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CONSOLATA HOSPITAL IKONDA 2017
The Consolata Hospital of Ikonda is a private, no-profit, catholic institution that belongs from its origin to Consolata Missionaries. Started in 1963, it was inaugurated by President of Tanzania Mwalimu Julius K. Nyerere on 7th October 1968. The mission of the Hospital is to provide general quality health care to the population of Tanzania and to promote access to health care for the needy with a special attention for children, women and people affected by chronic diseases.
Since 1997 it is registered with the Ministry of Health (reg.no.115002), The Hospital is recognised by NHIF (National Health Insurance Fund) and is member of CSSC (Christian Social Services Commission) and of ATE (Association of Tanzania Employers). In 2016, the hospital has received from Ministry of Health the upgrade from District level to Regional level. Today the hospital has a capacity of 359 beds and receives every day an average of 450-500 outpatients (including RCH and CTC), coming from different districts and regions Ikonda is located in the Southern Highlands of Tanzania, 2050m above sea level (9°22’10’’S, 34°14’22”E), in Njombe Region, in Makete District. The village has grown with the hospital and, especially in the last ten years, the increased number of people coming to hospital for treatment and work, has produced significant changes in its aspect and economy. It grew from a small village of farmers to an important centre for the all district with shops, one bank, many guesthouses and restaurants, daily buses and minibuses to Njombe, Makamabako, Iringa, Mbeya, and Tunduma. The Consolata Hospital stands in highlands, right hand side as one moves in Makete direction. It is accessible via compacted earth road of about 800 metres from village centre. Within an area of 30 acres of land it is “a village in the village” with various single storey buildings : the hospital building with administration block, outpatient department and
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CONSOLATA HOSPITAL IKONDA 2017
various wards but also residential quarter for priests and employees, canteen/restaurant block, garage block, carpenter and stores for a total of 92 buildings.
OPD (Out Patient Department) consists in eight doctors’ offices, two First Aid, one dental units, one ENT clinic, one ophthalmic department, physiotherapy and gym, and one pharmacy. Other day-hospital clinics are RCH (Reproductive child health), TB clinic and CTC (HIV Clinic). Diagnostics include Laboratory Department, X-Ray Department, CT scan, Ultrasound, Endoscopy, ECG and Echo cardio. IPD (In Patient Department) consists of ten wards: Male Ward, Female Ward, Paediatric Ward, Maternity, Premature Unit, Annex/Isolation, Private Ward, Orthopaedic Ward, Surgical Male Ward, Surgical Female ward (inaugurated in August 2017) and Antenatal with 359 beds. Theatre consists in four Operating Rooms, two Sterilization Rooms, one POP Room and one Dressing Room. Four new theatres are under construction and will be ready in 2018. Pharmacy consists in three stores. Hospital water main is feed by four registered springs on the mountains around. A central wood heater provides hot water to all the hospital and the laundry. The hospital has its own implant for purifying black water.
Electricity is available 24/7. The Hospital has its own water power station. Four diesel power generators are used during the dry season when there is shortage of water. The hospital is connected also with Tanesco. Patient’s records and data are managed by a computerized system with access from administration offices, reception, pharmacy, OPD doctor offices, nurse station of every ward and theatres. A Vodacom tower built in the hospital compound is providing phone and high speed internet services (3G) to Ikonda hospital and village. The hospital has a small incinerator.
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CONSOLATA HOSPITAL IKONDA 2017
Three oxygen generators provide medical oxygen feed to all the hospital wards. In the compound, there are also a garage, a workshop and a small carpentry for the needs of the hospital. A specialized workshop (Swissleg technology) produces artificial legs for amputated patients. A compound called “Kampini” gives accommodation to relatives who assist their patients admitted in the hospital. Because of increased number of patients and relatives, a new building has been built this year. There are now twelve big rooms, toilettes and showers and a large cooking area.
There are also two guesthouses of five and twenty rooms, one restaurant (another one will be opened in 2018) and some shops, all run by private people. This shopping centre has been opened in order to help people who are coming to the hospital to get food at very easy price. Inside hospital compound there is also a CRDB branch. The hospital has 85 single houses and 6 hostel for doctors, nurses and workers. Hospital chapel is under construction.
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CONSOLATA HOSPITAL IKONDA 2017
PERSONNEL The hospital actually has 298 staff, of different categories:
To sustain the growing number of patients and activities, the hospital staff has been increasing every year and in the last 10 years has been doubled: from 157 of 2007 to 298 of 2017.
2013 2014 2015 2016 2017
Physician 1 1 1 1 2
Surgeon 0 0 1 1 1
Medical Doctor 4 7 11 14 16
Assistant Medical Officer 7 6 5 5 6
Clinical Officer 7 8 6 4 5
Nurse 60 67 77 74 91
Medical attendant 36 36 41 41 39
Laboratory tech & assistant 8 11 13 13 14
X Ray technician 1 2 3 4 4
Pharmacy 7 8 8 8 8
Dental 2 1 1 2 2
Physiotherapy & orthopaedic tech 3 2 2 4 4
Administration Staff 13 16 15 19 20
Driver 5 5 5 5 5
Support Staff 72 75 69 73 79
On training 6 3
Total 225 245 258 274 298
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CONSOLATA HOSPITAL IKONDA 2017
The opposite, the financial support from Central and Local Government has gone decreasing every year, as shown in the table below.
Despite all the surveys carried out by Government during this year didn’t discover any mistakes or irregularities in personnel documents and payments, the contribution received by government is inexorably decreasing year by year.
EMPLOYEES PAID BY 2015 2016 2017
Consolata Hospital Ikonda 200 220 241
Central Government 36 34 30
Makete District 18 16 14
Boresha Afya - - 7
Missionaries/Volunteers 4 4 6
TOTAL 258 274 298
The hospital is actually paying more than 80% of the staff. Salary levels are aligned with those of the Tanzanian Government. N.B. The 14 health workers sent by the District are considered as a kind of compensation for the different services that the hospital is providing to the population of the district
7
CONSOLATA HOSPITAL IKONDA 2017
During the year 2017, many specialized doctors came in our hospital from Europe. Registered at Medical Council of Tanganika, they worked in our hospital as volunteers. All of them are experienced specialized doctors with many years of practice in Europe and many missions abroad in their CV. We consider them as part of our hospital for the big efforts they have done by giving specialized services to the patients and training local young medical doctors.
Dr.Alessandro Calisti Paediatric surgeon
Dr.Alessandro Testa Surgeon
Dr.Andrea Favara Surgeon
Dr.Andrea Riela Anaesthetist
Dr.Anna Gerlach Radiologist
Dr.Bruno Monzio Compagnoni Surgeon
Dr.Federica Mazzoleni Urologist
Dr.Francesco Vasciaveo Orthopaedic Surgeon
Dr.Gaetano Povolo Cardiologist
Dr.Gian Maria Baldini Infectious diseases specialist
Dr.Gian Paolo Zara Surgeon
Dr.Gianfranco Francioni Surgeon
Dr.Giovanni Crestani Gynaecologist
Dr.Giovanni Scozzari Gynaecologist
Dr.Giuliano Novaretti Orthopaedic Surgeon
Dr.Giuseppe Tormen Anaesthetist
Dr.Maria Grazia Andriani Paediatric surgeon
Dr.Maria Teresa Zenorini Gynaecologist
Dr.Martina Fabian Radiologist
Dr.Maurizio Catalani ENT
Dr.Michele Savore Orthopaedic Surgeon
Dr.Otello Regeni Orthopaedic Surgeon
Dr.Patrizia Stasi Paediatrician
Dr.Riccardo Pellicci Surgeon
Dr.Riccardo Rota Graziosi Infectious diseases specialist
Dr.Roberto Plazzi Orthopaedic Surgeon
Dr.Roberto Tormen, Orthopaedic Surgeon
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CONSOLATA HOSPITAL IKONDA 2017
Dr.Rolando Sancassani Orthopaedic Surgeon
Dr.Silvio Pasquato, Orthopaedic Surgeon
Dr.Simone Del Curto Anaesthetist
Dr.Stefano Nosengo ENT
Dr.Stefano Righini ENT
Dr.Wolters Bernhard Heinrich ENT
TRAINING AND CONTINUOUS EDUCATION
• During 2017 the Hospital supported three medical doctors who are attending specialization courses:
Specialization Number Year course University
ENT 1 2nd Bugando Catholic University
Urology 1 2nd Bugando Catholic University
Orthopaedic 1 1st Muhimbili University of Health
and Allied Sciences
• Even this year, the hospital sent three workers (one doctor and two nurses) for a stage of six weeks in theatre and ICU.at Ospedale degli Infermi, Rimini, Italy. We are thankful to Dr. Gianfranco Francioni and his staff for this great opportunity.
• Continuous education for doctors and nurses is carried on with meetings on different matters organized on weekly basis in the hospital.
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CONSOLATA HOSPITAL IKONDA 2017
ACTIVITIES
SUMMARY OF THE MAIN HOSPITAL STATISTICS
Trends in the service output are shown in the table below.
2013 2014 2015 2016 2017
Number of beds 310 322 322 322 359
Admissions 13,052 14,499 15,009 13,907 15,047
Major surgical operations 2,560 2,921 3,106 4,128 4,545
Minor surgical operations 907 1,602 2,085 2,371 2,474
Deliveries 1,646 1,697 1,756 1,622 1,605
OPD visits 59,369 74,228 83,063 85,607 98,754
HIV Clinic visits 22,141 21,155 21,459 23,632 23,148
RCH visits 15,498 14,832 23,215 18,474 17,220
Dental treatments 2,387 2,170 2,185 2,092 2,158
Laboratory examinations 117,951 143,212 195.059 221,609 242,481
X-RAY 11,348 14,862 19,268 19,137 18,704
Hospital deaths 626 595 619 641 559
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CONSOLATA HOSPITAL IKONDA 2017
LABORATORY EXAMINATIONS AND BLOOD TRANSFUSION
Laboratory services are available every day from 8 a.m. to 8 p.m. and during the night in case of emergency. In the table below a resume of the activities performed in 2017.
Blood sugar RBS 14,515
Serum Creatinine 11,998
Serum Urea 9,898
Serum Cholesterol 6,409
Liver function test - ALT (GPT) 5,893
Serum Uric Acid 5,339
Liver function test - AST (GOT) 2,812
PSA (Prostatic specific Antigen) 1,047
Serum Bilirubin:Direct & Total 457
Thyroid function test -T4 406
Thyroid function test - T3 397
Thyroid function test - TSH 324
Serum Potassium 228
Serum Tryglicerides 64
Serum Total Protein 51
Full Blood Picture (FBP) 36,753
ESR (Erythrocyte Sedimentation Rate) 14,252
CD4 3,421
Hemoglobin (Hb) 2,106
Sickle cell test 146
Differential WBC (periferal smear) 99
Bleeding & Clotting time 70
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CONSOLATA HOSPITAL IKONDA 2017
Urine analysis 10 parameters (UA) 19,435
Stool Analysis 14,325
Stool Occult Blood 5,773
Urine for Pregnancy Test (UPT) 849
Sputum x 3 569
Urine deposit 430
Sperm fluid 256
Malaria (B/S or MRDT) 9,093
HIV viral load 1,310
Culture & sensitivity/gram stain 628
MTB GeneXpert 235
CSF examination 48
Microfilaria (B/S) 15
Widal test (WT) 23,326
H.Pylory test 12,927
Syphilis test (VDRL/RPR) 10,178
HIV test 9,375
Rheumatoid factor (RF) 7,901
ASOT (Anti Streptolysin O Test) 7,337
Hepatitis B 903
Hepatitis C 883
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CONSOLATA HOSPITAL IKONDA 2017
BLOOD TRANFUSION UNIT Despite the high request of blood, the experience of our laboratory staff and the high standard of laboratory equipment, we did not carry on any blood donation campaign in the schools of Njombe Region. Following the restriction of Government, we relied on Zonal BTS Mbeya but the blood provided was insufficient for the needs of the patients. Nevertheless, many people were ready to help their
sick relatives and to donate their blood directly in the hospital. The numbers are shown in the table below:
BLOOD UNITS RECEIVED FROM MBEYA 642
BLOOD UNITS DONATED BY RELATIVES 913
TOTAL BLOOD UNITS TRANSFUSED 1,555
RADIOLOGY DEPARTMENT
X Ray
X Ray Chest PA 7,832
X Ray Pelvis AP 1,472
X Ray Lumbar-sacral spine AP&L 1,118
X Ray Chest AP&L 971
X Ray Knee AP&L (left) 829
X Ray Knee AP&L (right) 812
X Ray Tibia/Fibula AP&L (right) 533
X Ray Ankle AP&L (left) 406
X Ray Ankle AP&L (right) 371
X Ray Femur AP&L (right) 359
X Ray Femur AP&L (left) 356
X Ray Lumbar spine AP&L 338
X Ray Tibia/Fibula AP&L (left) 295
X Ray Abdomen Supine/Erect 255
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CONSOLATA HOSPITAL IKONDA 2017
X Ray Elbow AP&L (left) 218
X Ray Shoulder AP&L (right) 203
X Ray Skull AP&L 193
X Ray Thoracic Spine AP&L 193
X Ray Shoulder AP&L (left) 170
X Ray Ulna/Radius AP&L (right) 145
X Ray Wrist AP&L (left) 135
X Ray Elbow AP&L (right) 132
X Ray Foot AP&L (left) 115
X Ray Ulna/Radius AP&L (left) 115
X Ray Homeruns AP&L (left) 113
X Ray Homeruns AP&L (right) 113
X Ray Foot AP&L (right) 112
X Ray Cervical Spine AP&L 111
X Ray Hip AP&L (right) 109
X Ray Wrist AP&L (right) 94
X Ray Hip AP&L (left) 90
X Ray Hand AP&L (right) 62
X Ray Clavicle 57
X Ray Hand AP&L (left) 56
X Ray Foot O (left) 43
X Ray Calcaneus AP&L (left) 29
X Ray Foot O (right) 27
X Ray Calcaneus AP&L (right) 24
X Ray Skull O 22
X Ray Finger AP&L 20
X Ray Hip O (right) 18
X Ray Hip O (left) 16
X Ray Hand O (left) 12
X Ray Hand O (right) 10
TOTAL 18,704
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CONSOLATA HOSPITAL IKONDA 2017
CT SCAN
CT Scan Head 757
CT Scan Abdomen 276
CT scan Spine 141
CT Scan Chest 62
CT Scan Bones 28
CT Scan Pelvic 16
CT Scan Neck 6
TOTAL 1,286
OTHER INVESTIGATIONS
Ultrasound pelvic (USS) 11,145
Electrocardiography (ECG) 9,674
Ultrasound abdomen (USS) 6,187
Gastroscopy 718
Ultrasound Doppler (USS) 315
Echocardiography 299
Hysterosalpingography 164
Urethrography (UTR) 110
Barium Swallow (BaS) 36
Cystoscopy 24
Barium Meal (BaM) 15
Cystourethroscopy 13
Pancolonoscopy 11
Barium Enema (BaE) 3
Note: The ultrasound done in Maternity ward are not counted in this statistic
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CONSOLATA HOSPITAL IKONDA 2017
ADMISSIONS
Beds Admissions Days
Average length
Deaths Occupancy
Male General 42 2,079 17,223 8.3 119 114%
Female General 42 2,630 17,348 6.6 135 113%
Paediatric 33 1,784 12,070 6.8 67 100%
Annex/Isolation 36 1,859 12,884 6.9 110 98%
Surgical male 42 1,498 20,838 13.9 55 *
Surgical female 33
Orthopaedic 33 1,174 13,478 11.5 8 112%
Maternity/ Gynaecology
27 2,664 16,535 6.2 16 168%
Premature 12 72 892 12.4 12 20%
Private 14 309 2,974 9.6 37 58%
Antenatal 45 978 13,796 14.1 0 84%
TOTAL 359 15,047 128,038 8.5 559
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 patient’s 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 patient is admitted in the same bed, only one in patient day is counted.
Until July 2017 all surgical patients, men’s and women’s, were accommodated in one ward. In August 2017, a new ward with 33 beds was opened for women. The beds in surgical department are now 75, 42 for men and 33 for women.
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CONSOLATA HOSPITAL IKONDA 2017
THEATRE
The hospital has four operation theatres: one for General Surgery, one for Maternity/Gynaecology, one for Orthopaedic Surgery and the forth one used on rotation by urologists, paediatric surgeons, ENT surgeons... Due to the increased number of patients, new theatres are under construction and will be ready in 2018. Planned surgery procedures are done from Monday to Friday but theatre is open 24/7 for emergencies
In the table below is listed the work done in 2017. MAJOR OPERATIONS: 4,545
OPERATIONS ON THE NERVOUS SYSTEM
Craniotomy 8
Carpal Tunnel syndrome (CTS) decompression 1
OPERATIONS ON THE ENDOCRINE SYSTEM
Complete thyroidectomy 127
Thyroglossal cyst removal 7
Other partial thyroidectomy 4
Monolateral Thyroidectomy (lobectomy) 1
OPERATIONS ON THE NOSE, MOUTH AND PHARYNX
Nasal polypectomy 33
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CONSOLATA HOSPITAL IKONDA 2017
Tonsillectomy 26
Adenoidectomy 7
Parotidectomy 5
OPERATIONS ON THE RESPIRATORY SYSTEM
Tracheostomy 2
Excision of lesion/tissue of larynx 1
Thorax drainage (Underwater seal drainage) 1
OPERATIONS ON THE CARDIOVASCULAR SYSTEM
Varicectomy 5
OPERATIONS ON THE HEMIC AND LYMPHATIC SYSTEM
Splenectomy 21
Radical neck dissection 1
OPERATIONS ON THE DIGESTIVE SYSTEM
Laparotomy 348
Unilateral repair of inguinal hernia 198
Intraperitoneal Abscess Incision and Drainage 196
Repair of umbilical hernia 156
Haemorrhoidectomy 93
Anal fistulectomy/fistulotomy 77
Appendectomy simple 61
Cholecystectomy 48
Secondary suture (abdomen) 46
Anal fixure (Lord's procedure/internal sphincterotomy) 26
Incisional Hernia Repair 17
Rectum prolapse: abdominal rectopexy 15
Bilateral repair of inguinal hernia 12
Anal warts cauterization 8
Colostomy 7
Intraperitoneal Evacuation of hematoma 7
Tumor-wide excision (debulking) 7
Closure of stoma of large intestine 6
Rectum prolapse: perineal procedure 6
Re-opening recent laparotomy site 4
Abdominoperineal resection of the rectum (APR) 3
PSARP (anorectal plasty) 3
Gastric/duodenal ulcer excision and suture (perforation) 2
Right Hemicolectomy 2
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CONSOLATA HOSPITAL IKONDA 2017
Total gastrectomy 2
Gastric resection 1
Gastrojejunostomy 1
OPERATIONS ON THE URINARY SYSTEM
Re-opening post prostatectomy 15
Urethroplasty (for urethral stricture) 14
Repair of hypospadias or epispadias 7
Nephrectomy 3
Urethral dilatation (Bourgenage) 2
Urethroplasty 2
OPERATIONS ON THE MALE GENITAL ORGANS
Prostatectomy 273
Orchiectomy 99
Hydrocele Repair 88
Orchiopexy 9
Penectomy total 7
OPERATIONS ON THE FEMALE GENITAL ORGANS
Total abdominal hysterectomy 268
Dilatation & curettage of uterus following delivery or abortion 186
Myomectomy 76
Subtotal abdominal hysterectomy 38
Hysterectomy 15
Marsupialization of Bartholin's gland (cyst) 9
Excision of ovarian cyst 5
Unilateral oophorectomy 5
Repair of rectovaginal fistula 1
OBSTETRICAL PROCEDURES
Caesarean Section 780
OPERATIONS ON THE MUSCULOSKELETAL SYSTEM
ORIF: unspecified site 479
Removal of implanted devices from bone: unspecified site 79
Total Hip replacement 60
Sequestrectomy: unspecified site 55
Hip spica cast 26
Below knee amputation 20
Above knee amputation 19
Wedge osteotomy: unspecified site 18
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CONSOLATA HOSPITAL IKONDA 2017
Amputation through foot 15
Tendon Repair 14
Backslap 6
Acute Osteomyelitis Drainage 4
Maxillary sinus osteotomy 3
Open reduction of dislocation of hip 3
Amputation through hand 2
Ankle fusion 2
Arthrodesis of knee 2
Maxi facial multiple fractures reduction open 2
Amputation stump revision 1
Application of external fixator: tibia, fibula 1
Arthrodesis of hip 1
Arthrotomy for removal of hip prosthesis without replacement 1
Closed reduction of facial fracture: unspecified site 1
Toe amputation 1
Upper limb amputation 1
Zigoma fracture reduction 1
OPERATIONS ON THE INTEGUMENTARY SYSTEM
Skin grafting major 90
Excisional biopsy of Breast (lumpectomy) 48
Mastectomy 37
Post-burn contracture release 19
Keloid excision 18
Skin grafting medium 12
MINOR PROCEDURES: 2,474
OPERATIONS ON THE NOSE, MOUTH AND PHARYNX
Lingual frenotomy 4
OPERATIONS ON THE RESPIRATORY SYSTEM
Thoracentesis 10
OPERATIONS ON THE HEMIC AND LYMPHATIC SYSTEM
Biopsy of bone marrow 1
OPERATIONS ON THE DIGESTIVE SYSTEM
Abdominal Paracentesis 113
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CONSOLATA HOSPITAL IKONDA 2017
Liver Abscess Incision & Drainage 1
OPERATIONS ON THE URINARY SYSTEM
Suprapubic Cystotomy (SPC) 8
OPERATIONS ON THE MALE GENITAL ORGANS
Circumcision (adult) 22
Circumcision (child) 16
OBSTETRICAL PROCEDURES
Perineal tear repair 3
OPERATIONS ON THE MUSCULOSKELETAL SYSTEM
Biopsy of bone: unspecified site 1
Closed reduction of dislocation: unspecified site 139
Closed reduction of fracture & POP 178
Closed reduction of mandibular fracture 3
Club foot: percutaneous tenotomy 9
Disarticulation of ankle 4
Excision of bone for graft: unspecified site 1
Finger amputation 27
Finger fracture: epiblock treatment 1
Fracture reduction/POP: large 338
Fracture reduction/POP: medium 237
Fracture reduction/POP: small 116
Removal of k-wire 17
Closed reduction of temporomandibular dislocation (TMJ) 3
Talipes (Club foot): corrective POP 15
OPERATIONS ON THE INTEGUMENTARY SYSTEM
Debridement of wound/infection/burn 132
Escharotomy 1
Excision of cyst (skin and subcutaneous tissue) 268
Excision of skin warts 1
Foreign body removal without incision, not otherwise specified 6
Genital Cauterization Warts 32
Lipoma Excision 50
Skin grafting minor 8
Wound suture (deep/big) 22
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CONSOLATA HOSPITAL IKONDA 2017
Wound suture small 76
OTHER PROCEDURES
EAR wax removal 78
Foreign body removal ear 4
Foreign body removal eye 2
Foreign body removal nose 58
Removal of external fixators 49
Removal of intrauterine contraceptive device (IUD) 4
Removal of POP 194
Skeletal traction application 144
Skin traction 78
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CONSOLATA HOSPITAL IKONDA 2017
MATERNITY SERVICES
2016 2017
Total number of deliveries 1,622 1,605
Normal deliveries 904 825
Caesarean sections 718 780
Multiple deliveries 30 20
Total number of new-born 1,660 1,675
Total number of live births 1,645 1,660
Fresh stillbirths 4 5
Macerated stillbirths 10 9
Born before arrival 16 12
Premature 54 50
New-born with body weight < 2,500 g 183 162
Early neonatal deaths 16 14
Referral from lower level 16 30
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 one 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
2016 2017
Caesarean sections 718 770
Breech delivery 6 14
Induction 8 4
Vacuum extractions 1 4
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CONSOLATA HOSPITAL IKONDA 2017
CAESAREAN SECTIONS Caesarean sections are many because many mothers with previous caesarean sections or other problems are coming to our hospital even from other districts.
Previous caesarean sections 355
Prolonged Labour 17
Foetal Distress 121
Cephalic-pelvic disproportion 3
Mal position
Breech 10
POPP 11
Transverse 9
Face 1
Arm 0
Obstructed Labour 33
Gestosis PIH 20
Bad Obstetrical History (BOH) 5
Failure induction 8
Big Baby 4
Premature rupture membrane 1
Placenta previa 0
Twin 6
Antepartum haemorrhage (APH) 8
Oligohydramnios 8
Abruption placenta 2
Compound presentation 0
Cervical dystocia 2
Cephalic pelvic disproportion 1
Imminent rupture 0
Oblique lie 0
Congenital malformation 0
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CONSOLATA HOSPITAL IKONDA 2017
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 2016 2017
Cardiogenic shock due to PPH and DIC 1 1
Probable cardiogenic shock 2 malaria in pregnant 1 1
Pulmonary embolism 1 1
Acute respiratory distress 1 1
Total 4 4
Maternity care is the first target of the hospital since its foundation in 1963. The hospital carries on this project providing all the maternity services at a very low price, starting from free accommodation in Nuru house, free check up and ultrasound, and very low charge for delivery and caesarean section. This is for all the mothers with a special attention to the ones coming from our catchment area.
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CONSOLATA HOSPITAL IKONDA 2017
OUT PATIENT DEPARTMENT (OPD)
The total OPD attendance has been increasing yearly. People are coming also from far and not only from our catchments area.
NOTE: Persons attending RCH clinics or CTC are not included unless they are referred to the General O.P.D.
MONTHLY ATTENDANCE IN OPD
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CONSOLATA HOSPITAL IKONDA 2017
2016 2017
Total number of patients referred to the hospital from lower levels 60 88
Total number of patients referred from the hospital to higher levers 195 236
Total number of patients transfer to lower levels for TB treatment 278 318
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CONSOLATA HOSPITAL IKONDA 2017
EYE CLINIC
Eye Clinic Statistics 2016 2017
Conjunctivitis Bacterial
adults 153 199
children 77 52
Allergic 280 411
Other 138 52
Cataract 70 278
Trauma 48 98
Corneal Ulcer 40 41
Retina / optic Nerve 26 53
Uveitis 24 26
Corneal Scar 20 55
Glaucoma 17 15
Trachoma
adults
children
15
6
0 5
TOTAL 908 1,291
Blind Patients 3/60 BE 2016 2017
Normal eyes 107 163
Retina/optic 21 55
Cataract 111 251
Corneal Scar 12 37
Corneal Ulcer 0 22
Other / Unknown 74 208
TOTAL 325 736
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CONSOLATA HOSPITAL IKONDA 2017
Refractive Error 2016 2017
Presbiopia 175 185
Miopia 138 153
Aphasia / Pseudophakia 0 20
Other 137 145
Lids
ectropion 3 1
other 30 33
Lacrimal 6 13
Orbital 0 17
Strabismus / Amblyopia 0 4
Other diagnosis 87 25
TOTAL 576 596
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CONSOLATA HOSPITAL IKONDA 2017
DENTAL CARE
Forceps extraction permanent tooth 1,563
Forceps extraction of deciduous tooth (child) 313
Restoration of tooth by filling 167
Dental scaling and polishing 66
Impacted tooth extraction 14
Root canal treatment (endodontic) Premolar 7
Root canal treatment (endodontic) Molar 6
Flap Excision (Dental) 5
Removal of dental wiring 5
Root canal treatment .(endodontic) Anterior tooth 4
Dental abscess Incision & drainage 3
Tooth Extraction complex 3
Dental tumor excision 2
30
CONSOLATA HOSPITAL IKONDA 2017
ARTIFICIAL LEGS WORKSHOP AND PHYSIOTHERAPY
Started in 2016, the workshop produces artificial legs for amputated patients but also orthosis and splints for adult and children. This is the work done in 2017:
Orthosis Ankle Foot (AFO) Child 48
Prothesis Below knee 33
Orthosis Ankle Foot (AFO) Adult 22
Prothesis Above knee 13
Orthosis Arch support Child 8
Orthosis Arch support Adult 6
Orthosis Supramaleolar (SMO) Child 6
Orthosis Wrist (Cock-up splint) Adult 4
SACH foot replacement Adult 3
Stump Socks 30cm 3
Thomas splint without joint Child 3
Orthosis Wrist (Cock-up splint) Child 2
Prothesis Below knee Child 2
Prothesis Above knee Child 1
SEWHO (Shoulder Elbow Wrist Hand Orthosis)Child 1
Socket for Above knee Adult 1
Stump Socks 50cm 1
Thomas splint without joint Adult 1
The technicians work together with physiotherapy department in order to follow the patient’s rehabilitation. Hospital gym is open every day for inpatients and outpatients. In 2017 584 patients attended physiotherapy department.
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CONSOLATA HOSPITAL IKONDA 2017
FREE TREATMENT FOR CHILDREN Since 2006, the hospital is providing free treatment to all the children under 10 coming from Makete District both outpatients and inpatients. During 2017 the children assisted free of charge were 5,590: they received 540 surgical operations, 2,370 laboratory tests, 324 radiology services, 4,436 bed/days, 110 dental treatments and medicines for a total cost for the hospital of tsh 82,924,705
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CONSOLATA HOSPITAL IKONDA 2017
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 5,329 registered patients and 3,321 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
New patients 38 38 35 24
No consultations 5,457 5,114 5,380 5,076
Recorded patients 5,585 5,623 5,658 5,682
Male 2,285 2,305 2,317 2,325
Female 3,300 3,318 3,341 3,357
Children 508 511 512 513
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
New patients 64 44 32 35
Patients on ARVs 2,209 2,244 2,263 2,280
Male 840 864 870 870
Female 1,369 1,380 1,393 1,441
Children 135 136 124 115
Transferred IN 9 8 15 9
Transferred OUT 13 13 7 10
Dead 5 8 5 7
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CONSOLATA HOSPITAL IKONDA 2017
VOLUNTARY COUNSELLING AND TESTING (VCT)
COUNSELLED Tested HIV + Tested HIV -
Age M F M F M F
1.5 - 14 187 123 14 11 173 112
15 – 24 164 290 12 37 152 253
25 – 49 883 886 194 190 688 796
50+ 284 255 42 36 242 760
TOTAL 1,518 1,554 262 274 1,255 1,921
Patients registered in our CTC clinic received ARVs but also prophylaxis with Co-trimoxazole for a total cost for the hospital of TSH 16,883,675.
They were also tested for CD4, full blood picture, renal function tests and liver function tests twice in a year with a total cost for the hospital of TSH 63,729,000.
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CONSOLATA HOSPITAL IKONDA 2017
TB CLINIC
Patients who started treatment this year:
DIAGNOSIS CHILDREN ADULT TOTAL
Pulmonary TB AFB Negative 21 84 105
Pulmonary TB AFB Positive 0 112 112
Miliary 0 22 22
Spine 2 31 33
Glandular 3 23 26
Extra Pulmonary TB Meningitis 1 3 4
Others 7 48 55
TOTAL 34 323 357
Since January 2017, a GeneXpert machine has been installed in the hospital, donated by Italian Episcopal Conference.
Results of treatment of AFB + patients detected last year
Regimen Cured (smearing
positive)
Treatment completed (no smear
res.)
Dead Treatment Failed
Defaulters Transferred Total
Standard course
0 28 3 3 3 156 187
Short course 6 0 0 4 0 101 111
Re-treatment 0 2 0 0 0 19 21
MTB-MDR 1 0 0 0 0 3 4
TB/HIV COLLABORATIVE SERVICES 2017
TOTAL TB PATIENTS: 357
HIV NOT TESTED: 9 HIV TESTED: 348
HIV POSITIVE: 172 HIV NEGATIVE: 176
REFERRED TO CTC:169 NOT REF TO CTC: 3 (died)
UNDER ART: 142 UNDER C.P.T.:84
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CONSOLATA HOSPITAL IKONDA 2017
MOTHER AND CHILD HEALTH (RCH) CLINIC
Clinic in the hospital that serves Ikonda and Tandala people and a mobile RCH that serve an RCH the people of Ihela, Usagatikwa, Masisiwe and Ibaga.
Hospital
RCH Outreach
RCH Total
ANTENATAL (first visits) 159 40 199
CHILD CARE (first visits) 116 53 169
First visits is the number of new registrations during the year
IMMUNIZATION BCG DPT 3 OPV 3 MEASLES
Hospital RCH 1,081 131 131 352
Outreach RCH 0 44 44 0
FOLLOW UP OF CHILDREN UNDER FIVE YEARS 2016
Villages Follow-Up Leave Died Cont. Follow-Up
IHELA 644 12 1 631
MASISIWE 567 4 0 563
TANDALA 3,260 23 0 3,237
IKONDA 3,893 37 2 3,854
USAGATIKWA 945 12 2 931
TOTAL 9,309 88 5 9,216
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CONSOLATA HOSPITAL IKONDA 2017
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 in five villages: Tandala, Ihela, Usagatikwa, Masisiwe and Ibaga and Ikonda and surroundings.
2013 2014 2015 2016 2017
Total clients counselled
256 273 247 149 169
Total clients tested
256
273
247
149
169
Positive 31 21 38 4 4
Negative 225 252 209 145 165
Clients not tested 0 0 0 0 0
Clients given drugs (NVP)
Adults Children
31 31
0 40
0 38
0 4
0 31
Children given milk (exposed baby)
33 39 53 56
639
Total partners tested
112 142 174 96 112
Positive 8 5 15 9 8
Negative 104 137 159 87 104
Total children tested
at 18 months
2 9 10 26
22
Positive 0 0 0 0 0
Negative 2 9 10 26 22
Total children tested by PCR
30 40 39 28
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Positive 0 0 0 0 0
Negative 30 40 39 28 36
Note: Most of these children were born before PMTCT program has been started.
FOOD PROGRAM ASSISTANCE
In 2017, the Hospital has continued a food program assistance to prevent and treat malnutrition. This program involves five 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.
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CONSOLATA HOSPITAL IKONDA 2017
PHARMACY
Pharmacy Department provides pharmaceutical care services to both inpatients and outpatients attending the hospital. It is organized into three operational units: Main pharmacy, Outpatient pharmacy and CTC Pharmacy.
Main Pharmacy ensures that all essential medicines are available in the hospital through proper procurement, inventory, storage, and distribution with assistance of a computerized network system.
Hospital drug list includes around 400 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 diseases, eye, ear, nose, skin problems, immunological products, vaccines and anaesthesia. Local factories like Aspen Shelys, Prince Pharmaceuticals and Mansoor Daya Chemicals are among our suppliers with a percentage of 11.4% of the total. ARVs, TB drugs and vaccines only are supplied free of charge by Government through MSD.