Tanzania Eye Health Care Forum

Kilimanjaro Christian Medical Centre

Eye Department

Annual Report

2017

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 2017 saw the employment of three nurses to the Eye Department (Epaphra Kimathi, Tumaini Myombo and Baraka Kisanga) and one medical attendant (Ikunda Kipokola). Also with the graduation of Dr Jafar Ally Othman, we expect him to join our staff as he may be attached to the AMOO School. We now have nine ophthalmologists, just one short of our aim of 10 ophthalmologists by the year 2021.

One medical attendant, Calista Senya successfully pursued a certificate course in Ophthalmic Assistant at Mvumi, continuing the tradition of capacity building among our departmental general cadres in eye healthcare sciences. Jeromin Munishi joined us this year.

2. Equipment and Instrumentation

Just before the close of 2017, we were lucky to receive new equipment, thanks to Michael Kaschke of Carl Zeiss Germany. We received a Carl Zeiss OPMI Lumera 300 operating microscope, Carl Zeiss Primus 200 OCT and Carl Zeiss Visucam 524 FFA Fundus Camera. The Zeiss Stratus OCT 3000 could not be repaired besides the efforts of the Zeiss technical team from South Africa. We were also able to have the Keeler Cryomatic operational again, after procuring Cryo-probes from Germany.

3. Consumables

At some instance during the year when we had ran out of Voriconazole gtt, we had acquired Amphotericin B iv and made hospital preparation topical antifungal eye drops. Also Salama Pharmaceuticals is now able to supply us with Streptokinase for Autologous Plasmin Vitreolysis.

Table 3: Cosumables

	Description	Per Month	Annual Consumption
1	Dexamethasone Chloramphenicol	1870	22,440
2	Olopatadine	200	2,400
3	Timolol	880	10,560
4	Brimonidine	125	1,500
5	Sodium Cromoglycate	1020	12,240
6	Moxifloxacin	30	360
7	Econazole	40	480
8	Silicone Oil	15	180
9	Ciprofloxacin	400	4,800
10	Dorzolamide	0	0
11	Voriconazole	-	-
12	Tetracycline occ	120	1,440
13	Latanoprost	250	3,000
14	Chloramphenicol occ	240	2,880
15	Chloramphenicol gtt	140	1,680
16	Prednisolone	90	1,080
17	Atropine	140	1,680
18	Perfluorooctane	2	26
19	Crescent Knife	23	276
20	MVR Blade	76	912
21	Keratome	46	552

4. Infrastructure and Vehicles

Building Maintenance, Repair and Development

The Eye Department Management Committee recommended that physical expansion of the ward area be considered, two options have been proposed; a second floor over the Eye Wards or ward area in the Primary Eye Healthcare Unit at Sokoine Road.

Vehicle Maintenance and Repair.

The Toyota Coaster 35 seat bus suffered severe engine damage when Sadikieli Chaki drove the engineering department to Manyara without doing a pre-journey check of radiator water and engine oil. It cost the Eye Department some Sh 10 million to have it repaired and has ran well ever since.

Table 4: Vehicles

Vehicle	Particulars
Toyota Land Cruiser Hard Top T 805 ABB	Ran efficiently
Toyota Land Cruiser Hard Top T 872 ABB	Ran efficiently
Toyota Coaster Minibus T 187 ASG	Underwent Engine Overhaul.
Land Rover 110 TDI T 415 ADS Eye Outreach Program	Ran efficiently
Land Rover 110 TDI 780 ANM Childhood Blindness Prevention Program.	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. In response to hospitals stance, we started holding departmental Work Improvement Team (commenced on 3^rd April 2017) meetings with the aim of implementing 5S-Kaizen. On 16 November 2017, KCMC administration stated that they will require election of heads of departments and nurse coordinators.

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 2018 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 Program (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 23 Old Faithful.

MACHO 24 Practicing Ophthalmology.

MACHO 25 Ugonjwa wa Kisukari wa Macho.

MACHO 26 Clinical Protocols for Diabetic Retinopathy.

2. Eye Seminar KCMC was not held in 2017, but we had one TOS sponsored CPD on 6 May 2017 on Retina Diseases with attendance of 22 persons.

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 Light for the World Childhood Blindness Prevention Program.

5. Public Awareness Campaigns: During World Sight Day week 9^th to 13^th October 2017, some 136 patients benefitted from free eye health screening at the Primary Eye Healthcare Unit of the Eye Department. Some 35 (58 men and 78 women) patients had refractive errors, 33 had cataract and 6 were pseudophakic.

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

We were able to do all the planned 12 DEDSO visits for 2017.

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, Babati and Karatu District Hospitals. The planned visit to Lushoto in May had to be postponed as landslides had blocked passage, we went in June instead. All the planned six Week-long Eye Surgical Outreaches were done and in addition we also conducted two extra surgical outreach to Endulen and Wasso with KCCO’s collaboration.

Table 6.1: Outreach Services

	Number of Visits	Number of Patients Screened	Number of Patients Operated
Day Eye Diseases Screening Outreach	12	1381	93
Week-long Eye Surgical Outreach	8	1242	336
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.

2. Easy access to child eye healthcare services.

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

In course of this year, we implemented LftW Project 1786 Childhood Blindness Prevention Project in six districts; Rombo, Same, Lushoto, Tanga, Longido and Karatu. Some 17,543 children benefited from the eye screening in their own districts through school screening and health units screening. Some 2958 children were identified as having ocular ailments and some 2009 were treated on the spot while 611 were referred for further management elsewhere. The project supported 84 children undergoing cataract surgeries with 143 eyes operated.We were also able to conduct four Pediatric Ophthalmology Clinical Outreaches (POCO).

Pediatric Ophthalmology Surgical Outreach (POSO)

We also commenced implementation of Future in Sight project of childhood blindness prevention in Ifakara and Peramiho hospitals, in the December 2017 Pediatric Ophthalmology Surgical Outreach some 21 children were operated on location and further six were referred and were operated at KCMC. Some 94 children benefitted from medical treatment, some 63 were refracted and some 12 low vision devices were dispensed to 7 children.

Diabetic Retinopathy Screening Program

In course of the year 2017, we had continued to conduct diabetic retinopathy screening outreaches within Kilimanjaro Region using our own sustainability funds with some 1,163 patients screened and 246 found to need intervention. Also effective from 1^st October 2016 we had launched the CBM funded Arusha Diabetic Program, in 2017 some 1508 patients had been screened and 215 identified as needing intervention.

Table 6.2: Diabetic Retinopathy Screening Program

	Male	Female	Total
Diabetic Retinopathy Screening in Kilimanjaro	390	773	1563
Patients Identified in Kilimanjaro	76	170	246
Diabetic Retinopathy Screening in Arusha	1018	490	1508
Patients Identified in Arusha	136	79	215

7 (a). Diagnostic Ophthalmic Medicine

The Eye Clinic provides consultation for every working day of the week; currently there are nine ophthalmologists, one assistant medical officers’ ophthalmology, 19 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. Currently on average we attend to some 142 patients every day, a new strategy will have to be developed to address patient care as the numbers increase. Soon we shall have to fully operationalize unit 3 of the department to cope with the numbers.

Table 7.1: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
Wednesday	Cornea	E.Muna
	Pediatric Ophthalmology	F. Godfrey M. Msina

Thursday	Ocular Oncology	I.Makupa
	Pediatric Ophthalmology	F. Godfrey M. Msina

Friday	Medical Retina	H. Maro E. Muna W. Makupa
	Pediatric Ophthalmology	F. Godfrey M. Msina

Table 7.2: Diagnostics

Visual Fields	1218
Fundus Flourescein Angiography	-
Optical Coherence Tomography	-
Cornea Topography	-

Table 7.4: Consultations

Total Number of Consultations	35,362
New Consultations	9,183
Return Visits	26,180
Males	17,529
Females	17,833
Children (< 16 yrs)	6301 Boys: 3637 Girls: 2664

Table 7.5: Top 20 Diseases

	Description / Particulars	Numbers
1	Other Disorders of Eye	5148
2	Refractive Errors (Presbyopia)	5078 (1256)
3	Disorders of Conjunctiva (Allergic)	4985 (3893)
4	Retina Diseases (Diabetic Retinopathy) (Retina Detachment) (Other Retinopathy)	4155 (2919) (581) (655)
5	Glaucoma	3877
6	Cataract	3869
7	Pseudophakia	3846
8	Normal Eye	2181
9	General Symptoms	1487
10	Cornea Disorders (Keratitis) (Cornea Opacity)	1320 (795) (525)
11	Trauma	530
12	Blindness	477
13	Uveitis	457
14	Lid Disorders	380
15	Lachrymal Disorders	231
16	Strabismus	197
17	Ocular Malignancy	183
18	Optic Nerve Disorders	175
19	Orbit Disorders	135
20	Headache	78

Table 7.6: Top 10 Ocular Diseases in Children

	Description / Particulars	Numbers
1	Conjunctiva Disorders (Allergy)	1297 (1131)
2	Other Disorders of the Eye	1188
3	Refractive Errors	986
4	Normal Eyes	601
5	Pseudophakia	356
6	Cataract	216
7	Cornea Disorders (Keratitis) (Cornea Opacity)	202 (53) (110)
8	Glaucoma	192
9	Trauma	150
10	Strabismus	145

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 7.7: Top 10 Minor Theatre Procedures (Total No … )

1. PRP	564	6. Cyclophotocoagulation	99
2. Bevacizumab Injections	494	7. Minor Surgeries	74
3. YAG Calpsulotomy	259	8. Prothesis Fitting	57
4. Focal / Grid Laser	236	9. Gancyclovir Injections	52
5. Triancinolone Injections	99	10 Retrobulbar Ethanol	30

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 Ketotifen, Brimonidine, Dorzolamide and Olopatadine. Still we are striving to stock Lodoxamide and Acetly-Cysteine.

Optical Services

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

Table 7.8: Spectacles

1. Adults Refracted	Male 3205 + Female 3993 = 7198
2. Children Refracted (Independent)	Boys 476 + Girls 432 = 908
3. Total Number of Glasses Dispensed	Males 1923 + Females 2441 = 6144
4. Of whom subset of above (Nr 3).	Boys + Girls = NA

Eye Ward

We finally commenced with painting of the terrazzo floor with white painting, with expectations to conclude it in 2018 and later move into the Eye Clinic. As an integral part of the 5S-Kaizen activities, electrical ventilators were installed in the male and female toilets to reduce the foul smell. All the hospital beds were painted white as planned.

Table 7.9: Admissions

Total Number of Admissions	3098
Males	1702
Females	1396
Children (< 16 yrs)	665 Boys:407 Girls:258

Table 7.10: Top 10 Diseases in Eye Ward

1. Cataract	1577	6. Corneal Ulcers	102
2. Retina Diseases	363	7. Strabismus	18
3. Other Diseases	359	8. Keratitis	14
4. Ocular Trauma	299	9. Conjuncitval Carcinoma	11
5. Glaucoma	116	10. Retinoblastoma	11

Eye Theatre

In course of the year protocols for sterilization of non-pyrogenic instruments were reviewed and effective from 7 November 2017 we switched to Glutaraldehyde chemical sterilization of non-pyrogenic instruments. We also switched to thermal sterilization of Keratomes, Crescent Knifes and Myringovitreoretina Blades.

Table 7.11: Eye Surgeries

Total Number of Surgeries	3055 (Outreach Included 3391)
Males	1725
Females	1330
Children (< 16 yrs)	795 Boys: 501 Girls: 294

Table 7.12: Top 10 Ocular Surgeries

1. Cataract Surgery (Phacoemulsification)	1701 (2037)* (390)	3. Glaucoma Surgery (Trabeculectomy) (Goniotomy)	124 (14) (38)
2. Retina Surgery	382	5. Conjunctiva Surgeries (Excision Biopsies) (Pterigia Excision)	166 (80) (61)
3. Cornea Surgeries (Cornea Repair)	186 (102)	8. Orbital Surgeries (Evisceration) (Enucleation) (Exenteration)	91 (35) (19) (16)
4. Lid Surgeries	126	9. EOM Surgeries	66
5. Other Surgeries (Unspecified) (EUA)	169 (103) (66)	10. Lacrimal System Surgeries (DCR)	44 (15)

* Including Outreach Surgeries

Table 7.13: Top 10 Ocular Surgeries in Children

1 Cataract Surgeries	298	6 Strabismus Surgery	50
2 Cornea Surgeries (Cornea Repair)	106 (60)	7 Retina Surgeries	58
3 Other Surgeries (Unspecified) (EUA)	76 (41) (35)	8 Orbital Surgeries (Evisceration) (Enucleation) (Exenteration)	22 (4) (10) (2)
4 Lid Surgeries	52	9 Conjunctiva Surgeries	19
5 Glaucoma Surgeries (Goniotomy)	58 (38)	10 Lacrimal System Surgeries (DCR)	20 (2)

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 8.1: Low Vision Services

Total Number of Low Vision Patients	460
Low Vision Patients (Children < 15 years)	KCMC: Men 111 + Women 75 = 186 Outreach: 274
Total Number of LVD issued to Patients	288 KCMC: Male 73 + Female 33 = 106 Outreach: 182

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

On 22 September 2017, Dr Elisante Muna was appointed Principal of AMOO School to replace Dr Irma Makupa. With these changes we expect a renewed vigor in that school.

Table 9.1: Assistant Medical Officers Ophthalmology

	Name	Year	District / Country
First Year AMOO	1. Yahaya Mgima	2017 - 2019	Singida Municipal
	2. Reuben Linkanti	2017 - 2019	Malinyi DC
	3. Joan Kibula	2017 - 2019	Pangani
	4. Laurence Mremi	2017 – 2019	Arusha
	5. Jacqueline Hamsha	2017 - 2019	Sengerema
	6. Elton Munguya (HBFC)	2017 - 2019	Zambia
	7. Kpanna Jonas (HBFC)	2017 - 2019	Benin

Second 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	Kinondoni
	7. Salome Manga (HBFC)	2016 – 2018	South Sudan

AMOO who Graduated in August 2017	1. Lubari Loro (HBFC)	2015 - 2017	South Sudan
	2. Lochi Lotularith (HBFC)	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
	7. Stephen Wisely (HBFC)	2016 – 2017	South Sudan
	8. Loice Noah (HBFC)	2016 - 2017	South Sudan
	10. Abdou Billah (HBFC)	2016 - 2017	Benin

Undergraduate Teaching

Some 174 MD3 did their clinical ophthalmology rotation in course of the year. For the first time in years, some four students had to supplement their ESE 6. Dr Irma Makupa has taken over the undergraduate teaching.

Postgraduate Teaching

All the four fourth year residents successfully graduated in August. Dr Milka Mafwiri from Muhimbili University of Health and Allied Sciences was our external examiner for the last time. One of our finalist was the best MMed of the graduating class.

Table 9.2: Masters of Medicine Ophthalmology

	Name	Year	Country
MMed I	-	2017 - 2021	-

MMed II	1. Shariza Kanji	2016 - 2020	Tanzania
	2. Livin Uwemeye	2016 - 2020	Rwanda
	3. Daniel Mashamba	2016 - 2020	Tanzania
	4. Filemon Darabe	2016 - 2020	Tanzania
	5. Francisco Mulobuana	2016 - 2020	Mazambique
	6. Mario Monjane	2016 - 2020	Mozambique
	7. Chabane Amisse	2016 - 2020	Mozambique
	8. Abrahamo Matova	2016 - 2020	Mozambique

MMed III	9. Francis Masse	2015 - 2019	Tanzania
	10. Festo Kampwaga	2015 - 2019	Tanzania
	11. Saqalain Kassamali	2015 - 2019	Tanzania
	12. Maria Kisanga	2015 - 2019	Tanzania
	13. Nuru Mwambola	2015 - 2019	Tanzania
	14. Nelly Fopoussi	2015 - 2019	Cameroon
	15. Joyce Awum	2015 - 2019	Cameroon
	16. Lydia Fokuang	2015 - 2019	Cameroon
	17. Nelson Mutajwaa	2014 - 2019	Tanzania
	18. James Shimba	2015 - 2019	Tanzania

MMed IV	19. Einoti Matayani	2014-2018	Tanzania

MMed who Graduated	Theophile Tuyisabe	2013-2017	Rwanda
	Jacquelin Mchilla	2013-2017	Tanzania
	Jafar Majala	2013-2017	Tanzania
	Christovao Matsinhe	2013-2017	Mozambique

Table 9.3:Sub-Specialty Fellowship

Name	Sub-Speciality	Year	Country
Boniface Ikenna Eze	Vitreoretina Surgery	2017	Nigeria
Teshager Wondale	Pediatric Ophthalmology	2017	Ethiopia

Continuous Professional Development

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

Table 9.4: Ophthalmic Assistant

	Name of Nurse Trained at Mvumi	Year
1	Salome Siay	2013
2	Lucy Mmbaga	2014
3	Adeline Shayo	2015
4	Winfrida Mosha	2016
5	Calista Senya	2017

Courses, Seminars and Conferences

A team of 11 people attended the COECSA 2017 conference at the Commonwealth Speke Munyonyo Lodge in Kampala, these were William Makupa, Honest Maro, Elisante Muna, Mchikirwa Msina, Einoti Matayani, Nelson Mutajwaa, Apaisaria Kiwia, Evadrisila Silayo, Winfrida Mosha, Felister Makundi, Praxedi Moshi and Hilda Mushi.

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 10.1: Trend

	2010	2011	2012	2013	2014	2015	2016	2017
PRP	226	322	257	233	294	348	272	564
Focal	129	252	212	208	212	136	184	236
Bevacizumab Inj	163	354	264	404	460	518	502	494
Gancyclovir Inj	43	21	24	39	45	53	42	52

Table 10.2: Trend

	2010	2011	2012	2013	2014	2015	2016	2017
Number of Consults	22284	24004	24207	24599	26087	27331	32678	35363
New Patients	10156	7863	8040	7134	7665	7654	8945	9183
Revisits	12128	16141	16167	17465	18422	19677	23733	26180
Children	4027	4595	4642	4560	4798	4946	5598	6301
Admissions	2548	2654	2569	2498	2503	2628	2932	3098
Surgeries	2251	2490	2295	2265	2251	2251	2798	3055
Surgeries Children	428	473	418	408	486	448	626	795
Cataract Surgeries	1609	1501	1706	1736	1581	1630	2050	2037
CS at Centre*	1317	1325	1412	1408	1317	1384	1725	1701
CS at Outreach	292	176	294	328	264	246	325	336
CS Children	117	129	135	140	183	131	217	298

*CS = Cataract Surgeries

Achievements

Table 10.3: Implementation by Category of EDDP 2017

Category	ID	Activity	Result
	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.	Done Jafar Ally
	1.1.2	Recruitment and retention of Assistant Medical Officers Ophthalmology to have 2 AMOO at the centre.	NA
	1.1.3	Recruitment of Nurses to the Eye Department.	Done Kisanga Kimathi Myombo
		Recruitment of Medical Attendants to the Eye Department.	Done Kipokola
	1.2	Continuous Professional Development
	1.2.1	CPD through visiting specialists with the aim of capacity building at KCMC	Done Mietsch
	1.2.2	Training of nurses in ophthalmic assistant course.	Done Senya
	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.	Done Laswai
	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 Kampala

2. Equipment and Instrumentation.	2.1	Annual planned preventive maintenance of eye healthcare medical equipment and instrumentation.	In Process
	2.2	Annual plan for equipment servicing negotiated at the time of purchase for the purpose of prolonging their life span.	Done Constellation
	2.3	Acquisition of autoclave from India.	Done Matron
	2.4	Acquisition of 2 more Alcon Constellation phacoemulsification hand pieces.	Done
	2.5	Development of instrument repair and sharpening workshop and technician.	Pending

3. Consumables.	3.1	Adequate, appropriate and sufficient eye healthcare consumables for smooth service delivery.	Partially Done
	3.2	Liaise with TFDA on consumables acquisition.	NA
	3.3	Acquisition of Lester Jones tubes	Not Done
	3.4	Acquisition of Biological Glue for Cornea Surgeries	Not Possible

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	Not Done
	4.1.3	Annual fire response and evacuation drills needed.	Pending
	4.1.4	Installation of sign posts and notice boards.	Done 5S-Kaizen
	4.1.5	Expansion of clinical area into a second site as number of patients seeking eye healthcare services increases.	Done PEHC
	4.2	Eye Ward
	4.2.1	The Eye Ward floor needs improvement, either by tiling it or painting it with floor paint.	In Process Floor Paint
	4.2.2	The eye ward washrooms need wall painting, wall tiling, electrical air vents and scent stones.	Done Air Ventillators
	4.2.3	Painting of hospital beds.	Done
	4.3	Eye Theatre
	4.3.1	The PVR device in the Eye theatre is to be made operational again.	Not Possible
	4.3.2	The plan is to ensure that each of the seven tables is equipped with emergency power supply unit (UPS).	Not Relevant
	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.	Not Relevant
	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.	In Process
	4.5.3	Hiring of a driver.	Done Munahaya

5. Administration, Management and Finance.	5.1	Regular meetings of the Departmental Management Committee to deliberate and advise on administrative and developmental matters.	Done WIT
	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	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.	Not Done
	6.2	Maintenance of Diabetic Retinopathy Screening	Done
	6.3	Maintenance of the Eye Department Newsletter MACHO	Done
	6.4	Maintenance of the Eye Seminar KCMC	Not Done
	6.5	Public awareness campaigns and Eye Health Education through the medium of Radio	Done
	6.6	Maintenance of Day Eye Diseases Screening Outreach with one visit per month	Done
	6.7	Maintenance of Week-long Eye Surgical Outreaches with six visits per year.	Done
	6.8	Investigate areas of need in view of extending Eye Surgical Outreach services into those areas	Continuous Process
	6.9	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	Done Zeiss
	7.1.2	Acquisition of 532nm Green Laser Machine for Medical Retina services	Pending
	7.1.3	Acquisition of 4 Slit Lamp Biomicroscopes (Zeiss)	Done
	7.1.4	Set up departmental microbiology services	Not Done
	7.1.5	Develop Uveitis, Medical Retina, Neuro-ophthalmology and Ocular Pathology sub-specialties	In Process
	7.2	Therapeutic Ophthalmic Medicine
	7.2.1	Stocking of Lodoxamide, Acetylcysteine, and Ascorbate and will increase income from an underserved niche.	Done
	7.2.2	Investigate the possibility of reinstating eye drops production at the department	Not Possible
	7.2.3	Updating of eye surgical instruments / squint surgery set. Acquisition of Endoscopic equipment for DCR.	Done with ENT
	7.2.4	Commence cornea transplantation services.	Pending

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
	9.2	Ophthalmic Nursing
		Participate in the theoretical and practical training of ophthalmic assistant trainees.	Done
	9.3	AMO Ophthalmology
	9.3.1	All AMO Ophthalmology trainees must observe at least five cornea repairs during their training.	Not Relevant
	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	Not Relevant
	9.3.4	Regulation of AMOO surgical training by Ocular Surgery Coordinator	Done
	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.	Not Relevant
	9.3.6	The intake of AMOO trainees had been increased to 10 since 2008, the plan is to maintain this number.	Not Relevant
	9.4	Undergraduate Teaching
	9.4.1	Fundoscopy training of medical students.	Continuous Process
	9.5	Postgraduate Training
	9.5.1	Maintenance of the Ophthalmology Academic Committee	Pending
	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	Done
	9.5.3	Maintenance of the student examination register	Done
	9.5.4	Increase of ophthalmologist training output to 10 a year.	In Process
	9.6	Sub-Speciality Training
		Enroll Paediatric Ophthalmology, Vitreoretina Surgery, Small Incision Cataract Surgery and Phacoemulsification Cataract Extraction trainees when available.	Done Eze, Teshager and Bobb Semple.

10. Research	10.1	Departmental Patient Data and Archives Management
	10.1.1	System maintenance once every three months.	Partially Done
	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.	Pending
	10.2	Student Research
	10.2.1	In-house supervision of student research / dissertations	Continous 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 medical attendant has been trained in Ophthalmic Assistant (Calista Senya).

2. A large team attended the COECSA conference at Munyonyo Kampala.

3. Some three new nurses and one medical attendant were employed.

4. Acquisition of OCT, FFA and Operating Microscope from Germany.

5. Departmental bus was successfully repaired.

5. All four scheduled departmental management meetings took place.

6. A store keeper has been employed.

7. KCCO’s return was barred.

Challenges

During the year 2017, we faced several challenges, these could be summerized as:

1. The breakdown of OCT in November 2016, meant that we were not able to provide quality eye healthcare.

2. For months, we did not have access to a B-Scan sonograph, impairing clinical decisions.

3. The Fundus Flourescein Angiopgraphy was not operational, it ceased to work in 2012.

4. Cornea Cross Linking Services not taking off.

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

6. The departmental driver, since resigned, had caused our 33 seater Toyota Coaster to suffer engine cease as he drove it all the way to Manyara National Park without radiator water and engine oil.

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 2017, some 44 items of the 59 that couls realistically be implemented were done, giving an implementation score of 75%. 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).

Table 10.4: EDDP Scores

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%
2017	59	44	75%

Plans

Table 10.5: Implementation Plans for 2017

Category	ID	Activity
1. Human Resource for Eye Healthcare Development.	1.1	Staff Related Matters
	1. 1.1	Recruitment and retention of ophthalmologists to reach the target of ten practicing ophthalmologists.
	1.1.2	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	Continuous professional development of non-medical personnel.
	1.2.4	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.
	2.5	Development of instrument repair and sharpening workshop and technician.
	2.6	Acquisition of Phacoemulsification equipment for wet-lab use.
	2.7	Acqusition of Specular Microscope.

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.
	4.1.6	Acquisition of more toys in the Pediatric Ophthalmology Clinic.
	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.
	4.3	Eye Theatre
	4.3.1	The PVR device in the Eye theatre is to be made operational again.
	4.4	Building Maintenance, Repair and Development
	4.4.1	Extension of clinical area for specialized clinics, office space and private ward 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, Tanga and Manyara.
	4.5.3	Installation of tubeless tyres in one of the Toyota Land Cruisers.
	4.5.4	Installation of set belts in the vehicles that do not have them.

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.
	5.5	Installation of a printer in the ophthalmologists office.

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	Acquisition of 532nm Green Laser Machine for Medical Retina services
	7.1.2	Acquisition of 2 Slit Lamp Biomicroscopes
	7.1.3	Set up departmental microbiology services
	7.1.4	Develop Uveitis, Medical Retina, Neuro-ophthalmology and Ocular Pathology sub-specialties
	7.1.5	Setting up of a desk top computer for Retinoblastoma services.
	7.1.6	Installation of colur printers for OCT and Cornea Topography.
	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.
	7.2.5	Acquisition of Maxitrol unguentum.
	7.2.6	Stocking of Metronidazole iv in Eye Wards.
	7.2.7	Acquisition of Hyaluronic Acid sterile ophthalmic solution.

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 assistant 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	Regulation of AMOO surgical training by Ocular Surgery Coordinator
	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 2018

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. Jafar Majala (2013 - 2017) Sumbawanga

2. Jacqueline Mchilla (2013 - 2017) Monduli

3. Theophile Tuyisabe (2013 - 2017) Rwanda

4. Cristovao Mastinhe (2012 - 2017) Mozambique

5. Einoti Matayani (2014 – 2018) KCMC

6. Nelson Mutajwaa (2014 – 2019)

7. James Shimba (2015 – 2020) Bugando

8. Francis Masse (2015 - 2019) JWTZ

9. Festo Kapwaga (2015 – 2019) JWTZ

10. Saqalain Kassamali (2015 -2019) Arusha

11. Maria Kisanga (2015 – 2019) Mawenzi

12. Nuru Mwambola (2015 – 2019) Bugando

13. Nelly Fopoussi (2015 – 2019) Cameroon

14. Joyce Awum (2015 – 2019) Cameroon

15. Lydia Fokuang (2015 – 2019) Cameroon

16. Shariza Kanji (2016 – 2020) Bugando

17. Livin Uwemeye (2016 – 2020) Rwanda

18. Daniel Mashamba (2016 – 2020) Kagera

19. Filemon Darabe (2016 – 2020) Mt Meru

20. Francisco Mulobuana (2016 – 2020) Mozambique

21. Abrahamo Matova (2016 – 2020) Mozambique

22. Mario Monjane (2016 – 2020) Mozambique

23. 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. Hussein Munahaya* (Driver)

Eye Pharmacy

1. Aspreda Mlay (Eye Pharmacy)

Optommetrists/Opticians

1. Bibiana Allagwa (Optometrist and Head of Unit)

2. Upendo Mmari* (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. Epaphra Kimath*

6. Geneva Mchau*

Eye Ward

1. Tumaini Myombo*

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

7. Baraka Kisanga*

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. Calista Senya

6. Chenkele Mzava

7. Beatrice Kilenga*

8. Aurea Msaki

9. Yukunda Kipokola*

Eye Theatre

1. Anna Ngowi*

2. Jeromin Munishi*

3. Serapia Ottaru*

Eye Laundry

1. Deogratias Karia*

Primary Eye Healthcare Unit

1. Neema Bayagha* (Office Attendant)

Diabetic Retinopathy Screening Program

1. Valeria Matei* (Project Officer)

2. Dismas Silonga* (Medical Photographer)

3. Ashura Sedute* (Project Manager – ADP)

4. Lusekelo Nyale* (Data Entry Clerk)

Ophthalmology Library

1. Helen Nyereu

List of Graduated MMed Ophthalmology Students

1. Kazim Dhalla (2001) KCMC

2. Bernadetha Shilio (2002) KCMC

3. Joel Dembele (2002) Mali

4. Judith Mwende (2004) Morogoro

5. Hemed Abbas Kilima (2005) Nkinga

6. Emeritus Chibuga Bugimbi (2005) Wasso

7. Hassan Gelema Hassan (2006) KCMC

8. Sidney Mwala Mulenga (2006) Zambia

9. Musonda Mumba (2007)

Zambia

10. William Makupa (2008) KCMC

11. Elijah Munachonga (2008)

Zambia

12. Honest Maro (2009) KCMC

13. Ahmed Al-Attas (2009) Zanzibar

14. George Kabona (2009) Iringa

15. Celestine Habyakare (2009)

Rwanda

16. Furahini Mndeme (2010) KCMC

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) Mawenzi

26. Elisante Jackson Muna (2013) Mwanga

27. Frank Sandi (2014) University of Dodoma

28. Mchikirwa Msina (2014) KCMC

29. Sob Laurianne (2014) Cameroon

30. Chansa Kayula (2014) Zambia

31. Chelu Chisanga (2014) Zambia

32. Andrew Makupa (2015) KCMC

33. Sarah Kweka (2015) KCMC

34. Evarista Mgaya (2015) Bugando

35. Christopher Mwanansao (2016) Bugando

36. Vangilisasi Msola (2016) Mbeya Consultant

37. Isac Vasco da Gama (2016) Mozambique

38. Theophile Tuyisabe (2017) Rwanda

39. Jacqueline Mchilla (2017) Monduli

40. Jafar Ally Othman Majala (2017) Sumbawanga

41. Cristovao Matsinhe (2017) 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

)

9. Boniface Eze Ikenna 2017 (Nigeria)

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)

7. Teshager Wondale 2017 (Ethiopia)

List of Former Heads of Department

Joseph Taylor 1971-1982

Marylyn Scudder 1982-1993

Walter Jana 1993-1993

David Hunter 1993-2000

Mark Wood 2000-2000

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

163. Lubari Loro (HBFC) 2017 South Sudan

164. Lochi Lotularith (HBFC) 2017 South Sudan

165. Stephen Wisely (HBFC) 2017 South Sudan

166. Loice Noah (HBFC) 2017 South Sudan

167. Abdou Billah (HBFC) 2017 Benin

168. Daniel Kirumbi 2017 Katesh

169. Fortunatus Nkane 2017 Bahi

170. Amiri Mmasi 2017 Amana Da es Salaam

171. Charles Kasuka 2017 Misungwi

***

	2010	2011	2012	2013	2014
Cases	2794	2974	3481	4248	4787
Rank	Nr 5	Nr 5	Nr 3	Nr 3	Nr 1
Percentage of Total	12.5%	12%	14%	17%	18%

Tanzania Eye Health Care Forum

Sunday, September 23, 2018

MACHO 17

Eye Department KCMC Annual Report 2017