MediShare - Rotary International

Join to Provide Surgeries to Two ZAMBIA Hospitals

On December 21, 1998, a large shipping container filled with medical equipment, instruments, drugs and supplies arrived in Dar es Salaam, Tanzania, and transshipped 1100 km. overland to Kasama, ZAMBIA (click here for map), It was destined for two remote, rural hospitals in separate sections of this land–locked country in South Central Africa.

This project is a unique nine–way partnership among Rotary Clubs in the United States and in Zambia, the Rotary International Foundation, MediShare International, the Bush Hospital Foundation (MSI's European partner), Direct Relief International, of Santa Barbara, CA., and the US Government. This grant will establish a modest but very serviceable surgical and general anesthetic facility in each of two very remote, very deserving small hospitals in different regions in Zambia.

The Santa Maria Rural Health Centre is located on Chilubi Island in the vast Bangweulu Lake (much of it, an enormous – approximately 3500 sq. kilometers – lake/swamp) in northwestern Zambia. The nearest Rotary Club, some 135 km distance, is the Mansa Rotary Club. St. Fidelis Mission Hospital is near Kasama which is approximately 300 km. northeast of Mansa. It will be assisted by the Kasama Rotary Club. Both hospitals are operated by the Archdiocese of Kasama, affiliated with the White Fathers. Although the Archdiocese manages both hospitals, all patients, regardless of means, beliefs or lack thereof, are admitted. No questions are asked.

(MediShare and partners, the Bush Hospital Foundation and Direct Relief International, require that all clinics and hospitals receiving assistance must admit all who seek care on this basis)

St. Fidelis Mission Hospital, near Kasama, is a 70–bed hospital, serving a population estimated to be 43,000 people. In 1996 (last year for which full statistics are available) this hospital served 1854 inpatients and 7294 outpatients. One hundred percent of the population served is rural.

Santa Maria Rural Health Centre, is a 78 bed hospital serving an estimated population of 53,000. In 1996 2152 inpatients and 36,001 outpatients were treated – or 28,706 patients more than at St. Fidelis, although both hospitals are about the same size. The inpatient census in the two hospitals themselves are comparable in the numbers. However, the astonishing outpatient figures include those treated at several outpatient clinics established as the direct result of the use of the new Land Rover Mobile Clinic/Ambulance recently provided by Bush Hospital Foundation–MediShare International.

Until now, neither hospital has ever had a surgery unit, a fact that frequently means that doctors may be unwilling to practice on staff with such a lack of basic facilities. Medical treatment in these cases is provided by auxiliaries, generally nurses. Patients requiring surgery and anaesthesia, as for severe trauma, complications involving maternity, or even x–ray must now be referred to distant facilities. In the case of Santa Maria Rural Health Centre, referred patients must be transported across the lake in an open, outboard motor boat – a four to eight hour trip over water if the weather and wind permits, plus several more hours over primitive, dirt roads, if they are not washed out.

This original SMHC (hospital) boat sank in a storm in February, 1999. The Bush Hospital Foundation–MediShare acquired a replacement boat in the summer of 1999, a boat with twin forty–horsepower engines. It was upgraded and modified in Europe preparatory to its being shipped to the hospital on Chilubi Island. In addition to providing transportation, it also serves as a marine ambulance.

Dr. Smithwick examines the Zambia shipment at
Direct Relief International, Santa Barbara, California.

The local Rotary Clubs in Zambia served as coordinators to facilitate safe delivery and acceptance of the shipment to both hospitals. The donations to St. Fidelis Rural health Centre were officially handed over at a colorful ceremony on Friday, March 19, 1999. The official Guest of Honor who received the equipment on behalf of the Ministry of Health of the Zambian Government was the executive director, Kasama District Health Services, Ms. Wedlock Mulaubwa (sic) who handed over the supplies and equipment to the Hospital Management. Receiving the equipment and supplies on behalf of the hospital was His Most Rev. Bishop James Spaitta, the Bishop of Kasama Archdiocese.

In appreciation, Sr. Annie Chanda, the Sister in Charge, wrote:

"I wish to express my sincere gratitude over the various medical equipment/supplies you bought and sent us. Every thing arrived safely and intact. The Archdiocese of Kasama did a recommendable (sic) job, as well in ensuring transportation of these goods from the port of Dar–es–Salaam (Tanzania) up to this place, though they encountered some minor problems in the process.

St. Fidelis Hospital, Zambia

I'm assuring you that your generous offer has really solved a lot of problems at our health facility. We are very much ready to open up an operating theatre and improve, in our service delivery to a large number of our needy people. You have actually contributed a lot to the improvement of the quality of life and restoration of human dignity of the people of Zambia at large.

Thank you very much for you (sic) kindness. I hope and pray you will still remember St. Fidelis Rural Health Centre again in the near future. You are a caring people.

Wishing you God's blessing in your daily tasks.

Yours sincerely,
Sr. Annie Chanda
Acting in–charge"

Mr. Humphrey Goma, President of the Kasama Rotary Club in a personal report to MARCO President Robert Currier, MD, writes in part:

"On behalf of the Rotary Club of Kasama, the community of Kasama, particularly the community around St. Fidelis Rural Health Centre and indeed on behalf of the government of the Republic of Zambia we wish to express our profound appreciation to your organization for financial support to purchase the various Medical Equipment and Supplies for St. Fidelis Hospital and for the hard work you had personally put into the Project.

Wishing you all the success in all your future endeavors in caring for the needy the world over."

Humphrey C. Goma
Rotary Club President, 1999
Kasama, Zambia

Because of its remote location and the necessity for a favorable convergence of weather, wind, availability of a hospital boat and the coordination of several groups, the delivery to Santa Maria Health Centre has been more complex. However, in late December word was received that the boat and motor replacement, provided by the Bush Hospital Foundation/MSI has arrived in Mansa, Zambia, which will make it possible for the MSI–Rotary provided shipment of medical equipment and supplies to be delivered to the SMHC on Chilubi Island.

"The boat will be transported by road to Nsombo (which is a village on Lake Bangweulu in the Northern Province of Zambia) on Sunday the 28th of November." "We from Rotary Club of Mansa will travel – – – from Samfya to meet the boat at Chilubi Island and hand over the equipment and the boat to the Santa Maria Hospital." Chiman Patel Rotary Club of Mansa

Robert Smithwick and Chiman Patel, of the Mansa, Zambia, Rotary Club

This grant provided a carefully selected list of equipment, instruments, drugs, and supplies that will establish a basic surgical unit in both hospitals. The list was developed as a result of an on–site visit by MARCO member Dr. Mike Marks, medical director of MediShare's European partner, the Bush Hospital Foundation. These new facilities will also serve as an emergency treatment facility. These major projects will be completed at low cost as the experienced, non–profit, partner agencies, MediShare International–Bush Hospital Foundation, and Direct Relief International, are able to make available largely donated (from manufacturers, private and public health providers, etc.) medical material. This material is then offered to pre–qualified medical facilities in Third World countries – such as these two hospitals in Zambia.

Of major significance is the fact that these organizations can frequently provide medical/hospital/dental equipment, instruments and supplies at a typical leverage of from 10 to 20 times. To illustrate, on average, $1000 can produce from $10,000 to $20,000 worth of medical supplies as computed at wholesale prices if purchased in the US. Much of the on–going work of our partner agencies, as Direct Relief, International, is volunteer, and all of the 'staff' of both the BHF and MediShare International are unpaid volunteers. Therefore costs are kept very low.

Thus, in the current proposal, $8,708 donated by Rotary (the full and exact amount requested) and out of pocket costs supported by the Ludin Memorial Fund, delivered over 2000 lbs. of medical material valued (wholesale) at $38,788. This is not equal to the usual leverage as noted above since much of what was sent to Zambia is new and in unopened boxes. MediShare's contribution paid only for direct out–of–pocket costs of developing the grant proposals.

Although this single Grant supports two hospitals, involving two Rotary Clubs in Zambia, for economic reasons the material was packed into one single container, thus nearly halving the shipping costs. Each hospital's material was packed in separate sub–containers. At the final destination the one large shipping container was opened and the two separate lots were transported to the individual hospitals with the assistance of members of each of the Mansa and the Kasama Rotary Clubs. Shipping costs were supported largely by a Federal USAID grant awarded Direct Relief International and the overland transport in Africa was supported by the Archdiocese.

This project broke new ground for MediShare International–Bush Hospital Foundation. For the first time a wide–ranging partnership was forged to meet a unique, innovative medical enterprise with an important and prestigious world–wide organization, the Rotary Foundation. Discussions are already well underway in this area of California with other Rotary Clubs that are eager to develop similar projects.