Tanzania is emerging as a regional hub in specialized healthcare services provision. Dar es Salaam is now turning into a point of call for referral patients from neighbouring countries.

Having inherited notable achievements in healthcare provision in the past 60 years, President Samia Suluhu Hassan has set her eyes on making Tanzania a medical tourist destination of choice. It was President John Magufuli, who in February 2020 started talking about the need for Tanzania to tap into what he said was the $72 billion-a-year global medical tourism market.

When she took over President Hassan pushed the idea further. In July 2021, Dr Dorothy Gwajima, the minister for Health, Community Development, Gender, Elderly and Children, unveiled a medical tourism promotion team.

Veteran cardiologist and Jakaya Kikwete Cardiac Institute (JKCI) executive director Mohamed Janabi chairs the team. The government wants to start with JKCI because it already receives patients from Comoro, Zambia, the Democratic Republic of Congo, Burundi, Rwanda, Uganda and Kenya.

Dr Gwajima says the government has sent an application to the World Health Organisation (WHO) for a formal recognition of Tanzania as a medical tourist hub.

More investments needed

Whether medical tourism is feasible or not will depend on how Tanzania invests in medical human skills development, telemedicine, digital economy, transport infrastructure, accommodation facilities, health services price affordability and overhauling of customer care service, among others.

There is also no bypassing creating favourable investment climate and a conducive business environment to facilitate the establishment of medical facilities, pharmaceuticals and medical equipment manufacturing as well as investments in research and development, analysts say. Following the adoption of the Arusha Declaration in 1967, Tanzania went ahead and banned the private for-profit healthcare providers through the Private Hospitals Regulation Act of 1977. This Act was repealed in the 1980s but investors would need reassurance that nothing of the sort would recur. At this point, though, Tanzania’s medical tourism ambitions are realistic, considering the fact that the government has partially reversed exporting medical tourists to India and other countries.

In a report of 60 years of Tanzania’s health sector that she presented to reporters on Monday, November 8, Dr Gwajima said that in the financial year 2020/21 only two patients were referred to hospitals outside the country compared to 554 in the financial year 2015/16. Obviously the Covid-19 pandemic that saw global travelling banned by most countries and which put a serious strain on healthcare services of every country in the world contributed to this very small number of patients referred to more specialized medical treatment outside the country. What is clear, however, is that the number of patients started going down since 2016 when government’s efforts to buy more specialized diagnostic machines and equipment gained speed. In 2018 the number of patients going for treatment outside the country had come down to 350 from the 550 of 2016, according to statistics provided by the-then minister for Health, Community Development, Gender, Children and the Elderly, Ummy Mwalimu.

Specialized medical services

In the report of 60 years of the health sector, Dr Gwajima outlined several achievements in specialized medical services the country has gained which can help the country become a medical services hub in the region. The report highlights investments done in specialized public medical facilities. These include;

JKCI: Established in 2015, it offers specialized cardiology and cardiovascular diagnosis and treatment. Recently JKCI finished the installation of the Cathlab and Carto 3 system. The system was bought at Sh4.6 billion. About 6,500 patients have already been diagnosed and treated using the system that requires only small incisions as opposed to open-chest surgeries. About 2,436 patients have received cardiovascular treatment through the system. The new state-of-the-art medical system is set to attract more patients from inside and outside the country.

Muhimbili: The Muhimbili National Hospital is offering specialized medical services that are rare in the region. They include renal transplant, with 64 patients having been treated till now. Muhimbili also performs cochlear implant to children and adults. 32 children and two adults have already received this medical service; Muhimbili also offers interventional radiology services. Muhimbili also offer dialysis services.

ORCI: The Ocean Road Cancer Institute (ORCI) now employs the use of LINAC and CT simulator that have enabled chemotherapy treatment in a much more efficient way using 3D technology. The government has also allocated Sh14.5 billion for the construction of a building to house Cyclotron and PET CT-Scan to facilitate specialized screening and diagnosis that cannot be conducted anywhere in east and central Africa.

Improvement in medical services at ORCI has attracted patients from outside the country, according to Dr Gwajima. In the 2020/21 financial year 55 patients from outside the country received diagnosis and treatment services. The treatment has also reduced referrals outside the country by 90 per cent, saving about Sh10 billion, according to Dr Gwajima.

MOI: The Muhimbili Orthopaedic Institute has installed a machine (Angio Suite) that has made it possible to conduct brain surgeries using minimally invasive techniques without opening up the skull. Experts say this minimizes collateral damage to the surrounding scalp, brain, blood vessels, and nerves. The government has spent Sh7.9 billion on Angio Suite. 68 patients have already been operated without opening up the skull since January 2021, Dr Gwajima says. She adds that apart from Tanzania, that kind of machine is only found in South Africa.

Bugando Medical Centre: the Lake Zone referral hospital offers specialized treatments such as renal dialysis. Recently a chemotherapy treatment machine called brachytherapy was installed. The hospital also has CT-Scan and machines and has installed a Sh2.4 billion MRI machine. The hospital also performs surgeries to children with congenital malformations (children born with disabilities). Bugando has an Intravenous (IV) Fluids production centre that caters for some of its needs.

KCMC: The facility is a referral hospital for the northern zone regions. It is equipped with modern diagnostic machines such as MRI, CT-Scan (Slice 128). An oncology department is being established currently to reduce referrals from the northern zone to ORCI. Expansion of the hemodialysis and endoscopy departments is ongoing.

BMH: The Benjamin Mkapa Hospital in Dodoma is a referral hospital for the central zone regions. Established in 2017, BMH currently performs renal transplants (23 patients have already received new kidneys) and it also offers treatment of removing kidney stones without open surgeries.

Mbeya Referral Hospital: which is a referral hospital for southern highland regions, offers Laparascopic surgeries that enable operations using small holes. It also offers haemodialysis services. Its laboratories are of high grade and can test such diseases as Ebola. Mbeya Referral Hospital has also established an Intravenous (IV) Fluids production centre.

Future plans

To deepen Tanzania’s role as a medical hub the government is installing software programmes in hospitals as well as enhancing performance merits by scorecards to overhaul services delivery and professionalism by healthcare professionals in the country.

When unveiling the medical tourism team Dr Gwajima emphasized on the need to take customer care to another level to attract as more patients as possible form outside the country.

The government is also constructing seven regional hospitals for the new regions (Njombe, Songwe, Simiyu, Geita, Manyara, Songwe and Mara – Kwangwa) and expanding some of the old hospitals and establishing new departments and services. Currently the government is installing medical oxygen production plants in seven regional referral hospitals (Geita, Manyara, Dodoma, Dar es Salaam-Amana, Mtwara, Ruvuma-Songea, Mbeya).

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