"Why don't we ourselves have a rehabilitation centre for people with disabilities who suffer from epilepsy?" This was the question doctor Sarah Kahumbya asked herself in 2019, having just returned from Hamburg to Dar es Salaam, Tanzania's capital. Sarah Kahumbya heads the Cardinal Rugambwa Hospital (CRH) there. The staff here just call her "Sister Sarah" - the hospital belongs to the Archdiocese of Dar es Salaam and is run by the nuns of the Women's Order of Saint Theresa.
Children develop quickly
Today, the CRH has a rehabilitation centre that mainly treats children. "We built that out of shipping containers and cut the windows in there ourselves," says Sister Sarah, laughing. Improvisation is part of the clinic's daily routine. The Tanzanian-German project team was able to finance the containers through funding from the GIZ Hospital Partnerships Program.
Today, the centre regularly offers "Screening Days" for mainly children with disabilities who are suspected of having epilepsy. One of the most common causes of epilepsy in people with disabilities is cerebral palsy, which is associated with severe spasticity. The rehabilitation centre also offers movement therapy and occupational therapy. This is an effective therapy, especially for children, because we can observe progress in them very quickly," says the doctor. The nuns also work together with the nearby Muhimbili National Hospital, which sends its neurologist for rounds.
Staff receive training
The partnership with the Evangelisches Krankenhaus Alsterdorf (EKA) has given them a lot of motivation through the joint visits and training, the doctor reports. In 2020, the clinic partners purchased an electroencephalogram (EEG), which has since been used to train staff. Through these and other measures, the CRH has been upgraded from a "District Hospital" to a "Referral Hospital" in Tanzania. A big step towards the future.
People with disabilities often affected by epilepsy
The CRH and the EKA are Christian institutions. Both specialise in people who have long been ignored: Children and adults with physical and mental disabilities. The EKA has been a focus clinic in Germany for people with epilepsy since 1990. This neurological condition affects around one third of all people with disabilities worldwide. However, the number is particularly high in sub-Saharan Africa due to neglected tropical diseases such as river blindness and swine tapeworm infection. Because there are only about twelve neurologists in Tanzania, epilepsy often goes untreated in this large country.
Stigma and exclusion
Epileptics suffer from convulsive seizures caused by birth-related brain damage, accidents or tumours. In addition, there is social stigmatisation through stereotypical images and prejudices: For example, if an epileptic seizes next to a fireplace in a hut where the family usually cooks, the relatives do not necessarily save him or her from the flames. The reason: they are afraid because they think that they could catch epilepsy themselves. This has fatal consequences for the person affected: He suffers the most severe burns - and is even more restricted as a result.
"This year we will expand the training courses in both cities, Hamburg and Dar es Salaam," says Marion Förster, project manager of the German side. The need for education and training in neurology is high, she says.
Her Hospital Partner Sister Sarah, meanwhile, has further ideas: "If mothers could work and stay overnight at the CRH with their sick children during therapy, that would be a big step." They would stay on site at the clinic for longer and still not have any loss of earnings. Including this group of relatives in particular is very important, says Sister Sarah. "Our partnership will bear some more fruit."