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Badilisha Lugha KISWAHILI

This outcry over poor healthcare delivery!

17th May 2012
Many health facilities in Tanzania experience serious shortage of staff

Globally, nurses all over the world, know Florence Nightingale as the pioneer of the nursing profession.

Born in Florence, Italy on May 12, 1820, she came to prominence for her pioneering work in nursing during the war between Russia and Turkey in 1853 where she tended to soldiers.

Nightingale’s  ambition to become a nurse arrived when she was 25 years old. When an idea came to her that she should embark on the profession, she told her father – William Nightingale.
But her father, a wealthy landowner, was against the idea and turned down her daughter’s request outright.

It transpired that during the time, women were not allowed to be employed, and nursing was associated with working class women.

Undeterred, Florence, an Anglican, believed God had called her to be a nurse.

Her dreams came through in 1851, when her father eventually granted permission for her to train as a nurse.

The woman  who had inspired her to be a nurse was Elizabeth Blackwell who was then employed at St. Bartholomew’s Hospital in London – the first woman to qualify as a doctor in the United States of America (USA).

The young woman studied nursing at the age of 31 years at the Institute of Protestant Deaconesses  in Germany.  Two years later, she went back to London  where she was appointed Superintendent of a hospital for invalid women.

Every year, on May 12, the world celebrates International Nursing Day to remember her birthday.

It is to be noted that in the good old days, hospitals in Tanzania were regarded as redeemers; for any sick person taken there was expected to receive consolation, his or her degree of sickness notwithstanding.

But some few years ago, the situation changed; so much that one falling sick and taken to a hospital, especially government owned, was extremely worried of what would befall him or her.

Assuming Florence was here, she would certainly regret having joined the profession.  She would remember her father’s reluctance to let her become a nurse. Evidently, the spirit of nurses country-wide leaves much to be desired. 

In the case of Tanga Regional hospital, for example, there has, for sometime, been public outcry from poor health services providers. The public have ,for sometime, been   unsatisfied with the services  provided, so much that they , at one time,  over six  years ago ,aired their grievances to President Jakaya Kikwete at a mass rally at the Mkwakwani Stadium when he visited Tanga during his first five year tenure in office.

However, for some people, especially the old folks, the regional hospital was one of the best health providers  in the country.

But as time passed by, the situation gradually changed; with some nurses being branded rude to patients.

It transpired that when the President received the grievances, he instructed the then Regional Commissioner Mohamed Abdulaziz to visit the hospital, as a matter of urgency, to view of the then  prevailing situation.

When the Regional Commissioner went there, he was taken to various wards, including the sensitive maternity wing. Here, he found two to three expectant mothers sleeping in one bed.

A few others slept on the floor with mattresses without covers. Abdulaziz was told that there were no sufficient beds for patients, not only in the maternity wing but also in others. The nurses further complained of serious shortage of staff, saying a shift nurse was serving more than 40 patients – an extremely overworking situation.  The obtaining climate, undoubtedly led to unintentional change of attitude by most nurses towards patients, in items of patient service satisfaction.  The workload was just too much for the staff - a fact an ordinary patient would not easily understand.

In essence, the situation had been brought about by the fact that whereas the population was growing, the government budget for the health sector remained the same. This is because with the population rising, more patients were expected to be handled at health centres. Many Tanzanians view the situation as a shortcoming on the part of the government.

Statistics available show that hardly 50 per cent of expectant mothers visit health facilities  in the country;  the rest deliver their babies through services provided by traditional midwives.

In effect, the reasons some expectant mothers desist from delivering in public services is not known, though there are unofficial reports that in some hospitals, maternity wards are regarded as police cells.

In a nutshell, shortage of health providers in public hospitals is a serious challenge that is an inhibitor to efficient performance of nursing as a profession.

At the Internatiional Nursing Day held at national level in Tanga, the Tanzania Nurses Association (TANNA) blamed the poor health services provided by some health centres on serious shortage of nurses.

Romana Sanga, the association’.s Secretary General ,said in a message that nurses were grossly overworked, a situation which affected their health - consequently providing services which were below standard – creating numerous complaints by the public.

“One nurse is presently serving between 50 and 80 patients- against the international standard of one nurse per ten patients.

Sanga also detailed other challenges facing the nursing career as shortage of equipment for provision of health services.

She requested the government to consider provision of transport, housing, uniforms and similar allowance to nurses.
This year’s theme goes under the title “Closing the Gap From Evidence to Action”.

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