Imagine a hospital without any doctors. Imagine a hospital without the drugs to treat patients for simple conditions like asthma or diabetes. Imagine a hospital without the equipment to do basic tests like kidney function or ultrasound. This was the situation when Health Improvement Project Zanzibar was first set up ten years ago. Ru MacDonagh, a UK Consultant Surgeon who had spent time working in East Africa, was asked by the Government of Zanzibar to create a charity which could help make long-term sustainable improvements to the healthcare in rural Makunduchi hospital. Six years of hard work later Makunduchi was vastly improved and HIPZ was asked to help manage a second hospital on the island.

The charity has gone from strength to strength on a very simple formula. Firstly, we focus on strengthening hospital management and improving basic infrastructure. Secondly, we place volunteer doctors and medical staff to work for at least six months in the hospitals, working closely with local staff on training and improving systems. It means that the charity has an in-depth understanding of problems on the ground and can work together with local staff on solutions which will have a lasting impact.

One example is in child malnutrition. Poor nutrition leads to stunting in 42% of children in Tanzania. Acute malnutrition is a major contributor to the high child mortality rate: eight children in every 100 never make it to their fifth birthday. HIPZ has created systems in the hospitals so that all children are screened for malnutrition, and then quickly put onto treatment if they need it. Previously, many children admitted to hospital for malnutrition were not getting the specialist milk they needed because there was no working fridge in the paediatrics ward. HIPZ bought a fridge and helped train nurses and leaders in the local community to store and prepare the milk. We created simple guidelines appropriate to local resources. The new system helped save baby Haji whose mother had died in childbirth. At three months old Haji (left) weighed only 2.3kg and was suffering pneumonia and anaemia. With a bed for grandmother and baby in the newly renovated specialist malnutrition ward, focused care from nurses, and regular visits from the trained lead clinician, Haji (right) made a happy and healthy full recovery.

HIPZ is successful because we’re embedded in the hospitals, working within local structures and focused on upskilling local staff. Our aim is to help make sustainable improvements to the point that the hospitals will no longer need our involvement. We are a small charity with only one paid member of staff in the UK and a huge team of volunteers across the UK and Zanzibar who are passionate about making a difference to healthcare on the island. Dr Mike Spencer Chapman, who grew up in Iffley, spent a year with his partner Caitlin volunteering for HIPZ in 2013 and is now a trustee for the charity. More information is available on our website: www.hipz.org.uk and we greatly appreciate the support we receive from donors.

Caitlin Farrow