The Tanzanian Partnership - 'Pamoja Tunaweza’

This project describes a unique partnership and global collaboration that has introduced laparoscopic surgery as a new service to Tanzania. In 2002, with an average occupancy of 116%, the Chief Executive of Kilimanjaro Christian Medical Centre (Tanzania) approached Northumbria Healthcare to explore the possibility of introducing this service to address the backlog of patients on surgical wards.

The benefits of laparoscopic surgery are numerous. For the patient: less invasive surgery and less anaesthesia, much reduced chance of haemorrhage requiring transfusion (HIV risk), fewer days in hospital, less chance of complications, less requirement for post-operative medication and nursing care, reduced need for outpatient follow up, a swifter return to work and, importantly, less overall burden to the patient in terms of cost.

For the hospital: reduced theatre time , ability to manage day case elective surgery to ease congestion on surgical wards, less patient aftercare required and lower costs of service delivery. People may say that laparoscopic surgery is not an obvious choice for implementation in a less developed country due to the high-tech nature of the equipment and the high-level skills required of the surgical team.

The real challenge was to be able to develop the new service from an NHS hospital in Northumberland, 7000 kilometres away! With full support from our Board & Charity Development Group, Northumbria approached this as a long term training development programme. The team committed to a decade of sustained effort and support, working within a challenging environment, with few resources and frequently without electricity. Each year new procedures have been introduced and keyhole techniques are now routinely used for diagnostics and biopsy, improving the health outcomes for thousands of patients.

Each year Northumbria invites surgical registrars to be part of the laparoscopic training course in Tanzania. They gain experience of international development, classroom lecturing and curriculum development, skills which can be difficult to acquire through the standard training programme. The additional confidence and skills acquired from international experience has been well received at surgical (ST3) interviews. Recently secured AHSN monies will enable the learning from this project to be shared across the UK.

Key Learning : Firstly remember ‘Pamoja Tunaweza’, which in English means ‘together we can’. This unique and very special partnership has brought together teams of engineers, surgeons, theatre nurses, operational managers and external stakeholders to work together to advance surgical teaching and training in Tanzania and launch a new surgical service and bring vital care closer to home. The shared vision and strong partnership working of the UK and Tanzanian teams gave the momentum needed to struggle through new uncharted territory and succeed on two levels: service development and innovative workforce development. Reciprocity is a fab thing. The stark absence of resources in Tanzania has taught our own staff a lot about gratitude, creativity and innovation - while the health benefits for Tanzania are obvious, Northumbria, as a well resourced NHS organisation, has gained just as much from this partnership as Kilimanjaro Christian Medical Centre.
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