CONSOLATA HOSPITAL IKONDA
founded in 1963
P.O.Box 700 Njombe, tel 0752 41161, email: [email protected]
Annual Report 2014
CONSOLATA HOPITAL IKONDA
Annual Report 2014
THEME OF THE YEAR 2015
“Every patient is our main concern”
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
THE HOSPITAL AND ITS ENVIRONMENT
The Consolata Hospital Ikonda is located in the Southern Highlands of Tanzania, 2050m
above sea level (9°22’10’’S, 34°14’22”E), in Njombe Region. It is one of the three
hospitals of Makete District with the Lutheran Hospital of Bulongwa (50 km far) and
Makete District Hospital (30 km far).
The Consolata Hospital of Ikonda is a private, no-profit, catholic institution that belongs
from its origin (1963) to Consolata Missionaries. The mission of the Hospital is to provide
general quality health care to the population of the area and to promote access to health
care for the needy with a special attention for children, women and people affected by
chronic diseases.
It is registered since 1997 with the Ministry of Health (reg.no.115002), it’s recognised by
NHIF (National Health Insurance Fund) and is member of CSSC (Christian Social
Services Commission) .
Today the hospital has 322 beds and receives every day an average of 250-350
outpatients, coming from different districts and regions.
The presence of the hospital has produced important changes in Ikonda village and in the
area around moving from an economy of subsistence farming to commerce with an
increased number of buses and minibuses (13 daily), taxis, motorbike taxis, shops, guest
houses and restaurants.
The hospital itself is the biggest contributor of Tanzania revenue Authority (TRA) and
National Social Security Fund (NSSF) of Makete District.
Ikonda village has been connected to electricity from National Grid starting from August
2014.
Page 1
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
A SHORT HISTORY
The history of Consolata Hospital of Ikonda started on 25th February 1961 when Bwana
Kiluswa, Executive Officer, Ukinga Chiefdom wrote a letter to the Missionary i/c,
Benedictine Fathers, R.C.M Sunji, Lupila asking for a New Mission Hospital in Ukinga. This
is part of the letter of Bwana Kiluswa:
“Reverend Sir, on behalf of the Wakinga I am writing this letter to ask your Mission to
establish a Mission Hospital in the Ukinga Chiefdom. Ukinga, within the last thirty
years has experienced a very small increase in population…. This has been caused by
medical deficiencies in the Chiefdom. A great number of deaths both of infants and
grown-ups have taken place…. The Wakinga will highly be thankful to your Mission if
this request is met with cordial thought.”
The parish priest of Sunji sent the letter to Abbot-Bishop Eberhard Spiess OSB, of Peramiho
who wrote (18th March 1961) a letter to the Bishop Beltramino of Tosamaganga explaining to
him that the right place to build a hospital will be Kisinga Mission that it is more in the centre
of the Ukinga.
Because of the heavy expenditure of establishing a proper hospital, the Bishop Beltramino
and the Consolata Fathers Superior asked help to the General Superior of Consolata Fathers
in Turin asking for support. The answer from Turin was positive and the Executive Officer of
Ukinga Chiefdom was informed by Fr. Pagani, parish priest of Kisinga.
On 4th October 1963 the Right of Occupancy of 60 acres of land for the construction of the
Consolata Hospital of Ikonda was approved and the construction of the hospital started. At
the end of the 1968 the Consolata Hospital had 60 beds, houses for fathers, sisters and
doctors.
The Consolata Hospital of Ikonda was inaugurated by the President of Tanzania, Julius K.
Nyerere on 7th October 1968.
Since then the Consolata Hospital experienced different collaborations with many
Organizations and volunteers doctors.
Page 2
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
HOSPITAL DESCRIPTION
The actual bed capacity of the Hospital is 322 beds distributed in rooms of three bed
maximum, with one toilette and one shower every six beds. IPD (In Patient Department)
consists of these wards: Male Ward, Female Ward, Paediatric Ward, Maternity,
Premature Unit, Annex/Isolation, Private Ward, Orthopaedic Ward, Surgical Ward and
Antenatal.
The Hospital has the following units:
- O.P.D.(Out Patient Department)
- First Aid
- 2 Dental Units
- Ophthalmic Department
- X-Ray
- CT scan
- Ultrasound
- Endoscopy
- Laboratory
- Dressing Room
- POP Room
- Physiotherapy and Gym
- 4 Theatres
- 2 Delivery rooms
- 3 Pharmacy stores
- Infusion Unit
- 2 Sterilization rooms
- R.C.H. and PMTCT
- C.T.C./ V C.T. Unit (HIV clinic)
- F.P.A. (Food Program Ass.)
- Mortuary
- Laundry
The Hospital also runs outreach clinics and Counselling services (P.M.T.C.T.) and H.B.C.
(Home basic care).
Ambulance services are available.
The Hospital runs for his own needs a garage, a workshop and a small carpentry.
Electricity is available 24h. The Hospital has its own hydroelectric power station. Electrical
generators are used when there is shortage of water. Since August 2014 hospital is
connected also with Tanesco.
Hospital water main is feed by 4 springs (registered) on the mountains around.
A central water heating provides hot water to the whole hospital and the laundry.
The hospital has its own implant for purifying black water.
The hospital has a small incinerator for garbage.
An Oxygen Generator provides oxygen feeds to all the hospital wards.
Page 3
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
A compound called “Kampini” gives free accommodation to relatives who assist their
patients admitted in the hospital: it consists of 12 big rooms, toilettes and showers and a
large cooking area.
Inside the hospital compound there is a restaurant, a grocery and two shops run by private
people. This shopping centre has been opened in order to help people who are coming to
hospital to get food at very easy price.
The hospital has 53 single houses and 6 hostel for nurses and workers.
In May 2014 we have started the implementation of a new software, Hospital Management
System developed by Power computers. This system will help to manage hospital
activities with increased number of patients. The implementation will go on in 2015
gradually involving all the departments.
Page 4
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
PERSONNEL
The number of hospital staff has been increased from 225 employees in 2013 to 245 in
2014 in order to sustain the growing number of patients and activities.
They are paid as follows:
PAID BY
Number of staff (2013)
Number of staff (2014)
Consolata Hospital Ikonda
180
196
Central Government
36
36
Makete District
9
13
225
245
TOTAL
Despite the increased number of patients treated in our hospital, the financial support from
Ministry of Health of Tanzania has not increased: 36 workers only are paid by central
government, and not 73 as promised on basis of nominal number of beds.
Makete District sent 13 health workers as a compensation for the different services that
the hospital is providing to the population of the district, according to the service
agreement signed on 17th November 2014 between the Hospital and the District Council.
Physician
2008
0
2009
0
2010
0
2011
0
2012
0
2013
1
2014
1
Medical Doctors
1
3
5
5
2
4
7
A.M.O.
4
5
6
6
5
7
6
Clinical Officers
7
6
4
3
6
7
8
Nurse
48
52
55
57
59
60
67
Medical attendant
24
23
23
27
23
36
36
Laboratory tech.
4
4
3
3
4
5
4
Laboratory ass.
1
1
1
2
3
3
7
Radiographer
1
1
1
1
1
1
2
Pharmacy, Dental & Physiotherapy
9
11
11
9
11
12
11
Admin. Staff
9
9
11
12
10
13
16
Drivers
5
5
5
4
4
5
5
Support Staff
50
52
65
71
75
72
75
Total
163
171
190
200
203
225
245
Page 5
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
In the following table is compared the number of hospital employees with the estimated
required workforce for each department.
Est. Req.: Estimated Requirement aligned with national government policy
Actual: Number of employees at 31st December 2014
MEDICAL
Physician
Paediatrician
Obstetrician./Gynaecologist
Surgeon
Ophthalmologist
Anaesthesiologist
Dermatologist
Medical Officer General
AMO. Anaesthesiology
Assistant Medical Officer General
Assist. Medical off. Ophthalmic
Anaesthetic Technician
Clinical Officer
Orthopaedic Technician
Medical Total
Page 6
Est. Req
Actual
Gap
1
1
1
1
1
1
1
6
2
6
1
1
5
1
29
1
0
0
0
0
0
0
7
1
5
0
0
8
0
22
0
-1
-1
-1
-1
-1
-1
+1
-1
-1
-1
-1
+3
-1
-7
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
NURSING & MEDICAL ATTENDANTS
Officer Supervisor (Matron/Patron)
Nursing Officer General
Nursing Officer Paediatrics
Nursing 1 Psychiatry
Ass. Nursing officer
Nurse I
Nurse II
Nurse I (Anaesthetic)
Nurse II (Anaesthetic)
Medical Attendant
Nursing & Medical Attendants Total
X-RAY
Radiographer
Radiographic Assistant
X-Ray Total
LABORATORY
Technician (Diploma)
Assistant Technicians
Laboratory Total
PHARMACY
Pharmacist
Pharmaceutical Technician
Pharmaceutical Attendant
Pharmacy Total
DENTAL
Dental Surgeon
Assistant Dental Officer
Dental Technician
Dental Therapist
Dental Total
PHYSIOTHERAPY
Physiotherapist
Occupational Therapist
Physiotherapy Total
ADMINISTRATION
Administrator
Health Secretary/Admin.
Personal Secretary
Records Officer
Assistant Rec.
Assistant accountant
Chief accountant
Page 7
Est. Req
Actual
Gap
2
13
3
3
2
13
56
4
3
23
122
2
1
0
1
12
15
31
4
1
36
103
0
-12
-3
-2
+10
+2
-15
0
-2
+13
-19
Est. Req
Actual
Gap
2
2
4
0
2
2
-2
0
-2
Est. Req
Actual
Gap
6
2
8
4
7
11
-2
+5
+3
Est. Req
Actual
Gap
3
1
5
9
1
1
6
8
-2
0
+1
-1
Est. Req
Actual
Gap
1
1
1
1
4
0
0
0
1
1
-1
-1
-1
0
-3
Est. Req
Actual
Gap
2
2
4
0
2
2
-2
0
-2
Est. Req
Actual
Gap
1
1
1
1
1
1
1
1
1
0
0
2
1
0
0
0
-1
-1
+1
0
-1
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
Data clacker
Administration Total
SUPPORT STAFF
Launderers
Kitchen Attendant
Mortuary Attendant
Electrician
Plumber
Carpenter
Tailor
Cleaners
Driver
Security guard
Support Staff Total
GRAND TOTAL
5
12
11
16
+6
+4
Est. Req
Actual
Gap
9
5
2
1
1
1
3
31
5
12
70
7
6
2
2
2
1
2
39
5
14
80
-2
+1
0
+1
+1
0
-1
+11
0
+2
+11
Est. Req
Actual
Gap
262
245
-17
TURNOVER OF MEDICAL PERSONNEL
Although the Hospital took the step since many years ago to align salary levels to those of
the Tanzanian Government, nursing staff and junior medics have been leaving for NGOs,
government hospitals and other institutions. This high turnover has been an obstacle to
maintaining quality health services and management building.
The reasons causing clinical officers and nurses to leave the Hospital might be found in
the poor environment and distance from big towns.
The following table clearly shows the high level of turnover in the medical staff (Medical
Officers, AMOs, Clinical Officers, Nurses, Medical Attendants, Laboratory Technicians and
Assistants and Radiographers).
NEW MEDICAL STAFF EMPLOYED IN 2014
55
MEDICAL STAFF LEAVING THE HOSPITAL IN 2014
26
The hospital has tried to retain the medical personnel by several means, as for example:




Almost free of charge provision of house with full free of charge water supply 24
hours a day
Free of charge shamba (piece of land for cultivation)
Access to salary advance
40 million for loans
Nevertheless, as figures above clearly prove, the results have been very poor and it has
been not possible to get proper commitment by medical staff.
We do not believe any more that these are really means to retain personnel.
Mobility of personnel has other reasons: this is a problem all over Tanzania and not only in
our hospital.
Page 8
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
tTRAINING
During 2014 the Hospital supported 3 people in school as shown in the table below.
CARDE
MEDICAL OFFICER
NUMBER
2
SPECIALIST DOCTOR
TOTAL
1
3
PLACE
IMUTU
BUGANDO
NOTE:
 The 3 medical employees listed above under training have not been counted in the
staff table at beginning of chapter 0.
Since 2003 the hospital has funded training for 90 medical employees. Unfortunately the
results are not reassuring at all since 41 of them have left mostly without completing the
contract with the Hospital.
For this reason it is no more policy of the hospital to sponsor personnel for study.
CONTINUOUS EDUCATION
The Hospital continues the program to train the personnel.
Training on job was done in Ikonda by many specialists:








Orthopaedics: dr. Roberto Tormen, dr. Roberto Plazzi, dr. Francesco Vasciaveo,
dr Giuliano Novaretti, dott. Giuseppe Bonomi, dr.Silvio Galvagno
Anaesthesist: dr.Giuseppe Tormen
Dentist: dr.Giuseppe Vasta
Cardiologists: dr. Marco De Marco, dr.Gaetano Povolo
Gynecologist: dr. Giovanni Crestani, dr. Giovanni Scozzari
Paediatrician: dr. Giovanni Cecchini, dr.Patrizia Stasi
Plastic surgeon: dr.Francesco Bellezza
Surgeons: dr.Aldo Infantino, dr.Alessandro Testa, dr.Pietro Iani, dr.Bruno
Compagnoni
The hospital sponsored also a AMO who attended a training course in Echocardio in
Ospedale Molinette, Torino, Italy.
Page 9
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
ACTIVITIES
SUMMARY OF THE MAIN HOSPITAL STATISTICS
Trends in the service output and number of employed staff are shown in the table below.
Year
2008
2009
2010
2011
2012
2013
2014
Number of beds
210
222
305
305
310
310
322
Admissions
7,734
9,522
11,202
11,549
12,292
13,052
14,499
Major surgical operations
774
1,019
1,336
1,695
2,088
2,560
2,921
Minor surgical operations
491
567
534
1,040
1,234
907
1,602
Deliveries
881
1,027
1,157
1,406
1,410
1,646
1,697
OPD visits
31,320
37,878
41,771
46,249
51,699
59,369
74,228
HIV Clinic visits
17,875
19,118
20,526
20,682
23,634
22,141
21,155
R.C.H.visits
9,642
48,778
41,965
35,098
13,884
15,498
14,832
Dental treatments
1,849
1,997
2,235
2,197
2,406
2,387
2,170
Laboratory examinations
50,842
53,029
70,860
75,358
97,188
117,951
143,212
X-RAY
2,313
2,831
4,392
5,051
5,832
11,348
14,862
Hospital deaths
279
440
272
515
566
626
595
Page 10
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
LABORATORY EXAMINATIONS AND BLOOD TRANSFUSION
Laboratory services are available every day from 8 a.m. to 8 p.m. and also during the night
in case of emergency. In the table below a resume of the activities performed in 2014,
compared with 2013.
MICROBIOLOGY
2013
2014
WIDA TEST
18,804
22,996
H. PLYLORI
7,227
8,582
VDRL/RPR
11,296
6,335
ASOT
4,998
5,526
RF
4,265
5,348
ZN
1,408
1,361
HEPATIRIS B
224
519
HEPATITIS C
214
513
CULTURE
548
498
G/STAIN
283
290
CSF
56
83
FULL BLOOD PICTURE
15,429
24,975
HAEMOGLOBIN
3,724
4,288
CD4
3,637
3,961
CELLS MORPHOLOGY
16
46
SICKLING TEST
30
37
BLOOD BLEEDING FACTOR
29
29
BLOOD CLOTTING FACTOR
29
25
ALT
5,033
4,711
BLOOD SUGAR*
5,228
5,400
CREATINE
2,577
4,445
UREA
2,567
4,381
AST
833
1,662
URIC ACID
489
1,321
CHOLESTEROL
201
660
BILIRUBIN TOTAL
152
279
BILIRUBIN DIRECT
151
251
HAEMATOLOGY
BIOCHEMISTRY
Page 11
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
K+
186
219
TG
58
52
URINE ANALYSIS
11,534
14,937
STOOL ANALYSIS
8,154
10,048
BLOOD SLIDES
2,045
3,472
628
2,150
BLOOD GROUPING
1,501
2,304
CROSSMATCHING
886
1,508
PARASSITOLOGY
URINARY PREGNANCY TEST
BLOOD TRANSFUSION UNIT
Laboratory activities have grown if compared with previous year following the growth of
number of patients.
Laboratory
examinations
2009
2010
2011
2012
53,029
70,860
75,358
97,188
2013
2014
117,951 143,212
* This is the number of blood sugar tests done in laboratory and it refers to OPD patients
only. Blood sugar tests done in the wards are not included.
Page 12
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
BLOOD TRANFUSION UNIT
The blood bags supplied from Zonal BTS Mbeya are insufficient compared with the
demands of the wards and the theatre. For this reason since long the hospital has started
a transfusion unit equipped with Elisa machine. Laboratory staff visited some schools
around to promote blood donation: the schools involved are TTC Tandala, Lupaseco
Secondary School, Ukwama Secondary School and Mang’oto Secondary School.
UNITS OF BLOOD RECEIVED FROM MBEYA
665
UNITS OF BLOOD RECEIVED FROM DIFFERENT DONORS
376
TOTAL UNITS OF BLOOD TRANSFUSED
UNITS NOT TRANSFUSED FOR DIFFERENT REASONS
Page 13
1,041
65
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
RADIOLOGY DEPARTMENT
X Ray
2009
2010
2011
2012
2013
2014
Bones
1,035
1,487
2,070
2,528
6,933
8,177
Chest
1,690
2,789
2,823
3,092
3,349
5,960
Abdomen
56
59
76
120
320
272
Others
50
57
82
92
746
453
TOTAL
2,831
4,392
5,051
5,832
11,348
14,862
Total Number of X-Ray
16,000
14,000
12,000
10,000
8,000
6,000
4,000
2010
2011
2012
Page 14
2013
2014
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
OTHER INVESTIGATIONS
2013
2014
Ultrasound
3,889
7,1861
ECG
2,407
4,667
Echo Cardio
186
114
Gastroscopy
1
17
Note 1: The number refers to the tests done in OPD only. The ultrasound done in the
wards are not included
CT SCAN
At the end of November 2014 a CT Scan machine (Siemens 6 Slice) started working in
Ikonda. CT scan of brain, abdomen and bones can be performed.
Page 15
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
ADMISSIONS
Beds
Admissions
Days
Deaths
Occupancy
Male General
42
2,080
8
180
113%
Female General
42
3,315
6
148
125%
Paediatric
33
1,909
7
56
118%
Annex/Isolation1
36
1,684
7
97
91%
Surgical
42
978
17
41
138%
Orthopaedic2
33
927
10
13
85%
Maternity/
Gynaecology
27
2,227
9
28
156%
Premature
8
83
16
16
45%
Private
14
299
9
16
51%
Antenatal
45
997
17
0
101%
Average length of stay per admission: Number of in patients days / Number of admissions
Bed occupancy rate: (Number of in patient days X100) / = (Number of beds x 365)
The number of in patients days is calculated as follows: every day, at midnight, the number of patients present in each
ward is counted. When a patient is discharged and the same day another patients is admitted in the same bed, only
one in patient day is counted.
Note 1: Annex and Isolation wards moved in February 2014: Isolation entered in a new building
while Annex occupied the building of old Isolation.
Note 2: Orthopaedic ward has been opened in February 2014 only. Before that, the orthopaedic
patients were accommodated in different wards.
The diagram below shows that for many days during the year the actual daily bed
occupancy was bigger than the total hospital bed capacity. That means that many patients
were accommodated in the corridors and ward TV room.
Hospital Bed Occupancy 2014
450
400
350
300
250
200
150
100
50
0
Daily Bed Occupancy
Page 16
Num ber of Beds
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
Hospital Admission Trend
16,000
15,000
14,000
13,000
12,000
11,000
10,000
2010
2011
2012
Page 17
2013
2014
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
SUMMARY OF MAIN IN-PATIENTS DIAGNOSIS
N.
I- INFECTIOUS AND PARASITIC
DISEASES
<5
Death
>5
Death
1
Clinical AIDS
22
1
528
100
2
Bacterial diseases
62
2
210
14
3
Enteric inf.
5
0
214
8
4
Amoebiasis
2
0
18
3
5
Other Diarrhoea dis.
191
5
309
5
6
Hepatitis
3
0
17
4
7
Intestinal Worms
2
0
3
0
8
Leprosy
0
0
1
0
9
Cerebral Malaria
79
7
112
12
10
Other Malaria
244
9
406
19
11
Schistosomiasis
0
0
5
0
12
Tuberculosis
9
0
438
57
13
Genital Discharge Syndrome
0
0
9
0
14
Genital Ulcer Diseases
0
0
22
0
N.
II-NEOPLASM
<5
Death
>5
Death
15
All Neoplasm
21
0
370
11
N.
III- ENDOCRINE DISEASES
<5
Death
>5
Death
16
Thyroid diseases
0
0
144
0
17
Diabetes Mellitus
0
0
208
16
N.
IV-NUTRITIONAL DISORDERS
<5
Death
>5
Death
18
Protein Energy Malnutrition
43
5
19
0
19
All others nutritional disorders
1
0
1
0
N.
V- BLOOD DISEASES
<5
Death
>5
Death
20
Sickle cell anaemia
2
0
4
1
21
All other anaemia
116
13
350
52
22
Other haematological diseases
0
0
5
0
N.
VI- MENTAL DISORDERS
<5
Death
>5
Death
23
Neuroses
0
0
48
0
24
Psychoses
0
0
92
0
N.
VII- NEUROLOGICAL DISEASES
<5
Death
>5
Death
25
Ear diseases
8
0
14
0
26
Epilepsy
6
0
59
1
N.
VIII – CARDIOVASCULAR DISEASES
<5
Death
>5
Death
Page 18
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
27
Cardiac Failure
4
0
258
42
28
Hypertension
2
0
523
52
29
Rheumatic Fever
0
0
18
0
30
Other cardiovascular diseases
2
0
296
42
N.
IX – RESPIRATORY DISEASES
<5
Death
>5
Death
31
Upper Respiratory tract infections
.28
0
12
1
32
Obstructive pulmonary diseases
0
0
0
0
33
Pneumonia
368
19
514
46
34
Other respiratory diseases
11
0
218
0
N.
X – DIGESTIVE DISEASES
<5
Death
>5
Death
35
Liver diseases
1
0
99
15
36
Peptic ulcers
0
0
196
14
37
Other non-infectious gastric-intestinal
53
0
264
20
N.
XI – GENITOURINARY DISEASES
<5
Death
>5
Death
38
Non-infectious kidney diseases
2
0
261
2
39
Pelvic inflammatory diseases
0
0
45
0
40
Urinary Tract Infectious
41
0
226
0
41
Other gynaecological diseases
0
0
324
0
N.
XII – SKIN DISEASES
<5
Death
>5
Death
42
Infective skin diseases (non viral)
38
0
79
0
43
Non infectious skin diseases
58
0
100
0
N.
XIII – MUSCULOSKELETAL AND
CONNECTIVE DISEASES
<5
Death
>5
Death
44
Osteomyelitis
2
0
108
1
45
Non-infectious rheumatic or joint diseases
2
0
198
0
N.
XIV – CONGENITAL DISORDERS
<5
Death
>5
Death
46
Congenital disorders
80
1
46
0
N.
XVI- MISCELLANEOUS
<5
Death
>5
Death
47
Ill defined symptoms, no diagnosis
0
0
123
0
48
Snake and insect bites
0
0
11
0
49
Burns
54
2
41
1
50
Fractures
62
0
845
4
51
Poisoning
6
0
13
0
Page 19
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
TOP TEN CAUSES OF HOSPITAL DEATHS (YEAR 2014)
Page 20
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
THEATRE
The hospital has four operation theatres: one for General Surgery, one for
Maternity/Gynaecology, one for Orthopaedic Surgery and another one for emergencies.
Planned surgery procedures are done from Monday to Friday but theatre is open for
emergency operations everyday 24 hours. In the table below is listed the work done in
2014.
TOTAL MAJOR OPERATIONS: 2,921
ABDOMINAL SURGERY
Inguinal hernia
Umbelical hernia
Acute appendicitis
Epigastric hernia
Intestinal resection+anastomosis
Peritonitis
Incisional hernia
Exploratory laparatomy
Adesiolisis
Bowel obstruction due to volvulus
Gastro-jejunostomy
Burst abdomen resuturing
Splenectomy
Perforated peptic ulcer
Colostomy &ileostomy closure
Tubercolosis peritonitis drainage
Re-opening post laparatomy
Gastric resection
NON-ABDOMINAL GENERAL SURGERY
Subtotal thyroidectomy
Lumpectomy
Mastectomy
Thyroglosal cyst
Parotid tumor excision
UROLOGICAL SURGERY
Prostatectomy
Hydrocelectomy
Orchidectomy
Soprapubic cystostomy
Re-opening post prostatectomy
Urethral dilatation
Bourgenage
Penis amputation
Nephrectomy
Testicular cyst
Page 21
509
118
75
65
41
35
34
31
25
21
19
11
10
10
5
4
2
2
1
176
94
66
7
6
3
209
115
46
20
10
8
4
3
1
1
1
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
ANO-RECTAL SURGERY
Haemorrhoidectomy
Anal fissure
Anal fistulae
Thiersch’s procedure for rectum prolapse
Eua
PLASTIC SURGERY
Skin graft
Release/excision of scar and post burn contractures
Keloid
OBSTETRIC AND GYNAECOLOGY
Caesarian section
Total abdominal hysterectomy
Annexectomy (Ovariectomy/Salpingectomy)
Tube surgery
Ectopic pregnancy
Miomectomy
Pelvic abscess
Subtotal hysterectomy
Molar pregnancy evacuation
Imperforated hymen
ORTHOPAEDIC & TRAUMA SURGERY
ORIF
Chronic osteomyelitis sequestrectomy
External fixation
Amputation
External fixation removal
Contracure release
Traction skin (skeletal)
Re-ORIF
Re-amputation
Plastic surgery (slap)
Hip protesis
Tendon repair
Arthrodesis
Nerve release
Bone grafting
Radial head resection
Page 22
134
74
31
25
2
2
84
44
31
9
1,236
854
245
63
28
15
10
9
6
4
2
573
316
66
55
29
27
23
14
14
7
6
6
4
3
1
1
1
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
TOTAL MINOR OPERATIONS: 1,602
SURGICAL NOT INCLUDED ABOVE
Abscess incision and drainage
Lipoma excision
Cut wound stiching
Soft tissue tumour
Cyst excision
Stitch abscess
Other cist
New growth
Foreign body removal
Ganglion cyst
Malignant ulcer
ORTHOPAEDIC AND TRAUMA
Fracture reduction/POP immobilization
Plate removal post ORIF
Kirschner wire removal
Nail removal post ORIF
Figure of eight bandage
Surgical toilette
Skin grafting
Tenoctomy
Bone excision
Screw removal post ORIF
MINOR GYNECOLOGICAL SURGERY
Incomplete abortion dilatation and curettage
Dilatation and curettage for DUB
Genital warts cauterization
OTHERS
Paracentesis
Circumcision
Under water seal drainage
Thoracocentesis
Keloid excision
Page 23
412
134
116
44
38
28
18
10
9
7
7
1
881
680
56
49
27
17
17
15
8
7
5
223
154
45
24
86
37
31
7
9
2
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
ANAESTHESIA
Type Of Anaesthesia
Spinal Anaesthesia
1,845
Intravenous without endotracheal intubation
897
Intravenous with endotracheal intubation
392
Local anaesthesia
147
Saddle
92
SURGICAL DEATHS
Elective Surgery
Haemorrhage
2
Others Tumour
1
Other causes
4
Emergency Surgery
Pre or Postoperative sepsis
25
Pre or Postoperative sepsis + HIV
5
Peritonitis
4
Haemorrhage
1
Other Causes
10
Total surgical deaths
52
Page 24
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
MATERNITY SERVICES
2013
2014
1,646
1,697
Normal deliveries
862
843
Abnormal deliveries
784
854
27
28
Total number of new-born
1,673
1,725
Total number of live births
1,641
1,691
Fresh stillbirths
7
5
Macerated stillbirths
25
29
Born before arrival
11
13
Premature
58
83
New-born with body weight < 2.500 g
184
184
Early neonatal deaths
19
11
Total number of deliveries
Multiple deliveries
Delivery: The process leading to the expulsion of the products of conception with a gestational age of 28
weeks or more. A multiple delivery should be recorded as 1 delivery. Due to multiple pregnancies, the total
number of children born is usually bigger than the total number of deliveries.
Abnormal delivery: A delivery that, to take place, had to be assisted “actively“ with an outside intervention
like : pharmacological induction, vacuum extraction, symphisiotomy, forceps extraction, caesarean section. A
delivery where just an episiotomy has been done, has to be considered a normal delivery.
Stillbirth: Any child delivered after the 28 week of pregnancy that does not afterwards breathe or show any
sign of life. If the heart is beating after delivery, although there is no sign of respiration, the death should not be
recorded as a stillbirth but as a neonatal death. A child born dead before 28 weeks gestation should not be
recorded as a stillbirth.
ASSISTED DELIVERIES
2013
2014
Caesarean sections
784
854
Breech delivery
24
29
Induction
16
12
Vacuum extractions
3
3
Forceps deliveries
0
0
Page 25
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
CAESAREAN SECTIONS
Caesarean sections are many because many mothers with previous caesarian sections or
other problems are coming to our hospital even from other districts.
Previous caesarean sections
262
Cephalic-pelvic disproportion
152
Foetal Distress
152
Placenta praevia
18
Big Baby
4
Mal position
113
POPP
59
Breech
31
Face
5
Transverse
18
Obstructed Labour
83
Gestosis PIH
25
Cord Prolapse
22
Bad Obstetrical History (BOH)
15
Premature rupture membrane
9
Antepartum haemorrhage
8
Prolonged Labour
7
Multiple Pregnancy
3
Abruption placenta
2
Imminent rupture
2
Warts, Condylomata
1
Uterine fibroids
1
Pregress VVF Repair
1
Page 26
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
MATERNAL DEATHS
Maternal death: The death of a woman while pregnant or within 42 days of termination of
pregnancy irrespective of the duration and the site of pregnancy from any cause related to or
aggravated by the pregnancy or its management.
Maternal deaths
2013
2014
Anaemia due to PPH
0
1
Haemorrage
1
0
Total
1
1
2013
2014
Maternal mortality rate
0.060%
0.059%
Perinatal mortality rate
1.5%
0.92%
Early neonatal mortality rate
1.1%
0.94%
Hospital maternal mortality rate: (Hospital maternal deaths x 100.000) / Total number of hospital
deliveries
Perinatal death: a death taking place in the period going from the 28th week of gestation and the
first week after birth.
Hospital perinatal mortality rate: (Hospital Stillbirth+deaths at 0-7 days after birth) x 1.000 /
(Hospital Live birth + Stillbirths)
Early neonatal death: a death taking place from within 28 days after birth.
Hospital early neonatal mortality rate: (Hospital deaths within 28 days after birth x 1.000) /
Hospital live births
Page 27
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
OUT PATIENT DEPARTMENT (OPD)
The OPD is open every day from Monday to Sunday from 7.30a.m. to 8.00p.m.
Pharmacy and laboratory services within OPD are available with the same timetable.
The total OPD attendance has been increasing yearly in the time period shown below.
People are coming also from far and not only from our catchments area.
OPD Visits Trends
80,000
70,000
60,000
50,000
40,000
30,000
Visit Trend
2009
2010
2011
2012
2013
2014
37,878
41,771
46,249
51,699
59,369
74,258
NOTE: Persons attending RCH clinics or CTC are not included unless they are referred to the
General O.P.D.
2013
2014
Total number of patients referred to the hospital from lower levels
56
97
Total number of patients referred from the hospital to higher levers
367
195
Total number of patients transfer to lower levels for TB treatment
127
174
Page 28
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
MONTHLY ATTENDANCE IN OPD
OPD ATTENDANCE
8,000
7,000
6,000
5,000
4,000
3,000
2,000
1,000
ug
us
ep
t
te
m
be
r
O
ct
o
N ber
ov
em
b
D
ec er
em
be
r
S
A
Ju
ly
Ju
ne
pr
il
M
ay
A
Ja
nu
a
Fe ry
br
ua
ry
M
ar
ch
0
Page 29
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
TOP TEN: DISEASE/CONDITION (NEW CASES)
PHYSIOTHERAPY
Number of sessions
2012
2013
2014
3,294
2,971
3,039
DENTAL CARE
Treatment
N. of Children
(0-14 years)
N. of Adults
(+15 year)
201
1,455
Fillings
6
163
Others
47
298
Total
254
1,916
Extractions
Page 30
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
EYE CLINIC
Eye Clinic Statistics
2013
2014
adults
137
109
children
31
50
Allergic
178
287
Other
31
151
Cataract
96
180
Trauma
68
74
Corneal Ulcer
31
31
Retina / optic Nerve
23
27
Uveitis
14
18
Corneal Scar
27
17
Glaucoma
4
10
adults
15
10
children
0
0
655
964
Conjunctivitis Bacterial
Trachoma
TOTAL
Blind Patients 3/60 BE
2013
2014
Normal eyes
51
69
Retina/optic
2
15
Cataract
12
6
Corneal Scar
4
0
Corneal Ulcer
0
0
Other / Unknown
1
12
TOTAL
70
102
Page 31
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
Refractive Error
2013
2014
Presbyopia
68
104
Myopia
55
102
Aphasia
0
4
Other
16
154
ectropion
3
3
other
11
13
Lacrimal
2
3
Orbital
7
7
Strabismus / Ambilopia
3
0
Other diagnosis
33
32
TOTAL
198
422
Lids
MENTAL ILL
Illness
New Cases
Re-Attendance
TOTAL
Schizophrenia
45
125
170
Epilepsy
49
106
155
Confusional state
44
33
77
Exogenic Depression
31
25
56
Hysteria
32
20
52
Organic psychosis
22
19
41
Anxiety Neuroses
23
10
33
Psychosomatic illness
13
10
23
Senile dementia
7
3
10
Hypomania
1
8
9
Mental retardation
6
3
9
Personality disorder
3
3
6
Endogenous Depression
2
2
4
Others
5
1
6
TOTAL
283
368
651
Page 32
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
TB CLINIC
Patients who started treatment this year:
DIAGNOSIS
<5 years old
>5 years old
TOTAL
Pulmonary TB AFB Negative
4
175
179
Pulmonary TB AFB Positive
0
55
55
MILIARY
2
42
44
SPINE
1
29
30
GLANDULAR
1
18
19
Extra Pulmonary TB MENINGITIS
0
2
2
OTHERS
2
82
84
10
403
413
TOTAL
Results of treatment of AFB + patients detected last year
Regimen
Cured
(smearing
positive)
Treatment
completed
(no smear
res.)
Dead
Treatment
Failed
Def.
Transferred
Total
Standard course
0
18
9
0
1
279
307
Short course
2
0
1
0
1
52
56
Re-treatment
1
0
0
0
0
1
2
TB/HIV COLLABORATIVE SERVICES 2014
TOTAL TB PATIENTS: 413
HIV NOT TESTED
HIV TESTED
HIV POSITIVE
HIV NEGATIVE
56
357
234
123
14%
87%
66%
34%
REFERRED TO CTC
NOT REF. TO CTC
UNDER ART
UNDER C.P.T.
216
18
152
136
92%
8%
70%
63%
Page 33
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
HIV CLINIC
Ikonda Hospital has a busy CTC clinic, open from Monday to Friday from 8.00 a.m. to 3
p.m. and on Saturday from 8.00 to 1.00 p.m.
Started in 2004, it is one of the CTCs in Makete District with Makete, Bulongwa,
Matamba, Lupila, Mang’oto and Lupalilo. It has 5,158 registered patients and 3,088
treated with ARVS. It follows the national guidelines of NACP. HIV test kits and ARVs are
provided from government on quarterly base.
Ikonda CTC also provides free clinical and laboratory follow up for the registered patients.
SUMMARY OF CTC ACTIVITIES
QUARTER I
QUARTER II
QUARTER III
QUARTER IV
No. New patients
62
85
37
64
No consultations
5,433
5,240
5,400
5,082
Recorded patients
4,990
5,069
5,102
5,158
Male
1,771
1,798
1,811
1,840
Female
2,742
2,789
2,806
2,827
Children
477
482
486
491
N.B. The number of recorded patients is a cumulative number
PATIENTS TREATED WITH ARVs IN IKONDA CTC
QUARTER I
QUARTER II
QUARTER III
QUARTER IV
57
69
60
67
Patients on ARVs
2,894
2,963
3,021
3,088
Male
1,046
1,066
1,084
1,111
Female
1,592
1,637
1,672
1,707
Children
256
260
265
270
Transferred
20
28
45
12
Dead
8
20
11
11
New patients
Page 34
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
VOLUNTARY COUNSELLING AND TESTING (VCT)
CLIENT
COUNSELLED
Tested HIV +
Tested HIV -
Age
M
F
M
F
M
F
1.5 - 14
172
178
27
26
145
152
15 – 24
267
333
39
52
228
281
25 – 49
1,289
1,460
308
270
981
1,190
50+
445
490
57
66
388
424
2,173
2,461
431
414
1,742
2,047
TOTAL
Note: In September 2014 VCT was not done because of shortage of HIV tests in the
country.
Tested Clients per Age Band (Year 2014)
2200
2000
1800
1600
1400
1200
1000
800
600
400
200
0
1.5 -14
15 - 24
25 - 49
50+
HIV +
53
91
578
123
HIV -
297
509
2,171
812
PITC results are not included in these data.
Page 35
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
MOTHER AND CHILD HEALTH (RCH) CLINIC
There is an RCH clinic in the hospital that serves Ikonda and Tandala people and a mobile
RCH that serve the people of Ihela, Usagatikwa, Masisiwe and Ibaga.
Hospital RCH
Outreach RCH
Total
ANTENATAL (first visits)
127
41
168
CHILD CARE (first visits)
115
49
164
First visits is the number of new registrations during the year
IMMUNIZATION
BCG
DPT 3
OPV 3
MEASLES
Hospital RCH
1034
168
168
239
Outreach RCH
0
49
49
0
FOLLOW UP OF CHILDREN UNDER FIVE YEARS 2014
Villages
Follow-Up
Leave
Died
Cont.
Follow-Up
IHELA
731
9
1
721
MASISIWE
604
5
1
598
TANDALA
2,492
23
2
2,467
IKONDA
2,460
16
0
2,444
USAGATIKWA
1,072
15
0
1,057
TOTAL
7,359
68
4
7,287
Page 36
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
P.M.T.C.T. (PREVENTION OF MOTHER TO CHILD TRANSMISSION)
Ikonda Hospital runs P.M.T.C.T. program according to national guidelines, both inside the
hospital, in maternity ward and in RCH, and in5 villages: Tandala, Ihela, Usagatikwa,
Masisiwe and Ibaga and Ikonda and surroundings.
2012
2013
2014
Total clients counseled
255
256
273
Total clients tested
255
256
273
22
233
0
22
22
31
225
0
31
31
21
252
0
0
40
22
33
39
86
9
77
112
8
104
142
5
137
0
2
9
0
0
0
2
0
9
31
30
40
1
30
0
30
0
Positive
Negative
Clients not tested
Clients given drugs
(NVP)
Children given milk
(exposed baby)
Total partners tested
Adults
Children
Positive
Negative
Total children tested
at 18 months
Positive
Negative
Total children tested by
PCR
Positive
Negative
Note: Most of these children were born before PMTCT program has been started.
FOOD PROGRAM ASSISTANCE
In 2014 the Hospital has continued a food program assistance to prevent and cure
malnutrition. This program involves 5 villages visited every month by the mobile clinic but
also children admitted in paediatric ward and other patients in bad conditions admitted in
the hospital.
Page 37
CONSOLATA HOSPITAL IKONDA
Annual Report 2014
PHARMACY
Drug list includes 350 items for gastro-intestinal system, cardiovascular system,
respiratory system, central nervous system, infections, endocrine system, obstetrics,
gynaecology and urinary-tract disorders, nutrition and blood, musculoskeletal and joint
deseases, eye, ear, nose, skin problems, immunological products, vaccines and
anaesthesia.
The expenditure for drugs in 2014 was 805,691,889 tsh.
Government supplied free ARVs, drugs for TB, Coartem for malaria and drugs for STI
(2,957,050 tsh).
INFUSION UNIT
Infusion unit started in 2000, is still producing fluids.
Dextrose 5% in small volumes for children is produced in the hospital because still not
available in the local market.
Normal saline produced in our unit is used for irrigation and dressing . In the table below
the quantities produced in 2014
I.V.Fluids
Produced in Ikonda
Dextrose 5% 100ml
1,223
Dextrose 5% 150ml
448
Dextrose 5% 250ml
316
Sodium Chloride 500ml
3,319
Water for inj 100ml
327
Page 38