Day 5 - A Day at Illula Hospital and Gonglionga Rock

Today's blog written by Joanna Kroschel!

As I write the blog for the group on Tyler and my 18th wedding anniversary, I am thankful for our thoughtful church family that brought an anniversary card halfway across the world to help us celebrate. Asante sana! Thank you very much!

This morning we got to sleep in, then had a leisurely breakfast of eggs, toast with Tanzanian jam, smoothies with fresh fruit, and fresh coconut and pineapple purchased by the Englands and Clarks at the local market. It was delicious!

Afterwards we boarded our trusty coaster bus, announced our attendance by calling our family animal sounds (moo!), and drove down the “13 bump hill” toward Ilula for a visit to the Ilula Lutheran Hospital. We had a competition on this drive to see who could get a picture of the most interesting thing being carried by a pikipiki, or motorbike. Chris saw a casket but couldn’t get a picture of it fast enough.  A love seat ended up taking the prize. The Tanzanian ingenuity never ceases to amaze me.
When we arrived at Ilula Hospital, we met with Frank, the hospital accountant. He graciously stepped in to be our tour guide when our original guide was busy.  He patiently answered our 20 questions and then took us on our tour of the hospital.  Unlike U.S. hospitals, each area of the hospital is in a different building. There are about 200 patients cared for each day.

One of the first things I noticed upon touring the Ilula Hospital campus was a sign on the Ilula Institute of Health and Allied Sciences Building saying it was donated by the Peter J. King Family Foundation.  This foundation also has ties to United Hospital, my employer back home. Such a small world! Upon returning, I did more research on the Foundation and learned it has many ties to Tanzania and the Iringa Diocese, Evangelical Lutheran Church of Tanzania.  I encourage you to check out their great work.

Ilula has a 3-year nursing school on campus with 155 current students.  Some live on campus in on campus housing, while others live at home or with family nearby. They have 16 teachers.  Like most places, they are short on teachers and I was encouraged to join their staff.

Our next stop was the triage area.  Unlike the U.S. with our big waiting rooms and fancy flat screen TVs, this was simply an open aired hallway with some benches, old wheel chairs, and a vintage stainless steel hospital gurney. The triage area was staffed by nurses and a doctor that determined the course of action for each person. All hospital care is paid for a la carte. Registration is 3,000 Tanzanian shillings, which is equivalent to $1.10 in the U.S.  Once the doctor determines the plan of care, the patient presents to that building.  The laboratory is in one building, imaging in another, and the operating room, or theater as it’s called here, is in another.  The Ilula Hospital has a simple x-ray machine and an ultrasound machine.  There are no CT machines, MRIs, or mammography available here. Those scans, if available, would be done at a larger regional hospital such as the ones in Iringa or Dar es Salaam. The price for each test is listed on the door to that room.  We commented during lunch how there is such a lack of transparency in U.S.  We could learn a lesson or two from the Tanzanians.  Since my background is in stroke care, I inquired about the number of stroke patients they see.  He said high blood pressure and diabetes is on the rise, so they are seeing more strokes.  People arrive much too late for rescue treatment though.

They had one ambulance that serves a population of around 50,000 people from surrounding villages.  Unlike the U.S., most people arrive by private transport from up to 100km, or 62 miles away.  While we were there, the ambulance was not in use.  That was amazing to me. Most people here do not have private vehicles here. Transportation to the hospital would likely be on foot, motorbike, or 3-wheeled taxi called a bajaj.

The care provided at Ilula seemed to focus on maternal and child health. The government has done a lot of education to encourage women to receive prenatal care and to present to the hospital prior to labor to receive care. I was surprised to learn that could mean arriving 2-4 weeks prior to the due date.  He reminded us that many women had to travel 100km with unreliable transportation to get to the hospital, so they couldn’t just leave when labor began. After all the speed bumps and rough roads, we women agreed that contractions on a motorbike would not be pleasant!  With the average life span in Tanzania being about 60 years, the focus on reproductive health and that of children seemed to make sense. They had rooms for child and reproductive health, vaccines, HIV prevention, antenatal care, and family planning.

Another big difference we learned was that families provide the food and linens for the patient while at the hospital. Frank wondered how we could provide food for the U.S. patients.  We explained that care is much like a restaurant and hotel where patients order what they want to eat and rooms are cleaned daily. He commented that that sounded expensive. We agreed. Very few people have insurance in Tanzania. Instead, they pay out of pocket.  Even though the cost of tests and procedures are very cheap by U.S. standards, it is very expensive for Tanzanians.  If patients can’t afford to pay, their hospital fees are covered by the hospital employees via the Poor Patient Fund.  Each morning the employees have a daily prayer and take up a collection.  He estimated last week’s needs were around 200,000 shillings, or about $75. The BKB does help contribute to this fund.

We had another delicious lunch in the guest house, where we were befriended by some stray cats.  It took all their might for the kids not to pet the cats. Although it would have been cheap, we didn’t want to risk needing to use the hospital for rabies shots.

After returning to Iringa, the group took a short, but steep hike up Gangilonga Rock. Gangilonga is the Hehe word for “talking stone.”  We got a great view of the city, and took tons of photos.

We wrapped up the evening with a fabulous dinner at Saivilla, just a short walk from the Lutheran Center. We had another great night of visiting and sharing life stories. In addition to learning about the Tanzanian culture, this trip has given us the blessing of getting to know members of our own congregation better.