South to Haydom!

Last week a couple of Norwegians (a pediatrician and a community health expert) came by FAME, and I showed them around. It turned out they were visiting from Haydom Lutheran Hospital, which is about 100 miles to our Southwest. After the tour, they invited me to come visit Haydom. I always enjoy learning more about healthcare in the area, so I said I would love to.

On my next day off, I saddled up the piki piki, and headed out before dawn toward Haydom. The road is all dirt and rock, winding through the hill country around Mbulu. It would have been a miserable drive in the car, but the dirt bike is built for that sort of thing.

Six hours later, I pulled into the gate of a major referral hospital in the middle of the wilderness. Haydom was opened in the 1960s on a previously uninhabited hilltop to serve an extremely rural population, mostly Iraqw and Datoga, spread out to the South of Lake Eyasi.

Now it serves as the primary hospital for 400,000 people and as a referral hospital for more than 2,000,000. With 450 beds (and I'm told up to 600 admitted patients at a time), it's a bit busier than our little clinic in Karatu. Each year, they perform 2,000  major surgeries and deliver 6,000 babies.

At first glance it doesn't look much different from other hospitals in Tanzania-- stuffy, poorly-lit hallways with beds packed into the wards and patients overflowing into the hallways. But going through department after department, you quickly realize just how many capabilities this facility has in comparison to other institutions in the area. Surgery, optometry, dentistry, inpatient, outpatient, HIV clinic, radiology, pediatrics, maternal and child health, labor and delivery, ICU, neonatal ICU, CT scanner... even a detox center.

Here's a view of their outpatient clinic, named for Ole Olsen, the Norwegian doctor who was the driving force behind the hospital until his death in 2005.

They also host a small contingent of international volunteers, and I had a very illuminating chat with their volunteer coordinator, who faces a lot of the same challenges we have at FAME.

The biggest issue for Haydom, not unlike many hospitals, is funding. Only Haydom's situation is especially acute since right now the Norwegian government is underwriting 66% of their budget, to the tune of three million dollars per year, and they are pulling the plug in 2015. It seems like nobody is quite sure how the hospital is going to deal with two thirds of their budget disappearing next year. They've known about the Norwegian government's plan to end funding for the past five years, but it's as if nobody thought they would actually go through with it.

It will be interesting to see how this situation plays out. The hospital is so important for so many people, and if they raise fees and cut services to cover the shortfall, the vast majority of their patient base will no longer be able to afford care there.