How one Burundian doctor became the only OBGYN in Sengerema, Tanzania

Dr. Harusha Simplice is the only obstetrician-gynecologist at Sengerema Designated District Hospital, serving over 700.000 people. After becoming a general practitioner Dr. Harusha secured his specialist training through Touch’s Treat & Train program, which improves medical education and patient care in the Lake Zone.  

A Burundian refugee forced to flee to Tanzania as a teenager, Dr. Harusha Simplice always knew he wanted to be a physician. According to his mother, at the ripe age of two he used to comfort his friends and family by reassuring them that one day he would be a doctor. His father also wanted to be a doctor, but he was never able to practice as he died in an accident two months after graduating from medical school. When Dr. Harusha was in his final year of schooling his mother was diagnosed with cervical cancer and died just a year later. It was his mother’s death that cemented his desire to help women and strive to one day become an obstetrician-gynecologist.

After graduating, Dr. Harusha began practicing medicine at Sengerema Designated District Hospital. Five years later, Dr. Harusha, now a father of two boys with another one on the way, decided he needed to find a way to receive specialized training to become an obstetrician-gynecologist and pursue his aspiration of helping women. At this point Dr. Harusha encountered Touch Foundation, just as we were in the process of expanding our Treat & Train program to Sengerema Designated District Hospital. Through Dr. Harusha’s perseverance and partnership with Touch, he was able to receive the education required to specialize in Obstetrics and Gynecology.

Today, Dr. Harusha is the only trained OBGYN at Sengerema Designated District Hospital. This 300-bed hospital serves over 700,000 people and delivers about 25-30 babies per day. For Dr. Harusha, it is not uncommon to attend to multiple women giving birth in the same room with the help of just two nurses. In fact, in Tanzania the shortage of healthcare workers is a main contributor to the high maternal death rate.

In early October, Dr. Harusha completed a training held by our partner MeduProf-S on SonoSite ultrasound machines in order to perform heart disease and obstetric ultrasound screenings during maternity checkups. For all of the clinicians present at the training, this was their first experience with an ultrasound machine. In the United States, women usually receive an initial screening at the beginning of their pregnancies to confirm a viable pregnancy. Most women in the United States will receive numerous ultrasounds throughout a pregnancy, and at least 1 anatomy screening at 20 weeks to ensure healthy development. Most Tanzanian women have never received an ultrasound screening during their pregnancy, but this is changing as women are increasingly requesting them and the technology is becoming more widely available.  Dr. Harusha’s training, and others like it, will not only give women access to ultrasounds to ensure the health of their developing babies, but will also screen them for any heart anomalies, which can go undiagnosed until delivery, putting the mother at risk during labor.  Following the training, the SonoSite ultrasound machine installed at Sengerema hospital, and three additional machines were installed in other high-risk area health centersDr. Harusha truly believes in the sustainability of the unique education model of Touch’s Treat & Train program.  He continues to learn new skills which are valuable for him and also valuable to the medical students he is training and to the women he is attending to. For Dr. Harusha, continuing his education and partnership with Touch is empowers him to achieve his goal of saving the lives of women and children.

Why can strep throat have such huge health consequences in Tanzania?

Rheumatic Heart Disease is a preventable cardiovascular condition that is rare in the U.S. but still causes hundreds of thousands of deaths each year in low-resource settings with weak health systems. It begins with a case of untreated strep throat.

A case of strep throat is no stranger to school-aged children in the United States. If treated with antibiotics, this common bacterial infection is relatively harmless and uncomplicated. But for people in countries like Tanzania, it’s not that simple. Cases of strep throat may be left untreated because basic health services cannot easily be reached and, over time, this spirals into an inflammatory reaction of the heart valves called acute rheumatic fever, which then induces rheumatic heart disease (RHD). RHD disproportionately affects young adults in the prime of their lives and can be especially fatal for pregnant women.

Renae Stafford, Touch’s Program Director of Academic and Clinical Services, co-authored an article published in March in Global Health that compiles information to help us better understand how to treat and prevent RHD in Tanzania and Uganda.

The study found that nearly 2% of schoolchildren in Tanzania and Uganda are affected by RHD. Moreover, deaths from RHD persist even in the presence of care with up to 27% of patients dying in surgical wards. Poor infrastructure and medical supplies, insufficiently trained healthcare workers, and other weaknesses in the health system contributed to these poor outcomes. Additionally, a lack of patient knowledge, stigma, and a history of poor interaction with healthcare workers mean that patients often don’t seek care until it’s too late. Ultimately, the Global Heart article stresses that there remains a great need for high-quality, up-to-date data on RHD, especially within low-income countries like Tanzania.

At Touch Foundation, we are committed to working with our partners to protect people in Tanzania and internationally from dying from this preventable yet fatal cardiovascular condition. With the support of Medtronic Foundation, Touch is tackling RHD by ensuring the health system is equipped to prevent, diagnose, and treat patients, especially vulnerable children and pregnant women, by conducting health worker training, upgrading equipment at health facilities, and hosting strep screening days at schools. Read more about how we are addressing non-communicable diseases like RHD here.

Read the full article: Annesinah H. Moloi, Sumaya Mall, Mark E. Engel, Renae Stafford, Zhang Wan Zhu, Liesl J. Zühlke, David A. Watkins, The Health Systems Barriers and Facilitators for RHD Prevalence, Global Heart, Volume 12, Issue 1, 2017, Pages 5-15.e3, ISSN 2211-8160, http://dx.doi.org/10.1016/j.gheart.2016.12.002.

The story of Allan Joel and his drive to save lives in the operating room

June, 2017

Five billion people live without access to safe, affordable surgical and anesthesia care. These operating room services are crucial to treating people with cardiovascular conditions, bone fractures, pregnancy complications, and many other health issues. If these services are inaccessible it can lead to an avoidable disability or premature death.  This situation is far too common in Tanzania where surgical and anesthesia care is lacking and the country is facing a large shortage of healthcare workers with the needed skills.

Allan Joel is an ambitious 29-year-old nurse anesthetist trained to meet all of a patient’s anesthesia needs before, during and after surgery or the delivery of a baby. Allan developed a passion for medicine in 1989, the year his father was diagnosed with diabetes. He witnessed his father suffer from inadequate medical care and decided at a young age to pursue nursing so that he could help his father and others in need. After graduating from nursing school, he applied for a nurse midwifery position at Sengerema Hospital, a 325-bed rural hospital serving 800,000 Tanzanians. Limited funding and resources at the hospital prevented Allan from getting a position and forced him to reconsider his career.

Touch accepted Allan Joel’s application to work as a medical scribe aiding the Treat & Train program. While Allan worked as a medical scribe, he was able to spend all of his free time volunteering in the ICU and operating theaters at Sengerema Hospital. In the ICU and operating theaters, Allan was exposed to anesthesiology and realized the impact he could have on patients’ lives in this field. Inspired to learn the skills necessary to provide life support in a safe surgical environment, Allan applied for a one-year nurse anesthetist certification at Bugando Medical Centre. With the help of a Touch-funded grant, he graduated in September 2016 and promptly returned to Sengerema Hospital to begin working in the operating room.

Mortality and morbidity related to anesthesia and surgery are all too common in Tanzania. We recognize the importance of a safe and sterile surgical environment to protect everyone, including patients, healthcare workers and students, from infection, injury, and other harm. Touch, together with hardworking individuals like Allan Joel, is working to improve access to safe surgical care and save lives at Sengerema Hospital and our other partner health facilities.

With Touch’s help, Allan was able to start a career in the field of anesthesiology. Although Allan’s work comes with many challenges, including working with only a limited number of trained specialists and equipment, his dynamic drive to find solutions has made him an integral part of the hospital. He has already devoted seven years of his life to improving the care of patients and aims to return to school next year to qualify as an Assistant Anesthesiologist. Touch is proud to support the ambition of young healthcare workers and improve the lives of Tanzanians by providing greater access to quality skilled providers and safe surgical care.