(22 July 2019)

We took an early morning flight (6am) from Dar es Salaam to Dodoma.  We watched the sunrise from the plane, and it was beautiful.  Besides what is early, anyway, when you’re traveling, and your body hasn’t figured out what time zone you’re in?

The early flight let us arrive in time for a quick breakfast before heading over to the Dodoma Christian Medical Center (DCMC) for introductions, welcome, and a tour.  Every day is a busy day at DCMC, and today was a children’s clinic day so there were an especially large number of children.

Scheduling clinical appointments for specific times days or weeks in advance is not really a thing here in Tanzania like it is in the United States.  Instead, people come to the clinic to get on that day’s schedule, and they expect to wait in line.  There are two triage areas at the hospital so patients are prioritized as to who needs to be seen first.  However, unlike many clinics in Tanzania, the doctors and staff at Dodoma are committed to their patients and typically stay until everyone has been seen.  It can make for some long days.

The staff at DCMC are amazing and have earned a reputation in the community and beyond for excellent patient relations and customer care.  The Senior Leaders have set the tone and example for listening with compassion and for understanding, and for providing quality care.

The center has grown—and grown quickly.  The effort started out managing several community dispensaries and helping the Lutheran Church bring them up to standard of care.  Then, DCMC started building physical buildings.  First services were the Dental Clinic and then Reproductive and Child Health.

In the early days, they had no inpatients and thus were not allowed to deliver babies because they didn’t have a surgery or other supportive medical services if an emergency were to occur.  Then one day, a mother hopped up on a gurney and refused to leave until her baby was born there because she felt so strongly that her baby should be born at DCMC.  This triggered a flurry of activity to support her that day and then grow the clinic to be able to support labor, delivery, and the neo-natal center.

Last year there were approximately 500 births at DCMC and zero maternal deaths.  That is an excellent record for any part of the world but especially amazing in Tanzania and Dodoma!

The center has continued to grow.  With 50 inpatient beds and several specialists, the center was designated a zonal hospital* by the national government agency.  This is a big deal, and it means that they can take referrals from district or regional hospitals.  The government has been so impressed, that they asked if DCMC would expand (even though DCMC is a private hospital and not a government hospital.)  The board of directors met last week for their regularly scheduled meeting and voted to expand the facility so watch for more exciting changes coming.

*to put the term “zonal” into context, know that in the Tanzanian system, the first line of medical care are the community dispensaries.  The dispensaries are managed by a district hospital.  (In US terms, you can think of a district as parallel the county-level, a region is like a state.)  There are several districts within a region, so for example, the Dodoma region has 5 districts.  Zonal is a step above a regional hospital, and it seems to not be as connected to a political geography.  A zonal hospital must have a minimum number of specialists and other criteria.  The fact that DCMC was recognized as being worthy of the zonal designation is impressive.