Tag Archives: children

Mount Meru Hospital, Tanzania

Each Friday for the next three weeks, the Tanzania EWH team will  work at Mount Meru Hospital just outside the heart of Arusha.

The Tanzanian health care system consists of larger referral/consultant hospitals such as Kilimanjaro Christian Medical Center, regional referral centers covering several districts, and smaller hospitals covering one district each such as Karatu Hospital.

Mount Meru is a regional hospital with departments for obstetrics and gynecology, pediatrics, surgery, out-patients, and units for ophthalmology and dentistry. The hospital also has a laboratory and an intensive care unit. The hospital typically sees 500 patients per day on an outpatient basis and admits approximately 250-290 patients every day.

Generally there is a fee to be seen by a doctor at Mount Meru; however, as a public hospital, they are obliged to serve all people, and will provide free health care to those who cannot afford  it.

The typical population served by the hospital consists of farmers, pastoralists or industry workers. These are families that earn a low to middle-class income. Some of those who work in the outskirts of the districts covered by Mount Meru Hospital (for example people coming from Ngorongoro or Longido district) have nine hours travelling time to the hospital. Others simply can’t afford the cost of transportation. As a result, acute patients, especially pregnant women and children, often reach the hospital too late for doctors to do anything.

According to hospital staff, the largest barriers to provide health care services in Tanzania are lack of capacity to handle all, but especially acute patients, lack of funding and lack of accessibility to medicines, supplies and health care technologies. These issues are more or less apparent in all across governmental Tanzanian hospitals from the district level up to referral/consultant levels. Handling acute cases is a particularly large problem at district hospitals, which is why regional hospitals like Mount Meru experience a very high occupancy rate and a high number of patients, that do not reach the hospital in time for an ideal outcome of their treatment.

At Mount Meru Hospital, one challenge in meeting the demand is the large amount of donated equipment of which only about half is currently functioning. The entire region has just one biomedical engineering technician (BMET), Mr. Sharif Rajabu Kishakali. As of early 2015, he is the first ever BMET at Mt. Meru Hospital. He is currently working on a preventative maintenance program for the hospital’s equipment. The attached pictures are a collection from the projects he is currently working on.

When Toys are Not Just Toys

Around the world LEGO Company is famous for inspiring creativity through play. Nowadays LEGO is also being used widely for educational purposes. In Tanzania, I found a new use of LEGO that I would have never imagined possible.

This summer I was one of six students from EWH DTU participating in the annual Engineering World Health Summer Institute in Tanzania. We brought 27 kgs of LEGO bricks from LEGO Charity with us. During our stay, we found schools and orphanages to which we could donate the LEGO bricks.

In one case, however, the LEGO bricks could be used for purpose more serious than pure entertainment. I was fortunate enough to meet Dr. Marieke Dekker, currently the only paediatric neurologist in all of Tanzania – a country with a population of almost 50.000.000.

Dr. Marieke Dekker works with hundreds of children with serious neurological disorders in her work. As a neurologist she uses the LEGO bricks to test fine motor skills and cognition of the children. She is able to asses their development and at the same time give them a once in a lifetime gift that brings great joy. Many Tanzanian children have never seen, let alone owned, toys before:

According to Dr. Marieke Dekker, “LEGO bricks are a great success, especially here, dealing with children suffering from neurological disease. Neurological conditions are often well visible and they are known to cause stigmatisation in African society – it is a huge social problem.”


The stigmatisation of these conditions, even by family members, complicates many children’s access to care. As Dr. Marieke Dekker points out, cerebral palsy is the most common paediatric neurological disorder in Africa. The disease is primarily caused by poor perinatal circumstances and healthcare. The severeness of cerebral palsy is varying results in cognitive, behavioural and learning disabilities. Children with less severe cerebral palsy have proved to be a very successful target group for LEGO bricks.

The LEGO bricks allow doctors like Marieke to assess motor skills, as it “‘breaks the ice’ in the patient-therapist relation and the ultimate joy is to be given the toy upon going home.” says Marieke.

In many cases, the cerebral palsy can be devastating, rendering a child dependent on care around the clock. This group is unfortunately also very common in Africa, mostly concerning school-age children with spinal cord problems. Due to dangerous traffic, falling from trees (harvesting fruits, a major part of African diet), tuberculosis and other infectious diseases, a disproportionate number of children are paraplegic and wheelchair-bound for life.

“Since there is no rehabilitation medicine in Tanzania, they remain in-patients until the family cannot pay the hospital bill anymore, or until they die from pneumonia or infected pressure sores. Many of these children were given LEGO bricks. They built, rebuilt, remodelled and rearranged… it gave them and their caretakers a spark of joy in a circumstance of misery.”  says Marieke Dekker.

Marieke’s patients truly benefit from using the LEGO bricks in the clinic professionally as well as psychologically. It means infinitely much to children to whom such toys would never be affordable, let alone available.

Marieke, the EWH DTU chapter, and I wish to continue this collaboration by bringing LEGO bricks with us to the Summer Institute in Tanzania in years to come!

All photos were taken and published in this article with consent from patients and parents.