Selian Lutheran Hospital

The population in the district is about one million. Arusha town is estimated at about 300,000. The area surrounding the hospital itself is densely populated.

Muheza Hospice Care

The hospice services the whole of Muheza district. Based at Teule Hospital, most of its referrals come from the hospital. The following chart and tables 6 and 7 provide the 2004 referral details.

Chart 1 Muheza Hospice care: referral by diagnosis

Table 6 Teule Hospital Ward Referrals to Muheza Hospice Care, 2004

Source: Muheza Hospice Care Annual Report, 2004

Table 7 Cancer referrals to Muheza Hospice Care, 2004

Source: Muheza Hospice Care Annual Report, 2004

PASADA

The service covers the geographical area of the Archdiocese of Dar es Salaam. This includes all three districts of Dar es Salaam plus three districts of the coast region. Dispensaries are widespread, the furthest being 110 kilometres from the PASADA headquarters. The catchment area of population is about 800,000. The free service is available to people of all faiths and to everyone who can access it, including the very poor:

but the problems are very often they don’t have the money for the bus fare or they don’t have money for food or for other things. So… the idea of decentralisation, taking the services as close to the community as possible, also makes it more accessible for people.²¹

Ocean Road Cancer Institute

Cancer patients are referred here from all over the country. Many patients simply arrive at the hospital without a referral. The hospital does not have the financial capacity to provide follow up support for patients and contact is often lost. The palliative care team acknowledges how emotionally difficult this is, having established relationships with many of the patients over several years.
Hussein Mtiro:

So they come here, we know each other, we are friends ... we get information, when they die some relative will inform us that the patient has died. Some will write, some will phone. We need to support them but we can’t do that, we have no facilities, so we just pray for them.²²