Eye Department KCMC Annual Report 2016

Kilimanjaro Christian Medical Centre

Eye Department

Annual Report

2016

Introduction

The Eye Department KCMC is the main referral site for ophthalmic cases from Northeastern Tanzania and is the tertiary eye healthcare centre for Kilimanjaro, Arusha, Tanga and Manyara Administrative Regions of Tanzania. Every year in excess of 30,000 patients seek eye healthcare services at our department. Besides eye healthcare service delivery, the Eye Department is also a training centre for Ophthalmologists, Assistant Medical Officers Ophthalmology, Ophthalmic Nurses, Optometrists and Medical Students.

Objectives

General Objective

Quality of life improvement of the visually impaired through provision of quality eye healthcare services.

Specific Objectives

1) Provision of quality eye healthcare services to all who seek it and all who need it.

2) Training all tiers of eye healthcare cadres to meet the national demand and needs.

3) Conducting quality eye healthcare research to identify areas of need for the purpose of improving service delivery and prioritization of training.

Strategies

1. Development of human resource for eye health through recruitment, retention of eye cadres and promotion of continuous professional development.

2. Ensuring that there is adequate, appropriate and sufficient eye medical equipment and instrumentation for the purpose of quality service delivery, training and research.

3. Ensuring that there are appropriate and sufficient eye health care consumables for smooth running of service delivery.

4. Actively promote development and maintenance of supportive assets and infrastructure for eye healthcare.

5. Develop and maintain the eye department’s administrative, management and fiscal (sustainability account) structure.

6. Develop, maintain and expand prevention of blindness activities through eye outreach services and eye health education.

7. Improve the quality of eye healthcare services provided at the eye department KCMC.

8. Develop and consolidate visual rehabilitation with economical and social integration.

9. Provide high quality training to all tiers of trainees.

10. Foster a research friendly environment with the aim of improving service delivery, identification of areas of need and prioritization of training.    

1. Personnel

The year 2016 saw the retirement of Dr Honest Kitingati after having served since 1998. Dr Kitingati was part of the team recruited to the department at a time when Dr David Hunter was the only ophthalmologist at the department. We now have nine ophthalmologists, just one short of our aim of 10 ophthalmologists by the year 2021.

One nurse, Winifrida Mosha successfully pursued a certificate course in Ophthalmic Assistant at Mvumi, continuing the tradition of capacity building among our departmental general nurses in eye healthcare sciences. Elitrude Lyimo and Evetha Kimaro also retired this year.

2. Equipment and Instrumentation

In course of the year, we have acquired a Portable Keratometer-Autorefractor (Retinomax K3 Plus) which will enable us to perform ocular biometry on outreach location. The Carl Zeiss Stratus OCT 3000 broke down and we are awaiting a team from Zeiss South Africa to come and service it. We acquired a Cornea Cross Linking Machine from Appasamy and we are looking forward to operationalizing it in 2017.

3. Consumables

After some difficulties with acquiring ocular anti-fungal medication Econazole 2% and Natamaycin 5%, we now have a supplier who can meet our needs. Also Salama Pharmaceuticals have made available Dorzolamide and Olopatadine eye drops. We have also been able to procure raw material for manufacture of Chlorhexidine 0.2% eye drops at St Luke Foundation.

4. Infrastructure and Vehicles

Building Maintenance, Repair and Development

In 2016, we saw connection of adjoining corridor to the main building corridor, increasing access to the rest of the KCMC complex.

Vehicle Maintenance and Repair.

The Eye department has five vehicles, two Toyota Land Cruisers Hardtop, two Land Rovers 110 and a Toyota Coaster 35 seat bus.

Table 1

Vehicle	Particulars
Toyota Land Cruiser Hard Top T 805 ABB	Ran efficiently
Toyota Land Cruiser Hard Top T 872 ABB (AMO Ophthalmology School)	Ran efficiently
Toyota Coaster Minibus T 187 ASG	Ran efficiently
Land Rover 110 TDI T 415 ADS Eye Outreach Programme	Ran efficiently
Land Rover 110 TDI 780 ANM Childhood Blindness Prevention Programme.	Ran efficiently

5. Administration, Management and Finance

All the four planned Eye department Management Committee meetings were held during the year as well as the two planned Eye Department Staff meetings. There has been an emphasis on keeping the minutes of these meetings to keep track of the decisions and issues raised. The question of record keeping had plagued the department between 2000 and 2010. Matters pertaining to nursing continue to be an administrative challenge as there is always a sporadic and saltatory approach of raising their problems.

Eye Department Medical Records

Starting from 1^st January 2010 we had shifted from the Aravind software to Eyesoft software, and services had run smoothly. Denis Mollel has finished working on the software to bill the patients electronically; however this is not fully utilized. One of the tasks for 2017 is to increase utilization of the electronic billing service.

6. Preventive Ophthalmic Medicine

The Preventive Ophthalmic Medicine section of the department has two arms:

a) Ocular Health Promotion

b) Prevention of Blindness.

Ocular Health Promotion

This is being implemented through Eye Health Education Programme (EHEP), whose content covers the following:

1. Alimentary Hygiene

2. Ambiental Hygiene

3. Behavior Hygiene.

4. Workplace Protection.

5. Vaccinations and Prophylaxis.

The form through which Eye Health Education is being implemented is a follows:

1. Quarterly issuance of Eye Department KCMC Newsletter “MACHO”. All four issues planned for the year had been written, printed and distributed. These were:

MACHO 19 Aleji ya Macho.

MACHO 20 Development of Cornea Services.

MACHO 21 Outcome of Diabetic Retinopathy Screening at Mt Meru Hospital in 2015.

MACHO 22 Ukungu wa Lensi ya Jicho.

2. Eye Seminar KCMC was not held in 2016, but we had five COECSA-USAID sponsored CPD in course of the year on child eye health.

3. Issuance of Brochures. The following patient information brochures are available:

a) Allergic Conjunctivitis

b) Cataract

c) Glaucoma

d) Uveitis

e) Diabetic Retinopathy

These are written in Swahili language and are available to patients in the eye clinic.

4. Mass Media: Radio messages addressing Child Eye Health were broadcast under the aegis of COECSA-USAID Childhood Blindness Prevention Program.

5. Public Awareness Campaigns: The Eye Department organized screening services on the week of 10 to 13 October 2016 for World Sight Day. Some 44 patients were screened in five days. There were 27 women and 17 men, six were referred to the eye clinic for further workup, 18 were given spectacles of whom 11 were presbyopic. The three most common diagnoses were Allergic Conjunctivits with 13 patients, Presbyopia with 11 patients and early Cataract and Glaucoma had each three patients.

Prevention of Blindness

1. Day Eye Diseases Screening Outreach (DEDSO): this is a population screening activity within Kilimanjaro Region and some districts of Manyara and Meru, whereby clinicians screen the population for eye diseases, those identified are transported for free to the Eye Department for intervention and then they are transported back to their village of origin when they are discharged. The patients pay only for the cost of intervention, usually TZS 50,000/=. The eye screening activities concentrate on the following conditions:

a)  Childhood Eye Diseases

b) Optical Services and Refraction

c) Cataract

d) Glaucoma

e) Diabetic Retinopathy

2. Week-long Eye Surgical Outreach (WESO): this is a service to hospitals too far from KCMC for patients to be transported for intervention, instead the satellite hospitals screen the patients ahead of time and when the surgical team arrives then surgeries are performed. Sometimes there is a need for Eye Screening Activity during the visit. The collaborative partners are Lushoto, Korogwe, Handeni, Babati and Karatu District Hospitals.

Eye Outreach Services

All the 12 planned Day Eye Diseases Screening Outreaches were done as well as the six Week-long Eye Surgical Outreaches.

Table 2: Outreach Services

	Number of Visits	Number of Patients Screened	Number of Patients Operated
Day Eye Diseases Screening Outreach	12	1945	118
Week-long Eye Surgical Outreach	6	1041	325
Mwanza Pediatric Outreach*

*Jointly done with CCBRT

Childhood Blindness Prevention Program.

The aims of all the KCMC based childhood blindness prevention programs are as follows:

1. Early identification and early referral of sight threatening cases to KCMC.

2. Easy access to eye healthcare services at KCMC.

3. Availability of child eye healthcare services.

4. Follow-up after intervention, optical correction and visual rehabilitation.

5. Public awareness campaigns on child eye health.

Light for the World

We have developed a new service delivery project on child eye health with Light for the World, we are awaiting the actual implementation in 2017.

Seeing is Believing

At long last, equipment was purchased and distributed under the project, with Bugando Medical Centre benefitting. The school eye screening and the health unit screening activities are on full swing. Since May 2014, some 147,854 children had been screened for eye diseases and vision, representing 99% of the set target for KCMC while 1236 children whom underwent some kind of ocular surgery representing 133% of the set target and of whom 568 underwent cataract surgery representing 71% of the set target.

COECSA-USAID

In course of the year, the project had funded the training of one Pediatric Ophthalmologist for KCMC, Dr Mchikirwa Msina. Some five CPD on child eye health were done having a total of 326 participants who benefitted. Some 28 midwives were trained in child eye health and 21,054 children screened for eye diseases while 508 were identified and treated. Brochures on Allergic Conjunctivits and Ocular Health Promotion were developed, printed and distributed to school children and healthcare providers. The project also funded radio broadcasts on child eye health, aired at prime time on Saturdays and Sundays for maximum penetration. On school health education, some 2856 secondary school students benefitted from this activity in Hai District. National Retinoblastoma Guidelines were developed, pending final write up.

7 (a). Diagnostic Ophthalmic Medicine

The Eye Clinic provides consultation for every working day of the week; currently there are nine ophthalmologists, two assistant medical officers’ ophthalmology, 17 MMed Ophthalmology residents and 14 AMOO students manning the clinics. There are five specialized clinics, Paediatric Ophthalmology Clinics every day of the week, Vitreo-Retina Surgery Clinics on Mondays, Glaucoma Clinic on Tuesdays, Oculoplastic Clinics on Wednesdays, Ocular Oncology Clinics on Thursdays and Medical Retina Clinics / Laser Microsurgeries on Fridays.  

Our service delivery system strives to increases access and availability for those with disabilities. The category of disabilities considered are: Mental, Complex Neurological, Visual, Hearing, Speech, Physical, Digestive, Urogenital, Skin and Esthetic.   

Eye Clinic

As the number of patients in the clinic increases, issues of congestion and long waiting periods are getting more acute. A new strategy will have to be developed to address patient care as the numbers increase.

Clinic Timetable

Day of the Week	Sub-Specialty	Sub-Specialist
Monday	Vitreo-Retina Surgery	W.Makupa
	Uveitis	W. Makupa
	Neuro-Ophthalmology	W. Makupa
	Pediatric Ophthalmology	F. Godfrey M. Msina
Tuesday	Glaucoma	H.Philippin
	Pediatric Ophthalmology	F. Godfrey M. Msina
Wednesday	Oculoplastic	H.Maro
	Cornea	E.Muna
	Pediatric Ophthalmology	F. Godfrey M. Msina
Thursday	Ocular Oncology	I.Makupa
	Pediatric Ophthalmology	F. Godfrey M. Msina
Friday	Medical Retina	W. Makupa H. Maro E. Muna
	Pediatric Ophthalmology	F. Godfrey M. Msina

Table 3: Diagnostics

Visual Fields	NHIF 676 + Cash 430 = 1106
Fundus Flourescein Angiography	-
Optical Coherence Tomography	NHIF 1467 + Cash 864 = 2331
Cornea Topography	-

Table 4: Consultations

Total Number of Consultations	32,678
New Consultations	8,945
Return Visits	23,733
Males	16,254
Females	16,424
Children (< 16 yrs)	5598    Boys: 3170  Girls: 2428

Table 5: Top 20 Diseases

	Description / Particulars	Numbers
1	Other Disorders of Eye	4889
2	Disorders of Conjunctiva (Allergic)	4713 (3876)
3	Pseudophakia	4446
4	Refractive Errors (Presbyopia)	4096 (1301)
5	Cataract	4074
6	Glaucoma	3767
7	Retina Diseases (Diabetic Retinopathy) (Retina Detachment) (Other Retinopathy)	3270 (2235) (455) (580)
8	Cornea Disorders (Keratitis) (Cornea Opacity)	1237 (676) (561)
9	Normal Eye	1199
10	General Symptoms	934
11	Trauma	625
12	Uveitis	516
13	Blindness	481
14	Lid Disorders	393
15	Lachrymal Disorders	257
16	Strabismus	227
17	Optic Nerve Disorders	182
18	Orbit Disorders	135
19	Headache	92
20	Ocular Malignancy	64

Table 6: Top 10 Ocular Diseases in Children

	Description / Particulars	Numbers
1	Conjunctiva Disorders (Allergy)	1356 (1212)
2	Other Disorders of the Eye	1153
3	Refractive Errors	565
4	Pseudophakia	408
5	Normal Eyes	273
6	Glaucoma	255
7	Trauma	226
8	Cornea Disorders (Keratitis) (Cornea Opacity)	211 (121) (100)
9	Cataract	201
10	Strabismus	180

7 (b). Therapeutic Ophthalmic Medicine

Minor Theatre

Minor Theatre is where minor surgical procedures are done, as well as laser microsurgeries for diabetic retinopathy or capsulotomy. Also fitting of prosthetic eyes is done. For the minor theatre to operate it has got to have a nurse manning that station, usually one of the Eye Clinic nurses fulfills this duty. The room is equipped with sterilizers that sterilize instruments used in minor surgeries. Off hours it also serves as a wet lab for trainees.

Table 7: Top 10 Minor Theatre Procedures  (Total No … )

1. Bevacizumab Injections	502	6. Minor Surgeries	71
2. PRP	272	7. Prothesis Fitting	65
3. Focal / Grid Laser	184	8. Cyclophotocoagulation	49
4. YAG Capsulotomy	178	9. Gancyclovir Injections	42
5. Triancinolone Injections	145	10 Retrobulbar Ethanol	16

Eye Pharmacy

We are still working hard at improving the variety of ocular pharmaceutical agents, especially drugs for rare diseases and for the niches of the upper echelons of the society. We succedded in stocking Dorzolamide and Olopatadine. Still we are striving to stock Lodoxamide and Acetly-Cysteine.

Optical Services (GSF Optical Project)

Optical services had ran efficiently in course of the year. There were some problems with mounting of lenses but this has been addressed.

Table 8: Spectacles

1. Adults Refracted	Male 2766 + Female 3386 = 6152
2. Children Refracted (Independent)	Boys 365 + Girls 360 = 725
3. Total Number of Glasses Dispensed	Males 1731 + Females 2015 = 3746
4. Of whom subset of above (Nr 3).	Boys + Girls = NA

Eye Ward

We were finally able to purchase nine new hospital beds, it means all our 68 bed space is by normal hospital beds and not canvas field hospital beds. From the original 50 canvas beds we are only left with 11.

Table 9: Admissions

Total Number of Admissions	2932
Males	1696
Females	1158
Children (< 16 yrs)	583       Boys: 367          Girls: 216

Table 10: Top 10 Diseases in Eye Ward

1. Cataract	1579	6. Conjuncitval Carcinoma	94
2. Other Diseases	509	7. Corneal Ulcers	88
3. Ocular Trauma	270	8. Keratitis	33
4. Retina Diseases	181	9. Retinoblastoma	20
5. Glaucoma	119	10. Strabismus	18

Eye Theatre

In course of the year protocols for sterilization of non-pyrogenic instruments were developed and are pending adoption. They involve use of proteolytic enzymes and sodium hypochloride disinfection of instruments prior to Formaldehyde Vapor Cabinet sterilization.

Table 11: Eye Surgeries

Total Number of Surgeries	2304 (Outreach Included 2550)
Males	1015
Females	841
Children (< 16 yrs)	448        Boys: 260    Girls: 188

Table 12: Top 10 Ocular Surgeries

1. Cataract Surgery (Phacoemulsification)	1725 (2050)* (389)	3. Glaucoma Surgery (Trabeculectomy) (Goniotomy)	124 (30) (33)
2. Retina Surgery	189	5. Conjunctiva Surgeries (Excision Biopsies) (Pterigia Excision)	114 (70) (38)
3. Cornea Surgeries (Cornea Repair)	178 (95)	8. Orbital Surgeries (Evisceration) (Enucleation) (Exenteration)	74 (29) (19) (13)
4. Lid Surgeries	160	9. EOM Surgeries	55
5. Other Surgeries (Unspecified) (EUA)	144 (101) (43)	10. Lacrimal System Surgeries (DCR)	35 (11)

* Including Outreach Surgeries

Table 13: Top 10 Ocular Surgeries in Children

1 Cataract Surgeries	217	6 Strabismus Surgery	37
2 Cornea Surgeries (Cornea Repair)	101 (59)	7 Retina Surgeries	24
3 Other Surgeries (Unspecified) (EUA)	76 (41) (35)	8 Orbital Surgeries (Evisceration) (Enucleation) (Exenteration)	20 (5) (8) (3)
4 Lid Surgeries	60	9 Conjunctiva Surgeries	20
5 Glaucoma Surgeries    (Goniotomy)	56 (33)	10 Lacrimal System Surgeries (DCR)	15 (3)

8. Rehabilitative Ophthalmic Medicine

After problems with procurement of low vision devices last year, this year we were able to have adequate devices to satisfy the patient demands.

Table 14: Low Vision Services

Total Number of Low Vision Patients	431
Low Vision Patients at KCMC (Children < 15 years)	220 Men 99 + Women 52 = 151 Boys 31 + Girls 38 = 69
Total Number of Patients who got LVD	256 KCMC: 122 Men 65 + Women 21 = 86 Boys 11 + 25 Girls = 36 Outreach: 134
Number of Low Vision Patients Outreach	211

9. Training Services

School of Optometry

Collaboration with School of Optometry has been smooth and the students have continued to benefit from clinical exposure at the Eye Department.

Ophthalmic Nursing

We are continuing with collaboration with School of Ophthalmic Nursing and their Ophthalmic Assistant Course, the course has proven to be beneficial for Primary Eye Healthcare at district level.

Assistant Medical Officers Ophthalmology

At long last NACTE accreditation is picking up with Eye Department support. The student registered on NACTE website for the first time ever. Stakeholders meeting was held in course of the year.

Table 15: Assistant Medical Officers Ophthalmology

	Name	Year	District / Country
First Year AMOO	1. Frank Mwakalundwa	2016 – 2018	Kyela
	2. Upendo Mwakabalile	2016 – 2018	Singida
	3. Peter Kabangila	2016 – 2018	Singida
	4. Ferdinand Makubi	2016 – 2018	Kolandoto
	5. Rehema Bidaga	2016 – 2018	Mbarali
	6. Theresia Masochi	2016 – 2018	Dar es Salaam
	7. Stephen Wisely	2016 – 2018	South Sudan
	8. Loice Noah	2016 - 2017	South Sudan
	9. Salome Manga	2016 – 2018	South Sudan
	10. Abdou Billah	2016 - 2017	Benin
Second Year AMOO	1. Lubari Loro	2015 - 2017	South Sudan
	2. Lochi Lotularith	2015 - 2017	South Sudan
	3. Daniel Kirumbi	2015 - 2017	Katesh
	4. Fortunatus Nkane	2015 - 2017	Bahi
	5. Amiri Mmasi	2015 - 2017	Amana DSM
	6. Charles Kasuka	2015 - 2017	Misungwi
AMOO who Graduated in August 2016	1. Grace Kaale	2014-2016	Zambia
	2. Simon Luvanda	2014-2016	Makete
	3. James Mitelo	2014-2016	Zambia
	4. Zayana Mshana	2014-2016	Kondoa
	5. Hizza Abdallah	2014-2016	Morogoro
	6. Baako Unzi	2015 - 2016	South Sudan
	7. Pasquino Allam	2015 - 2016	South Sudan

Undergraduate Teaching

Some 132 MD3 did their clinical ophthalmology rotation in course of the year. Also as from October 2016, the MD3 students commenced the 12 week Clinical Practical Skills Training in ophthalmology.

Postgraduate Teaching

All the three fourth year residents successfully graduated in August. Dr Milka Mafwiri from Muhimbili University of Health and Allied Sciences was our external examiner. One of the finalists almost failed.

Table 16: Masters of Medicine Ophthalmology

	Name	Year	Country
MMed I	Shariza Kanji	2016 - 2020	Tanzania
	Livin Uwemeye	2016 - 2020	Rwanda
	Daniel Mashamba	2016 - 2020	Tanzania
	Filemon Darabe	2016 - 2020	Tanzania
	Francisco Mulobuana	2016 - 2020	Mazambique
	Mario Monjane	2016 - 2020	Mozambique
	Chabane Amisse	2016 - 2020	Mozambique
	Abrahamo Matova	2016 - 2020	Mozambique
MMed II	James Shimba	2015 - 2019	Tanzania
	Francis Masse	2015 - 2019	Tanzania
	Festo Kampwaga	2015 - 2019	Tanzania
	Saqalain Kassamali	2015 - 2019	Tanzania
	Maria Kisanga	2015 - 2019	Tanzania
	Nuru Mwambola	2015 - 2019	Tanzania
	Nelly Fopoussi	2015 - 2019	Cameroon
	Joyce Awum	2015 - 2019	Cameroon
	Lydia Fokuang	2015 - 2019	Cameroon
	Nelson Mutajwaa	2014 - 2019	Tanzania
MMed III	Einoti Matayani	2014-2018	Tanzania
MMed IV	Theophile Tuyisabe	2013-2017	Rwanda
	Jacquelin Mchilla	2013-2017	Tanzania
	Jafar Majala	2013-2017	Tanzania
	Christovao Matsinhe	2013-2017	Mozambique
MMed who Graduated	Isac Vasco Da Gama	2012-2016	Mozambique
	Christopher Mwanansao	2012-2016	Tanzania
	Vangilisasi Msola	2012-2016	Tanzania

Sub-Specialty Fellowship

Name	Sub-Speciality	Year	Country
Mchikirwa Msina	Pediatric Ophthalmology	2016	Tanzania

Continuous Professional Development

The department is committed to finance training of one nurse in Ophthalmic Assistance course at Mvumi every year.

	Name of Nurse Trained at Mvumi	Year
1	Salome Siay	2013
2	Lucy Mmbaga	2014
3	Adeline Shayo	2015
4	Winfrida Mosha	2016

Courses, Seminars and Conferences

A large team of ophthalmologists, AMOO and nurses attended the 2016 COECSA Annual Scientific Conference at Ngurdoto Lodge. These were William Makupa, Irma Makupa, Heiko Philippin, Elisante Muna, Mchikirwa Msina, Honest Maro, Sarah Kweka, Dustan Kiwelu, Christopher Mwanansao, Jaquiline Mchilla, Jafar Ally Othman, Theophile Tuyisabe, Einoti Matayani, Saqalain Kasamali, Apaisaria Kiwia, Ndia Ndosa, Rose Towo, Asha Msuya, Flora Peter, Mary Machange, Adelina Shayo, Winfrida Mosha, Rose Shirima, Valentina Minja and Sadikieli Chaki.

10. Research Services

It has been resolved in the Eye Department Development Plan 2011 - 2021 that each ophthalmologist conducts one publishable research every year. So far no research has been conducted. Three dissertations were done by the third year residents. One second year resident also defended his dissertation.

Table 17: Publications by Departmental Cadres

	Authors	Title of the Publication	Journal
1	Makupa II, Swai B, Makupa WU, White VA, Lewallen S.	Clinical factors associated with malignancy and HIV status in patients with ocular surface squamous neoplasia at KCMC Tanzania.	British Journal of Ophthalmology 2012; 96(4): 482-484
2	Hu VH, Weiss HA, Massae P, Courtright P, Makupa W, Mabey DC, Bailey RL, Burton MJ.	In vivo confocal microscopy in scarring trachoma.	Ophthalmology 2011 Nov; 118(11): 2138-46
3	Furahini Godfrey Susan Lewallen	Conjunctiva squamous cell neoplasia.	Ophthalmology 2010 Jul; 117(7): 1458
4	Furahini Godfrey Susan Lewallen	Epidemiology and management of ocular surface squamous neoplasia in Tanzania.	Ophthalmic Epidemiology 2010 Jun; 17(3): 171-176

Table 18: Trend

	2010	2011	2012	2013	2014	2015	2016
PRP	226	322	257	233	294	348	272
Focal	129	252	212	208	212	136	184
Bevacizumab Inj	163	354	264	404	460	518	502
Gancyclovir Inj	43	21	24	39	45	53	42

Table 19: Trend

	2010	2011	2012	2013	2014	2015	2016
Number of Consults	22284	24004	24207	24599	26087	27331	32678
New Patients	10156	7863	8040	7134	7665	7654	8945
Revisits	12128	16141	16167	17465	18422	19677	23733
Children	4027	4595	4642	4560	4798	4946	5598
Admissions	2548	2654	2569	2498	2503	2628	2932
Surgeries	2251	2490	2295	2265	2251	2251	2798
Surgeries Children	428	473	418	408	486	448	626
Cataract Surgeries	1609	1501	1706	1736	1581	1630	2050
CS at Centre*	1317	1325	1412	1408	1317	1384	1725
CS at Outreach	292	176	294	328	264	246	325
CS Children	117	129	135	140	183	131	217

*CS = Cataract Surgeries

Achievements

Table 20: Implementation by Category of EDDP 2016

Category	ID	Activity	Result
	1.1	Staff Related Matters
1. Human Resource for Eye Health Development.	1. 1.1	Recruitment and retention of ophthalmologists to reach the target of ten practicing ophthalmologists.	In Process
	1.1.2	Recruitment and retention of Assistant Medical Officers Ophthalmology to have 2 AMOO at the centre.	Not Done
	1.1.3	Recruitment of Nurses to the Eye Department.	In Process
	1.2	Continuous Professional Development
	1.2.1	CPD through visiting specialists with the aim of capacity building at KCMC	Done Miertsch USAID
	1.2.2	Training of nurses in ophthalmic assistant course.	Done Mosha
	1.2.3	Training of nurses in ophthalmic nursing.	NA
	1.2.4	Continuous professional development of non-medical personnel.	Done Nderingo
	1.2.5	Encourage Office Assistant to take afternoon secretarial courses.	Not Done
	1.3	Courses, Seminars and Conferences
	1.3.1	Facilitation for staff members with relevant scientific papers to attend the annual COECSA scientific conferences.	Done Ngurdoto
2. Equipment and Instrumentation.	2.1	Annual planned preventive maintenance of eye healthcare medical equipment and instrumentation.	Done Yambazi
	2.2	Annual plan for equipment servicing negotiated at the time of purchase for the purpose of prolonging their life span.	Not Done
	2.3	Acquisition of autoclave from India.	Not Done
	2.4	Acquisition of 2 more Alcon Constellation phacoemulsification hand pieces.	In Process
	2.5	Acquisition of 4 Diode Laser 810nm goggles.	Done
	2.6	Development of instrument repair and sharpening workshop and technician.	Not Done
3. Consumables.	3.1	Adequate, appropriate and sufficient eye healthcare consumables for smooth service delivery.	Done
	3.2	Liaise with TFDA on consumables acquisition.	Done
	3.3	Acquisition of Lester Jones tubes	Not Done
	3.4	Acquisition of Biological Glue for Cornea Surgeries	Pending
4. Infrastructure and Vehicles.	4.1	Eye Clinic
	4.1.1	Eye clinic floor surface improvements (Tiling)	Pending
	4.1.2	Setting up in a permanent manner the audio-visual teaching aids in the clinic	Pending
	4.1.3	Annual fire response and evacuation drills needed.	Done KCMC
	4.1.4	Installation of sign posts and notice boards.	Not Done
	4.1.5	Expansion of clinical area into a second site as number of patients seeking eye healthcare services increases.	Pending
	4.2	Eye Ward
	4.2.1	The Eye Ward floor needs improvement, either by tiling it or painting it with floor paint.	Pending
	4.2.2	The eye ward washrooms need wall painting, wall tiling, electrical air vents and scent stones.	Not Done
	4.2.3	Four hospital beds are needed in the private rooms.	Done 9 Beds
	4.2.4	Painting of hospital beds.	Not Done
	4.3	Eye Theatre
	4.3.1	The PVR device in the Eye theatre is to be made operational again.	Not Done
	4.3.2	The plan is to ensure that each of the seven tables is equipped with emergency power supply unit (UPS).	Not Done Relevance?
	4.3.3
	4.3.4	Acquisition of Operating Lights for the Oculoplastic Surgery Room.	Done
	4.4	Building Maintenance, Repair and Development
	4.4.1	Extension of clinical area for specialized clinics, office space and private ward rooms	Pending
	4.4.2	Building of hostel for residents and visiting fellows, preferably twenty self contained rooms.	Pending Relevance?
	4.5	Vehicle Maintenance and Repair
	4.5.1	All vehicles operational and regularly serviced.	Done
	4.5.2	Conversion of Toyota Coaster for Medical Photography and Laser therapy in Arusha.	Pending
5. Administration, Management and Finance.	5.1	Regular meetings of the Departmental Management Committee to deliberate and advise on administrative and developmental matters.	Done
	5.2	Maintenance of the Departmental Development Fund for the purpose of capital equipment purchase, professional development of personnel and infrastructural development.	Done
	5.3	Strive to develop the Eye Department into Kilimanjaro Ophthalmology Institute by 2021.	Pending
	5.4	Raise the profile of the Eye Department by developing a website or a blog.	Done
	5.5	Register the Eye Department with the IAPB for the purpose of accessing affordable medical equipment.	Pending
6. Preventive Ophthalmic Medicine.	6.1	Acquisition of a portable slit lamp biomicroscope for outreach use.	In Process Aurolab
	6.2	Acquisition of a portable keratometer for outreach use.	In Process Retinomax
	6.3	Maintenance of Diabetic Retinopathy Screening	Done Expansion
	6.4	Maintenance of the Eye Department Newsletter MACHO	Done
	6.5	Maintenance of the Eye Seminar KCMC	Not Done
	6.6	Public awareness campaigns and Eye Health Education through the medium of Radio	Done
	6.7	Maintenance of Day Eye Diseases Screening Outreach with one visit per month	Done
	6.8	Maintenance of Week-long Eye Surgical Outreaches with six visits per year.	Done
	6.9	Investigate areas of need in view of extending Eye Surgical Outreach services into those areas	Continuous Process
	6.10	Acquisition of Portable A-Scan Machine for Outreach use.	Pending
7. Clinical Ophthalmic Medicine.	7.1	Diagnostic Ophthalmic Medicine
	7.1.1	Reinstatement of Fundus Flourescein Angiography services	Pending $ 30,000
	7.1.2	Acquisition of 532nm Green Laser Machine for Medical Retina services	Pending $ 35,000
	7.1.3	Acquisition of 4 Slit Lamp Biomicroscopes (Zeiss)	In Process Aurolab
	7.1.4	Set up departmental microbiology services	Not Done Relevance?
	7.1.5	Develop Cornea, Uveitis, Medical Retina, Neuro-ophthalmology and Ocular Pathology sub-specialties	Done
	7.2	Therapeutic Ophthalmic Medicine
	7.2.1	Stocking of Olopadatine, Lodoxamide, Acetylcysteine, Ascorbate and Dorzolamide will increase income from an underserved niche.	Done
	7.2.2	Investigate the possibility of reinstating eye drops production at the department	Pending Relevance?
	7.2.3	Updating of eye surgical instruments / squint surgery set. Acquisition of Endoscopic equipment for DCR.	Done with ENT
	7.2.4	Acquisition of Cornea Cross Linking Machine	Done
	7.2.5	Commence cornea transplantation services.	Done
8. Rehabilitative Ophthalmic Medicine.	8	Have adequate and appropriate low vision devices to ensure an effective and efficient service delivery	Continuous Process
9. Training	9.1	Optometry
		Participate in the clinical training of optometry students.	Done Kiwelu
	9.2	Ophthalmic Nursing
		Participate in the theoretical and practical training of ophthalmic nursing trainees.	Done
	9.3	AMO Ophthalmology
	9.3.1	All AMO Ophthalmology trainees must observe at least five cornea repairs during their training.	?
	9.3.2	The school must include Medical Ethics in the curriculum.	Not Done
	9.3.3	Phacoemulsification cataract surgery training for competent practicing AMOO	NA
	9.3.4	Regulation of AMOO surgical training by Ocular Surgery Coordinator	Done Muna
	9.3.5	Glaucoma filtration surgery training be offered to competent cataract surgeons after graduating for those who will be serving in geographically isolated areas from whence referrals for glaucoma patients are not practical.	NA
	9.3.6	The intake of AMOO trainees had been increased to 10 since 2008, the plan is to maintain this number.	Continous Process
	9.4	Undergraduate Teaching
	9.4.1	Development of a manual for undergraduate ophthalmology training will cement the course content for some years to come.	Done
	9.4.2	Fundoscopy training of medical students.	Done
	9.5	Postgraduate Training
	9.5.1	Maintenance of the Ophthalmology Academic Committee	Done
	9.5.2	Maintenance of the separation of Postgraduate Training Coordinator with separation of the training into Bascic Ophthalmic Sciences, Clinical Ophthalmology and Ocular Surgery	Continuous Process
	9.5.3	Maintenance of the student examination register	Continuous Process
	9.5.4	Increase of ophthalmologist training output to 10 a year.	Done
	9.6	Sub-Speciality Training
		Enroll Paediatric Ophthalmology, Vitreoretina Surgery, Small Incision Cataract Surgery and Phacoemulsification Cataract Extraction trainees when available.	Done
10. Research	10.1	Departmental Patient Data and Archives Management
	10.1.1	System maintenance once every three months.	?
	10.1.2	Establishment of data entry ports to enable clinicians and nurses to register investigations, procedures and discharges. This will cut down on time wasted in queues and loss of income from incomplete data entry.	Partially Done
	10.2	Student Research
	10.2.1	In-house supervision of student research / dissertations	Continuous Process
	10.3	Departmental Research
	10.3.1	In order to develop our autochthonous research capacity, it will be required for each staff member (ophthalmologist) to conduct at least one research every year.	Not Done

In summary:

1. One nurse has been trained in Ophthalmic Assistant (Winifrida Mosha).

2. A large team attended the COECSA conference at Ngurdoto Lodge.

3. Acquisition of Cornea Cross Linking Machine from India.

4. Acquisition of portable Keratometer.

5. All four scheduled departmental management meetings took place.

6. Arusha Diabetic Project commenced.

7. Increment of number of consultations from 27331 in 2015 to 32678 in 2016, an increment of 5347 patient.

8. Rehabilitative ophthalmic services had run smoothly.

Challenges

During the year 2016, we faced several challenges, these could be summerized as:

1. Relative shortage of doctors during October to December period as residents were away.

2. Failure to repair some of the diagnostic equipement, a case in point being the Fundus Flourescein Angiopgraphy.

3. Inadequate clinical area.

4. Inability to do cornea grafting limits our ability to visually rehabilitate patients.

5. Department cadres are not conducting clinical research, there are no annual publications coming out of the eye department.

6. Poor performance by one of the departmental driver.

Conclusion

The Eye Department Management Committee sat on the 19 December 2016 to evaluate the performance for the year and identify the objectives for 2017.

The development plan evaluation is based upon achievement of the objectives and performance indicators. For the purpose of quantifying performance, a system of scores is employed. Score of three is given to successfully achieved objective, a score of two is given to a partly achieved objective and a score of one is given to an objective not achieved. From the total score a simple percentage is calculated. In 2016, of the 80 categories, 39 (64%) were successfully implemented, 22 were not and 19 are still pending. In 2015, some 55 items from the development plan were scored giving an implementation score of 73.3%. In 2014 some 64 items from the development plan were scored, giving an implementation score of 47%, while 10 items remained pending representing some 16%. For 2013, 61 items were evaluated and an implementation score of 70% was obtained, in 2012 (51 items scored) implementation score was 77% and in 2011 it was 63% (40 items scored).

	Year	Total Number of Categories	Number of Items Scored	Performance Score
	2011		40	63%
	2012		51	77%
	2013		61	70%
	2014		64	47%
	2015		55	73%
	2016	80	61	64%

Plans

Table 21: Implementation Plans for 2017

Category	ID	Activity
	1.1	Staff Related Matters
1. Human Resource for Eye Healthcare Development.	1. 1.1	Recruitment and retention of ophthalmologists to reach the target of ten practicing ophthalmologists.
	1.1.2	Recruitment and retention of Assistant Medical Officers Ophthalmology to have 2 AMOO at the centre.
	1.1.3	Recruitment of Nurses to the Eye Department.
		Recruitment of Medical Attendants to the Eye Department.
	1.2	Continuous Professional Development
	1.2.1	CPD through visiting specialists with the aim of capacity building at KCMC
	1.2.2	Training of nurses in ophthalmic assistant course.
	1.2.3	Training of nurses in ophthalmic nursing.
	1.2.4	Continuous professional development of non-medical personnel.
	1.2.5	Encourage Office Assistant to take afternoon secretarial courses.
	1.3	Courses, Seminars and Conferences
	1.3.1	Facilitation for staff members with relevant scientific papers to attend the annual COECSA scientific conferences.
2. Equipment and Instrumentation.	2.1	Annual planned preventive maintenance of eye healthcare medical equipment and instrumentation.
	2.2	Annual plan for equipment servicing negotiated at the time of purchase for the purpose of prolonging their life span.
	2.3	Acquisition of autoclave from India.
	2.4	Acquisition of 2 more Alcon Constellation phacoemulsification hand pieces.
	2.5	Development of instrument repair and sharpening workshop and technician.
3. Consumables.	3.1	Adequate, appropriate and sufficient eye healthcare consumables for smooth service delivery.
	3.2	Liaise with TFDA on consumables acquisition.
	3.3	Acquisition of Lester Jones tubes
	3.4	Acquisition of Biological Glue for Cornea Surgeries
4. Infrastructure and Vehicles.	4.1	Eye Clinic
	4.1.1	Eye clinic floor surface improvements (Tiling)
	4.1.2	Setting up in a permanent manner the audio-visual teaching aids in the clinic
	4.1.3	Annual fire response and evacuation drills needed.
	4.1.4	Installation of sign posts and notice boards.
	4.1.5	Expansion of clinical area into a second site as number of patients seeking eye healthcare services increases.
	4.2	Eye Ward
	4.2.1	The Eye Ward floor needs improvement, either by tiling it or painting it with floor paint.
	4.2.2	The eye ward washrooms need wall painting, wall tiling, electrical air vents and scent stones.
	4.2.3	Painting of hospital beds.
	4.3	Eye Theatre
	4.3.1	The PVR device in the Eye theatre is to be made operational again.
	4.3.2	The plan is to ensure that each of the seven tables is equipped with emergency power supply unit (UPS).
	4.4	Building Maintenance, Repair and Development
	4.4.1	Extension of clinical area for specialized clinics, office space and private ward rooms
	4.4.2	Building of hostel for residents and visiting fellows, preferably twenty self contained rooms.
	4.5	Vehicle Maintenance and Repair
	4.5.1	All vehicles operational and regularly serviced.
	4.5.2	Conversion of Toyota Coaster for Medical Photography and Laser therapy in Arusha.
	4.5.3	Hiring of a driver.
5. Administration, Management and Finance.	5.1	Regular meetings of the Departmental Management Committee to deliberate and advise on administrative and developmental matters.
	5.2	Maintenance of the Departmental Development Fund for the purpose of capital equipment purchase, professional development of personnel and infrastructural development.
	5.3	Strive to develop the Eye Department into Kilimanjaro Ophthalmology Institute by 2021.
	5.4	Register the Eye Department with the IAPB for the purpose of accessing affordable medical equipment.
6. Preventive Ophthalmic Medicine.	6.1	Acquisition of a portable slit lamp biomicroscope for outreach use.
	6.2	Maintenance of Diabetic Retinopathy Screening
	6.3	Maintenance of the Eye Department Newsletter MACHO
	6.4	Maintenance of the Eye Seminar KCMC
	6.5	Public awareness campaigns and Eye Health Education through the medium of Radio
	6.6	Maintenance of Day Eye Diseases Screening Outreach with one visit per month
	6.7	Maintenance of Week-long Eye Surgical Outreaches with six visits per year.
	6.8	Investigate areas of need in view of extending Eye Surgical Outreach services into those areas
	6.9	Acquisition of Portable A-Scan Machine for Outreach use.
7. Clinical Ophthalmic Medicine.	7.1	Diagnostic Ophthalmic Medicine
	7.1.1	Reinstatement of Fundus Flourescein Angiography services
	7.1.2	Acquisition of 532nm Green Laser Machine for Medical Retina services
	7.1.3	Acquisition of 4 Slit Lamp Biomicroscopes (Zeiss)
	7.1.4	Set up departmental microbiology services
	7.1.5	Develop Uveitis, Medical Retina, Neuro-ophthalmology and Ocular Pathology sub-specialties
	7.2	Therapeutic Ophthalmic Medicine
	7.2.1	Stocking of Lodoxamide, Acetylcysteine, and Ascorbate and will increase income from an underserved niche.
	7.2.2	Investigate the possibility of reinstating eye drops production at the department
	7.2.3	Updating of eye surgical instruments / squint surgery set. Acquisition of Endoscopic equipment for DCR.
	7.2.4	Commence cornea transplantation services.
8. Rehabilitative Ophthalmic Medicine.	8	Have adequate and appropriate low vision devices to ensure an effective and efficient service delivery
9. Training	9.1	Optometry
		Participate in the clinical training of optometry students.
	9.2	Ophthalmic Nursing
		Participate in the theoretical and practical training of ophthalmic nursing trainees.
	9.3	AMO Ophthalmology
	9.3.1	All AMO Ophthalmology trainees must observe at least five cornea repairs during their training.
	9.3.2	The school must include Medical Ethics in the curriculum.
	9.3.3	Phacoemulsification cataract surgery training for competent practicing AMOO
	9.3.4	Regulation of AMOO surgical training by Ocular Surgery Coordinator
	9.3.5	Glaucoma filtration surgery training be offered to competent cataract surgeons after graduating for those who will be serving in geographically isolated areas from whence referrals for glaucoma patients are not practical.
	9.3.6	The intake of AMOO trainees had been increased to 10 since 2008, the plan is to maintain this number.
	9.4	Undergraduate Teaching
	9.4.1	Fundoscopy training of medical students.
	9.5	Postgraduate Training
	9.5.1	Maintenance of the Ophthalmology Academic Committee
	9.5.2	Maintenance of the separation of Postgraduate Training Coordinator with separation of the training into Bascic Ophthalmic Sciences, Clinical Ophthalmology and Ocular Surgery
	9.5.3	Maintenance of the student examination register
	9.5.4	Increase of ophthalmologist training output to 10 a year.
	9.6	Sub-Speciality Training
		Enroll Paediatric Ophthalmology, Vitreoretina Surgery, Small Incision Cataract Surgery and Phacoemulsification Cataract Extraction trainees when available.
10. Research	10.1	Departmental Patient Data and Archives Management
	10.1.1	System maintenance once every three months.
	10.1.2	Establishment of data entry ports to enable clinicians and nurses to register investigations, procedures and discharges. This will cut down on time wasted in queues and loss of income from incomplete data entry.
	10.2	Student Research
	10.2.1	In-house supervision of student research / dissertations
	10.3	Departmental Research
	10.3.1	In order to develop our autochthonous research capacity, it will be required for each staff member (ophthalmologist) to conduct at least one research every year.

Collaborations

Development Partners

The following are development partners of the eye department KCMC

1. Christoffel Blindenmission: CBM has financed the eye department buildings construction back in 1976 and since 1971 then gave all the supported needed for service delivery and training.

2. Light for the World (Austria): Light for the World sponsors ophthalmology residents and supports childhood blindness prevention program.

3. Eye Care Foundation: ECF supports Ocular Semeiology training of residents

4. University Hospital Birmingham: UHB Link has been giving support in equipment, residency training and examinations.

5. College of Ophthalmology of East Central and Southern Africa: Facilitates curriculum harmonization.

6. Orbis International: Has been building capacity at the Eye Department especially in Pediatric Ophthalmology care.

Acknowledgments

On behalf of the Eye Department I would like to express our sincere gratitude for the conducive environment, support and guidance afforded to us by the Executive Director and the administration of GSF- KCMC in pursuance of our daily activities in the department but also the in participatory departmental development planning. Most of the planned equipment acquisition and building improvements are relying on expected donor support; I would like to recognize the fundamental contribution of Christoffel Blindenmission to the department over the years and also of Light for the World (Austria) who has enabled a number of doctors to train as ophthalmologists increasing the number of eye care cadres in the country. Other important partners are COECSA, Eye Care Foundation (The Netherlands) and University Hospital Birmingham to which the department is paired under the Links Program. UHB has provided equipment, training and examination support to the department since 2007.

William Makupa

Head of Ophthalmology Department

31^st January 2017

List of Staff

Ophthalmologists

1. William Makupa (Head of Department, Vitreo-Retina Surgeon)

2. Irma Makupa* (Ocular Oncologist)

3. Honest Maro (Oculoplastic Surgeon)

4. Furahini Mndeme (Paediatric Ophthalmologist)

5. Heiko Philippin* (Glaucoma Sub-specialist)

6. Mchikirwa Msina (Pediatric Ophthalmologist)

7. Elisante Muna (Cornea Sub-specialist)

8. Andrew Makupa (Vitreo-retina Fellow)

9. Sara Kweka (Pediatric Ophthalmology Fellow)

MMed Trainees

1. Christopher Mwanansao (2012 - 2016) Bugando

2. Vangilisasi Msola (2012 - 2016) Mbeya Consultant

3. Isac Vasco da Gama (2012 – 2016) Mozambique

4. Jafar Majala (2013 - 2017) Sumbawanga

5. Jacqueline Mchilla (2013 - 2017) Monduli

6. Theophile Tuyisabe (2013 - 2017) Rwanda

7. Cristovao Mastinhe (2012 - 2017) Mozambique

8. Einoti Matayani (2014 – 2018) KCMC

9. James Shimba (2015 – 2019) Bugando

10. Francis Masse (2015 - 2019) JWTZ

11. Festo Kapwaga (2015 – 2019) JWTZ

12. Saqalain Kassamali (2015 -2019) Arusha

13. Maria Kisanga (2015 – 2019) Mawenzi

14. Nuru Mwambola (2015 – 2019) Bugando

15. Nelly Fopoussi (2015 – 2019) Cameroon

16. Joyce Awum (2015 – 2019) Cameroon

17. Lydia Fokuang (2015 – 2019) Cameroon

18. Shariza Kanji (2016 – 2020) Bugando

19. Livin Uwemeye (2016 – 2020) Rwanda

20. Daniel Mashamba (2016 – 2020) Kagera

21. Filemon Darabe (2016 – 2020) Mt Meru

22. Francisco Mulobuana (2016 – 2020) Mozambique

23. Abrahamo Matova (2016 – 2020) Mozambique

24. Mario Monjane (2016 – 2020) Mozambique

25. Chabane Amisse (2016 – 2020) Mozambique

 

Assistant Medical Officers Ophthalmology

1. Honest Kitingati (AMO-O)

2. Dustan Kiwelu (AMO-O)

Assistant Medical Officers Ophthalmology Trainees

1. Grace Kaale (Zambia)

2. Simon Luvanda (Makete)

3. James Mitelo (Zambia)

4. Zayana Mshana (Kondoa)

5. Hizza Abdallah (Morogoro)

6. Lubaris Loro (South Sudan)

7. Baako Unzi (South Sudan)

8. Lochi Lotularith (South Sudan)

9. Pasquino Allam (South Sudan)

10. Daniel Kirumbi (Katesh)

11. Fortunatus Nkane (Bahi)

12. Amiri Mmasi (Amana DSM)

13. Charles Kasuka (Misungwi)

14. Frank Mwakalundwa (Kyela)

15. Upendo Mwakabalile (Singida)

16. Peter Kabangila (Singida)

17. Ferdinand Makubi (Kolandoto)

18 Rehema Bidaga (Mbarali)

19. Theresia Masochi (Dar es Salaam)

20. Stephen Wisely (South Sudan)

21. Loice Noah (South Sudan)

22. Salome Manga (South Sudan)

23. Abdou Billah (Benin)

Administrative Personnel

1. Domina Maro (Administrator)

2. Odilia Kessy (Secretary)

3. Yohana Shirima* (Procurement Officer)

4. Humphrey Nderingo (Accountant)

5. Sia Kisanga* (Office Attendant)

6. Henry Marealle* (Childhood Blindness Prevention Coordinator)

7. Lucresia Temba* (Cleaner)

Medical Records

1. Godson Mng’ale* (Medical Records)

2. Rehema Lyimo* (Medical Records)

3. Helga Lyamuya* (Medical Records)

4. Neema Mrema* (Cashier)

Drivers

1. Sifaeli Moshi* (Driver)

2. Sadikieli Chaki (Driver)

Eye Pharmacy

1. Aspreda Mlay (Eye Pharmacy)

Optommetrists/Opticians

1. Gasper Mmari (Optometrist and Head of Unit)

2. Bibiana Allagwa (Optometrist)

3. Aimbora Kimaro (Optometrist) 

4. Hildegard. Mushi (Optometrist)

5. Zenobia Mkenda* (Optometrist)

6. Allen Mwenda* (Optical Technician)

7. Alexander Lissu* (Optometrist and Outreach Coordinator)

Nurses Coordinator and In Charge

1. Apaisaria Kiwia (Coordinator Nurse Eye)

2. Praxedi Moshi (Nurse In Charge Eye Clinic)

3. Hilda Mafole (Nurse In Charge Eye Ward)

4.  Rosemary Lyaro (Nurse In charge Eye Theatre)

Eye Clinic

1. Adeline Shayo

2. Flora Peter*

3. Mary Machange*

4. Felister Makundi*

5. Elitrude Lyimo

6. Geneva Mchau*

Eye Ward

1. Evadrisila Silayo 

2. Rachel Massawe

3. Grace Tumaini

4. Asha Msuya

5. Nsia Ndossa

6. Salome Siay

7. Rose Towo

8. Asha Kwedilima

Eye Theatre

1. Rose Shirima

2. Fidea Mussa 

3. Pulkeria Marandu

4. Valentina Minja

5. Winifrida Mosha

6. Leah Tarimo

Medical Attendants

Eye Clinic

1. Erasmos Mlay*

2. Ruwaichi Makundi

3. Grace Tesha*

4. Mary Lyimo

Eye Ward

1. Eva Ittima

2. Charisma Olotu*

3. Lilian Kimambo

4. Mary Kimaro

5. Serapia Ottaru*

6. Chenkele Mzava

7. Beatrice Kilenga*

8. Aurea Msaki

Eye Theatre

1. Anna Ngowi*

2. Evetha Kimaro

3. Calista Senya

Eye Laundry

1. Deogratias Karia*

GSF Optical Centre

1. Neema Bayagha* (Office Attendant)

Diabetic Retinopathy Screening Programme

1. Valeria Matei* (Project Officer)

2. Dismas Silonga* (Medical Photographer)

3. Ashura Sedute (Project Manager – ADP)

4. Lusekelo (Data Entry Clerk)

Ophthalmology Library

1. Helen Nyereu

List of Graduated MMed Ophthalmology Students

1. Kazim Dhalla (2001) Tanzania

2. Bernadetha Shilio (2002) Tanzania

3. Joel Dembele (2002) Mali

4. Judith Mwende (2004) Tanzania

5. Hemed Abbas Kilima (2005) Tanzania

6. Emeritus Chibuga Bugimbi (2005) Tanzania

7. Hassan Gelema Hassan (2006) Tanzania

8. Sidney Mwala Mulenga (2006) Zambia

9. Musonda Mumba (2007) Zambia

10. William Makupa (2008) Tanzania

11. Elijah Munachonga (2008) Zambia

12. Honest Maro (2009) Tanzania

13. Ahmed Al-Attas (2009) Tanzania

14. George Kabona (2009) Tanzania

15. Celestine Habyakare (2009) Rwanda

16. Furahini Mndeme (2010) Tanzania

17. Emmanuel Byamukama (2010) Rwanda

18. Jason Pithuwa (2010) DR Congo

19. Amadou Issifou Alfa Bio (2011) Benin

20. Marvice Okwen (2011) Cameroon

21. Chantal Giramahoro (2012) Burundi

22. Adubango Udendere (2012) DR Congo

23. Blanche Nguena (2013) Cameroon

24. Felida Mwacalimba-Chilufya (2013) Zambia

25. Japhet Bright Boniface (2013) Tanzania

26. Elisante Jackson Muna (2013) Tanzania

27. Frank Sandi (2014) Tanzania

28. Mchikirwa Msina (2014) Tanzania

29. Sob Laurianne (2014) Cameroon

30. Chansa Kayula (2014) Zambia

31. Chelu Chisanga (2014) Zambia

32. Andrew Makupa (2015) Tanzania

33. Sarah Kweka (2015) Tanzania

34. Evarista Mgaya (2015) Tanzania

35. Christopher Mwanansao (2016) Bugando

36. Vangilisasi Msola (2016) Mbeya Consultant

37. Isac Vasco da Gama (2016) Mozambique

List of Retina Surgery Fellows

1. Kazim Dhalla 2004 (Tanzania)

2. Amos Kibata 2006 (Kenya)

3. Samwel Rotimi 2006 (Nigeria)

4. Emeritus Chibuga 2007 (Tanzania)

5. Ludovika Tindiyebwa 2008 (Uganda)

6. Asiwome Seneadza 2009 (Zambia)

7. Joseph Msosa 2010 (Malawi)

8. William Makupa 2011 (Tanzania)

List of Paediatric Ophthalmology Fellows

1. Mboni Chileshe 2010 (Zambia)

2. Furahini Mndeme 2011(Tanzania)

3. Abou-Bakr Sidik Domingo 2014 (Togo)

4. Emebet Girma Tigeneh 2015 (Ethiopia)

5. Marvice Okwen 2015 (Cameroon)

6. Mchikirwa Msina 2016 (Tanzania)

List of Former Heads of Department

Joseph Taylor 1971-1982

Marylyn Scudder 1982-1993

Walter Jana 1993-1994

David Hunter 1994-1999

Mark Wood 1999-2000 

Anthony Hall 2000-2011

List of Assistant Medical Officers Ophthalmology

1. B. Mbaga 1978

2. Maimu 1978

3. Ngadala 1978    

4. Aziz Mohamed 1978

5. P. Mihale 1979

6. P. Mushi 1979

7. Milanzi 1979

8. A. Mwijaje 1979

9. H. Macha 1979

10. Ntuliwe 1980

11. Mndeme 1980

12. Magogo 1980

13. Sempindu 1980

14. Chisongela 1980

15. Kadete 1981

16. P. Mbaga 1981

17. Belachew 1981 (Ethiopia)

18. Yateri 1981

19. B. Issema 1983

20. Lema 1983

21. Mshanga 1983

22. Maleko 1983

23. M. Ndolezi 1985

24. S. Sawaya 1985

25. Kabuka 1985

26. Tirfe 1985

27. Kasei 1986 CCBRT

28. Mandia 1986

29. Kifua 1986

30. Mboje 1986

31. Lutufyo 1986

32. Chambo 1988

33. John A 1988

34. Mbele 1988

35. Saidi 1988

36. Mwaipopo 1988 Bombo Hospital Tanga

37. Mhagama 1991

38. Ami 1991

39. Abubakar 1991

40. Mwashubila 1991

41. Solomon 1992

42. Mhoro 1992

43. Shayo 1992 Singida

44. Kaji 1992 Sekou Toure

45. Shangali 1992 Mawenzi

46. Mutelele 1993

47. Humbaro 1993

48. Ngereza 1993

49. Katanga 1993

50. Temba 1993

51. Mlundwa 1994 Kibosho Hospital

52. Kunei 1994

53. Mzirai 1994

54. Mponera 1994

55. A. Mwasilu 1994

56. S. Gendo 1994 Musoma

57. Mushami 1995

58. Safi 1995

59. Naheko 1995

60. Humbi 1995

61. Mwanamaziku 1997

62. Mpingwa 1997

63. Nadeit 1997

64. Rwabukambwe 1997 Ndolage Kagera

65. Mujaki 1998

66. Kiwelu 1998 KCMC

67. Kitin’gati 1998 KCMC

68. Nega 1998 (Eritrea)

69. Lubuva 1998 Babati

70. Ole Kuney 1998 KIA

71. Simba 2000

72. Chillambo 2000

73. Kajuna 2000

74. Mnzavas 2001

75. Msenga 2001 Police HQ Dar es Salaam

76. Kashashari 2001

77. Mollel 2001

78. I. Kitinga 2001

79. Erick Msigomba 2002

80. Andrew Kirumbi 2002 Mvumi

81. Dennis Jerry 2003 CCBRT

82. David Ulandah 2003

83. Alfred Midaho 2003

84. Elias Seleli 2004 Sengerema

85. Victor Mudaala 2004 (Zambia)

86. John Bosco 2004 Mvumi

87 Bennett Msovu 2005 St Elizabeth Arusha

88. Patrick Kabangutse 2005 Kabanga - Kasulu

89. Elmeleki Kathani 2006 Kolandoto

90. Frida Kassiane 2006 Bombo Hospital Tanga

91. Xavier Karlenza 2006 CCBRT

92. Willington Kabadi 2007 Kabanga - Kasulu

93. Michael Sanka 2007 Dareda

94. Steven Maufi 2007 Sumbawanga

95. Gilbert Mrema 2007 Mkuranga

96. Mwanahawa Kombo 2008 Mt Meru

97. Secondri Njau 2008 Morogoro

98. Anthony Mbassa 2008 Biharamulo

99. Mwanga Nkayagwa 2008 St Gaspar Itigi

100. Emmanuel Masinga 2008 Maswa

101. Yasini Mwichande 2008 Mafia

102. Florence Mwakila 2008 Morogoro

103. Charles P. Hinju 2009 Songea

104. Sadikieli Kaayi 2009 Haydom

105. Ephraim Kambewa 2009 (Malawi)

106. David Sawe 2009 (Kenya)

107. Bernadetha Twinomkama 2009 Musoma

108. Magdalene Mangi 2009 Tumbi - Pwani

109. Francis Kifutumo 2010 Nkinga

110. David Manento 2010 Heri - Kasulu

111. Godfrey Kajimbwa 2010 Vwawa - Mbozi

112. Erick Myonga 2010 Makete

113. Festus Mhagama 2010 Utete - Rufiji

114. Edward Kuresoy Ole Motika 2010 Orkusmet

115. Zuberi Semkuya 2010 Bukoba

116. Kileha Kampehehe 2010 Kasulu

117. Gloria Ndossy 2010 Rombo

118. Naomi Shayo 2010 Mawenzi

119. Major David Mbewe 2010 (Zambia)

120. Fariji Kilewa 2011 Ilembula

121. Suzana Malangu 2011 Mvumi

122. Hhangali Hhangali 2011 Mbulu

123. Nganyanga Sosoma 2011 Nzega

124. Frank Mbewe 2011 (Malawi)

125. Patrick Kibe 2011 (Kenya)

126. Argent Moonga 2011 (Zambia)

127. John Ngaa 2012 Singida

128. Ashraf Mlanzi 2012 Mvomero

129. Muhoja Jibalo 2012 Kwimba

130. Elias Mwakasita 2012 Kyela

131. Upendo Abedi 2012 Mtwara

132. Allico Mwajute 2012 Mbeya Referral

133. Editruda Sanga 2013 Nkasi

134. Mwita Machage 2013 Lindi

135. Ntabi Ntabi 2013 Magu

135. Henry Msangama 2013 Mpanda

136. Elizabeth Makamba 2013 Mwanza Regional

137. Grace Temba 2013 Rombo

138. Alexander Buhinu Lukuba 2013 Isanga Prison Dodoma

139. Malik Missiru 2013 Mahenge

140. Mashaka Matundwe 2013 Morogoro

141. Japhet Chomba 2013 Kigoma

142. Arseno Ngowi 2014 Mpwampwa

143. Nassoro Khamisi 2014 Meatu

144. Stephen Kunjumu 2014 Ifakara

145. Sr Gonzaga Salala 2014 St Gemma Dodoma

146. Emanuel Mbawala 2014 Mbeya

147. Betty Mbawala 2014 Songea

148. David Mtumoozi 2014 Malawi

149. Emil Malaki 2015 Kibondo

150. Khalfani Mwanga 2015 Hai

151. Malish Emmanuel 2015 South Sudan

152. Josephine Millanzi 2015 Mtwara

153. Anath Musa 2015 Geita

154. William Munyonyela 2015 Ngara

155. Edson Sanga 2015 Ilembula

156. Joseph Sunguro 2015 Musoma

157. Edmund Malinzi 2015 CCBRT

158. Grace Kaale 2016 Zambia

159. Simon Luvanda 2016 Makete

160. James Mitelo 2016 Zambia

161. Zayana Mshana 2016 Kondoa

162. Hizza Abdallah 2016 Morogoro

***