Temeke is located in the Dar es Salaam region, and the health services for tuberculosis are in turn divided into eight follow-up districts, each of which is headed by a medically trained district coordinator, with a physician as the regional coordinator.
Temeke has a population of an estimated 1.3 million, and it is the poorest of the three health regions in Dar es Salaam. Overall, around 25 per cent of all tuberculosis cases in Tanzania are diagnosed in Dar es Salaam.
LHL International has had formal cooperation with the health programme in Temeke since 2006. This cooperation resulted in the establishment of the patient organisation Mukikute, which subsequently became a separate project partner.
Public and private actors
Work with tuberculosis in the municipality is carried out by both public and private clinics, but they all must follow the guidelines and the treatment protocols that have been established nationally as the professional standard.
A good tuberculosis programme requires good diagnostics and quality assured laboratory services, health personnel who conduct themselves professionally in relation to the patients and perform their job correctly, and good cooperation with other actors.
The regional coordinator travels around regularly and provides guidance to the various clinics to ensure that they work systematically and correctly. Unfortunately, the public system is not fully financed. Even if the patients are not required to pay for the tuberculosis medicines they need, being sick entails so many added expenses that poverty is a serious obstacle to people completing the entire course of treatment.
The cooperation with LHL International shall contribute to improving the results so that more patients can be diagnosed and treated early. This contributes to better coordination of the efforts for those who suffer from both tuberculosis and HIV, and it focuses attention on particularly vulnerable individuals such as children, slum dwellers, substance abusers, the elderly and refugees.
The preparation of patient-friendly information materials and health communication has contributed to improving the climate of cooperation at the clinics, and to a better understanding of the patient’s situation when they suffer from tuberculosis. Health personnel have also obtained an opportunity to participate in professional courses and in research, so that they can present their results beyond the local community.
There are still many challenges because many patients are diagnosed far too late, and thus there is a greater risk that they die or have infected others before they receive treatment. Cooperation with the patient organisation Mukikute is therefore important in order to improve public education and the grassroots efforts in the fight against tuberculosis in Temeke.