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St. Francis Referral Hospital - Ifakara

St. Francis Hospital belongs to the Roman Catholic Diocese of Mahenge and has fulfilled so far – according to a contract with the government – the assignment of a Designated District Hospital. It was responsible for the medical care of Kilombero and Ulanga Districts, in other words, for about 600.000 people living in an area approximately as large as Switzerland.
On 28/06/2010 the Minister of Health, Prof. David Mwakyusa, appointed St. Francis Hospital as Referral Hospital. Now it is one of 9 Referral Hospitals in Tanzania. That means that all hospitals in the surrounding districts which are not equipped with the necessary personnel and gadgets and can therefore not treat certain patients properly transfer them to Ifakara. Its area of responsibility has been extended this way, and the responsible staff are faced with great new challenges.

Planned to meet European standards

The new hospital was planned by Dr. Karl Schoepf himself. It was his goal to build a modern hospital with European standards. Its architecture is therefore –according to the tropical climate – bright, open and airy in all directions, with big windows, wide terraces in front of every ward and spacious areas of lawn between the buildings. On the other hand, the functional arrangement corresponds in its logic to the European example.
The whole hospital is a ground-levelled construction, except for two one-storey buildings on either end of the central longitudinal axis formed by a broad roofed corridor open to both sides.

The wards are accessible from this passageway (photo above)

The main entrance is situated on the ground floor of the front building. The offices of Administration and Medical Director lie on the first floor. In the rear building there are a kitchen, the library, the pharmacy, the hospital chapel and the offices of the new University.
The foundations of the whole hospital are more than half a meter higher than the lawn, so as to safeguard the buildings against being flooded in the rainy season, even during heavy thunderstorms. Finally, all important connecting passages are roofed.

Departments:

St. Francis Hospital has 371 beds and is divided into departments for Surgery, Internal Medicine, Gynaecology and Obstetrics, Paediatrics, Chronic Diseases and Intensive Care. Additionally, there are outpatients’ departments and wards for Tuberculosis, Dental Medicine, Physiotherapy, Occupational Therapy, Psychiatry, Leprosy, Rehabilitation, an X-ray department and a laboratory. And a special laboratory for the production of infusions, something not imaginable in Europe. Outpatients are examined and treated in a special building situated in front of the hospital, with departments for eye diseases, skin diseases and HIV/AIDS.

The figures of patients are impressive:

In the Outpatient Department, about 100.000 patients are treated per year, in the Inpatient Departments 17000. The number of births amounts to about 5000 per year. This vast number of patients has to be seen in relation to the number of doctors (as at December 14th):
10 Specialists
11 Medical Officers
11 Assistant Medical Officers
23 Interns
125 Nurses

Hospital Management

The hospital is run by a special committee, the “Board of Governors”. It consists, for one half, of representatives of the Diocese of Mahenge and for the other of government officials. Bishop Salutaris Libena is Head of the Board.


Rt. Rev.Salutaris Libena, Bishop of Ifakara Diocese


Day-to-day affairs are carried out by a committee consisting of 3 persons:
Dr. Fr. Winfried Gingo - Medical Director,
Mr. Onesmo Ngenzi - Administrator and
Mr. Meshak Lubeleje - Patron

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Financing

The hospital is co-financed by the Tanzanian Government and the Diocese of Ifakara.
Running costs such as basic salaries of employees and medicaments are covered by the government.
The Diocese is responsible for the maintenance of buildings and gadgets, for investments, and bonuses.
“Cost-Sharing” is another important source of income. It means, patients are charged a certain amount of money for hospital stays, treatment, examinations (e.g. X-ray), operations and medicaments. Only very poor people are exempt from this charge. The income from this source amounts to 36% of the budget.
Theoretically, this financing model seems to be reasonable. Unfortunately, in practice it does not work at all.

...main problems