Tuesday, October 13, 2015

Bitter Reality

The idea of wiriting this post came up after listening to opinions and beliefs of many people - including my relatives, friends, benefactors and volunteers - on how our health center in Kiabakari operates and survives.

The common presumption is that our facility operates financially on Tanzanian government / Church / NGOs donations and support. That is why people think that the medical service we provide in Kiabakari should be offered on free-of-charges basis.

Yes, I would love to see this happening. This is our dream and vision. But the bitter reality is far from this wonderful desire.

Not only we do not get any support from the above mentioned sources, yet still we are obliged by the Tanzanian law and Catholic Church practice in Tanzania to make various payments and contributions, apart from the regular expenditure as in any other facility of this type elsewhere in Tanzania and in the world.

Our income in the health center comes from these sources: firstly, out- and in-patients - from their payments for medical services and medicine they are administered or prescribed; secondly, National Health Insurance Fund payments for services and medicine we offer to the members of the insurance scheme (we treat them for free and the compensation comes a few months later in the form of a bank cheque - they deduct any discrepancies and mistakes the doctor-in-charge of the facility makes while filling them, thus causing losses for us); thirdly - any donations in kind (bandages, water for injections, gloves etc) in and outside of the country. Fourthly - volunteers work which helps to attract more patients and hopefully to generate much needed income for the struggling facility.

Last year alone, I personally had to find extra six million plus Tanzanian shillings to help see us through the end of the year. This year already more than two million went in for the same purpose - to help to make ends meet. This money I had to find somewhere somehow and this not comes easy, believe me.

Today, despite having three volunteering doctors in the health center, my manager came to me to ask for help so he can pay social security and income tax payments. He was short half a million shillings.

We are surrounded by bush private labs, pharmacies and medical mini-facilities run by local people, who in most cases do not bother to register their businesses, do not pay taxes and all required by law - payments and contributions. The same people wage war on us, spreading black PR to discourage people from using our services and to go to them. Obviously, all their smear campaing is entirely false and is a pure lie. But this is how the world goes and how people fight for income, not only here, but I believe - everywhere else.

Since the opening of the health center in January 2008, the administration of the facility went from hands to hands and since two and half years I was left alone with the help of my secretary - whom I made a manager of the facility - to run the show. Since its beginnings till this day noone came up with the valid and workable plan and vision - how to run the facility and keep it financially safe and stable in the long run and the foreseeable future. People came and went, struggling to run it, then walking out seeing it is extremely hard, stressful and frustrating. I am not an exception. This is not my job to run the medical facility. I see clearly that my good will and desire to see this important helth center survive financially and to be safe in the long term - is not sufficient. We need organizations, people, something to make it secure and working. Who and how? I do not know at this point of time. I feel most of times so much left alone. Occasional donations, development projects and volunteers are missing the point and may even fool the public to think that things are going well. The daily running of the facility and keeping its finances in black and succeeding in fulfilling the challenges of the payment list below is a daily nightmareish reality for Amon and myself.

I am dreading the moment when I will hit the wall and be forced to raise my hands up in defeat and close the health center due to a bancruptcy. This would be a disaster to everybody involved in the conception, construction and running of this facility - Polish government, Diocese of Musoma, NGOs and private benefactors, volunteers and donors. But most of all - it would be a death sentence for many Tanzanians whose lives might be saved here.

Below is the list of the payments, expenditure and contributions we do here in Kiabakari in our health center. I hope this will be an eye opener to many of you - what we are facing here and how hard it is to survive in this environment. And hopefully it will be a wake up call to all of you who think that in Kiabakari the health center is a neverending story of success and easy-peasy money-making machine.


  1. Salaries and allowances of the employees 
  2. Holidays and other benefits of the employees 
  3. End / Termination of contracts - financial packages 
  4. Medicine and drugs procurement 
  5. Social security of the employees - NSSF 
  6. Income tax of salaries - PAYE 
  7. Tanzania Revenue Authority tax (SDL) 
  8. Health Insurance of the employees 
  9. House allowances for the employees 
  10. Land rent annual payment 
  11. Fire safety inspection annual fee 
  12. Fire extinguishers inspection fee (2-3 times a year) 
  13. Goverment licence fee and income tax of the facility 
  14. 5% of annual income - contribution to the Diocese of Musoma 
  15. Annual contribution to the Health Department of Diocese of Musoma 
  16. Annual contribution to the Health Department of the Tanzanian Episcopal Conference 
  17. Hospitality (guests, inspections, visitations - food and drinks) 
  18. Health center board members meeting allowance (quarterly) 
  19. Servicing and maintenance of the medical equipment (batteries, paper, gel, needles, gloves, perishables for lab tests and lab samples etc.) 
  20. Uniforms and boots for security guards and uniforms for employees 
  21. Staff canteen costs (breakfast and lunch) 
  22. Electricity bills 
  23. Water consumption bills 
  24. Office stationaries 
  25. Printing of health center perishables - files and various forms for departments of the facility (reception, pharmacy, lab, doctor etc.) 
  26. Minor repairs (infrastructure, pump house, furniture etc.) 
  27. Service of the generator 
  28. Fuel for the generator 
  29. Official travels of staff members for meetings, workshops, seminars etc. 
  30. Transportation costs 
  31. Communication (post office box, mail, internet, phone credit etc.) 
  32. Cleaning and laundry department equipment and cleaning agents 
  33. General cleaning of the premises and garden caretaking allowance 
  34. Dogs’ food 
  35. Dogs’ caretaking (drugs, vaccinations, bathing and allowance for the person in charge of dog care) 
  36. Gifts and funeral donations and contributions 
  37. Other occassional payments, donations and contributions.
Please, pray to Almighty God, to Whom nothing is impossible, to make possible a dream of so many people of good will, mainly our people in Kiabakari and the area, that our health center survives, is in good professional and capable hands. May Divine Mercy uses this facility as its favorite channel to touch lives and bodies of God's children and to heal them.

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