Antke Zuechner – Improving children’s health through the mother
As a pediatrician, Antke Zuechner knows that the health status of children is in a large part determined by the health and knowledge of their mothers. Dr. Zuechner is working at Bugando Medical Centre in Mwanza Tanzania for three years with a German nonprofit called AGEH (Association for Development Cooperation); one of the main reasons she has committed her time and expertise to this East African hospital is the great need in terms of the sheer volume of children in Tanzania and the lack of pediatricians and other health professionals.
Dr. Antke Zuechner
Dr. Zuechner divides her time between working in the wards, particularly in the Neonatal Intensive Care Unit (NICU), and teaching students in the adjacent university, Bugando University College of Health Sciences. For a start, women need to know their HIV status in order to ensure they do not pass the infection to their newborns, especially since new drugs and practices make infection of the child so preventable. Education about HIV/AIDS, breastfeeding and other topics related to child health are important aspects of prenatal and antenatal care that Dr. Zuechner engages in on a daily basis. It is not uncommon for the mother to face a problem with breastfeeding due to calorie or vitamin deficiencies that are driven by a poor diet and poverty. A well recognized fact is that the economic status of a person affects their health-seeking behavior. A woman would need the means to travel to a hospital or health facility in order to receive and pay for their necessary treatment; fortunately, the government of Tanzania mandates that treatment for women and children under five is free of charge.
In Sengerema Hospital outside of Mwanza, a novel initiative to reduce the risk of pregnancy or delivery complications is at work. A housing complex has been devoted to pregnant at-risk women so that in the event of an emergency they are close to a well-equipped and staffed facility. This addresses a slue of the problems in Tanzania and throughout Africa: the lack of transport to health facilities, the unavailability of equipment and chronic understaffing. Perhaps programs such as this are possible in other areas in an effort to reduce maternal mortality. Dr. Zuechner has witnessed too many women that go into labor in transit to a health facility and put their child in danger.
Dr. Zuechner chose the medical profession because its dynamic and interesting work, research and experiences amaze her. Only one year into her three year stretch at Bugando, she realizes that she has quite a bit to learn still about the culture and medical situation. Driven by visible improvements to the situation, motivated students and residents, and a commitment to care for the 20 million children in Tanzania, she will continue to battle one of the world’s highest maternal and child mortality rates through her work.
Erick J. Mazyala: Challenges in Transforming Medical Schools in Tanzania
Medical professors throughout the globe have a similar role of ensuring that future doctors acquire adequate training to provide competent and safe care.
In Tanzania, as is the case for the majority of Least Developed Countries (LDCs), the need for doctors is exceedingly high. Life expectancy is 43.5 years compared to 78.9 in developed countries. Doctor: population ratio in Tanzania stands at 1:30,000, well below the World Health Organization’s (WHO) recommended doctor: population ratio of 1:1,000. Most of the deaths in Tanzania and LDCs in general are due to preventable or curable causes. This is most often due to limited access to basic healthcare. In poor resource settings and a tropical climate, conditions are ripe for parasites and infectious diseases, many of which remain neglected.
Tanzania endorsed the Millennium Development Goals (MDGs) in 2000, but we are far from meeting the 2015 targets. For example, according to data from 2008, infant mortality is 68/1000 live births, under-five mortality rate is 112/1,000 live births, and maternal mortality is 578/100,000 live births. The proportion of the population below the basic needs poverty line (earning less than $1 per day) is 33 %.
Availability of healthcare givers who are competent enough to deliver primary healthcare and correctly diagnose diseases are in high demand in Tanzania. This will improve in the long run to ensure accessibility of primary healthcare to the community. Medical institutions such as Bugando’s university in Mwanza are trying hard to expand student enrollment to reduce the deficit of physicians. With this in mind, being a medical academic at Bugando’s university, I feel overburdened, yet privileged, charged with the responsibility of nurturing future doctors.
With better infrastructure and information technology (IT), we will be able to transform the curriculum to a more student-centered approach in which students can become more active learners via problem-based learning (PBL). As is the case in most sub-Saharan African medical schools, Internet connectivity and IT, an indispensable entity in modernizing medical trainings, is underdeveloped. The relatively small faculty size is another serious challenge.
The Touch Foundation, through charity donations from the international community, has been working tirelessly with the people of Tanzania to support the training of doctors and other healthcare workers at Bugando’s university. However, there is still a long way to go in improving physical infrastructures such as lecture theaters, laboratories, IT facilities, and expanding the faculty to match the high student enrollment.
Dr. Erick J. Mazyala is an Assistant Lecturer in the Anatomy and Histology Department of Bugando University College of Health Sciences (BUCHS), which is the second largest medical school in Tanzania and is supported by the Touch Foundation.
Dr. Donald Catino — Investigating the evidence for herbal traditional medicine
I am an an internist and have done a medical literature search 1950 to 2009, gathering nearly 100 articles which give objective evidence of the efficacy of these herbs in a wide variety of diseases: HIV, tuberculosis, malaria, other parasitic diseases, and common bacterial infections, as well as diabetes, asthma, seizures, thrombosis, estrogen deficiency and even dental caries and periodontal disease.
Most of the current evidence is in vitro laboratory testing, but some animal, and a few human studies have been done. I will be presenting this evidence to the Weill Bugando medical staff on Oct. 21. My goal is to begin to convince the medical staff of the value of Herbal Traditional Medicine, and to begin to forge a working relationship between the hospital physicians and the local healers.
Mutual understanding, education and respect, followed by mutual patient consultation, and eventually cooperative clinical research are the long term goals.
Dr Donald Catino and his wife Pamela are visiting again and continuing their interests in Herbal Traditional Medicine in Tanzania. Dr. Catino has been practicing medicine for more than 45 years.
Liz Pavlovich — Switching places: traditional and western medicine
Echinacea, ginger root tea, acupuncture – all considered legitimate treatments by many people nowadays. But on the flip side of things, there can be a tendency to belittle the traditional medicine and traditional healers in non-western countries as reminiscent of the “backwards” lifestyle and health care. In Africa, where up to 80% of the population uses traditional medicine as the primary form of health services and access to western health services is absurdly low, this perception helps no one.
Reconciling where we should stand on traditional medicine is difficult for social and cultural reasons. It can also be frustrating for practical reasons, such the dire need for more doctors, nurses and pharmacists who are trained primarily in western methods to halt the spread of diseases like malaria that can be treated easily with the correct regime of modern medicines. But a symbiotic relationship between the two methods that promotes the best of both worlds is possible.
Local populations are apt to listen to traditional healers – these skilled persons are respected by their communities as a way to treat ailments of a natural or supernatural nature. They will persist as the voice and mind of those they serve. We therefore need to be able to work with traditional healers so that positive change can be realized. This means open exchanges between the two groups to break down stigmas and eliminate some of the conclusively harmful practices. Hope lies in the fact that some organizations and African governments have already created courses to educate traditional healers on prevention and detection of HIV/AIDS. These healers are now agents of positive change to help stop the spread of this pandemic.
My work with the Touch Foundation in Tanzania to support a university that trains doctors and other health workers is not in spite of traditional medicine. Part of our mission to give people greater choice and knowledge, more confidence in health facilities as they become better staffed and equipped, and a much needed improvement to quality of life.
Liz Pavlovich is a Program Officer at the Touch Foundation and is based in Mwanza, Tanzania.