Hello! I’m Cole Wensman, a quality improvement consultant with our Global Health Ministries consulting team, alongside my fellow healthcare administrators Maureen, Theresa, and the illustrious Cindy. We’re here to help facilitate a quality improvement conference on Thursday and Friday and to develop a recommendation for the diocese as it considers upgrading Ilula Hospital to a Regional Referral Hospital. (If you’re curious about Tanzania’s tiers of care, Cindy covered that nicely in her 1/17 post.)
We started the day attending devotions and morning report with hospital leadership and the management team. After prayers and readings, the pastor offered a homily focused on trust in what God has given us, forgiveness, and choosing to focus on the positive rather than the negative (a helpful perspective when reflecting on the resource gap between Tanzania and higher-income countries). Department leaders then shared announcements, followed by a financial report from the previous day.
When the morning report transitioned to the clinical discussion, our intrepid group of non-clinical healthcare administrators broke off to meet with Alamu Kikoti, the hospital administrator. Meanwhile, our esteemed clinical colleagues—Cole, Tawa, Yusra, Manny, Randy, John, and Solvieg—continued with the report and then headed out for rounds in the wards.
Our meeting with Mr. Kikoti was informative. We learned about the competitive landscape for patients in and around Ilula, the IT systems the hospital relies on, and the potential plan to recruit specialists for ophthalmology and orthopedics, which would upgrade the hospital to a Regional Referral level.
Next, we met with Israel, the hospital’s nurse patron (roughly equivalent to a Chief Nursing Officer in the U.S.). He oversees all nursing activity, manages supply shortages, and leads training for new equipment. He explained that one of his biggest challenges is staffing. When given the opportunity, many nurses leave for government positions that offer better pay and greater job security.
After lunch, we attended a hospital board meeting that included the newly appointed diocesan general secretary, Shadrack. Board members shared updates on hospital projects and staffing, and Randy provided news from Shoulder to Shoulder. We left as the board paused for lunch, giving us time to debrief the morning’s conversations and prepare materials for the upcoming quality improvement conference.
Our final interview of the day was with Frank Sanga, head of Pharmacy, who walked us through the process of purchasing medications and medical supplies. In the evening, most of our group took a long walk around town. I’m writing this as we get ready for dinner.
A bit of potpourri for the committed reader:
We stumbled upon choir practice during morning prayer, and I continue to be amazed by the people of Ilula’s ability to sing beautifully, especially as a group, seemingly at the drop of a hat
During clinical report, Manny shared insights from his time in the pharmacy, sparking a discussion on the ethics of drug patents and the tension between incentivizing innovation and providing affordable medications to as many people as possible
Randy also shared that there isn’t a strong culture of blood donation in Tanzania. In the past, when blood was needed, families were often asked which relative could donate who was least likely to have HIV
Talking about competition in healthcare here feels a bit strange—why compete when so many need care? But it becomes relevant when certain, more complex, services can command higher reimbursement…a dynamic that feels surprisingly familiar to those of us from the U.S.
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