Image donated by Abbot Dionys, Ndanda Hospital.

“The jar of flour was not spent, neither did the jug of oil become empty, according to the word of the Lord that he spoke by Elijah.” (1 Kings 17:16)

Ndanda Abbey is a Catholic abbey, which is located in the heart of Makonde land and has been here for 105 years.  Onsite is a bustling hospital, called Ndanda Hospital, which provides essential health care services to the entire region.

This hospital, which is run in cooperation with the Benedictine sisters, has 300 patient beds, which are supported by 300 workers and attended by 150 trained staff members.  In 2010, there were 10,429 inpatients treated at the hospital.  There are medical, surgical, gynecological, maternity, pediatric, and tuberculosis wards, a laboratory, and dental clinic.  The laboratory alone tested 19,910 patients for malaria and other blood-borne illnesses last year.  The hospital also has an x-ray machine, a pharmacy, and an active surgical ward.  The outpatient department treated 46,666 patents in 2010.  Alongside the hospital is a nurse training school.  Additionally, the Abbey supports local AIDS education and counseling programs throughout the area in villages with the aid of NGOs.  One of the unique advantages of the Ndanda Hospital is the fact that there is constant access to clean water from local, spring-fed water sources as well as stable hydro-electricity supplied by the same springs.

The Abbey is a great place to rest and break from our work in Mtwara.  A few Sundays ago, as we finished breakfast after church at Ndanda Abbey during a weekend visit, Abbot Dionys, the leader of the Abbey, stopped by the dining room to greet us.  Abbot Dionys has guided the Abbey for about ten years and has lived and worked in the Lindi and Ndanda areas for over forty years.  Kind, generous, and hospitable, the Abbot was outfitted in his Sunday garb of a long white tunic, which was complemented by his equally white head and chin beard.  On Sunday, the fact that he sought us out, and again showed support and interest in our work, was very encouraging.  In fact, the next day, he even let Ross test-drive his car.  The Abbot is the type of person who stops to talk to old village women and sick people sitting along the road that I somehow never even notice until he stops.  When he shakes your hand and says, “God bless you,” you know that God will.

Today the Abbot had the Ndanda Hospital on his mind and proceeded to share his worries that the hospital will face a financial crisis for the months of July 2011 to December 2011 and even more so in the year of 2012.  In July, the hospital was short of funds equal to about $141,560 USD.  By the end of 2011, the funding shortage will be $707,650.  This means that at this point, the hospital is no longer able to pay salaries or other expenses.  According to the Abbot Dionys, the reason for this funding shortage is complex.

One part or the reason for the funding crisis is that in 2007, the government pledged to support 54 employees and approve support for 35 more, but the funding for these employees has not yet come to Ndanda.  With increased government commitment to fund the hospital, the Catholic funding was gradually withdrawn.  Now there is a funding crisis, and the Abbot does not know where to turn.

Additionally, in November 2010, Ndanda Hospital was officially announced a Regional Referral Hospital by the government, which means that five district hospitals in the Mtwara and Lindi regions can transfer critical-cases there, especially orthopedic cases, motor vehicle accident cases, and other surgeries.  Two Dutch medical students who sat with us at that Sunday who are working medical rotation at a district hospital in the area testified to this fact.  They remarked that in the few weeks that they had been practicing at a district hospital, they had sent several patients to Ndanda because they did not have sterile gloves or other basic supplies on hand to use to perform even simple safe procedures.  In 2010, there were 2,778 major surgeries performed at Ndanda Hospital.

At a recent staff meeting where hospital employees and Abbey leaders proposed cuts in budget, they found that the most expensive areas of hospital functioning were surgical services.  At this time, patients are charged 30,000 Tanzanian Shillings (or $18.50 USD) per a surgery, the price of a bus ticket for one person from Ndanda to Dar, a price that most people are challenged to pay, but can reasonably pay perhaps out of savings or with the help of relatives.  For many years, this has been the standard price of the surgeries as a gift of charity to the community, although in actuality, the doctor’s fees, supplies, medicines, upkeep and maintenance of the operating room, sterilization of instruments, instruments themselves, etc. all add up to much more than 30,000 Shillings per surgery.  If the price of surgery is increased, I personally fear that many Tanzanians who need life-saving surgeries may go untreated for inability to pay.  In 2010, the income generated from patients was $328,840.

At this point, the Abbot does not know where he will get the funding needed to keep the Ndanda Hospital afloat in the coming months.  He has written the president of Tanzania as well as other government representatives, and the government states that they simply have no money to give from their funds.  We have heard that this may be because the government is currently directing a lot of healthcare spending to establishing clinics in the very rural areas in conjunction with one of Bill Clinton’s humanitarian aid projects.  Recently, the government has also increased salaries of hospital workers by 25% and the cost of medicines continues to rise.  Although these advancements are favorable for hospital workers and village people in far-out, rural areas, it puts a strain Ndanda Hospital’s financial situation.  The Abbot has written individual donors, friends, in Europe, but he admits that he is skeptical that individual donors will be able to make up for the wide gap in funding that looms before him in the next month and for the months to come.

The only option is to dramatically reduce services or dramatically increase the price for services.  For example, an increase in service prices of 100% to patients would keep the hospital afloat for 4 months in 2012, but an increase in service prices by 100% may be unreasonable and have devastating consequences, especially for the poorest of patients.  I personally dread the impact that the loss of surgical services will have on the already under serviced communities of the Mtwara and Lindi regions at large.

May the same Lord who provided abundance to spring from the Widow of Zaraphath’s last morsel to fill Elijah during time of famine, the Lord who sees each suffering patient in the Mtwara region, provide a sustainable funding solution for Ndanda Hospital.

Learn more about Ndanda hospital and Abbey at http://www.ndanda.org.

Heather volunteering in labor ward of Bombo Hospital in Tanga, Tanzania
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