Kilimanjaro Christian Medical Center, Tanzania
Background
In Africa there is an appalling lack of cardiac care. Among some of the poorest countries, there are no medical services for heart disease. In many others, there might be only one national referral center in the entire country that has cardiac specialists, serving just a small number of people.
Children and young adults are hardest hit, as they are the populations most affected by heart disease in low-income countries. They suffer mainly from congenital heart disease (the #1 birth defect worldwide) and rheumatic heart disease (caused by untreated strep throat). Many live for years in heart failure, too disabled to attend school or help their families with work at home. Many die young.
Thousands of these early deaths could be prevented. Treatment strategies exist now that make cardiac care accessible and affordable in developing country settings. What is lacking is the will, expertise, and financial support from developed countries to help leaders in Africa to start these services.
Our Initiative
The Foundation for Cardiovascular Care in Africa (FCCA) is an initiative of the nonprofit East Africa Medical Assistance Foundation in Minnesota (U.S.) to bring partners together to address this need.
Over three years, FCCA has supported the development of a plan to build a cardiovascular center at KCMC Hospital. Construction of the cardiovascular center will begin in early 2023. The center will open in January 2026.
KCMC is a 720-bed teaching hospital, and the major referral and specialty hospital for Tanzania’s Northern Zone. The hospital is a large complex with 2,000 students, and 1,300 staff. KCMC has affiliated medical and nursing schools, and a research center.
A key partner for KCMC is the Minneapolis Heart Institute Foundation (MHIF), who is supporting sending a full team of Tanzanian physicians, technicians, and nurses for cardiac training to Dar es Salaam and to India for up to three years, returning to open and run the cardiovascular (CV) center at KCMC. This education plan is modeled on a successful pilot program developed by MHIF in Ethiopia, training the country’s first full cardiac surgery team.
Another key partner is the Minnesota Chapter of the American College of Cardiology, who is supporting KCMC clinicians with patient consults now, and expects to provide in-person training and mentorship when the Tanzanian cardiac team returns from India to open the KCMC cardiac center.
Medical experts from Foundation ZGT-Overzee and Foundation Mwika in the Netherlands are also engaged with KCMC in planning of the CV center, bringing added expertise in vascular care and IT.
Our long-term goal is to set up a total of three new cardiovascular training centers in Africa, including a focus on preventing and treating heart disease in children in impoverished settings.
FCCA’s cardiac care initiative has grown out of a highly successful Minnesota partnership to support KCMC in specialty training. For over 30 years, a group of Minnesota physicians, hospital administrators and advocates have supported the development of radiology and imaging at KCMC. In 2013 they expanded the partnership to support KCMC’s development of cancer care, with an emphasis initially on children. Now they are working to support creation of KCMC’s first cardiovascular center, serving a catchment area of 15 mil people. FCCA experts in Minnesota are helping with health facility design, medical equipment planning, operational and financial planning. KCMC now has a “shovel-ready” plan for construction, start-up, and longer-term operations of the center so it is sustainable.
The Cardiovascular Center
The KCMC Cardiovascular Centre will offer treatment for children and adults with heart disease, equipped with one OR, two cath labs, and one hybrid cath lab/OR. KCMC is a public/private partnership between the Evangelical Lutheran Church and the government of Tanzania, with support from the Tanzanian Ministry of Health. KCMC has an exceptionally strong leadership team, led by Executive Director Professor Gileard Masenga, MD. KCMC has a track record of steady and impressive growth and integrity, and experience managing large construction projects. It is well positioned to establish an ambitious cardiovascular center.
The CV center will serve as a training center for fellows from Tanzania and elsewhere in Africa, so other countries can begin or expand their cardiac services. As a key step in our larger vision of three new African cardiac training centers, this project has the potential to catalyze scale-up of the development of cardiac care in Africa. KCMC is well situated for training and convenings – it’s near an international airport (Kilimanjaro International Airport), and it has fiber optic cable high speed internet for live, long-distance teaching, developed with its research partner Duke University Global Health Institute.
As it has with its other specialty programs, KCMC will work with local primary healthcare providers to set up systems for patient referral and follow-up, using proven models developed in Africa. The result: a comprehensive cardiac program at all levels of the health system –- community, primary and tertiary.
This initiative is a model for developing cardiac care in a low-income setting where none exists, starting from scratch. KCMC is engaging the Ministry of Health in planning – for support and to enable replication.
The model is expected to include a pilot program developed by KCMC in collaboration with the Ministry of Health to raise awareness and understanding of rheumatic heart disease (RHD) in children, so that it can be prevented and treated. An MHIF-supported RHD prevalence study is underway at KCMC’s sister research institute, which will help lay the foundation for this work.
Finances
Cost
$10.7 mil For construction & equipment. (A similar project in the U.S. would cost over $100 mil.)
Income
$4.0 mil A loan for equipment
$2.9 mil KCMC has been encouraged to apply for a grant from the Gov’t of Tanzania to fund equipment
$3.8 mil We are seeking gifts and recoverable grants to support construction
For more info, contact Wendy Bennett wenbennett@mac.com
