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In January, 2012, Justine MacWilliam, project manager for AmeriCares Health Worker Safety Initiative, traveled to Bugando Medical Centre in Tanzania to see first-hand the remarkable achievements that Bugando’s workers have made in improving hospital safety during the three-year pilot initiative. Here, Justine provides a glimpse of the life-saving culture of change the initiative has created among hospital staff.
"Many of Tanzania's health workers haven’t had adequate training on preventing the spread of hospital-related infections and injury."
Saturday, April 28th, is World Day for Safety and Health at Work, a day to raise awareness about the importance of preventing injury and disease related to workplace hazards. Hospitals everywhere pose workplace hazards, especially in developing countries, where health workers risk their lives each day on the job.
In Tanzania, where AmeriCares has its longest-standing Africa partnership, infectious diseases are still the leading cause of death, and access to vaccines is extremely limited. Many of the country's health workers don’t have consistent access to safety-oriented supplies to protect themselves and most health workers haven’t had adequate training on preventing the spread of hospital-related infections and injury. Tanzania also has the lowest rate of physicians per capita of any country in the world, with only one doctor per 100,000 people. In an effort to protect Tanzania’s sparse and underequipped health care workforce, in 2008 AmeriCares launched the Health Worker Safety Initiative (HWSI), with a goal to develop a center of excellence in safety at Bugando Medical Centre, a teaching and referral hospital staffed by 1,200 health workers and nearly 1,000 medical students who care for nearly 250,000 patients each year.
"During my most recent visit, all of Bugando’s health workers had already attended safety trainings, and big changes were evident."
Through the HWSI, all of Bugando’s health workers participated in two-day safety trainings. These workshops include critical occupational safety topics ranging from infection prevention and control to proper use of personal protective equipment and fire safety. Trainings are led by a team of 40 Bugando health workers from different departments who were themselves trained at the launch of the project, using a special curriculum developed specifically for the HWSI. AmeriCares also supports the project with regular donations of safety-oriented supplies and equipment, vaccines against hepatitis b, tetanus, and yellow fever, and grants for infrastructure upgrades to improve hospital conditions.
During my most recent visit, all of Bugando’s health workers had already attended safety trainings, and big changes were evident. “Everyone is more aware of occupational hazards from what they’ve learned in the trainings and from seeing what happens when other people are injured,” explained Nurse Gemetilda Katongo, a health worker safety trainer who has 20 years of experience as a nurse at Bugando. “Since the project and the trainings began there have been less injuries and needle pricks among health workers. Also, when people are injured they now understand the consequences, so they follow proper procedure and use post-exposure prophylactics more strictly.”
"One of the greatest successes of the HWSI is the way that it has transformed the work environment for Bugando’s staff."
What struck me the most in my discussions with nurses at Bugando was how empowering the project has been for the hospital’s health workers, and the level of enthusiasm among health workers for applying the lessons of the trainings. Nurse Katongo explained “I know the hazards that can appear and I am teaching people and they respect me.” Nurse Deborah Mollel, a 30-year veteran of Bugando agreed, “All health workers are reinforcing good behaviors with one another. We work together as a team. The changes in behavior are the most important part of the project—these will be long-lasting.”
One of the greatest successes of the HWSI is the way that it has transformed the work environment for Bugando’s staff. Health workers told me that they feel more confident when treating patients now that they have been vaccinated against hepatitis B and have the gloves and other important pieces of equipment that keep them safe on the job. These improvements have changed the attitudes of health workers about coming to work each day. Nurse Mollel told me, “Now we are proud to say that we work at Bugando. Our safety and working conditions are now so much better compared to other hospitals, and we are well-stocked with the supplies to keep us safe.”
I know that this year on World Day for Health and Safety at Work, I will think about the hugely dedicated health workers at Bugando Medical Centre, and celebrate the great achievements that AmeriCares and Bugando have made together in building a safer, healthier place to work.