2008 Annual Report of Wasso Hospital: Ngorongoro's District Designated Hospital. In this report you will find some background information of our hospital and a summery of our achievements and challenges in 2008.

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Contributing to a better health status of the people, by improving the quality of the
health care services and making them accessible, acceptable and affordable
Annual Report 2008
Wasso District Designated Hospital
Postal: PO Box 42, Loliondo
Fax: +255 ­ 27 ­ 253 049
Tel: +255 ­ 27 ­ 253 190
Email: mo­ic@wasso­hospital.org
Website: www.wasso­hospital.org
Prepared by Dr Christian van Rij, accordingly to CSSC template 2009

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Contents
EXECUTIVE SUMMERY ........................................................................................................................................ 3
BACKGROUND ................................................................................................................................................... 4
HISTORICAL DATA OF FACILITY ...........................................................................................................................................
4
AREA OF OPERATION .......................................................................................................................................................
5
POPULATION AND DEMOGRAPHY OF THE AREA OF COVERAGE .................................................................................................. 6
SITUATIONAL ANALYSIS ..................................................................................................................................... 7
FINANCIAL ANALYSIS ....................................................................................................................................................... 7
STAFFING .....................................................................................................................................................................
. 7
INFRASTRUCTURE AND ACCESSIBILITY ................................................................................................................................. 8
MAJOR BURDEN OF DISEASES ............................................................................................................................................ 9
INSTITUTIONAL ARRANGEMENT ....................................................................................................................... 1
. 1
STRATEGIES ...................................................................................................................................................... 2
1
ACHIEVEMENTS AND CONSTRAINTS .................................................................................................................................. 3 1
WAY FORWARD ........................................................................................................................................................... 4
1
STAFF ESTABLISHMENT ..................................................................................................................................... 6
1
STAFF ON TRAINING ...................................................................................................................................................... 6
1
SOCIAL WELFARE ......................................................................................................................................................... 7
1
SUMMARY OF SERVICES GIVEN ......................................................................................................................... 8
1
MEDICAL SERVICES ....................................................................................................................................................... 8
1
PARAMEDICAL SERVICES ................................................................................................................................................ 0
2
SUPPORTIVE SERVICES ................................................................................................................................................... 1
2
SATELLITE SITE: DIGODIGO DISPENSARY ............................................................................................................ 4
2
EPILOGUE AND ACKNOWLEDGEMENTS ............................................................................................................. 5
2
ANNEX 1: DISEASE STATISTICS ........................................................................................................................... 7
2
ANNEX 2: MAP NGORONGORO DISTRICT ........................................................................................................... 8
2
ANNEX 3: NGORONGORO DIVISIONS, WARDS AND POPULATION ...................................................................... 9
2
ANNEX 4: INCOMING AND OUTGOING STAFF IN 2008 ....................................................................................... 0
. 3
ANNEX 5: COMMUNITIES SERVED WITH OUTREACHES ...................................................................................... 2
3
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3.
Executive Summery
Wasso Hospital is a District Designated Hospital. The remote location is making our operation quite
difficult as it gives logistic problems. Due to this we also have higher running costs and it makes it
also more difficult to attract good staff. The patients we are serving are among the poorest of the
country, which limits us in making a financial balance with patient fees for the costs not covered by
governmental sources.
Wasso Hospital Key Data 2007 2008
Outpatients 16,589 16,951
Although 2008 was a challenging year
for Wasso Hospital, we feel blessed Admissions 2,316 3,094
that we managed to overcome these Death / Admission Ratio 0.032 0.021
difficulties. In the medical field we Deliveries 523 605
continued with our different projects, Perinatal Mortality / Delivery Ratio 0.048 0.031
like the outreaches and the Care and Treatment Clinic for people living with HIV/Aids. Although we
faced a shortage of medical officers at our site, we are happy to announce that the quality of care
remained good or improved in all major areas. We did not have complaints for malpractice and the
ratio of death per admission dropped with one third. Although we had an increase of 16% of the
amount of deliveries, we did not had any maternal death and our perinatal mortality ratio dropped
with 34%.
As a reflection of good medical practice, we saw the number of patients rise slightly in our
outpatient department and significantly in our inpatient department. The hospital also managed to
gain a good name at Dutch universities making them decide to send student doctors for electives to
our hospital, which boosted an atmosphere of education at our hospital.
Administratively we also made a lot of progress. We managed to fill the gap in our management
team with the arrival of a new administrator in June. The management became more transparent by
clarifying the basis of management decisions, and by proposing an organogram to the staff so that
lines of communication within the hospital became clear. Finally we also managed to improve our
financial transparency to donors and to gain further trust from by undertaking all efforts to make a
cost reductions in our not medically very relevant expenditure. Together with a good medical
performance, this triggered our donors to assist us more, which
enabled us to make large reductions in our debts.
Digodigo Dispensary is run as a satellite of Wasso Hospital. It is
located 68 kilometer from Wasso Hospital. Staff shortages en drugs
shortages remain a difficult issue for this site. We have the ambition
to make several improvements to the site in the coming year to
facilitate its upgrading to a Health Centre with a Service Agreement
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with the Ministry of Health and Social Welfare (MOHSW). But even
though these problems exist, Digodigo Dispensary still remained the dispensary with the highest
utilization in the district.
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Background
Historical data of facility
Dr Herbert Watschinger studied medicine in the early ninety
fifties. After graduating from medical school he studied
theology to enable him to also give spiritual care. After he
became a parish priest in Linz, Austria, he made a large trip
to East Africa in 1960. As a result of this trip he met Sister
Guida Reichhör who insisted that he would come to Loliondo
to start a hospital among the Maasai. Up to that moment
there were – besides traditional practices – no health care
services available in the district. Dr Watschinger accepted
this challenging mission and started to mobilize the Austrian
community to assist him in the establishment of a hospital
for the Maasai. Although doctor Watschinger was living in
the parish in the border village Loliondo, he chose to establish the hospital about 8 kilometers more
to the south at Wasso. He decided to build it next to a natural water source where the pastoralistic
Maasai were coming to give water to their cattle (and this is also why the hospital has also been
acting as the protector of water sources). On 2 September 1964 the hospital was opened.
From Wasso Hospital Dr Watschinger was also serving the Watemi in Sale Division. But sometimes
the Palalet river was making transport between Sale and Wasso, 68 kilometers apart, impossible.
Therefore the Watemi requested Dr Watschinger for assistance to build a maternity clinic there. Dr
Watschinger agreed to do that and in 1973 the Digodigo Clinic was opened.
Dr Watschingers ambition did not stop there as he realized that the people in the very south of the
district were still poorly served. For long time he had been serving the population around Endulen by
performing flight clinics to that site, but in February 1976 he managed
to open his third health care facility in the district, Endulen Hospital.
Until the death of Dr Watschinger, financial resources were mainly
provided by private and church related organizations in Austria. After
this the Austrian government took over the majority (90%) of the
funding for the hospital. Austrovieh, later called Austroproject, was
entrusted to act as Austrian government project holder for the three
Watschinger hospitals.
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In 1995 Wasso Hospital has been officially designated as the district
hospital. This designation is based on an agreement between the
Tanzanian Ministry of Health and Social Welfare (MOHSW) and the
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Catholic Archdiocese of Arusha, who is the legal owner of Wasso

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Hospital. This is entitling the hospital to receive government grants for staff, drugs and some other
charges. Since that time the percentage wise financial contribution of the Tanzanian government to
the hospital has increased. From the year 2000 the Austrian government started to cut down their
contributions to the hospital as the Austrian government wanted to focus on other countries for
their development aid. From 2005 onwards, the support from the Austrian government completely
ceased, which caused large financial problems at the facilities.
In the first decade of the 21st centenary the hospital
continued grew quickly in correspondence with the
increase of the population of the district. This is for
Number of Beds
example reflected in the raise of the amount of beds 200
available at the hospital. The most recent increase in the
100
number of beds was made after moving into the three
new wards in the summer of 2007. These wards were 0
build in the preceding years with financial assistance from 1990 1997 2002 2007
the Ambassador of the United Arab Emirates Mr. Mallala
Al Ameri.
Area of operation
Wasso Hospital is the district designated hospital of Ngorongoro district which measures 14,036 km2.
Ngorongoro is the most isolated district of the Arusha Region. Just south of the Ngorongoro Crater,
the district is bordered with Karatu district. In the west it is bordered with Serengeti National park, in
the north with Kenya and in the east with (the salty) Lake Natron in the Rift Valley. Administratively
the district is divided into 3 divisions, 14 wards and 37 registered villages (see annex two and three
for more details).
Wasso hospital is located in the so called Rift Area, 20 km from the Kenyan border at an altitude of
2,005 meters; in between the Serengeti steppe in the west and the Rift escarpment / mountain
ranges in the east. Wasso is located 6 km south of the district headquarters Loliondo.
Wasso Hospital Catchment Area describes the area
where we are supposed to provide a health care
to. According to government resolution, our
catchment area consists of 30,002 people in 2008
(supposed to reflect a part of the Orgosorok
Ward). In reality Wasso Hospital is the leading
service provider in a much larger area, which we
call Service Area. This consists of the Loliondo and
Sale Divisions and a large area in Kenya (see annex
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2). Other health care facilities in the area are
mentioned in annex three, but besides Endulen
Hospital and Arash and Digodigo Dispensary, there
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quantitative contribution is not large.

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Population and demography of the area of coverage
Projected from the 2002 national census, in 2008 Ngorongoro District was populated by 186,464
people divided over roughly 32 thousand households. This means on average 13 people per square
kilometre. The annual growth was estimated at 4.5% (roughly twice as high as country average).
There is no data known about the age distribution and life expectancy of our population. Also key
indicators for the health care are not know on district level. As reference we shall therefore mention
the Tanzanian averages (data from WHO statistics from 2007):
Age structure: <14 years: 43%; 15‐64 years: 54.1%; > 65 years: 2.9%. The median age is 18
years. Total life expectancy at birth is 50.5 years for males and for female 53.3 years.
The total fertility rate is 4.5 children born/woman. An estimated 43% of all births is attended
by skilled personnel. The maternal death rate is reported to be 578 per 100,000 but
estimated by WHO at 950 per 100,000. The under‐5 mortality rate in rural areas is 138 per
1000 live newborns.
We expect that the age distribution is even lower in our district, and likewise also the life
expectancy. The fertility rate is likely higher, the non‐medically supervised deliveries is certainly
higher, and therefore the maternal death rate will also likely be higher. Also the under five mortality
rate is expected to be higher.
The main and indigenous inhabitants of the district are the Maasai (±80%) and the Watemi (also
called Sonjos). The Maasai are mainly pastoralists who depend on cattle herding. The Watemi
sustain themselves mainly with agricultural activities and are living in Sonjo valley (the area around
Digodigo Dispensary). Both groups are therefore extremely vulnerable to periods of long drought. In
more recent times there is a big influx of job looking non‐indigenous ethnic groups to the area
around Wasso and Loliondo. The Maasai and Watemi have quite distinct cultural differences.
Language problems are still a serious problem in our district where especially people with a Maasai
background have often difficulties expressing themselves in Swahili. Also the districts literacy rate is
estimated to be far below the countries average.
On average, the people in our district have little financial means. The Gross National Income (GNI)
per capita in Ngorongoro district was according to the 1998 Arusha Region Socio‐Economic Profile
one third of the countries average.
Extrapolating this ratio to 2008 would
mean an average income in Ngorongoro
of around 317 euro per capita per year.
Financial reserves are within the Maasai
population mainly invested in cattle.
Periods of drought in which many cattle
will die will therefore directly influence
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their means for living.
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Situational Analysis
Financial Analysis
In the past years, the MOHSW has been increasing its contribution to our district hospital, this is
done in form of payment of the salaries of staff, direct contributions to MSD, Basket Fund allocations
and some other charges. On the other hand government regulations are stipulating that the majority
of our in‐ and outpatients should be treated for free. In addition the hospital is also carrying out
several CHMT tasks like the outreaches and a school health program into two of the three divisions
of our district.
As the Basket Fund allocation is mainly used to compensate for the costs of the outreaches, and cost
sharing income (patient fees) are not adequate to cover for all patient related expenses, it is difficult
have the remaining (fixed and flexible) costs covered. Especially worth mentioning are the costs for
the staff allowances, which are not covered by the government, but are higher than the total patient
fee income. Also finding financial sources to cover for special projects – like for example the building
of staff quarters – is difficult. So for these issues we are mainly depending on external donors. The
fact that such external donors were not present in 2005 and 2006 resulted in huge debts, which
were still largely present in 2008.
During 2008 we managed to improve the financial status of the hospital significantly. We reduced
our costs by improving financial regulations and habits. On the other hand we managed to increase
our cost sharing income by providing a higher quantity and quality of our services. Furthermore we
managed to secure improved budgets for vertical programs run by the hospital. Finally two NGO’s,
Watschinger Foundation and CORDAID, have played a significant role by giving large financial
support in an integrated way to the hospital. Their donations should be seen as a recognition of our
improved transparency and performance in 2008.
Staffing
Attracting and retaining staff at a remote location like Wasso remains difficult. We have taken up
this task by not letting our staff down on our promises, among which is most notably the correct and
timely payment of salaries and allowances. Furthermore we have come with other incentives to
increase the team spirit, the atmosphere of friendship, and the identification of oneself with the
objectives of the hospital. We therefore invested in sport activities, in celebrations, shown our care
to our staff, by discussing our mission during staff meetings, and by giving small tokens of
appreciations like Christmas presents. Although the actual costs are not that high, these investments
have really shown its value.
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Staff incentives for new staff also involves giving salary top ups and providing the staff with a staff
house. Unfortunately financial recourses for salary top ups were very limited. Also the number of
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staff houses available are limited. It would be good if we could start new building project in the

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coming year so that we can continue providing staff with this incentive. Additional donors must
therefore be sought.
In spring 2008, the district authorities started to recruit staff from our Hospital. Initially this was said
to be done in order to retain them working at Wasso Hospital. Later, we regretfully learned that
most of the staff would be reallocated anyway. From the perspective of our staff, the most
important reason to join the government contract was that their pension scheme is much more
attractive. It is important that we can achieve a balance in governmental and FBO incentives.
Compared to national standards, the hospital significantly run short of medical staff in several areas.
Since October 2007 there was no administrator present, putting a severe workload on the other
members of the hospital management team. Fortunately a new administrator, Mr Claude Rieser
who was recommended by the Watschinger Foundation, joined us in June.
After Dr Msechu was not longer allowed to
continue working at Wasso since December
2007, the hospital was left with only two
medical officers for 2008. It was in late
December that a new medical officer would
join the hospital. Dr Frank Liso fortunately
joined us in October 2008 as an AMO to
assist in the huge work. The shortage of
AMO’s would remain 9 according to national
guidelines. In early 2008 we had 8 clinical
officers working with us, of which one was
allocated to Digodigo Dispensary.
Government guidelines stipulate that we would need 14 clinical officers.
Another big shortage was present in the nursing department; more specifically among Nurse
Midwives. The nursing department was usually not larger than 24 nurses (Nurse Officers and
Midwives combined), while this should be accordingly to government regulations 49. Although our
number of nurses remained reasonably stable during the year, it must be mentioned that the
turnover of nurses was quite significant.
Infrastructure and Accessibility
In 2007 several necessary improvements were done to new wards donated to the hospital in 2005
by the Ambassador of the United Arab Emirates. Besides that it made an increase in the number of
beds possible, it also assured that the former wards could be used for other purposes – for example
for the new CTC, for storage and as staff quarters. In 2008 we were also able to move the ICU to its
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new location which is more spacious and in connection with the nursing station.
The earthquakes in 2007 and 2008 caused many cracks in our hospital buildings. Slowly (limited by
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the high costs) we started repairing these cracks in 2008.

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TB ward appeared to be too extensively damaged to be repaired by ourselves. We have been trying
to look for possible solutions with the district authorities. The same applies for the bridge which
gives access to the hospital as it will likely not survive another rain season.
Wasso Hospital is in itself quite well accessible located next to Wasso village, with dirt road
connections to Loliondo and neighboring villages. Accessibility from further locations is difficult for
many due to the limited ways of transport in general in Ngorongoro: no tarmac road is present, dirt
roads are also in poor condition or barely existing and public transport is very limited. Referral
hospitals are at least one full day of traveling by road. Also most of our procurements need to come
from one day traveling far. For emergency transport there is only one ambulance available within
the district. In special cases we have the possibility to ask Flying Medical Service for an evacuation by
flight – though this is very costly. We try to bridge the problem of accessibility by also going on daily
basis with car and flight clinics to these hard to reach communities. Also for the flight clinics we are
depending of the assistance of Flying Medical Services – though they provide this service for free.
Communication within the district is poor, in large area’s radio call is the only means for direct
communication. Fortunately the network coverage for mobile phones is increasing. Landline
telephone is only available in a few limited places. Since 2006 we fortunately have an internet
connection via a satellite – though very costly.
Major burden of diseases
Malaria followed by pneumonia remain the biggest threat to people in our area, especially under
children. They are the number one and two disease in our top ten of illnesses and as the causes of
death. We therefore strongly support the government program on Alu as a free first line drug for
malaria as this is saving many lives. The reason we still see many deaths from these two diseases is
that patient still come very late to our hospital when the disease is already very advanced and
treatment with even second line drugs is then sometimes still too late.
Although malnutrition is only mentioned as the main admitting diagnosis in 40 patients, we do
notice malnutrition is a major complicating factor in patients admitted for other diseases like
pneumonia and burns. We are therefore see it as important to continue with our free patient meals,
although the real solution can only be made on a community level.
In the top ten of deaths, the most noticeable development is the sudden appearance of ARC (Aids
Related Complications) as the number one cause of death among admissions older than five years
(15 death in 2008 compared to 7 in 2007). Possible explanations could be: A) an increase in the
number of patients with ARC (increasing HIV‐epidemic); B) an increase of patients with ARC who are
seeking help (as it is better known that we can currently treat people living with HIV/Aids); C)
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previously insufficient recognition of ARC among doctors. Other changes in the top ten lists are not
very significant or are based on different naming of diseases.
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Although the numbers still remain relatively low, we do see a significant increase in diseases which
are associated with older age, like for example cardiovascular diseases. In 2007 total admission for
cardiovascular diseases was 20, but in 2008 it grew to 53.
Please see annex 1 for the top ten diseases for outpatients, inpatients and causes of death.
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Institutional Arrangement
The hospital is part of the Health Department of the Archdiocese of Arusha. The
medical officer in charge is therefore invited as a member to the Archdiocesan
Medical Board in which all Archdiocesan health facilities plus the Regional Medical
Officer are represented. Its meetings are held every quarter of the year.
Underneath the Archdiocesan Medical Board functions the Board of Governors of
the Hospital. Its chairman is the Bishop’s representative; the secretary of the
board is the medical officer in charge. Although the final constitution of the
Hospital Board of Governors is still to be decided by the Archdiocese, other
members are the Archdiocese Health Secretary, the Hospital Administrator and
the District Medical Officer. Its meetings are also quarterly, in advance of the
Archdiocese Medical Board Meetings.
Directly under the Board of Governors functions the Hospital Management Team,
which is responsible for the daily management of the hospital. It is chaired by the
doctor in charge and consists of the head of departments as mentioned in the underneath hospital
organogram. The organogram also reflects which units are under which department.
Once per month (or more when there is an emergency) the Hospital Management Committee is
formed to go through issues which need a broader discussion or consultation with unit leaders from
the hospital. In this team are the Head of the Departments (administration, medical, nursing and
accounting) plus a selective group of unit leaders. Currently this selection consist of the Head of the
Workshop, Head of the PHC department, one representative from the OPD/Doctors, one
representative from pharmacy/laboratory/radiology/ physiotherapy units (also called paramedical
group), and finally the in‐charge of Digodigo Dispensary.
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12.
Strategies
The Mission view of our hospital is that we “exists to fulfill the call of Christ in the healing ministry by
improving the health Status of all, especially those most in need”. Our Vision on how to achieve this
is that we should “undertake all efforts to contribute towards a better health status of the people in
the area, by improving the quality of the health services and by making them accessible, acceptable
and affordable”. For this we have undertaken several strategies to achieve this.
In order to link with especially the poorest communities who will else have difficulties to come to the
hospital, we organize an extensive outreach program. With these outreach program we go to 26
remote communities by car on four weekly basis, and to 11 communities on two weekly basis.
During these outreaches we provide general health care and an extensive mother and child health
program.
At Wasso Hospital we emphasize on good a quality of care. We try to achieve this by having every
working day a morning report where representatives of all medical and paramedical departments
meet to discuss the wellbeing and progress of our patients. During these morning reports we also try
to give continuing education to each other. Also by sending staff to training sessions elsewhere and
by upgrading our staff by sending them to school again, helps us to achieve good quality of care.
Finally, having students among us at the hospital will also create a better atmosphere of continuing
education.
One of the most important ways to make our hospital affordable is by implementing a flat fee
system since 2007. Patient will only pay the fee accordingly to the category they are in, which
reduces the risk of families running huge financial problems due to unexpected high medical costs.
This system has managed to attract more patients who otherwise would not have come to the
hospital. In conjunction with this system we have also set up an poor patient fund where people
who cannot even pay the flat fee rate can apply for assistance.
In order to improve the financial status of the hospital we have also linked with several NGO’s.
Watschinger Foundation and Cordaid have proven to be huge financial donors to the hospitals in an
integrated approach. Another significant NGO is EGPAF who assisted the hospital with large financial
contributions into the vertical program for HIV/Aids care. In order to receive continuing support
from NGO’s it is important that we remain transparent and accountable for all our activities and
spending.
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13.
Achievements and Constraints
In 2008 we have managed to improve the level of care to our
people by on one hand increasing the quantity of care we have
provided to them, and on the other hand by also increasing the
quality of care. The amount of patient served through our
outpatient department has increased with several hundred
patients to almost 17 thousand. We have managed to increase
the number of admissions by one third to 3,094 patients. Also
the amount of institutional deliveries has increased with 80
patients to a total of 605.
Although an increase of patients served can easily turn into a decrease of quality of service given, we
are happy to state that the opposite has happened. We have managed to decrease the amount of
deaths per admission with one third to 1 per 47 admissions instead of 1 per 32 admission in 2007.
We did not have any maternal death in 2008 and the perinatal mortality dropped to 1 per 32
deliveries from 1 per 21 deliveries in 2007.
It remains a difficult to reduce the amount of bed days per admission. This by the fact that many
patients live far from health care facilities. Many times we cannot discharge patients who could be
treated further as outpatients as they simply live too far to come for daily treatment to OPD. The
amount of bed days per admission is also higher
due to the fact that we have many mothers Bed Days 2008
admitted who are just waiting for safe hospital Total Number of Bed Days 43,421
delivery (such an admission can sometimes take Average no of bed days / admission 14 days
up to six weeks).
Administratively we have managed to achieve a better level of transparency to our staff. We
achieved this by making the staff better aware of guidelines and values we used as the basis for our
decisions. And we gained trust from our staff by also adhering to the same guidelines and values
when they even would not favor the hospital management. We also improved the information flow
from the lowest to the highest level of management, and vice versa, by establishing a renewed
hospital organogram in which everybody could identify him or herself. Also our archiving practice
has much improved by initiating a special system.
Financially we improved our spending by reducing a lot of unnecessary costs, and making
investments in specific areas. Not budgeted expenses were reduced as much as possible. Also the
budget preparations in itself were improved by making use of a better and more accurate and more
detailed estimations.
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The combination of an improved level of care with a more transparent and accountable expenditure
did not only give us more trust from our staff, but also from foreign donors.
Challenges were of course still there in 2008. Administratively we have not yet been able to identify
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all debts we currently have (especially with staff). The financial burden of unpaid debts was still that

14.
high that the balance between debit and credit is still negative. The payment of staff expenses and
other investments are still difficult issues. Shortages of medicines also occurred in 2008.
Attracting and retaining key staff also remained a challenge in this remote environment in a country
with a nationwide shortage of medical staff. The high performance we achieved in 2008 must
therefore be recognized as the additional hard work of the people in these units who were
understaffed.
Way Forward
We see it as very important that we continue in 2009 the successful path we have started in 2008.
Transparency and accountability will remain the key for gaining trust with higher organs, external
donors and our own staff. For 2009 it will be good to further clarify at which level the different
responsibilities and tasks situated, which will also reflect the area of authority each entity has.
It will be good to continue with all educational activities so that the level of care will remain high at
our hospital, or even further improve. A closer collaboration in this area is also needed with the
office of the DMO in order for the management to make better strategic decisions for trainings.
In order to gain and retain staff at our site, we see it as crucial that new significant investments are
made for staff quarters. As the hospital does not have the financial resources to make these
investments, an external donor will need to be found for this. It will be good to appoint a project
manager on this issue as quicker results can then be expected.
Continuing to be transparent and accountable to our donors will be essential in the future as donors
are getting more and more critical about how their donations are being utilized. In this contest it is
important that significant investments are made into our accounting department. The currently used
QuickBooks system is not transparent enough to many people. Besides that the current system also
has its security gaps and it is also not easy to keep up to date on a daily basis (especially as only one
person has the ability to enter the data). Plans are already being made to come to a new electronic
Hospital Management Information System (HMIS) which will not be employed by the accountant
only, but hospital wide. In such way tracking of all financial flows, goods and services provided can
be done accurately, with daily information to the management for decision making. It will also be
used to collect medical data in a comparable but quicker and more detailed way as the current
MTUHA reporting books.
We also see the upgrading of Digodigo Dispensary as essential in order to have it run in a sustainable
way. Several investments will need to be undertaken so the facility meets the essential criteria to
become a Health Centre. In the mean time investments will need to be made into the administrative
performance of the dispensary, especially in the area of the procurement of medicine.
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Unfortunately we did not have enough proper qualified staff for several units in 2008, but
fortunately we expect several staff to return from school in 2009 who can then assist us to revive
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these units / services. We for example expect one staff to return as a assistant dental officer and he

15.
can assist us to have a proper functioning Dental Unit again. Also we expect our first properly
schooled physiotherapist to return to the hospital. With his return we can really boost our services
to patients with locomotor problems. We also expect a social worker to return. He will be working
within the nursing department with the aim to assist patients with social problems, and also to
create linkages between the hospital and the communities we serve. Finally we expect also one
nurse officer to return from school in September.
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16.
Staff Establishment
The management team consisted in 2008 of the following people. Medical Officer in Charge: Dr
Christian van Rij; Administrator (from June onwards): Mr Claude Rieser; Accountant: Mr Joshua
Msigwa; Matron: Mrs Ndeskukurwa Mbise. Besides the above mentioned people we also had the
following people in our administration department. Secretary: Siwajibu Nzwegema; Office Assistant:
Joseph Parsambei (from September onwards); Cashier: Anna Jeremiah Msuya; Store keeper: Julieth
Mweleka. A vacancy for an accountant assistant was not filled.
Besides the above mentioned Dr Christian van Rij, there was only one other medical officer working
at the hospital, Dr Josephine Kyamakya. Fortunately Dr Frank Liso joined the doctors team in
October as an AMO. During the last weeks of the year, one additional doctor joined us, Dr Timizaeli
Sumunai.
The team of Clinical Officers consisted of 8 doctors of which one was allocated to Digodigo
Dispensary. In September Dr Rohella Kaserian left to school for upgrading. Four other clinical officers
would join government contract: one of them would be reallocated to Malambo, three others would
only remain part time available at the hospital. It is clear that new clinical officers must be recruited
in 2009.
The nursing staff was not at full strength accordingly to government regulations. Excluding Nurse
Assistants, the total amount of nurses should be 49. Our nursing department consisted on average
of about 24 nurses. Another complicating factor within the nursing department was that many
government seconded nurses would only remain for short period in the hospital before being
reallocated to other sites within the district. This complicated plans from the management to make
investments into specific people for specific tasks in the hospital. A better coordination with the
office of the DMO is needed on this.
The paramedical staff was not at full strength in 2008. Especially in the laboratory there was a
shortage after Mr Felix Zelote joined government contract and left the hospital (breaking his
bondage contract).
Please see annex four for a detailed overview of staff who left or joined an archdiocesan contract.
Realize that this list doesn’t reflect the changes that happened with seconded staff.
Staff on Training
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Full Name Education End Date
Apolonia Cyril Meela Diploma in Nursing 31‐07‐2010
Charles Julius Kivambe Assistant in Laboratory Technology 11‐09‐2009
Esther Nelson Besango B.Sc. Home Economics and Human Nutrition 19‐06‐2010
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Evance Josephat Mkini B.Sc. in Physiotherapy 19‐06‐2008

17.
Faraja Israel Malalika Certificate in Nursing 07‐31‐2008
Frank Lisso Assistant Medical Officer 06‐19‐2008
Jacob Joseph Seyai Nursing Officer 30‐06‐2011
Joseph Saisa Laizer Trained Nurse 31‐07‐2009
Linda Thomas Ndangoya Diploma in Nursing 19‐06‐2008
Lucas Toroya Advanced Diploma Social Worker 01‐08‐2008
Mlejo Ngurumwa Lembyino Diploma in Nursing Psychiatry 14‐06‐2010
Sabina James Kiromo Diploma in Nursing 11‐06‐2009
Theresia Tarimo Aloyce Nursing Officer 10‐09‐2009
Victor Mushi Ndale Dental Technician / Assistant Dental Officer 01‐09‐2009
Rohela Simon Kaseriani Bachelor of Medicine & Surgery 01‐01‐2013
Social Welfare
Staff under contract with the Archdiocese make social welfare contract. In 2008 there has been
some staff unrest as there were worries that not all mandatory payments had been paid in the
preceding years. Although it was not difficult for the management to prove that currently payments
were done properly, the administrator it lacked documents with individual staff NSSF summaries of
previous years. A task force was put on the issue and by the end of the year, serious progress had
been made to clear up this issue. The final NSSF summery will be made in 2009.
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18.
Summary of Services Given
Medical Services
Out­patient­department
We can reflect on a good running out patient department (OPD) in 2008. OPD 2008
Although staff shortages were present, the head of the OPD, dr Humphrey under five 7,244
Mshana, managed to run it well. We even saw a small increase in our above five 8,573
patients treated there, reaching almost seventeen thousand patients in retreatment 1,037
2008. 46% of the patients were under five years old and therefore treated referrals 97
for free. Furthermore we saw a decrease in the amount of patients we Total 16,951
had to refer.
The outpatient department consists of a room for the cashier, registration, dental, drug dispensary,
and five doctors rooms. Although this is already a huge improvement compared to the situation in
early 2007, we are still running short in space, especially for the waiting patients.
In­patient­departments
As mentioned before we saw an increase of 34% of our admissions. This gave a very significant
increase in the workload for the nursing staff. It would also challenge our budget as we in our flat fee
system can only regain a small portion of the actual admission costs. But fortunately we managed to
keep the quality of care up to a high level and even managed to achieve a reduction in our patient
mortality.
The following wards have been managed as one unit by Joyce Sinodya: Pediatric (36), ICU(6), TB (32)
and the Private Ward (5). The following wards have been managed as one unit by Cecilia Nkii:
Female (24), Male(20), Antenatal (24), and Labor (11) Ward (consisting of a first‐stage room, a labor
room, and a post‐delivery room). In total we have 155 beds plus 3 first stage beds and 3 delivery
beds.
Theatre
Mrs. Esther Clement has been besides assistant matron also the head of major theatre. In the past
year we have received many compliments from visiting specialist for the quality achieved in that
unit. In total 224 operations have been performed in major theatre. Caesarian sections are the
leading major operation performed (47 times in 2008), but abdominal and orthopedic surgeries are
also performed at our hospital.
Mrs. Bertha Stephen is besides our most experienced nurse anesthetist also the head of minor
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theatre. Minor surgeries, incision and drainages, curettages, fracture reductions and wound
dressings are performed on daily basis. In 2008 4474 procedures were done in minor theatre.
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19.
Specialist Outreach Program
During the past year we were happy that multiple specialist have been willing to come to Wasso to
assist us with patients in need of specialist care. We are also grateful to them that they assisted us
with continuing education program by giving lectures during their visits. In total we have received
the following 10 teams.
Date Specialty Via
4‐7 February Pediatrician AMREF
21‐24 April Gynecologist AMREF
19‐22 May Ophthalmologist St. Elizabeth
14‐17 July Surgeon AMREF
11‐14 August Ophthalmologist St. Elizabeth
22‐25 September ENT Surgeon AMREF
27‐30 October Urologist AMREF
3‐6 November Opthalmologist St. Elizabeth
1‐4 December Pediatrician AMREF
13‐17 December Orthopedic Surgeon Selian
Aids Control Program
Since February 2006 we have started to provide services to people living with HIV/aids. We were
grateful for the support we received from the NGO EGPAF who supported this vertical program in
many ways.
In 2008 we managed to test 645 people for HIV of which 95 were positive. At the beginning of 2009
we had 161 patients in total enrolled of which 81 were eligible to ARV, 78 were actually taking the
ARVs (of which 3 were under 14 years). We managed to do follow up on most of our patients,
although it remained a difficult task as often we were lacking a car for this purpose. Fortunately, we
expect to receive an additional car from EGPAF in 2009 so that this problem will be solved in the
near future. We hope that another constraint, the lack of enough staff trained on HIV/ART, will also
be solved in 2009.
Dental Unit
The Dental unit showed a decrease of patients served. In 2008 a 2007 2008
total of 365 patients received dental care; most of them needed Carriers 68 62
extraction as the condition of the teeth was too bad. Unfortunately Other 433 303
our assistant dental officer had to be discharged in December due Total 503 365
to integrity problems. Fortunately we expect a new Assistant Dental Officer to come back from
school in 2009.
Mother and Child Health Services
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In 2008 we continued giving Maternal and Child Health Services at our hospital. This service consist
of performing medical checks on al pregnant mothers and giving them the required vaccinations. In
2008 1335 mothers were checked during their pregnancy. Also the regular checkups were
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performed on newborn children, who also received their necessary vaccinations during their first

20.
years of life. The 2667 BCG vaccines from Wasso outreaches are a good reflection of the high rate of
vaccinations given by this unit. People could also come to this department for advices on family
planning.
Wasso
Pregnant mothers seen 1,335
Mothers seen after delivery 1,281
BCG vaccines given to children <1 year 2,667
Children underweight at 9 months 2,7%
Outreach Services
The above high numbers for our Mother and Child Health Services were not only achieved within the
hospital compound. Due to the fact that many communities have difficulties reaching our facility, we
have been reaching out to them since the early start of our hospital. We started with visiting the
communities by car clinics. But from 1969 with the help of the Flying Doctor Service, later AMREF,
and from 1983 onwards with Father Pat’s Flying Medical Service, we have became able to also serve
the furthest communities by airplane.
During these outreaches a clinical officer treats general illnesses, a nurse officer and a medical
attendant perform an integrated mother and child health care – where preventive measurements
like vaccinations are the key approaches. If seriously sick patient are met during the outreaches, they
are taken back to the hospital for further treatment.
Currently we are visiting on a 4 weekly basis the 18 sites with our car clinics from Wasso and 7 sites
from Digodigo. With the help of Flying Medical Services, we also provide clinics to 11 of the most
remote locations of our district every 2 weeks. Please see annex 5 for an overview of the 36
communities served with our outreaches.
Paramedical Services
Radiology Unit
In 2008 our radiology department has been performing fine. Our radiologist, Mr. Solomon Ombati
has been taking and developing x‐rays of outstanding quality. He has also developed himself into a
very able sonographer. Since early 2008 he also started making ECG on patients. The quality of the x‐
ray machine and developer are good; having enough films in stock has appeared to be a difficult task
due to a shortage of funds. The quality of the ultrasound machine is not adequate anymore due to
problems with the probes. As replacing the probes alone is very costly, we should look for a new
ultrasound machine in 2009. In total 1,494 x‐ray pictures have been made 1,033 patients. 1,560
patients received an ultrasound investigations.
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Laboratory Unit
The laboratory has set a good performance in 2008 though they have been short of staff and
equipment (especially reagents). Although the total number of investigations done is not counted,
in the underneath table reflects their performance on key indicators.
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21.
In early 2008 we were screening our own Investigations Performed Abnormal
blood donors for transfusion blood. But Blood slides 9,528 3,211
as there is a window period of false Stool 2,042 1,243
negative results following a recent TB Sputum 597 63
infection, we started to collaborate with Syphilis 398 39
the Blood Bank in Moshi who can Hemoglobin (<7g/dl) 1,561 740
overcome this window period with CSF Fluid 22 15
Gram Stain 287 216
sophisticated PCR testing on viral
HIV serology 645 95
DNA/RNA. But transport problems are
Units of blood transfusion 121 1
also with this issue an obstacle.
Pharmacy Unit
The pharmacy unit was in 2008 had difficulties keeping proper stocks as the amount of medicines
allocated to our MSD account reflects only 86 beds, while we have 155 beds at Wasso plus an
extensive outreach program. Additional procurements therefore had to be done, also at private
suppliers as MSD also often lacked certain essential items. The total amount spend on medicines and
medical supplies (including our MSD allocation) is roughly estimated on 120 million shilling for 2008.
Under the leadership of Mr. Roche Nyamhanga, the pharmacy underwent several significant
improvements, especially in the area of proper stock keeping and prescriptions. In the coming year
we will continue with these improvements where we will put special emphasis on proper
prescription and on an electronic ordering and stock keeping system.
Spiritual Services
We were happy that in January 2008 the hospital got strengthened by the arrival of Fr Willibrord
Muemans, a Belgian priest who served many years in Congo. It was very unfortunate that his health
started to trouble him and he therefore had to return to Belgium in September that year. The
spiritual service would continue to be given by the parish priest from Loliondo.
Supportive Services
Administration and Accounting
Administratively 2008 has been a very challenging year, especially as we were without an
administrator since October 2007. Fortunately the management team was strengthened from June
onwards by the arrival of Mr. Claude Rieser as the new administrator.
Within the administration we faced quite some difficulties as the organization of documents were
previously organized not properly so it was difficult to find specific documents (as for example
mentioned above with the issue of NSSF documents, but also when it came to the breakdown of the
debts we had with our staff). We therefore started to go through all old documents and organize
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them with a bookkeeping hierarchy. Also new documents were ordered in the same manner. By the
end of 2008 we had also made serious progress in electronizing all current documents by scanning
them, which makes them easily accessible and searchable.
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22.
A new challenge was also brought to the administration department when the MOHSW made a
significant change in the way salaries would be paid: the hospital would no longer receive a monthly
batch payment which was based on the staff status on a set point in June. It was the intention that
instead of that monthly changes would be send to the MOHSW and they would make the direct
payment to the individual bank account of the employees after deducting their NSSF contributions.
This would appear to be a difficult task as the infrastructure at the MOHSW was not ready for this
huge task.
As we recognized that the proper collection and availability of data is essential for many
management decisions, we started to consider to start a hospital wide computer used Hospital
Management Information System (HMIS). We started to link with the Evangelical Lutheran Church of
Tanzania (ELCT) as they had already started to develop and implement their system in three other
hospitals in northern zone Tanzania. The current system used is a combination of two web based
programs: Care2X for the medical data and webERP for store and accounting data. The hospital
management sees this system as the way forward to come to better management and accounting at
our hospital and will therefore make significant investment to initiate this system in 2009.
Workshop
At the workshop we managed to make several improvements in 2008. A new inventory was being
made and the use of the logbooks for trips was reestablished. We also managed to decrease the
amount of traveling to Arusha, causing a large reduction of our costs. We were also happy that with
the help of Ludwich Muelleder, we could repair the Mercedes Truck, enabling us to collect significant
procurements in town, for example at MSD.
Currently we have the following vehicles at our Workshop Unit:
Type of Vehicle Number plate Status
Mercedes Benz Lorry T798ANQ Working well
Nissan Patrol T868AJN Working good
Nissan Patrol T542AJP Working good
Toyota Landcruiser Hardtop T751AAK Moderate status
Toyota Pickup TZK 8803 Very poor status
Toyota Landcruiser Hardtop DFP6064 New, part of CTC project
Yamaha Motor cycle XT ART417 Working well, assigned to Digodigo
Yamaha Moter Cycle XT ART418 Poor state, needs repairs
Yamaha Motorcycle AG T491ASA Working good
A new Toyota Landcruiser Hardtop has been promised to our site as part of the CTC program; we
expect it to be delivered by EGPAF in the coming year.
Besides transport and repairs of the vehicles, the workshop unit is also supporting the hospital in
several other ways. Our specialists for water systems, carpentry and electricity have also performed
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very well in the past year.
Canteen and Resthouse
The canteen and resthouse underwent significant improvements in 2008 in quality and quantity of
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their services. Although the canteen and resthouse have been regarded as income providing

23.
services, they frequently had months on which they were run at a loss. But after several
improvements were made, we managed to improve this so they did not run on debts anymore at the
end of the year.
Environment and Security
In early 2008 we were facing quite some challenges on environmental and security issues.
Destruction of the environment was happening at the more remote edges of our area. Also theft
occurred. We therefore invested in these units by attracting new staff as guards or to assist in the
maintenance of the environment. After this we saw a marked improvement within these two units: a
better feeling of security and a better protection and maintenance of our environment was
achieved.
Cleaning and Laundry
The cleaning and laundry have been performing very well under the leadership of our matron, Mrs.
Mbise. In the laundry small investments have been made by procuring new blankets, and in the
cleaning unit into equipment. In 2009 we should look how we can make more significant
investments for bed sheets and patient clothing so that the situation will be more hygienic and
comfortable for our patients.
Patient kitchen
Also in 2008 we continued providing food to our patients for free as this is seen as a necessity in our
population where malnutrition often complicates the illnesses the patients are suffering from. Due
to financial constraints and steeply increased food costs, and an significantly increased number of
inpatients, the quality of the food provided declined somewhat. It would be good to look for
additional recourses to bring up the food quality in the coming year.
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Wasso Hospital Resthouse
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24.
Satellite Site: Digodigo Dispensary
Our clinical officer Joachim Mbosha served the people of Sonjo Valley 2008
another year as the in‐charge of Digodigo Dispensary. Although the OPD patients 6471
populations served is huge, the constraints on this dispensary are big. Admissions 252
Most significantly these are the staff shortages and the essential drug Deliveries 47
shortages. These problems could be solved to large extend if we could upgrade the Dispensary to
the status of a Health Centre and come into a Service Agreement with the government. Plans have
been undertaken to achieve this in the coming year. In the mean time, the dispensary has to be self
reliant in many areas; medicines for example can only be procured from their revenue made.
Although a CTC is officially already established on paper, we are discussing with EGPAF how we can
turn it into proper action. Plans for this, including the construction of a new building, have already
started to turn into actions by the end of 2008.
Despite of all constraints, Digodigo Dispensary remained among the best visited dispensaries of our
district.
Digodigo Dispensary
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25.
Epilogue and acknowledgements
2008 has been a challenging but great year for Wasso Hospital. The medical and administrative
progress made has been very significant on almost all areas. Although all management members
were relatively new, we have been able to overcome most difficulties with the blessing of God. This
also enabled the medical team to make good progress in the care given to the people. We feel very
blessed that we have managed to significantly increase the amount of care provided while the
number of deaths have declined sharply.
I want to use this opportunity to thank all of our staff members who have contributed to this good
year. The above mentioned achievements cannot be contributed to one or a few persons only. The
achievement was made while we worked together as a team, as together everybody achieves more.
Let us also continue in the coming year on this path of improving the care to our patients.
I also want to thank the Archdiocese of Arusha for all their contributions in the past year, with most
notably the seminar the Health Secretary had organized at Bulka where we could brainstorm about
the organization within our institutions. I also want to thank Fr Tenges for the significant added
value he has brought to the different boards in his position as the general secretary.
A special word of thanks should also be given to our RMO Dr Toure and his team – among which we
also met Mrs. Nyakwela our RNO, and Dr Chandre as acting RMO. As we have unfortunately been
without a DMO in our district in 2008 and we therefore appreciate the additional supervision visits
made to our district to ensure continuing proper medical care.
Besides the huge financial assistance the hospital has received from the Ministry of Health and Social
welfare, I also want to thank several other institutions for their continuing contributions to our
hospital. As a full list of institutions/NGO’s who gave technical advices to our hospital is extensive, I
want to remain mentioning the most significant.
First I want to thank the church congregation of the Sisters Oblates de l'Assomption and the Tweega
Medica Foundation who both contributed staff to our hospital since several years. This is an
essential ‘donation in kind’ as it remained a very difficult to attract well trained staff to our remote
district hospital.
Also we are very thankful for the continuing assistance Flying Medical Service has given us the past
year. It has been a blessing to welcome one of the pilots to come every two weeks with a plane so
we could serve the people in the most remote locations of our district. Their emergency evacuations
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have also saved many lives in the past year. And finally we were also much blessed by the spiritual
support and advices Father Pat has continued giving us in the past year, thank you for that.
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26.
I want to thank the Elizabeth Glaser Pediatric AIDS Foundation for their significant technical and
financial contributions for the program for the people living with HIV/Aids. In the past year we have
also appreciated very much the performance award from CORDAID. We are grateful that they were
so interested in our performance and even gave a significant award for it.
Last but not least I want to thank the Watschinger Foundation for their generous support to our
hospital. I highly appreciate their technical, financial and also personal support they have given to us.
I want to express my sincere gratitude to the work of Heini Staudinger who saw the revival of our
hospitals as his personal mission. Although I encourage him to continue with his good work, I must
say that his help in the past year made a huge difference already.
The above few lines can actually not reflect
our full appreciation to all the different
people who assisted the progress we made
in 2008. Realize that we really appreciated all
contributions made, no matter if they were
small or large. I feel very blessed that we
have been working with so many befriended
people who were dedicated to our vision to
provide good quality of health services in an
accessible, acceptable and affordable way.
Let us pray that we can in 2009 continue on
this good track also in 2009.
In Christ the Healer connected,
Dr Christian van Rij
Medical Officer in Charge
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27.
Annex 1: Disease statistics
Top Ten Diseases Outpatients Causes of Death < 5 year
Rank Disease Number Disease Number
1 Malaria 5149 Pneumonia 5
2 ARI 5580 Malaria 5
3 Diarrhoeal 1274 Diarrhoeal Diseases 4
4 Pneumonia 679 Neonatal Conditions 3
5 UTI 837 Malnourishment 2
6 Eye Infection 664 Anaemia 1
7 Worms 558 Burn 1
8 Skin Infection 415 Congenital Con. 1
9 Ear Infection 266 Other Illnesses 4
10 Anemia 112 Total 26
Top Ten Diseases Inpatients Causes of Death > 5 year
Rank Disease Number Disease Number
1 Malaria 904 Clinical Aids 15
2 ARI 147 Malaria 6
3 Diarrhoeal 222 Cardiovascular Disease 6
4 Pneumonia 492 Tuberculosis 2
5 UTI 94 Burns 2
6 Eye Infection 16 Anaemia 2
7 Worms 40 Respiratory Conditions 1
8 Skin Infection 12 Malnourishment 1
9 Ear Infection 2 Poisoning 1
10 Anaemia 116 Diabetes 1
Other Illnesses 4
Total 41
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28.
Annex 2: Map Ngorongoro District
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29.
Annex 3: Ngorongoro Divisions, Wards and Population
Division Ward Health Facilities Population
Loliondo Orgosorok Wasso Hospital; Loliondo Health Centre; 51,416
Magaiduru Dispensary;
Soitsambu Soitsambu Dispensary; Oloipiri Dispensary;
Sero Dispensary
Arash Arash Lutheran Dispensary
Sale Digodigo Digodigo Dispensary; Samunge Dispensary; 39,468
Ondonyosambu Oldonyosambu Dispensary
Sale Sale Dispensary
Malambo Malambo Health Centre
Pinyinyi Ngarasero Dispensary
Ngorongoro Ngorongoro NCAA Dispendary 77,580
Olbalbal Olbalbal Dispensary
Nainokanoka Nainokanoka Dispensary
Endulen Endulen Hospital
Kakessio Kakesio Dispensary
Naiyobi
Total 176,045
Wasso Hospital Catchment Area describes the area where we are supposed to provide a health care
to. According to government decision, our catchment area consists of 30,002 people in 2008.
Wasso Hospital Service Area is the area where we are providing medical services to the people. This
is Loliondo Division and Sale Division as the quantity of services by other facilities was minimal in
2008.
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30.
Annex 4: Incoming and outgoing staff in 2008
Outgoing staff
Full Name Designation specific Employment End
Namnyaki Lazaro Parkipuny Nurse Officer III 31‐10‐2008
Onesmo John Kiromo Driver I 31‐10‐2008
Jeremia Msika Kaduga Clinical Officer II 31‐12‐2008
Kennedy Israel Dodo Assistant Medical Officer / Dentist I 31‐12‐2008
Libori Ephrem Tarimo Clinical Officer II 31‐10‐2008
Felix Zelote Lukumay Laboratory Technician II 31‐10‐2008
Solomon Michael Ombati Technician II 31‐10‐2008
Agnes Lucas Ammi Senior Nurse 31‐10‐2008
Ansila Inyasi Silayo Nurse Officer I 31‐10‐2008
Cecilia John Nkii Senior Nurse 31‐10‐2008
Esther Clement Mpondo Nurse Officer II 31‐10‐2008
Loturiaki Ngunyi Korio Senior Health Officer 31‐10‐2008
Febronia Mushi Simbero Nurse Officer III 30‐11‐2008
New Incoming staff
Full Name Designation specific Employment Start
Claude Simon Rieser Senior Health Secretary 1‐5‐2008
Elias Elisha Nkambi Medical Attendant II 1‐8‐2008
James Robert Kiromo Medical Attendant II 1‐8‐2008
Momboshi Lendano Kesike Security Guard 1‐7‐2008
Juliana Melkiory Shirima Medical Attendant II 1‐12‐2008
Amina Adam Ramadhan Medical Attendant II 1‐10‐2008
Dorcas Nyaboke Mokaya Nurse Officer III 14‐2‐2008
Emanuela Castul Anney Nurse II 1‐4‐2008
Flora Charles Eliphadhil Medical Attendant II 1‐5‐2008
Hereswida Myaki Medical Attendant II 1‐11‐2008
Maoi Moriaso Kipakwa Medical Attendant II 1‐8‐2008
Nossim William Mollel Medical Attendant II 1‐7‐2008
Zaina Alfani Shemaghembe Nurse Officer III 1‐3‐2008
Samwel Samwel Mattur Medical Attendant II 1‐8‐2008
Sakara Murkuk Security Guard 1‐7‐2008
Balthazar Seho Bayo Technician II 1‐8‐2008
Peter Emanuel Losiki Medical Attendant II 1‐8‐2008
Sarim Joseph Kashe Medical Attendant II 1‐8‐2008
Kanja Motegha John Nurse Officer III 6‐1‐2008
Joseph Parsambey Principal Office Assistant 1‐12‐2008
Manace Williams Medical Attendant II 1‐8‐2008
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31.
Lennard Linus Daserwa Medical Attendant II 1‐8‐2008
Lilian Albert Masawe Nurse Officer III 29‐9‐2008
Zuwena Abdalah Christina Nurse Officer III 29‐9‐2008
Febronia Mushi Simbero Nurse Officer III 29‐9‐2008
Eliatikiswa Festo Pallangyo Medical Attendant II 1‐8‐2008
Moses Tumate Kikonya Nurse Officer III 1‐11‐2008
Jane Robert Kiromo Medical Attendant II 1‐12‐2008
Timizaeli Laanvuni Sumunai Medical Officer / Dentist II 4‐12‐2008
Julius Ole Sitoy Kututu Security Guard 1‐12‐2008
It should be noted that the above two tables only reflect staff under archdiocesan contract and not
seconded staff. Some of the staff who left the Archdiocesan contract, but remained working at
Wasso as seconded staff. The significant turn over in the group of seconded staff is also not
reflected in the above tables.
Wasso Hospital Car Outreach
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32.
Annex 5: Communities Served with outreaches
Currently we are visiting the following 18 sites on a 4 weekly basis with our car clinics from Wasso
• Magaiduru: 40 km from Wasso Hospital
• Esero / Orkuyaine: 28 km from Wasso Hospital
• Oloipiri: 34 km from Wasso Hospital
• Engusero and Sambu: 55 km from Wasso Hospital
• Ndulele: 70 km from Wasso Hospital
• Olosho: 74 km from Wasso Hospital
• Sukenya: 34 km km from Wasso Hospital
• Orongai: 34 km from Wasso Hospital
• Maaloni: 58 km from Wasso Hospital
• Mgongo: 63 km km from Wasso Hospital
• Mageri: 59 km from Wasso Hospital
• Olorien: 30 km from Wasso Hospital
• Olosoito: 60 km from Wasso Hospital
• Oldonyowass: 45 km from Wasso Hospital
• Olobo: 11 km from Wasso Hospital
• Lopolun: 15 km from Wasso Hospital
• Oloswashi: 72 km from Wasso Hospital
• Olemeishiri: 30 km from Wasso Hospital
The following 7 sites are visited by car clinic from Digodigo Dispensary on 4 weekly basis:
• Mugholo: approximate 8km from Digodigo
• Bwelo Mugholo: approximate 10 km from Digodigo
• Kisangiro: approximate 12 km from Digodigo
• Bwele Digodigo: approximate 12 km from Digodigo
• Makurendane: approximate 10 km from Digodigo
• Masusus: approximate 60 km from Digodigo
• Tinaga: approximate 30 km from Digodigo
The following 11 sites are visited by flight clinics from Wasso on 2 weekly basis:
• Olaika • Njurleen
• Mondorosi • Loorbilin
• Empopongi • Oljhoro
• Ololosokwan • Olemnei
• Orpirikata • Moniil
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• Pinyiny
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