Tanzania 1998

International staff: 16 National staff: 70 Cholera outbreak followed rains Although health planning is good, including a descentralisation project, implementation is impeded by the lack of economic resources and epidemic outbreaks. Tanzania faced cholera epidemics throughout 1997 and the first half of 1998 following torrential rains. MSF teams organised and supported cholera treatment camps in Kigoma, Dar-es-Salaam, Mtwara and Zanzibar. Activities included supervision, training local health personnel, drugs and medical material, an epidemiological monitoring system, and a water and sanitation programme. In mid-May 1998, heavy rainfall disrupted Dar-es-Salaam's water system and another cholera outbreak occurred. MSF is developing long-term projects improving access to health care in Mtwara and Kigoma districts. In Kigoma, where support for the 138-bed reference hospital in Kasulu covers 126,300 refugees and 391,000 Tanzanians, activities include maternity, mother-and-child health, patient consultations, surgery and a pharmacy. Other projects focus on epidemiological warning system, water and sanitation, and emergency preparedness. In Mtwara district (pop. 197,700), support to three 15-bed health centres and 29 dispensaries covers training, mother-and-child health, drugs and medical supplies, construction, refurbishment and equipment of health structures and an epidemiological monitoring system. In May 1998, in response to a malaria outbreak, a project began in Kagera district to improve early and effective treatment of uncomplicated cases at village level, and case management for severe cases, and to reduce morbidity, especially among under-fives.