Zinga, Tanzania

 A team of 13 Rotary clubs, five Rotary Districts, and an anonymous donor raised over $100,000 to donate digital medical imaging equipment to the first free standing pediatric hospital in Tanzania, Children’s Hospital, Zinga. The hospital is run by the IHP (International Health Partners) which was founded by Paula Lofstrom, a nurse administrator,  her husband, Dr. Denny Lofstrom and the late Mary Ellen Kitundu to provide better health care in Tanzania. Their vision is to create a 500-bed hospital all on one floor with 33 buildings on 63 acres of donated land. Zinga is located 35 miles from Dar-es-Salaam, the largest city in Tanzania.

As with any project, it is critical to do your homework and make sure that everything is well prepared. The DIMIST team spent quite a bit of time to work with the physicians on-site to make sure the proposed solution met the specific requirements of the pediatric clinic. The result was an X-ray system from Fuji, with a digital detector reader from the same vendor, an open source digital archive and database management system from ClearCanvas installed on a locally purchased server running Windows operating system, a medical grade display, remote computers to view the images, an Ultrasound unit and also digital dental acquisition detectors and software. All of these modalities (X-ray, Ultrasound, dental) create digital images which are centrally archived and viewable. The grant proposal which funded the equipment included a line item for training and support which paid for the travel for a DIMIST team member (Herman Oosterwijk) to support the installation which turned out to be invaluable, if nothing else to create a sense of urgency to meet the installation date as well as address any issues that might come up.

What is different in this installation from a typical deployment in a comparable clinic in let’s say a suburb in the US is the following:

• We used a digital solution for the X-ray which is called CR (Computed Radiography) which is mature and cost-effective unlike the more common Direct Digital detector technology (aka DR) which is widely used in the developed world. We saved at least US$25k.

• The digital archiving and viewing of the medical images (aka PACS system) uses an open source solution. The particular viewing for this

application, (Clearcanvas) has become more or less the de-facto standard for the developing world but is obviously not pushed by any of the local dealers as it does not create any revenue for them. We saved an estimated US $25k.

• We used two re-furbished dental detectors, provided by a local dealer in the USA. We saved here at least US$2,500.

• Since service was readily available from nearby Dar and since we had previous successful dealings with the dealer, we agreed to the change and used an Ultrasound directly imported from China instead of using a traditional US or European supplier. We saved an estimated US $15k

In conclusion, we could provide a digital imaging system for less than 2/3rd of the cost of a similar “commercial” system, which is a significant savings as these funds are provided by grass-roots fund raising and matching by Rotary International, but even more importantly, it is a more sustainable solution.