AMBULANCE SERVICES IN TANZANIA

tz-128_flag

AT-A-GLANCE

  • IN CASE OF EMERGENCY: DIAL 112
    • But you may be hard-pressed to find help quickly, so don’t hesitate to call a taxi
  • Prehospital transport is very limited, very much dependent on region, and is typically provided by private services
  • Generally, ambulance services are inadequate compared to wealthier countries, stemming from lack of staff or poor training and equipment
  • Transportation between facilities, such as from one hospital to another with a higher level of care, is sometimes provided by the facility, but there are geographic and infrastructural challenges
  • Not all hospitals have emergency care areas; if they do, they are typically understaffed and underequipped, though the Emergency Medicine Association of Tanzania (EMAT) is making big strides in improving emergency care and making it a national issue
  • The US Embassy notes that the private hospitals in Tanzania provide superior care to the public hospitals

SCOREBOARD

% of Seriously Injured Transported by Ambulance

Less than 10%

[Source: 2013 Global Status Report on Road Safety, WHO]

Road Traffic Injury Deaths
(per 100,000 population)

  • Tanzania
  • Russia
  • United States

[Source: 2015 Global Status Report on Road Safety, WHO]

Reported Homicides
(per 100,000 population)

  • Tanzania
  • Russia
  • United States

[Source: 2014 Global Status Report on Violence Prevention, WHO-UNDP]

HOW CAN I CALL AN AMBULANCE IN TANZANIA?

HOW DO I CALL FOR HELP?

Dial 112

As reported by the Tanzanian authorities in WHO’s 2013 Global Status Report on Road Safety, 112 is the official emergency number in Tanzania, routing to the police department. However, anecdotal reports from our contacts in-country say that 112 is unreliable -– when called, it will often just “ring endlessly.”

CAN I CALL FOR HELP ANYWHERE?

No, coverage by emergency medical services is limited, largely to Dar Es Salaam and other major metropolitan and/or tourist areas. A study of Kilamanjaro Christian Medical Centre, a major referral hospital in the northern city of Moshi, found that there was no evidence of prehospital care in the region. The average time to arrival to the hospital was greater than 1 hour. A minority of patients were transported to the hospital in ambulances (see Rotich 2015).

WHAT OTHER EMERGENCY NUMBERS CAN I CALL?

Officially, Tanzania has separate numbers for the three essential public safety and health services:

  • Ambulance: 114
  • Police: 112 and 999
  • Fire: 115

However, we cannot independently verify the availability and access of these numbers across the country. Based on our research and contacts, Police and Fire numbers are most likely to be answered, though calls may be re-directed to call centers in different locations depending on the caller’s location.

 

In addition to these public agencies, private ambulance providers exist and work together with private clinics, including:

WHAT ABOUT IN DISASTERS?
ARE THE RESPONDERS TRAINED?

The Emergency Medicine Association of Tanzania (EMAT) offers emergency care training for different levels of providers. Read here for a full list of Short Courses offered by EMAT in Dar Es Salaam. The availability of trained prehospital emergency care providers (i.e., “EMTs” or “Paramedics”) is scant and documentation and/or websites detailing their existence is equally scarce.

Training for emergency physicians and nurses, however, is increasing. According to a 2012 article in the African Journal for Emergency Medicine:

“Currently at most hospitals, emergency patients are cared for in Emergency Centres (ECs) staffed with rotating personnel who are neither trained nor equipped to provide complete resuscitative care, but dedicated emergency care training projects are emerging. The first Emergency Medicine residency in the country was initiated in 2010 and will produce its first graduates in 2013. In 2011, a dedicated Emergency Nursing curriculum was introduced, and the Emergency Medical Association of Tanzania (EMAT), the first Emergency Medicine professional society in the country, was formed and ratified by the Ministry of Health. EMAT has been given a mandate to develop feasible initiatives for the dissemination of emergency care training to district and sub-district facilities. However, significant gaps exist in the capacity for emergency medical care including deficits in human resources, essential equipment and infrastructure – concurrent issues that EMAT must address within its development strategy.”

HOW WILL I GET TRANSPORTED?
WHERE WILL I BE TRANSPORTED TO?

Public hospitals in Tanzania can be roughly divided into 3 groups. First are district hospitals at the lowest level of care, next are regional hospitals, and last are national referral hospitals at the highest level of care. There are also private hospitals.

In a formal review, the Tanzanian government evaluated 35 district hospitals, 13 regional hospitals, 3 special hospitals, and 4 referral hospitals. For a complete overview of the different levels of care in Tanzania along with resource and staffing requirements, see this document from the Ministry of Health and Social Welfare.

A 2013 study that surveyed 10 hospitals found that none of the district hospitals surveyed had a triage area or emergency room. The study found a low level of emergency care training for staff across all of the types of hospitals (see Baker 2013).

HOW WILL I PAY?

FOR TANZANIAN CITIZENS

According to a 2013 post on AllAfrica.com: “DEPUTY Minister for Regional Administration and Local Government, Mr Aggrey Mwanri, has said that ambulance services are supposed to be free of charge.

 Mr Mwanri said it was against the law to make patients pay for the service when in need since the government issues fuel and pays for the maintenance of the vehicles, thus no need to charge patients.”

 

FOR U.S. CITIZENS

Check with your health insurer before traveling to Tanzania to see if they cover you overseas, and to see if they cover emergency evacuation in the event of a serious health issue.

See the US Department of State’s website on supplemental insurance coverage

ADDITIONAL INFO

COMMON MEDICAL EMERGENCIES

ROAD TRAFFIC INJURIES

  • According to the World Health Organization, Tanzania has a traffic fatality rate of 32.9/ 100,000 population, compared to just 10.6 in the United States (2015)

INFECTIOUS DISEASE
According to the CDC, the following infectious diseases are present in Tanzania:

  • Dengue
  • Cholera
  • Malaria: CDC estimates a high risk for travelers
  • Zika virus: Now endemic to Tanzania
  • Typhoid: Transmission through infected food or water
  • Yellow Fever: More likely in visitors with prolonged stays
GOVERNMENT OVERSIGHT

All healthcare related activities in Tanzania are governed by the Ministry of Health, Community Development, Gender, Elderly and Children. However, there are no national guidelines or governance in Tanzania specifically for prehospital emergency care.

 

Telecommunications are regulated by Tanzania Communications Regulatory Authority (TRCA)

REFERENCES
  • Adhvaryu AR, Beegle K. “The Long-Run Impacts of Adult Deaths on Older Household Members in Tanzania.” Economic Development and Cultural Change; 2012;60(2):245–77.

  • Baker T, Lugazia E. “Emergency and critical care services in Tanzania: a survey of ten hospitals.”BMC Health Serv Res. 2013 Apr 20;13:140–9.

  • Casey ER, Muro F, Thielman N. “Analysis of traumatic injuries presenting to areferral hospital emergency department in Moshi,Tanzania.” Int J Emerg Med. 2012 Jul 30;5(28):1–7.

  • Chalya PL, Dass RM, Mchembe MD, Mbelenge N, Ngayomela IH, Chandika AB, et al. “Citywide trauma experience in Mwanza, Tanzania: a need for urgent intervention.” J Trauma Manag Outcomes; 2013 Nov 11;7(1):1–1.

  • Chalya PL, Mabula JB, Dass RM, Mbelenge N, Ngayomela IH, Chandika AB, et al. “Injury characteristics and outcome of road traffic crash victims at Bugando Medical Centre in Northwestern Tanzania.” J Trauma Manag Outcomes. BioMed Central Ltd; 2012 Feb 9;6(1):1.

  • Cox M, Shao J. “Emergency medicine in a developing country: Experience from Kilimanjaro Christian Medical Centre, Tanzania, East Africa.” Emerg Med Australas. 2007 Oct;19(5):470–5.

  • Evjen-Olsen B, Olsen Ø, Kvåle G. “Achieving progress in maternal and neonatal health through integrated and comprehensive healthcare services – experiences from a programme in northern Tanzania.” Int J Equity Health. 2009;8(1):27.

  • Little RM, Kelso MD, Shofer FS, Arasaratnam MH, Wentworth S, Martin IBK. “Acute care in Tanzania: Epidemiology of acute care in a small community medical centreLes soins aigus en Tanzanie: Épidémiologie des soins aigus dans un petit centre médical communautaire.” Afri J Emerg Med; 2013 Dec 1;3(4):164–71.

  • Lund Sorensen B, Bruun Nielsen B, Raschl V, Elsass P. “User and provider perspectives on emergency obstetric care in a Tanzanian rural setting: A qualitative analysis of the three delays model in a field study.” African Journal of Reproductive Health. 2011 Sep 1;15(2):117–30.

  • Nicks BA, Sawe HR, Juma AM, Reynolds TA. “The state of emergency medicine in the United Republic of Tanzania.” Afri J Emerg Med; 2012 Sep 1;2(3):97–102.

  • Pereira C, Mbaruku G, Nzabuhakwa C, Bergström S, McCord C. “Emergency obstetric surgery by non-physician clinicians in Tanzania.” Int J Gynaecol Obstet; 2011 Aug 1;114(2):180–3.

  • Reynolds TA, Mfinanga JA, Sawe HR, Runyon MS, Mwafongo V. “Emergency care capacity in Africa: A clinical and educational initiative in Tanzania.” J Public Health Policy 2012 Dec 5;33(S1):S126–37.

  • Rotich, CC. Evaluating Access to Prehospital Care for Traumatic Brain Injury Patients in a Resource Limited Setting: Focus on Prehospital Transport. INJ PREV2015;21:A9.
  • Schmid T, Kanenda O, Ahluwalia I, Kouletio M. “Transportation for Maternal Emergencies in Tanzania: Empowering Communities Through Participatory Problem Solving.” Am J Pub Health. 2001 Oct 17;91(10):1589–90.

  • Spangler SA. “Assessing skilled birth attendants and emergency obstetric care in rural Tanzania: the inadequacy of using global standards and indicators to measure local realities.” Reproductive Health Matters; 2012 Jun 1;20(39):133–41.

OFFICIAL TWITTER FEEDS

Recommended Posts

Leave a Comment

What can Beacon do for you?

Send us an email to share how you think Beacon can help your service.

Not readable? Change text. captcha txt