The Duke Global Health Institute (DGHI) recently hosted Bishop Frederick Onaeli Shoo, Presiding Bishop of the Evangelical Lutheran Church of Tanzania; his wife, Janet Shoo; Gileard Masenga, executive director of the Kilimanjaro Christian Medical Center; and Ahaz Kulanga, deputy provost of Kilimanjaro Christian Medical University College.
Bishop Shoo oversees the Good Samaritan Foundation, the parent organization for the Kilimanjaro Christian Medical Center (KCMC) and the Kilimanjaro Christian Medical University College (KCMUC) in Moshi—two of DGHI’s long-term partners.
While they were at Duke, we had an opportunity to talk with Bishop and Janet Shoo and Masenga and get their thoughts on the role of faith-based healthcare in Tanzania, the successes and challenges of KCMC and KCMUC, and the secrets of our thriving partnership.
(NOTE: The interview was edited for length and clarity.)
DGHI: What are you hoping to get out of your trip to Duke?
Bishop Shoo: We’ve come here to strengthen the partnership between KCMC and KCMUC. Many people at KCMC and around Moshi talk about Duke University, so I wanted to see what it’s like here and meet some of the key players in this partnership.
DGHI: Tell me about the connection between the faith-based and healthcare sectors in Tanzania.
Bishop Shoo: There is a very strong connection between healthcare and faith-based organizations in Tanzania, and that goes back to the history of the mission work in our country. The missionaries came in the 19th century and beginning of the 20th century. They had three main goals—preach the gospel, provide healthcare and educate the people—so you’ll find that wherever the missionaries were in Tanzania, they established a school, a hospital or healthcare center and a church.
Since then, the church—mainly Roman Catholics, Lutherans and Anglicans—has been a key player in the provision of health services in our country. Across the country, about 40 percent of healthcare is carried out by faith-based organizations, but in some rural areas, that number jumps to more than 60 percent.
DGHI: In addition to establishing and running hospitals and clinics, what are some other ways the faith-based sector is influencing the health of people in Tanzania?
Bishop Shoo: The mission of the church takes a more holistic approach to the human being. We think that people living an ethical life improves their health in one way or another. But we also are very much involved in providing what we call “primary health education.” As part of our mission, we go to parishes, to churches, door-to-door in rural and urban areas, and we talk about things like nutrition, hygiene, sanitation and the environment. And this has helped quite a lot.
Gileard Masenga: The church owns a number of hospitals, and many of those serve as teaching institutions, so the church also oversees training of medical professionals. For example, at KCMC, Bishop Shoo is the chairman of the board that oversees the hospital, where we have 15 small colleges that train students for different medical careers.
And when church missionaries go into communities to do the primary health education, they partner with experts from the hospitals and clinics. Right now, we’re doing an awareness campaign for cancer prevention, and part of that initiative is cervical cancer screenings for women.
(To learn more, watch Bishop Shoo’s talk, “The Role of Faith-Based Health Care Delivery in Sub-Saharan Africa.”)
DGHI: Part of your role as bishop is oversight of KCMC and KCMUC. What do you see as the biggest successes of those institutions?
Bishop Shoo: There are a lot of successes. One is the fact that we are able to take care of 30 percent of the entire population of our country—all of the north zone of the country comes to KCMC.
Gileard Masenga: Because KCMC is the zonal referral hospital for northern Tanzania, we cover five regions with a population of 15 million (of 50 million people total in Tanzania). And patients also come from other regions and even neighboring countries for specialized services.
Bishop Shoo: One of the other successes is our opthalmology department—we’re one of the leading hospitals in the treatment of eye diseases.
Gileard Masenga: We’re also very strong in ear/nose/throat, urology and dermatology.
Bishop Shoo: And in 2016, we established a cancer care center where we can do chemotherapy. In the past, people had to travel all the way to Dar es Salaam, away from their families. Now they can get the treatment in our area, where they can later go home or visit their family members.
Gileard Masenga: It’s the only cancer care center in northern Tanzania. Last year, we saw more than 3,000 cancer patients, and we gave chemotherapy to 800 people. And now we’re overwhelmed with patients. We hope to be able to start radiation services in the future.
DGHI: And what’s one of the biggest challenges KCMC faces?
Bishop Shoo: One is that the hospital is overcrowded. The patients are in every corner, and even the corridors, especially in the surgical ward. There aren’t enough rooms. And another challenge is not having the medical equipment we need to care for some of the patients.
Janet Shoo: Another challenge for KCMC is that so many patients travel from far away, and when they come to KCMC, they don’t have a place to stay.
DGHI: How do you think the partnership between KCMC, KCMUC and Duke has benefited the people of Tanzania?
Bishop Shoo: This partnership has contributed a lot toward enabling us to reach our mission, especially in the areas of research and training. Now we have a place where our young people and medical students can get state-of-the-art training. Recently we had visitors from the Tanzanian Commission of the Board of Universities, and when they looked at our facilities, they said, “We don’t have this anywhere in the whole of East Africa.” And then also the provision of scholarships and training for our young doctors has been a major contribution.
Gileard Masenga: Another success is the establishment of KCMUC, which is now one of the best universities in Tanzania. We train the whole range of medical professions—undergraduates, PhDs, nurses. We’ve contributed a lot to the human health in the country. And many alumni of the college work in very key, strategic positions in Tanzania—like myself. I was trained there and now I’m the director of the hospital.
Bishop Shoo: I think about one third of district and regional medical officers are a product of KCMUC.
DGHI: What specifically about the partnership do you think has contributed to the success of KCMC and KCMUC?
Gileard Masenga: With this partnership, we have transformed our training capacity with technology-based training. And the funding we received through the partnership was everything—it helped us completely change our education programs. The training opportunities have also been key.
It’s a very good long-term partnership model. The partnership is built on mutual trust, and now, in addition to being partners, we’re friends. When people from Duke come to Tanzania, it’s like they’re coming home. It’s a mutually beneficial partnership, which is really important.
Janet Shoo: And we have a super management team that works really well together.
Bishop Shoo: That's one of the things I’m happy about. I can see we have a young, energetic leadership or management team there, and this has been very encouraging. We expect more success with this management.
DGHI: How do you hope to build on the success of the partnership in the future?
Bishop Shoo: I would say we should continue in the same direction, especially with regard to training. And I would also like to find a way for the partnership to help us expand our infrastructure there.
Gileard Masenga: We should also be trying to improve the clinical services. With cancer, we need to start radiotherapy. I'd like to see a state-of-the-art radiotherapy unit, because 60 percent of cancer patients need radiation. Cardiology is another area for us to expand. We don't have a cardiology unit. In fact, there's only one cardiac center in all of Tanzania, in Dar es Salaam. So these are a few areas where we can work together with Duke and see how we can improve.
Now we have a place where our young people and medical students can get state-of-the-art training.Bishop Frederick Onaeli Shoo