Tanzania: Primary care in Mtwara and Kigoma

  • International staff: 15
  • National staff: 87 Half of Tanzania's 32 million people live below the poverty line, and life expectancy in the country is only 50 years. Child mortality rates are also sobering: 144 deaths for every 1000 children under five. Against this backdrop, MSF is working to aid the Tanzanian health care system, which is in a state of deterioration because of the poor economy, infrastructure problems and a shortage of medical professionals. MSF runs primary health care projects in the districts of Mtwara and Kigoma. The goal is to improve the quality of and access to basic health services. The Mtwara project reaches some 200,000 inhabitants, while in Kigoma (an area strongly affected by the country's many refugees) some 227,000 Tanzanians benefit. Fighting malaria and cholera Malaria is the number one killer in Tanzania. Since 1998 - when MSF intervened in a malaria epidemic in the Kagera region - the organization has pushed for effective treatment of this illness. Partly at MSF's urging, the Ministry of Health (MOH) recently abandoned chloroquine, which has a high resistance rate in Tanzania, in favor of another, less resistant first-line treatment for malaria. Since January 2000, MSF has been working to improve the Tanzanian health system's capacity to deal with the country's constant cholera outbreaks. This cholera preparedness project - known as CHOPIN - is based in Dar-es-Salaam and involves surveillance and data collection, training of front-line health staff, reinforcement of emergency stocks and raising community awareness. The program is based in the MOH and targets the general population. Refugees continue to flow into the country There are now an estimated 500,000 refugees in Tanzania, the reluctant host to thousands of refugees for several decades now. People have streamed across the border from Rwanda, Burundi and the Democratic Republic of Congo (DRC) into the Kigoma and Kagera regions in western Tanzania, looking for respite and safety from the wars back home. The Kigoma camps are strained to capacity, putting a heavy burden on the finances of the Tanzanian government. The last MSF intervention in a refugee camp in Tanzania was carried out in a transit camp for DRC refugees and ended in December 1998. MSF continues to provide technical assistance for NGOs working in the camps and collaborate with UNHCR on contingency plans for new refugees and disease outbreaks. Other work Until December 1999, MSF worked in the district hospital in Kasulu, training management and health personnel, rehabilitating health structures and improving the health information system. In cooperation with the Ministry of Home Affairs, MSF is currently evaluating possibilities for a health project in some of the country's penitentiaries, where detainees are particularly susceptible to communicable illnesses.