Tanzania – Colleen Lane (2014)

Healthcare Tip Sheet:
Traveling to or Living in Tanzania? What to know before you go.
Dispensaries and small community health centers, as well as traditional healers deliver the majority of healthcare in Tanzania. However there are also district hospitals, regional hospitals, and finally the consult hospitals which all have different services and varied ability to provide medical services.
Medical Dispensaries
1 per 10,000 people
A medical dispensary is able to provide basic medical supplies, vaccinations, and basic medications. Generally nurses staff dispensaries, although some private dispensaries may have an assistant medical officer or a physician. There are no inpatient facilities. Most dispensaries are able to provide basic preventative care, delivery services and mother-and-child care.
Health Centers
1 per 50,000 people
A health center usually has some capacity for inpatient care, generally about 20 beds. Typically they have a senior assistant medical officer, laboratory assistants, nurses and midwives on staff. They are able to provide basic preventative healthcare, immunizations, delivery services, and child health services. They also provide supervision to the dispensaries.
District Hospital
1 hospital per district (population 100,000-200,000), 1 bed per 1,000 people
Typically staffed by 2-4 medical physicians, also with assistant medical officers. Able to provide basic inpatient care and laboratory services: internal medicine, Ob/Gyn, pediatrics and general surgery. There are no specialized departments.
Regional Hospitals:
1 per district (population 1 million people)
Hospitals able to provide inpatient care, with experienced medical doctors, assistant medical officers, laboratory services and nurses. Many with schools for training assistant medical officers and some medical students may rotate there. They may have some departments of specialization. Theses are the hospitals that will refer patients to the referral or consult hospitals.
Consult/Referral Hospital
Each of the 3 hospitals service 1/3rd of the country’s population
There are three currently in the country. They have medical schools and teaching universities affiliated. Each has departments of specialization with experienced medical specialists and laboratory services. Accesses to advanced imaging (CT scans) as well as advanced laboratory testing are still limited even at these referral centers.
Dar es Salaam-Muhimbili Hospital
Mwanza- Bugando Medical Center
Moshi- (Kiliminjaro Christian Medical Center, KCMC)

Private Hospitals
The above-mentioned public hospitals and medical centers are often limited in the scope of medical care that they can provide. Therefore, many people with the means to do so often chose to attend private hospitals. A more comprehensive array of services can be offered, including more access to physician specialists, CT scans, and a wider variety of laboratory testing. A list of private hospitals is kept on the United States Department of State website, an updated link is provided below.
http://tanzania.usembassy.gov/list_of_doctors.html

Communicable Diseases:
As a traveler in the developing world, you are at increased risk of contracting common infectious diseases depending on the demographics of the regional to which you are visiting. The following is a list of communicable diseases that are present in Tanzania.
-Malaria http://www.who.int/mediacentre/factsheets/fs094/en/
-Typhoid http://www.who.int/immunization/diseases/typhoid/en/
-Tetanus http://www.wpro.who.int/mediacentre/factsheets/fs_20120307_tetanus/en/
-Tuberculosis http://www.who.int/mediacentre/factsheets/fs104/en/
-Traveler’s Diarrhea http://www.who.int/mediacentre/factsheets/fs330/en/
-HIV http://www.who.int/mediacentre/factsheets/fs360/en/
-Hepatitis A http://www.who.int/mediacentre/factsheets/fs328/en/
-Hepatitis B http://www.who.int/mediacentre/factsheets/fs204/en/
-Rabies http://www.who.int/mediacentre/factsheets/fs099/en/
-Schistosomiasis http://www.who.int/mediacentre/factsheets/fs115/en/
-Yellow Fever http://www.who.int/mediacentre/factsheets/fs100/en/
Travel Tips
1. Update your vaccinations before traveling.
Simple steps can be taken to decrease your risk of contracting the diseases listed above. This includes obtaining vaccinations against typhoid, tetanus, hepatitis A and B, as well as yellow fever prior to travel. The rabies vaccine is currently only recommended for travelers who plan to spend an extended period of time in endemic areas such as Tanzania, or those individuals who are planning to move to Tanzania.
**Bring your vaccination card with you! Some countries require proof of vaccination at customs during your point of entry.

2. Recognize the signs of dehydration, and treat it aggressively.
No matter where you are traveling in the world, you are at risk of developing the colorfully named: Montezuma’s revenge, Dehli belly, or traveler’s diarrhea. This common condition can quickly lead to dehydration and electrolyte abnormalities. High-risk areas for traveler’s diarrhea include developing countries in Africa, Asia, Central and South America as well as the Middle East. It is usually caused by bacteria contracted from undercooked foods, contaminated water, or unwashed fruits/vegetables. The E. coli bacteria is the most common cause, while Salmonella, Shigella and Campylobacter are less common causes.
• Drink plenty of fluids, water as well as fluids with electrolytes/sugar like sports drinks to keep hydrated
• If possible pack a few World Health Organization dehydration packets to use in case of traveler’s diarrhea
• Pack antibiotics to use in case of traveler’s diarrhea (Ciprofolaxacin or Azithromycin). Although, these antibiotics may be available for purchase in most big cities with a pharmacy without a prescription while traveling.
• Seek immediate medical attention at a hospital with a certified physician f you have bloody diarrhea, persistent vomiting that won’t allow you to keep down fluids, or a fever. These may be signs of a more serious bacterial infection.
• Seek immediate medical attention if you pass out, or feel like you might faint, especially when standing up, or if you feel your heart racing or pounding. These may be signs of severe dehydration and the need for IV fluids.

3. Be prepared for Malaria if traveling to an endemic area
The CDC website as well as your local travel clinic will advise you if the area to which you plan to travel has a risk for contracting Malaria. The best treatment for malaria is prevention! Be sure to get (and take!) you Malaria prophylaxis. This is a prescription, which you and your doctor will chose based on where you are traveling and the side affect profile. Also, remember to wear bug spray, daily, and wear long sleeves and pants at dusk especially during rainy season. But remember, if with all the right precautions taken you still may contract malaria.
• If you have a fever, joint pains, nausea, vomiting, headaches or flu-like symptoms, you may have Malaria. The quickest way to check is to purchase a rapid malaria test at any pharmacy. In Malaria endemic areas these tests are inexpensive and readily available. If you cannot find a Malaria test then you must go to a health care center for a blood screen.
• If your Malaria test (either blood screen or rapid test) is positive, you will need to get treated. In most cities and even smaller towns with a pharmacy or medical dispensary should have anti Malaria medication available for purchase.
• If you develop confusion, difficult breathing, or bleeding and either have a suspicion for Malaria OR a positive test then you need to seek immediate medical attention for possible severe Malaria.

4. Practice Safe Sex
When traveling abroad, you will have many new and exciting experiences. In some cases this may mean meeting new and interesting people, and possibly having a romantic relationship. Just like in the Unites States sexually transmitted infections (STIs) are common. Depending on the area of the world to which you are traveling there may be increased risk of certain STIs including syphilis and HIV.
• Be prepared to practice safe sex. Condoms are hard to find in many countries, especially religiously conservative countries. Therefore, condoms as well as your preferred birth control method should be on your packing list.

5. Be sure to bring Global Health Insurance
Some health insurance providers may provide some global coverage, but this should be clarified before you embark. Many insurance plans require that you buy short-term supplemental health insurance when traveling. This will cover expenses such as evacuation to your home country as well as expenses incurred in country needed for stabilizing and preparing you for transfer.
• Can compare prices for international health insurance at:
www.cignaglobal.com, www.globalhealthinsurance.com, www.imglobal.com

6. Be prepared for a hospital/clinic in the developing world
If you need to seek medical attention for any emergency, be prepared to encounter the healthcare system in a developing world. The clinic and hospital will be crowded and confusing. Bring a friend or if you are traveling alone ask someone at your hotel/hostel to accompany you. If you do not speak the local language, again ask a hotel or hostel employee to go with you. In most hospitals and clinics in developing countries you will be asked to pay for all medications, imaging studies (x-rays, CT scans), and services (stitches, surgery) in cash at the time they are delivered. So, be prepared. Bring plenty of local currency with you to the hospital. If you need to spend the night- you many need a friend to bring water and food, and maybe linen. So, plan ahead.
• Before leaving for your travel destination, look up location and addresses of local clinics and hospitals. As a general rule of thumb, private clinics and hospitals have more access to medications, and medical diagnostic tests.
• Go the US Department of State Website to find a list of reputable local doctors and hospitals
• Do not go to local healers, witch doctors or medicine men. Herbs used in local medicines may be harmful. Razors used to cut the skin for treatments can cause tetanus, and even transmit HIV.

7. Get a check up when you come home
Your primary care doctor will be able to screen you for possible diseases or conditions contracted when you were abroad. You may need treatment for parasite or worms if you were exposed. You may also need to be screened for tuberculosis.

This entry was posted on January 20, 2015, in Africa. Bookmark the permalink.

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