The laboratory staff consisted of one laboratory Technologist, two laboratory assistants and 6
laboratory attendants. We were also privileged to be visited by Laboratory Specialists from
AMREF Nairobi Kenya. Their inputs helped very much to improve the quality of service.
(See appendix XX for laboratory tests done).
7.3.2
X-ray Department
The department was ran by one Radiographer and 2 radiographic assistants. The old X-ray
machine we have (> 30 years) had some minor breakdowns.
X-rays examinations done were 1796 being an increase of 47% compared to the year 2001. Chest
x-rays taken accounted for 47% of total x-rays examinations done.
Ultrasound examinations done were 1411.
(See appendix XXI- for rays taken)
7.3.3
Pharmacy
The hospital pharmacy staff consisted of one Pharmaceutical Technician, two
Pharmaceutical Assistant and four other medical attendants.
11
The main source of drugs and
medical supplies was The Zonal Medical Stores (MSD). Other sources were private pharmacies
and some donations.
The main problem we faced was on and off out of stocks at MSD. The capitalization of
hospital pharmacies improved the availability of drugs and other medical supplies.
The drug revolving fund project continued very well.
The infusion making plant continued to operate normally. We produced different types of
intravenous fluids; Normal Saline, 5% Dextrose, Dextrose/ Saline, Blood Bottles, Ringer lactate
and Water for injection. We acquired a new autoclave for the infusion unit. (See appendix XXII)
7.3.4
Technical Department
The department dealt with all technical matters including medical equipment, plumbing,
carpentry, electricity, motor vehicle mechanics and plant mechanics.
The department still lacks a trained hospital technician. Occasionally we had to hire
technicians from outside the hospital to repair our equipment.
7.3.5
7.3.5.1
Domestic Department
Catering Services
The hospital provided food to all inpatients. The World Food Programme (WFP) continued to
support the hospital. Patients got 3 meals per day.
We used firewood and charcoal for preparing food. We haven’t started using electric cookers.
7.3.5.2
Laundry Services
Laundry attendants carried out the service. They used electric operated machine. Water
supply was adequate, so was electricity.
7.3.5.3
Estate Services
Staff tried their best to keep the hospital compound clean and attractive. Flowers and trees
were planted in the hospital compound.
7.3.5.4
Water supply
Water supply to the hospital compound and staff houses was steady.
We had no
machine/pump breakdowns to impair water supply. The hospital has big water tanks for
harvesting rain water amounting to 870,000 litres.
7.3.6
Medical Records Department
Patients’ records are kept at OPD. We still use a manual way of keeping patients’ records.
However we have started to computerize some of the patients statistics.
The department was
strengthened by the newly trained Health Records Technician who graduated from KCMC.
12
8.
SPIRITUAL SERVICES
The department is headed by the Hospital Evangelist who is responsible for providing
spiritual care to the patients and staff. He also works in collaboration with the Parish Pastors.
Daily morning devotions for hospital staff were conducted as usual. Almost all hospital
staff participated fully.
Counseling services were also offered to the patients, their relatives and hospital staff. The
hospital has 3 employees trained in clinical-pastoral education at Bugando Medical Centre.
9.
NYAKAHANGA HOSPITAL REHABILITATION PROJECT
The major parts of this project was completed in 2000. The remainng part of the project is the
training programme. By the end of the year 2002, the training programme status was as shown
below:
9.1
Candidates completed their courses 30
9.2
Continuing Candidates 9
9.3
Vacancies to be utilized in the year 2003
10
The Hospital administration has put in place the preventive maintenance schedule.
10.
FUTURE PLANS
Last year we were not able to achieve or implement some of the planned activities due to a number
of factors. However we still need to achieve the following:
1. To equip the Dental Unit with all the basic equipment/instruments
2. To equip the Intensive Care Unit
3. To train more laboratory staff
4. To train all Doctors on Ultrasound examinations
5. To implement all the objective of the ELCT Managed Health Care Programme
6. To upgrade the Pre-Nursing School
7. To have doctors specialized in Surgery and Obstetrics/Gynaecology.
8. To train a physiotherapist
9. To train a Hospital Technician
13
11.
VISITORS
The hospital received visitors from several places. They came from within the district, region,
country and also from abroad. We received many vistors from our church partners in Denmark,
Sweden,United States of America and Germany. In total we received 209 visitors..
(See appendix XXI V)
12.
ACKNOWLEDGEMENTS
First and foremost I would like to express my sincere appreciation to the following hospital
staff for participating in the preparation of this report in their different capacities; Mr. Sospeter
Kabululu, Mrs. Martha Josiah, Mrs. Pelina Kamafa, , Mr. Gilbert Magande, Mr. Evarist Tebuka,
Mrs. D. Aligawesa, Mr. Christopher Kishebuka, Mr. Gosbert Lutenta, Ms. Irene Kitare, Mr.
Antony Gordian,Mr. Jonathan Ntimba, Mr. Odhiambo Obure, Mrs Florida Kachecheba,
Mr.Kundael Kataraia, Ms. Verdiana Kairuki, Dr. John Kamuzora, Dr.Joseph Kashashari, Miss
Edina Kailembo, Ms. Martha Kamkuru and Mr. Mabula Shija.
Secondly, I would like to thank all the hospital staff clinical and non- clinical for
participating actively in the delivery of health care to our patients.
The Diocesan leadership was always ready to help the Hospital Management team
whenever needed. Thanks to His Lordship Bishop Nelson Kazoba for his continued support and
advice.
I would also like to thank the following Organization for their support.

AMREF Nairobi

The Danish Mission Council Development Department

The World Food Programme

ELCT Headquarters - ARUSHA

Christian Social Service Commission

The Church of Sweden Mission

The Danmission
Thanks should also go to the Government of Tanzania through the Ministry of Health for
the continued support. The regional and district health authorities were also very supportive.
Lastly I would also like to thank our neighbouring hospitals: Isingiro, Nyakaiga and
Ndolage for their co-operation.
May our Heavenly Father Bless all those who supported the Hospital in one way or the
other.
14
Submitted by
½
DR. AMOS MALISAWA NYIRENDA
(MB.Ch.B)
MEDICAL OFFICER IN CHARGE
MARCH, 2003
15
APPENDICES
APPENDIX I
A: COMPOSITION OF BOARDS/COMMITTEES
1) BOARD OF GOVERNORS
i)
Assistant to the Bishop ELCT Karagwe Diocese
Chairman
ii)
Administrative Secretary ELCT Karagwe Diocese
-Member
iii)
Medical Secretary Karagwe Diocese
-Member
iv)
Diocesan representative
-
Member
v)
Diocesan representative
-
Member
vi)
Diocesan representative
-
Member
vii)
District Medical Officer
-
Member
viii)
Regional Medical Officer
-
Member
ix)
Chairman, Social Services Committee District Council -
Member
x)
Principal Secretary MOH
Member
xi)
Medical Officer i/c Nyakahanga Hospital
-
2) HOSPITAL MANAGEMENT COMMITTEE
i)
Medical Officer i/c
-Chairman
ii)
Hospital Secretary
iii)
Principal – Pre-Nursing School -
Member
iv)
Hospital Matron
-
Member
v)
Hospital Treasurer
-
Member
-
Secretary
3) HOSPITAL MANAGEMENT ADVISORY COMMITTEE
i)
Medical Officer i/c
-Chairman
ii)
Hospital Secretary
-
Secretary
iii)
Hospital Matron
-
Member
iv)
Principal Pre-Nursing School
v)
Chief Clinician
-
Member
vi)
District Medical Officer
-
Member
vii)
Workers Union representative
-
Member
-Member
4) DEPARTMENT HEADS
1. Medical Officer In charge -
Dr. Amos Nyirenda
2. Hospital Secretary
Mr. Sospeter Kabululu
-
16
-
Secretary
3. Hospital Matron
-
Mrs. Martha Josiah
4. Chief Clinician
-
Dr. Joseph Kashashari
5.
Laboratory
6
Pharmacy
-Mr. Christopher Kishebuka
-
Mr. Kundael Kataraia
7. Radiology
-Mr Gosbert Lutenta
8. Dental Unit
Dr. John Kamuzora
9. RCH
-Mrs Florida Kachecheba
10. OPD
-Ms. Joan Mshwahili
11. Inpatient Services
- Ward A (Children) -
Mr.Mabula Shija
- Ward B (Medical)
-
Mrs. Perpetua Stephen
- Ward C (Surgical)
-
Ms. Irene Kitare
- Ward D (Obstetrics) -
Ms. Verdiana Kairuki
- Ward E (Medical)
Ms. Martha Kamukuru
-
- Ward F (Isolation) -
Mr. Odhiambo Obure
12.
Operating Theatre
Mr. Evarist Tebuka
13.
Medical Records
Mr. Anthony Gordian
14.
Pre-nursing School
-
Mrs. Witness Kanjagaile
15.
Finance
-
Mr. Jonathan Ntimba
16.
Registry
Mrs. Pelina Kamafa
17.
Supplies
Mr.Silidion Karugaba
18.
Technical Services
19.
Catering
20.
Laundry
-
Mr. Linus France
21.
Estate Services
-
Mr. Rezile Mushenyera
22.
Security
-
Mr. Rweshabura
23.
Spiritual Services
-
Mr. Benedicto Kamanyonga
Mrs. Georgia Nyamukama
24. Primary Health Care(PHC)-
-Ev. Gosbert Rutashobya
Mr.Lutenta Mwijage
17
APPENDIX II
SUMMARY OF INCOME AND EXPENDITURE FOR THE YEAR
2001/2002 as at 30 JUNE 2002
BUDGET
2001/2002
TZS
ACTUAL
2001/2002
TZS
ACTUAL
2000/2001
362,898,000.00
89,000 ,000.00
15,000,000
30,400,000
497,298,000.00
359,850,387.40
89,492,700.00
18,513,826.40
32,089,138.80
499,946,052.60
293,635,036.85
91,265,550.00
19,086,680.00
24,872,344.50
428,859,611.35
224,000,000
223,975,335.30
198,203,676.50
10,937,000
11,407,561.00
8,314,655.00
800,000
665,500.00
831,200.00
9,400,000
9,361,030.00
8,352,560.20
4,236,000
4,726,993.65
2,591,794.25
21,000,000
21,807,935.18
15,375,706.60
800,000
550,600.00
1,930,917.40
1,500,000.00
1,669,460.00
1,289,870.00
2,000,000
286,400.00
148,725.00
19,000,000
19,846,341.00
19,918,542.00
Technical Equipments
1,000,000
561,600.00
125,000.00
Games and Sports
Postmortem charges
Upkeep of station
Minor works
600,000
808,192.30
109,900.00
130,000
82,200.00
173,300.00
8,000,000
7,838,541.85
7,467,780.00
9,500,000
9,428,832.00
8,836,970.00
Boards, Meetings & Committees
1,300,000
1,095,000.00
1,426,200.00
In-service Training
Peoples Militia
Hospital Drugs
Hospital Diet
Periodicals and Books
Hospital Supplies
TOTAL EXPENDITURE
SURPLUS/DEFICIT
1,000,000
1,156,300.00
2,890,400.00
75,000,000
23,045,000
300,000
85,000,000
497,298,000
72,636,564.55
23,195,235.00
83,083.35
85,816,572.95
496,999,278.13
2,946,774.47
54,000.00
57,712,436.75
16,611,935.00
43,800.00
86,705,767.80
439,061,136..50
-10,201,525.15
INCOME
Government Grant
Patient Fees
Donation
Local Income
TOTAL
EXPENDITURE
Personal Emoluments
Travelling/Transport
Travelling on Leave
Office Expense
Telephone
Electricity
Water
Uniforms
Postage
Plants & Vehicles
18
TZS
APPENDIX IIIIA
C. 1 Staff establishment
0
1
2
3
4
5
6
7
8
9
10
11
12
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
38
39
40
41
42
ACTUAL NUMBER
PRESENT
2
0
1
2
1
1
7
0
1
2
1
1
1
2
15
38
0
3
2
0
1
0
4
0
0
0
4
0
0
1
90
0
6
1
1
7
0
1
1
1
0
2
1
DESIGNATIONS
Medical Officers - General
Medical Officers - Specialist
Dental Surgeon
Assistant Medical Officers General
Assistant Medical Officer - O
Assistant Dental Surgeon
Clinical Officers
Pharmacists
Pharmaceutical Technicians
Pharmaceutical Assistants
Laboratory Technicians
Laboratory Assistants
Radiographers
Radiographic Assistants
Nursing Officers
Nurse Midwives/Trained Nurses
Public Health Nurse A
Public Health Nurse B
Maternal & Child Health Aides
Medical Records Officers
Medical Records Technician
Medical Records Assistants
Medical Records Attendants
Dental Technicians
Dental Assistants
Anaesthetists
Anaesthetic Nurses
Ophthalmologist
Ophthalmic Opticians
Ophthalmic Nurse
Medical Attendants
Launderers
Laundry Attendants
Catering Officer
Cooks
Kitchen Attendants
Medical Engineering Technician
Carpenters
Plumbers
Accountants
Assistant Accountant
Accounts Assistants
Supplies Officers
19
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
Supplies Assistants
Watchmen
Drivers
Tailors
Estates Attendants
Mortuary Attendants
Registry Assistants
Registry Attendants
Personal Secretary
Typists
Office Attendants
Money collectors
Vehicle Mechanics
Plant Attendants
Hospital Secretary
2
13
2
1
3
1
0
0
1
1
1
3
1
1
1
IIIB Left Employees
No
Name
Designation
Reason
1 Jovither Kabisha
Accounts Assistant
Resignation
2 Pellagia Justine
Catering Officer
Resignation
3 Deusdedit Rwamalumba
Medical Assistant
Resignation
4 Alibina Serafini
Laboratory Assistant
Resignation
5 Edward Pastory
Estate. Attendant
Termination
6 Paschazia Kajura
Nurse Midwife
Resignation
7 Erica Sarakikya
Medical Stores Attendant
Termination
8 Agnes Rubereza
Public Health Nurse B
Resignation
9 Jane Marco
Nurse Assistant
Termination
10 Philbert Felecian
Kitchen Attendant
Termination
11 Dorosella Kyekaka
Nurse Assistant
Death
12 Benan Mwanga
Hospital Accountant
Death
20
III C New Employees
No
Name
Designation
Reason
1 Dr.Erasmus Kamugisha
Medical Officer
New employment
2 Dr.Marco Bitesigirwe
Assistant Medical Officer
New employment
3 Esther Nyarugenda
Nursing Officer
New Employment
4 Heronimo Katabazi
ClinicalOfficer
-do-
5 Jasper Ntongani
Clinical Officer
-d0-
6 Proscovia Rwebangira
Trainend Nurse
-do-
7 Mwesiga Kabululu
Electrician
New employment
8 Jane Kashara
Accounts Assistants
-do
9 Abednego Aligawesa
Laboratoty Attendant
-do—
10 Specioza Karumuna
Laboratory Attendant
-do-
11 Abella Bashagi
Laboratory Attendant
-do-
12 Anociatha Mukuta
Estate Attendant
-do-
13 Imani Lyakugwire
Estate Attendant
-doAPPENDIX IV
IN-SERVICE TRAINING OF STAFF
NAME
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
Grace Mjungu
Mchunguzi Mfuruki
Monica Rukanuga
Elias Johansen
Nelson Fredrick
Anastella Rwabulanga
Melchior Tibendelana
Valena Bigimbwa
Godefrida Gordian
Demetria Nyabuchocho
Georgina Kazaura
Amon Tinkasimile
Benan Mwanga
Boniface Bigiramungu
Langton Kishebuka
Beatus Karugaba
COURSE
A.M.O Bugando
Laboratory Assistant Bugando
NM Kiomboi
MD Makerere
Trained Nurse SUMVE
Nurse Midwife Bukumbi
Nursing Officer Kolandoto
Nursing Officer Sengerema
Nursing Officer Ndolage
Nurse Midwife Rubya
Nurse Midwife-Rubya
Pharmacy Tech, MMC (Pre Service)
PGD Financial Management IFM
Certificate in Accounts Nyegezi
Anaesthetic Nurse Bugando
Nurse Midwife Kiomboi
21
REMARKS
Continuing
Continuing
Completed
Continuing
Continuing
Continuing
Continuing
Continuing
Continuing
Continuing
Continuing
Continuing
DIED
Continuing
Continuing
Continuing
APPENDIX V
GENERAL HOSPITAL STATISTICS FOR THE PAST 5 YEARS
1998
1999
2000
2001
OPD Attendances
39,296
19132
29,761 36,361
Daily average OPD Attendances
107
52
82
100
Total Admissions
13,844
6393
7,362
9191
Bed Occupancy rate
114.5%
69%
71.5%
85%
Average Hospital Stay
6.0
4.4
4.1
4
DAYS DAYS DAYS DAYS
Number of Hospital Deaths
1114
371
372
551
Maternal Deaths
16
14
12
14
Total Deliveries
925
1,634
1,229
1174
Total Caesarian Sections
175
213
224
219
Caesarian Rate
19%
13%
18%
19%
Major Surgeries
336
427
502
513
Minor Surgeries
1077
1066
787
790
Total x-rays taken
1095
1023
850
1223
Total Laboratory Tests
79,935
55517
60,022 82,356
Blood Donors HIV Seropositive 17.2%
18.4%
20.7%
17.1%
22
2002
39911
109
9873
100%
8
DAYS
554
24
2037
398
19.5%
772
1068
1796
83,824
21.1
APPENDIX VI
OPD ATTENDANCE (DIAGNOSIS)
2001
DIAGNOSIS
Acute Flaccid Paralysis
Cholera
Dysentery
Relapsing fever
Measles
Meningitis
Malaria
Acute Respiratory Infection
Diarrhoeal Diseases (excluding notifiable)
Intestinal Worms
Pneumonia
Eye infections
Ear infections
Skin infection
Non-skin fungal infections
Asthma
Cardiovascular Diseases
Genital Discharge Syndrome
Genital Ulcer Disease
Sexually transmitted diseases (others)
Urinary Tract infection
Pelvic Inflammatory Disease
Anaemias
23
2002
UNDERFIVES
ABOVE FIVE
UNDERFIVES
ABOVE FIVE
<5
+5
<5
+5
0
0
24
0
1
0
5975
1092
1115
570
392
67
130
307
0
52
0
0
1
0
316
0
46
0
0
48
0
1
0
6323
780
350
440
302
198
135
479
8
147
734
215
60
40
1805
205
28
0
0
23
0
1
0
3547
1109
377
61
421
67
46
56
12
4
2
1
4
1
136
0
62
0
0
60
0
1
0
3993
814
213
247
186
112
115
121
63
97
356
201
146
74
1431
238
43
Pregnancy complications
Schistosomiasis
Neuroses
Psychoses
Protein Energy Malnutrition
Other Nutritional disorders
Epilepsy
Non infections gastro-intestinal diseases
Burns
Poisoning
Minor Surgical Conditions
Emergency oral care
Tuberculosis
Leprosy
Ill defined symptoms
Other Diagnoses
xxxx
0
0
0
17
8
94
308
9
0
93
73
0
0
113
716
201
0
209
68
10
13
71
91
19
13
448
1286
65
0
453
5357
XXXX
0
0
0
0
4
3
21
0
3
29
0
0
0
83
1918
191
1
74
18
0
3
51
336
3
7
479
3301
18
0
363
2013
Neonatal Tetanus
Plague
Rabid animal Bites
Rabies
Typhoid
Dental Caries
Periodontal Diseases
Other Dental Diagnoses
Clinical AIDS
Diabetes Mellitus
Thyroid Diseases
Non infections Skin disease
Vitamin A deficiency
Non infectious Eye diseases
Peptic Ulcers
Rheumatoid and joint diseases
Hypertension
0
0
5
0
2
608
0
98
3
0
0
23
1
53
0
10
0
xxx
0
29
0
67
1985
128
402
105
360
75
56
5
337
605
567
515
0
0
17
0
10
0
0
0
3
1
0
22
0
125
7
5
1
XXXX
0
58
9
228
2679
87
535
56
346
18
48
20
1411
538
382
276
24
Appendix VIA
TOP TEN OPD DIAGNOSES (ALL AGES)
2002
2001
NO
1
2
3
4
5
6
7
8
9
10
DIAGNOSIS
Malaria
Dental caries
Urinary Tract Infections
Acute Respiratory Infections
Diarhoeal Diseases
Intestinal worms
Skin infections
Cardivascular Diseases
Pneumonia
Peptic Ulcers
NUMBER
NO
12298
2593
2121
1872
1465
1010
786
734
694
605
1
2
3
4
5
6
7
8
9
10
DIAGNOSIS
Malaria
Dental caries
Acute Respiratory tract
infections
Urinary Tract Infections
Pneumonia
Diarrhoeal diseases
Conjunctivit
Diabetes
Intestinal Worms
Hypertension
NUMBER
7540
2679
1801
1567
607
545
532
511
297
277
Appendix VIB
TOP TEN OPD DIAGNOSES UNDERFIVES
2001
NO
1
2
3
4
5
6
7
8
9
10
DIAGNOSIS
Malaria
Diarhoeal Diseases
Acute Respiratory Tract
Infections
Dental caries
Intestinal worms
Pneumonia
Urinary Tract Infections
Non infectious GIT diseases
Skin infections
Ear infections
2002
NUMBER
NO
5975
1115
1092
608
758
392
316
308
307
130
1
2
3
4
5
6
7
8
9
10
25
DIAGNOSIS
Malaria
Acute Respiratory Infections
Pneumonia
Diarrhoeal diseases
Urinary Tract Infectious
Intestinal worms
Otitismedia
Anaemias
B.Dysentery
Animal bite
NUMBER
3547
987
421
319
136
50
39
35
23
17
APPENDIX VII
INPATIENT STATISTICS
MORBIDITY AND MORTALITY
UNDERFIVE (<5)
ABOVE FIVE (+5)
NUMBER
ADMITTED
DEATHS
NUMBER
ADMITTED
DEATHS
Acute Flaccid Paralysis
Cholera
Dysentery
Relapsing fever
Measles
Meningitis
Neonatal Tetanus
Plague
Rabid animal bites
Rabies
Typhoid
0
0
12
2
0
42
0
0
1
0
6
0
0
0
0
0
30
0
0
0
0
0
0
0
38
1
1
80
xxxx
0
1
1
43
0
0
0
0
0
37
xxxx
0
0
1
0
Acute Respiratory Infection (ARI)
Diarrhoeal diseases
Bacterial excluding notifiable
Other diarrhoeal diseases
Hepatitis
Intestinal worms
Leprosy
Malaria – complicated & severe
- uncomplicated
Schistomiasis
Tuberculosis
Genital Discharge Syndrome
Genital Ulcers Disease
Sexually Transmitted Diseases
Severe Protein Energy Malnutrition
Other nutritional Disorders
Anaemia
Neuroses
Psychoses
Epilepsy
Ear infections
Eye infections
Asthma
Pneumonia
Other Respiratory Diseases
Peptic Ulcers
Non infections Gastrointestinal disease
Pelvic Inflammatory Disease
Urinary Tract Infections
290
2
305
2
48
347
0
25
0
391
2324
0
6
0
1
0
31
3
420
1
0
2
19
5
5
511
131
2
14
0
78
0
4
0
0
0
45
0
0
0
0
0
0
11
0
59
1
0
0
0
0
0
50
0
0
6
0
0
35
150
7
74
2
174
1245
1
109
131
58
12
5
1
99
98
16
59
7
13
35
273
104
100
89
139
186
0
1
0
0
0
21
15
0
13
0
0
0
0
0
9
2
0
0
0
0
3
11
0
1
8
0
0
DIAGNOSIS
26
Complications of Pregnancy
Skin infections
Rheumatoid/Joint diseases
Perinatal/neonatal conditions
Snake and insect bites
Burns
Poisoning
Ill defined symptoms,
Other diagnosis
Clinical AIDS
All neoplasms
Thyroid Diseases
Diabetes Mellitus
Hematological diseases excl. anaemia
Vitamin A deficiency
Cataracts
Other non infectious eye diseases
Hypertension
Cardiac failure
Rheumatic fever
Other Cardiovascular diseases
Non infectious Liver diseases
Non infectious Kidney diseases
Gynaecological Diseases excluding PID
Non infectious Skin diseases
Osteomyelitis
Congenital disorders
Fractures
27
xxxx
11
1
33
0
11
10
5
1415
Xxxx
0
0
24
0
4
1
1
9
508
44
47
xxxx
9
6
13
195
1609
25
0
0
xxxx
0
2
1
4
12
16
3
1
0
7
0
0
11
0
8
0
8
3
5
0
0
0
15
6
10
0
0
0
1
0
0
0
0
1
0
2
0
2
0
0
0
1
0
59
46
21
44
0
0
17
117
99
38
18
43
8
11
38
28
31
22
66
30
2
0
4
0
0
0
0
10
9
2
4
1
4
0
0
0
0
2
APPENDIX VIII
TOP TEN INPATIENT ADMISSIONS (ALL AGES - DIAGNOSES)
SERIAL
NO
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
NUMBER
DIAGNOSIS
Malaria
Pneumonia
Respiratory infections
Diarrhea disease
Anemia
PID
UTI
Abortions
Meningitis
Tuberculosis
4134
722
719
547
519
457
216
210
122
115
TOTAL
7761
APPENDIX IX
TOP FIVE CAUSES OF DEATH (ALL AGES)
DIAGNOSIS
NO
NUMBER
1
Malaria
126
2
Meningitis
67
3
Anemia
64
4
Pneumonia
61
5
Clinical AIDS
39
28
APPENDIX X
Hospital/clinic
deliveries
Normal deliveries
Vacuum
Laparatomy
Caesarian section
EPH Gestosis
APH
BBA
Home deliveries by
MCHA
Deliveries by
TBAS
PPH
Retained placenta
Perineal tear 300
Maternal Deaths
Born alive
Fresh Still Birth
Macerated still
birth
Twins
Triplets
Low Birth weight
below 2.5 kgs
Birth Weight above
2.5 kgs
Early Neonatal
death (0 - 7)
Late Neonatal
death (7 - 28)
Abortions
BTL
JANUARY
126
125
87
39
2
6
0
31
0
2
1
0
0
0
0
0
1
122
7
4
14
0
29
104
5
0
23
6
FEBRUARY
124
124
91
33
4
6
0
23
0
1
0
0
0
0
0
0
1
124
2
4
12
0
17
113
7
0
17
10
MARCH
165
161
128
37
3
2
0
32
0
2
4
0
0
0
1
0
2
161
4
7
14
0
33
139
5
0
14
8
APRIL
144
141
102
42
1
1
0
40
0
2
3
0
0
3
2
0
2
141
2
5
8
0
23
125
4
0
10
7
MAY
164
163
119
45
3
4
0
38
1
4
1
0
0
1
1
0
1
155
14
9
8
0
21
147
5
0
19
8
JUNE
203
199
144
59
9
4
1
43
3
2
4
0
0
1
0
0
3
201
5
4
14
0
30
180
5
2
19
5
JULY
177
177
133
44
6
3
0
32
0
1
0
0
0
1
0
0
2
168
5
12
16
0
37
148
5
0
13
6
AUGUST
198
198
158
40
4
1
0
32
1
3
1
0
0
2
1
0
6
190
5
10
14
0
37
168
4
0
21
7
SEPTEMBE
198
196
155
42
4
6
0
31
1
1
2
0
0
1
0
0
3
192
2
14
18
4
33
177
9
0
24
4
OCTOBER
190
190
144
46
4
5
1
36
2
3
0
0
0
2
0
0
1
173
8
11
4
0
39
153
5
0
19
9
NOVEMBER
195
194
136
59
5
9
0
45
4
1
1
0
0
1
1
0
1
195
4
4
12
3
40
163
6
0
16
4
DECEMBE
158
158
115
43
0
2
1
39
1
1
0
0
0
1
0
0
1
159
2
2
10
0
19
144
5
1
17
8
2042
2026
1511
52
45
49
3
42
13
27
17
0
0
13
6
0
24
1981
60
87
14
7
358
1761
65
3
212
82
Abnormal
deliveries
Breech
Total deliveries
OBSTETRICS REPORT
R
R
TOTAL
9
2
4
29
APPENDIX XI
CAESAREAN SECTION INDICATIONS
INDICATIONS
2 or more previous scars
Cephalopelvic Disproportion (CPD)
Obstructed labour
Cord Prolapse
Deep Transverse Arrest
Uterine Inertia
Foetal Distress
Malpositioning
Eclampsia
Malpresentations
Cervical Dystocia
Placenta Praevia
Impending Uterine Rupture
Post VVF repair
Retained 2nd twin
Cervical stenosis
Abruption placenta
Eldery primigravida
Compound presentation
Term pregnancy with a cystocoele
TOTAL
NUMBER
104
82
57
13
7
1
30
31
3
21
8
22
5
1
2
1
2
1
3
1
1
1
398
30
APPENDIX XII
CAUSES OF MATERNAL DEATHS
Severe and complicated Malaria 3
AIDS
1
Post Partum haemorrhage
1
Puerperal Sepsis
6
Ruptured uterus
5
Liver Failure
1
Amniotic Embolism
2
Severe anaemia
2
Severe Pneumonia
1
Eclampsia
2
TOTAL 24
31
APPENDIX XIII
SURGICAL OPERATIONS
GENERAL SURGERY
Exploratory Laparotomy
Herni-rrhaphy + otomy
Extensive cutwound suture
Cholecystectomy
Adhesionlysis
Appendicectomy
Burst Abdomen repair
Splenectomy
Closure of colostomy
Colostomy
Skin grafting
Intususception release
Intestinal resection & anastomosis
Appendicular abscess drainage
Debndment - major
Sebacious cyst excision
Millard’s repair
Repair of perforated gastric ulcer
Gastro-jejunostomy
Jan.
Feb.
Mar.
April
May
June
July
Aug.
Sept
Oct.
Nov
Dec
TOTAL
2
5
7
1
3
7
3
1
2
6
6
4
2
8
4
2
5
3
2
7
5
2
11
2
1
1
1
1
1
1
1
1
1
1
1
52
48
1
1
1
8
2
1
1
1
2
2
4
1
2
1
4
1
4
1
1
1
1
1
1
1
1
1
1
1
1
2
1
1
3
1
2
Release of congenital bands of legs
Intestinal perforation repair
1
1
2
1
2
1
32
1
1
4
OBSTETRICS & GYNAECOLOGY
Caeserian Section
Salpingectomy (ectopic pregnancy)
VVF Repair
Repair of ruptured uterus
Bilateral Tubal ligation
Oöphrectomy
Total abdomen hysterectomy
27
1
21
30
1
37
31
1
2
5
1
4
4
4
6
1
1
14
1
2
8
1
1
Salpingoophrectomy
Hysterectomy
1
1
43
1
6
1
8
1
32
1
31
1
30
1
34
1
1
7
1
8
2
7
7
2
4
2
1
4
1
1
2
Subtotal hysterectomy
2
1
Tubal surgery
UROLOGY
Hydrocellectomy
orchidectomy
TURP
DVU
Transvesicle prostatectomy
Scrotal exploration
Urethraplasty
Reoair of urinary bladder rupture
Hypospadiasis excision
Testicular exploration
2
2
44
38
1
7
2
1
7
1
3
25
1
3
1
2
9
1
6
1
1
1
1
1
2
1
1
1
2
1
4
1
1
1
1
1
33
398
8
6
11
88
9
1
1
7
1
2
1
4
1
1
1
1
3
ORTHOPAEDICS
BKA
Squetrectomy
Symes amputation
ETA
Bilateral Triple release
ST & suture ofcompound fracture
Corrective osteotomy
1
1
1
1
1
1
1
1
1
1
1
1
4
1
2
1
1
1
OPTHALMOLOGY
ICCE
Cornear repair
3
5
1
3
1
Lens Aspiration
1
Iris reposition + 20 PC IOL Insertion
1
1
Enucleation
1
1
1
2
2
1
17
1
5
2
3
3
2
1
ENT
Anterior Turbinectomy
2
2
Triniming of Anterior Turbinate
2
2
MINOR OPERATIONS
98
62
90
57
34
84
59
63
48
68
59
55
63
806
APPENDIX XIV
DENTAL UNIT ATTENDANCES
REFER.
SURG.
OTHERS
CONS.
OTHERS
EXTRACT.
TREATMENT
NEOP.
TRAUMA
DIAGNOSIS
PERIO.
ATTENDANCE
SEX
AGE
M
F
< 15
15+
CARIES
MONTH
JANUARY
164
154
52
266
255
19
13
3
54
289
1
46
3
1
FEBRUARY
154
157
63
245
271
11
9
2
54
293
0
49
4
2
MARCH
106
129
194
181
19
7
2
57
206
0
50
7
2
207
6
12
0
43
220
0
43
0
1
41
APRIL
109
MAY
144
54
199
152
62
202
220
11
4
0
38
229
4
38
2
0
11
3
3
44
198
2
36
5
1
4
2
41
229
0
34
8
3
112
JUNE
94
142
53
183
192
JULY
101
173
50
224
214
161
71
229
235
8
4
8
45
247
0
43
5
5
236
4
6
2
46
238
1
24
6
1
AUGUST
13
139
SEPTEMBER
142
58
227
143
OCTOBER
149
NOVEMBER
124
166
51
264
260
2
8
2
43
275
0
33
4
3
48
198
211
6
3
1
39
223
0
33
2
0
189
297
7
6
0
31
215
0
22
4
0
2620
2779
117
72
25
535
2862
8
249
122
DECEMBER
102
139
52
TOTAL
1496
1782
655
35
50
18
APPENDIX XV
TUBERCULOSIS AND LEPROSY
NUMBER
SMEAR POSITIVE
63
SMEAR NEGATIVE
92
EXTRAPULMONARY
22
RELAPSE
3
LEPROSY (MULTIBACILLARY)
0
MALE PATIENTS
114
FEMALE PATIENTS
65
36
APPENDIX XVI
MCH CLINIC - UNDERFIVES CHILDREN ATTENDANCES
FIRST VISIT
0-12 MONTHS
FIRST VISIT
12MO-5YEARS
RE-VISIT
0-11 MONTHS
RE- VISIT
12 MO – 5
YEARS
BODY
WEIGHT
BELOW 60%
BODY
WEIGHT 60% 80%
JANUARY
133
0
783
1334
14
274
FEBRUARY
136
0
794
1175
14
185
MARCH
110
0
768
1382
7
166
APRIL
132
0
817
1309
10
224
MAY
157
0
776
1141
7
218
JUNE
184
0
924
1344
16
325
JULY
181
1
864
1521
4
249
AUGUST
156
0
930
1449
12
144
SEPTEMBER
150
0
1037
1520
16
317
OCTOBER
106
0
915
1272
11
276
NOVEMBER
175
0
1137
1329
9
235
DECEMBER
113
0
1001
1209
9
235
TOTAL
1703
1
10736
15995
129
2888
37
APPENDIX XVII
FAMILY PLANNING SERVICES
NUMBER OF CLIENTS PER METHOD
PILLS
INJECTABLE
IUCD
JANUARY
192
155
FEBRUARY
MARCH
APRIL
MAY
JUNE
JULY
AUGUST
SEPTEMBER
OCTOBER
NOVEMBER
DECEMBER
133
131
141
132
130
185
123
127
114
143
121
1539
TOTAL
NORPLAN
T
2
NATUR
AL FP
1
CONDO
MS
5
0
VSC
(BT
L)
28
117
129
161
148
162
213
145
168
162
89
188
2
3
5
0
2
2
3
3
3
2
1
5
11
1
4
3
5
3
4
2
4
4
1
1
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
0
31
35
25
30
19
37
23
18
25
26
26
1837
28
51
4
0
323
38
APPENDIX XVIII
UNDERFIVE VACCINATION AND BEARING AGE WOMEN
POLIO
DPT
0
1
2
3
1
2
3
MEASLES
BCG
T.T.
1
2
3
4
5
JANUARY
174
90
115
116
96
114
117
95
105
86
54
23
18
13
FEBRUAY
190
81
154
151
115
152
148
115
109
69
85
29
21
8
MARCH
230
96
134
164
117
134
164
114
106
81
61
31
14
27
APRIL
199
97
141
117
138
141
117
135
117
84
75
28
19
19
MAY
194
92
182
129
118
182
129
119
93
95
72
28
26
11
JUNE
253
111
184
185
137
184
185
137
95
172
90
33
35
14
JULY
246
102
186
163
151
188
170
129
103
110
129
32
29
14
AUGUST
21
107
197
183
173
197
179
170
105
80
58
55
23
11
SEPTEMBER
214
123
146
189
164
148
196
165
108
69
65
19
30
10
OCTOBER
131
59
137
142
189
137
142
189
102
95
59
48
51
23
NOVEMBER
213
102
156
151
136
155
149
138
114
153
56
20
26
18
DECEMBER
150
68
143
138
123
144
147
116
97
90
16
35
34
19
TOTAL
2338
1128
1875
1828
1506
187
1843
1622
1254
1184
820
354
326
187
39
APPENDIX XIX
369
0
17
10
7
0
4
FEBRUARY
4
174
443
0
44
4
15
0
0
MARCH
1
166
399
0
24
8
7
0
1
APRIL
3
182
390
0
55
10
17
0
2
MAY
5
206
507
0
50
32
11
0
0
JUNE
12
200
497
0
48
22
22
0
6
JULY
11
193
481
0
31
12
9
0
1
AUGUST
8
153
567
0
31
6
6
0
0
SEPTEMBER
1
138
563
1
20
6
6
0
2
OCTOBER
0
98
453
0
16
9
7
0
0
NOVEMBER
3
124
460
0
30
2
8
0
0
DECEMBER
0
93
463
1
16
4
2
1
1
TOTAL
50
1887
5592
2
382
125
117
1
17
40
OTHER
RISKY
160
SEVERE
ANAEMIA
2
AGE LESS
THAN 18
YEARS
JANUARY
CONDITIONS
MATERNAL
AGE MORE
THAN 35
YEARS
MATERNAL
BP >140/90
5 PREGNANCE AND
ABOVE
RE-VISIT
1ST VISIT AT
20 WEEKS &
ABOVE
1ST VISIT
BEFORE 20
WEEKS
ANTENATAL CARE
APPENDIX XX
LABORATORY TESTS DONE
TESTS
TOTAL
Blood slide (B/S)
Haemoglobin (Hb)
Sickle cell tests
Reticulocytes
ESR
White blood cells (WBC)
Differentials
VDRL
Others
21348
7735
255
15
2175
16208
411
996
93
Blood Glucose
SerumProteins
HIV Test
Creatinine
Blood grouping
X-matching
Widal test
1944
17
1546
171
2782
1892
2526
Urine
Albumin
Sugar
Acetone
Microscopy
Bile pigment
Urobilin
Pregnancy tests
Stool
Blood
Eggs
CSF
Cells
Proteins
Culture
2037
1589
634
7833
25
25
589
24
6220
392
392
0
41
AFB Smear
Gram stain
Cultures
2773
1085
92
APPENDIX XXI
DISTRIBUTION OF X - RAYS TAKEN
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
Chest X-ray
Skull X-ray
Barium meal
Abdominal X-rays
Barium swallow
Barium enema
I.V.P
Pelvis
HSG
Spine X-ray
others
TOTAL
853
157
47
88
21
5
3
62
42
136
382
1796
ULTRASOUND EXAMINATIONS
1411
ECG
42
APPENDIX XXII
INFUSION UNIT YEARLY PRODUCTION (LITRES)
Month
January
February
March
April
May
June
July
August
September
October
November
December
Total/year
0.9%
N/saline
208
445
299
528
399
1469
1113
678
527
536
436
732
7370
5%
Dextrose
303
357
353
367
427
791
395
669
574
564
614
392
5804
0.18%-4.37%
D/saline
92
105
158
212
310
22
185
446
389
317
306
408
2950
Ringers
Lactate
Blood
bottles
Water for
Injection
Dextrose
152
255
262
260
283
468
647
444
338
514
586
426
4635
100 mls
30
40
34
36
73
62
30
56
82
35
478
13
5
10
21
29
20
20
22
13
35
25
28
241
31
31
45
40
31
61
30
63
36
54
68
53
563
43
25%
Total
799
1228
1167
1428
1533
2867
2463
2332
1907
2076
2117
2074
22041
APPENDIX XXIII
EYE CLINIC STATISTICS
NO
1
2
3
4
DIAGNOSIS
DISORDERS OF
GLOBE:Anophthalmos
Endophthalmia
ORBIT:Orbital cellulitis
orbital tumor
Mucocelle
Others
LID:Coloboma
Herdeolum
Dermoid cyst
NLD-obstruction
Trauma
Others
CONJUNCTIVA:
Allergic conjunctivitis
Infective conjunctivitis
Chemical conjunctivitis
Foreign body
Conjunctiva mass
Trachoma
Pteryagium &Pinguecula
Jan.
Feb.
1
1
Mar
Apr
May
Jun
Jul
1
Aug
Sep
Oct
Nov
Dec
1
1
2
1
2
1
1
1
1
1
1
1
1
3
3
3
1
2
3
2
27
7
30
4
Total
7
1
2
3
3
2
1
1
1
1
1
3
5
7
2
4
1
1
1
17
15
2
24
5
1
1
2
3
4
12
4
2
1
3
5
1
2
5
4
1
2
2
1
23
5
47
11
1
1
1
4
7
30
6
4
2
4
1
2
2
1
36
12
2
4
3
44
3
1
2
4
3
56
13
2
2
3
2
5
2
1
4
2
47
19
1
1
1
12
44
9
1
1
3
2
1
3
2
4
2
4
17
3
2
5
2
40
2
21
10
12
393
110
8
9
28
10
56
Trauma
5
6
7
8
9
10
11
4
2
5
2
2
2
3
1
13
3
5
2
16
1
2
4
7
3
2
2
17
1
4
2
1
3
SCLERA:Sclera/Episcleraitis
CORNEA:Perforation
Cornea ulcer
Cornea scar
Keratitis
Glanuloma
Leucoma
Cornea foreign body
Others
ANTERIOR
CHAMBER:Hyphaema
Hypopyon
Others
IRIS &UVEAL TRACT:Uveitis
Iris coloboma
Others
LENS:Cataract
Aphakia & Pseudophakia
RETINA:Retinitis
Retina detachment
Retinablastoma
Retinopathies
MASCULA:Muculopath
Mucula hole
Others
2
3
3
2
1
1
5
4
30
2
7
3
5
1
3
2
6
8
8
2
8
4
5
1
2
3
7
2
2
1
7
8
3
2
9
1
1
1
7
1
1
4
2
1
1
3
3
1
16
41
31
101
1
27
2
1
3
1
5
4
1
5
3
3
1
3
6
1
9
1
17
9
14
9
10
10
11
3
2
1
1
1
1
2
3
1
1
1
10
1
41
1
2
6
3
6
2
14
4
3
2
7
2
2
1
1
1
1
1
2
9
6
1
3
1
45
2
2
1
8
1
114
52
1
8
1
8
12
1
2
12
13
14
15
16
17
18
19
20
21
OPTIC NERVE:Glaucoma
Papilitis
Neuropathy
Atrophy
Squint
Neuro-ophthalmology
Vit. A. Deficiency
Blind eye
Normal eye
Amblyopia
Dry eye syndrome
Refractive error &
Accomodation
Visual disturbances.
Migrane
TOTAL:ATTENDANCE
DIAGNOSIS
2
2
3
1
3
2
3
1
2
1
2
3
1
2
1
1
2
1
53
2
2
4
1
14
2
3
2
3
1
2
19
4
1
13
22
44
3
1
145
174
169
183
139
154
1
1
3
3
2
10
1
11
104
117
1
3
7
2
3
26
1
1
10
1
1
1
1
14
16
10
19
2
1
2
98
114
105
120
193
220
121
135
2
2
1
24
1
4
1
6
6
17
15
197
13
12
1
1
19
13
1
2
6
19
7
190
2
2
3
16
139
158
125
136
114
127
102
100
1554
3301
1
3
2
1
7
1
9
2
19
SURGERIES
1
2
CATARACT:ECCE + PC IOL
ECCE only
CORNEA:Repair
Suture removal
Foreign body removal
Pterygium Excision
10
2
1
3
1
3
2
1
1
1
1
1
2
1
3
VITRECTOMY
1
4
LID:Repair
1
1
1
46
1
1
1
1
1
17
9
10
4
1
1
1
2
1
4
Cyst/Tumor Excision
Rotation (RTABUT)
Frost suture
1
5
6
EVISCERATION
ENUCLEATION
2
2
7
CONJUNCTIVA:Peritomy
Mass Excision
1
3
8
9
NLD - Dilation &
syringing
I+D
TOTAL OPRERATIONS
OUTREACH PROGRAME:
JAN - MAR
APR - JUNE
JUL - SEP
OCT - DEC
1
2
3
4
5
6
7
8
1
1
1
3
2
1
1
1
1
1
29
1
1
2
1
1
4
3
11
1
1
5
1
2
ATTENDANCE
403
(MAY
8 ONLY)
250
92
EYE DROP PRODUCTION AUGUST - DECEMBER 2002.
Sodium chromoglycate 2% ….……………298
Gentamycin 0.3%…….…………………….120
Methylcellulose 1%…….…………………....40
Cyclopentolate 1%……….…………………..20
Prednisolone 0.5%….………………………100
Chloramphenical 0.5%…….……………….100
Atropine 1%…………….…………………….20
Benzakonium chloride 2%…….……………..1
47
7
8
2
5
6
1
5
1
1
2
73
APPENDIX
VISITORS
1. Daniel Lyatuu
KCMC MOSHI
2. Neema Voniatis
MOH DAR
3. Christine Kasambala
MOH DAR
4. Winifrida Kemilembe
DMO’S OFFICE KARAGWE
5. Alex Miti Isaack
PROGRAMME OFFICER CHEMA
6. Tuni Rishya
Karagwe
7. Rev.Modest Byomutonzi
ELCT NYAKAHANGA PARISH
8. Godfrey Kababare
BUKOBA
9. William Richard
NDOLAGE HOSPITAL
10. Dr.Leonard Washington
BIHARAMULO DDH
11. Fr.Valentine Mushumbusi
BIHARAMULO PARISH
12. Sr.Redempta Mchunguzi
BIHARAMULO DDH
13. Lonto R.Z Tizanga
BIHARAMULO DDH
14. M.J. Mtindo
TAKWIMU(M)KAGERA
15. Livingstone B.B
KARAGWE
48
XXIV
16. V.Mvulla
D.N.O KARAGWE
17. Abeid Yange
NRC ARUSHA
18. Aggrey Kitosi
NRC ARUSHA
19. Vestfyus Efferskole
TOMMERUP DENMARK
20. DR.Wafula J. Masika
NAIROBI
21. Dean Godfrey Aligawesa
ELCT KARAGWE DIOCESE
22. Mrs Donia Godfrey Aligawesa
ELCT KARAGWE DIOCESE
23. Focus M.Magesa
SHELYS PHARM’ DSM
24. DR.Peter Iveroth
ELCT HQ ARUSHA
25. Theresa Obwaya
CORAT AFRICA NAIROBI
26. Gideon Mbalakai
ELCT ARUSHA HQ
27. Ulla Vaeggemose
ELCT HQ ARUSHA
28. Clement Kwayu
BUMACO LTD MOSHI
29. Janet Kenyon
BULAWAYO ZIMBABWE
30. Chad Knutson
MILWAUKEE WISCONSIN USA
31. Dennis Knutson
MacFARLAND WISCONSIN USA
32. Samson Iburabuza
NYAKAHANGA VILLAGE
33. Odda Elia Rwabuti
NYAKAHANGA VILLAGE
34. Mry Kashaija
USTAWI WA JAMII(w) KARAGWE
35. Fulgence Rutayunga
HOSPITAL ADMIN’RUBYA
36. DR.Rwekenya
ISINGIRO HOSPITAL
37. Silvester Matandiko
MSD MWANZA
38. ABUBAKARI MGUMIA
RC KIGOMA
39. S.A Mashindike
DED KARAGWE
49
40. Major S.A Kempanju
M.M(W) KARAGWE
41. S.OLE TELELE
DC KARAGWE
42. Gava Mayanja
KILELE COMPANY MWANZA
43. Laurean Mashuga
KILELE COMPANY MWANZA
44. G.B Hilly
TRA KARAGWE
45. Dr.Sebastian Rwechungura
RTLC KARAGWE
46. Justine Asilla
BUKOBA
47. Z.B Maagi
MALIASILI KAGERA.`
48. Severine Mbena
MALIASILI
49. Longinus Majenge
MAJI MKOA
50. Jonas Kasiga
AFYA MKOA
51. Rama Masele
MISITU KARAGWE
52. Gen T.Kiwelu
RC KAGERA
53. A.K.Rwakayonza
DAS KARAGWE
54. Lt.Gao
DSO KARAGWE
55. Zacharia Nkya
ELCT INFUSION UNIT MOSHI
56. D.K.Mwandambo
TTCL MWANZA
57. Rev VICENT CHACHA
TTCL KAGERA
58. D.T.Mkama
TTCL KARAGWE
59. Lugakingira E.R
TRA KARAGWE
60. E.B.Kiiza
DISTRICT HEALTH BOARD
61. Dr.John Kasenene
Ag.DMO KARAGWE
62. Jovin Bitesigirwe
DISTRICT HEALTH BOARD
63. Selina Nguma
-do50
KAGERA
64. John Nyinondi
-do-
65. T.Kasenene
-do-
66. F.Cleophace
- do-
67. Yusto Nkaganyilwa
- do-
68. Kennedy Ngeregeza
DMO’S OFFICE
69. Colleen Witmer
WARREN PA
70. Grace Wambwa
ENGENDER HEALTH NAIROBI
71. Rehema Kahando
ENGENDER HEALTH DSM
72. Lorens Hedelund
DENMARK
73. Else Bjerg
DANMISSION /KARAGWE
74. G.Hedelund
DENMARK
75. Lissi Nielsen
DENMARK
76. T.Serensen
DENMARK
77. Sune Hjertmann
DANMISSION/KARAGWE
78. Hanne Vibeke Nielsen
DENMARK
79. Rose Hadrish
DENMARK
80. Inge Myer
DENMARK
81. Forgen Hejhalt
DENMARK
82. Inger Hejhalt
DENMARK
83. Edna Forgensen
DENMARK
84. Forgen Jorgensen
DENMARK
85. John Eaulberg
DENMARK
86. Vivian Dahlberg
DENMARK
87. Hamis Bora
EDP DAR
51
USA
88. Janath Kyamani
DMO’SOFFICE KARAGWE
89. Dr.Pius Tubeti
RMO KAGERA
90. Dr.S.joel
KARP
91. Mbakileki
BUKOBA
92. Lyimo Dennis
ARUSHA
93. Elisa Mhando
ELCT AUDIT DEPT ARUSHA
94. Nathan Mollel
-do-
95. Prisca Swai
MWANZA
96. Rev.Benjamin Sharua
ELCT ELVD
97. Christine Kato
MWANZA
98. Notkeris James
MWANZA
99. Martha Kituro
MWANZA
100. Sara Ambarang’u
MWANZA
101. Sarakikya Veronica
MWANZA
102. Mrs C.Lubao
POLISI MWANZA
103. Eliakunda Kimambo
MWANZA
104. Mary Lauwo
MWANZA
105. Frida Mwemezi
ELCT/ELVD
106. Geraldina Jonathan
MWANZA
107. Mrs Rhoda Kalaule
UN HABITAT NAIROBI
108. PROF.DR.Joe Lugalla
NEW
HAMPSHIRE
UNIVERSITY USA
109. Mwiru Siima
DAR
110. Domina Katunzi
RNO KAGERA
52
111. Cresensia Katesigwa
DMO’S OFFICE KARAGWE
112. DR.Samwel Gathere
NAIROBI KENYA
113. E.E.Mrema (SSP)
OCD KARAGWE
114. A.Mwalubanda
KARAGWE
115. Farestine Chambula
NIC BUKOBA
116. Adelaide Muganyizi
NIC BUKOBA
117. Nyoni M.J
DSO KARAGWE
118. REV. Yoram Karusya
KARAGWE
119. Mr.Sylvand R. Ishengiri
KARAGWE
120. Lene Kjul Thomsen
BRONDERSLEV, DENMARK
121. Janne Christensen
HJORRING DENMARK
122. F.Rwechururu
KARAGWE
123. A. Abeid
STUDENT UNIVERSITY OF
DAR-ES- SALAAM
124. Kristine Kaaber Pors
DMCDD HELLERUP,
DENMARK
125. Krista Rosenlond L.Bellows
DANMISSION, HELLERUP,
DENMARK
126. Bridget Hathaway
NGARA, KAGERA
127. Adam H. Kamana
NGARA, KAGERA
128. Rev. Amon Nzikobanyonka
KARAGWE
129. Rev. Daniel Maburuk
KARAGWE
130. Rev. Lewis John Hiza
UEM, DAR
131. Rev. Layasing De Silva
SRI LANKA
53
132. Rev. Kateghe Ndungo
CONGO
133. Rev. Joseph Kahungya
KARAGWE
134. Rev. George Chobya
KARAGWE
135. Ev. Sarapion Ishengoma
KARAGWE
136. Rev. Achim Dreesen
GABORONE, BOTSWANA
137. Erik Bendit Jensen
ELCT, ARUSHA
138. Tilly Lewinj – Cohen
KARAGWE
139. Livingstone B.B
KARAGWE
140. Mohamed Nassor Mohamed Al-Khanjiry
MWANZA
141. Mohamed Sultan Mohamed Al-Khanjiry
MWANZA
142. Hemed Mohamed Seleman
OMURUSHAKA
143. Dr. Maghasi M.J
NAIROBI
144. Audax J. Mugele
MOROGORO
145. F. Tibalintunza
MOROGORO
146. R. Bejumula
NYAKAHANGA
147. Dr. Kalagano
BUKOBA
148. H. I. Buchwa
BUKOBA
149. B.F. Tibashabwa
BUKOBA
150. Justins M. Mushashu
KARAGWE
151. Damas M.D. Meja
BUKOBA
152. Mary K. Mukandara
BUKOBA
153. Dr. Mussa M. Nyeshobora
BUKOBA
154. Mr. Mbakileki A.
BUKOBA
155. D.K. Mwandambo
MWANZA
54
156. Rev. Vincent J.W Chacha
BUKOBA
157. Gosbet Ndyamukama
BUKOBA
158. Adelina T. Mugenyi
KARAGWE
159. Daniel Masunzu
DAR – ES –SALAAM
160. Farida Kyelu
KARAGWE
161. Bjoru Bogebserg Huesen
DENMARK
162. Grethe Dalsgaurd
DENMARK
163. Soren BO Svendsen
DENMARK
164. Dan Maanson
DENMARK
165. .Inger Kseldsen
DENMARK
166. Ms. Mary A. Mushana
DAR-ES-SALAAM
167. M.C. Nsenguma
KARAGWE
168. Rev. Matius P. Barus (Indonesia)
GERMANY
169. Rev. Jackson Kanyiginya
KARAGWE
170. Rev. Dr. Benson Bagonza
KARAGWE
171. Peresiah Bagambilana
KARAGWE
172. R. Kinyina
KARAGWE
173. Dr. Gushaha
BUKOBA
174. Johanes John
KARAGWE
175. Oliva Owibingire
KARAGWE
176. Venant Thomas Mugenyi
NYAKAHANGA
177. Arthur Kanwakaita
KARAGWE
178. Noel H. Mring
DAR-ES-SALAAM
179. Malkut Singh Nanra
DAR-ES-SALAAM
55
180. Dr. J.B. Mabula
BUGANDO, MWANZA
181. Dr. M.R. Matasha
BUGANDO, MWANZA
182. Hellena Memiri
ELCT ARUSHA.
THE END
56