Council Designated Hospital

Special Services

Reconstructive Surgery for Crippled Children

Many children in the community Selian serves are crippled and have no access to corrective surgery or rehabilitative care. Some are born with congenital deformities and many more become crippled through drinking water with a high fluoride content; the condition is called skeletal fluorosis and causes bowed and painful legs.

The most severe cases of skeletal fluorosis are referred to Selian for corrective surgery. Selian surgeons together with Orthopedic Surgery volunteers operate on approximately 200 children with congenital or fluorosis-induced anomalies annually. The cost is minimal and the surgery restores these children to wholeness and allows many to walk again. It is truly a remarkable ministry of healing and prevention. Children come into the hospital unable to walk and then walk out under their own power.

Selian provides a wide range of reconstructive surgery options to our community. This includes not only orthopedic surgery for children crippled by congenital deformities and acquired deformities such as skeletal fluorosis, but also burns and trauma. Visiting volunteer orthopedic surgeons operate at Selian several weeks each year. This important work continues with financial support of Compassion Canada.

Equally important is the reconstructive surgery done by volunteer plastic surgeons. The repair of cleft lips and palates as well as the grafting of complicated burns is a wonderful ministry to those who have already suffered so severely from their trauma.

Vesico-vaginal Fistula Repair

Dr. Charles Sweke operates on a fistula patient.

There's a silent and tragic epidemic rampant in the poor countries of the world. It is not much discussed because it affects primarily women who are poor. It is an epidemic that turns mothers into outcasts.

Imagine a mother who lives deep in the bush when she goes into labor at home, perhaps with the help of a traditional midwife. If the baby is too large to pass through the birth canal, the baby's head exerts enormous pressure on the vaginal, rectal and bladder tissues which then die and results in leakage of urine and/or stool through the vagina (a vesico-vaginal or recto-vaginal fistula). The child usually dies in the process.

The joy of an expected child is replaced with a new problem: the continual leaking of urine and/or stool. It is impossible for her to stay clean. Her husband may banish or divorce her. Her family may send her away or keep her at a distance because of her smell. She is now "unclean."

Selian began the first center for fistula repair in northern Tanzania. The surgery is difficult and requires special training and experience. Drs. Sweke and Browning perform 100s of fistula repairs annually. Dr. Sweke undertook special fistula repair training at the well-known Fistula Hospital in Addis Ababa, Ethiopia where Dr Browning formerly served for over a decade.

In 2002 Selian opened a 16-bed ward dedicated to the specialized post-operative care needed by fistula patients. This ward was funded by donations from Impact-UK and the Rotary Club of Evergreen, Colorado. The Ministry of Health of the Republic of Tanzania has also provided operating funds for fistula repair.

Selian AIDS Control Program

The AIDS epidemic is devastating Tanzania. Selian has been responding to the epidemic since 1986 and the effort has grown dramatically in the past few years. The program now consists of a wide range of comprehensive services and preventive activities. The individual components of the program include:

1. AIDS Education and Awareness Raising: These efforts have continued to expand into new areas with concentration on the training of local church leaders, school educators, peer groups, traditional leaders and high risk groups within the community.

2. Voluntary Counseling and Testing (VCT): VCT is now available at three Selian sites. The largest is at the Arusha Town Clinic, second is Selian Hospital in Ngaramtoni, and the third is in the Health Center at Mto Wa Mbu. These clinics provide VCT to over 1000 patients per month.

3. Prevention of Maternal to Child Transmission of HIV (PMTCT): This program began in 2002 and has expanded in all subsequent years. Over ninety percent of women in the antenatal clinics agree to be tested for HIV. HIV-positive rates are fortunately low with about 13% testing positive and requiring treatment for PMTCT.

4. Medical Care and ARV Treatment for HIV Patients: In 2003 Selian began treating AIDS patients at the Arusha Town Clinic with anti-retroviral drugs (ARVs). The Selian ARV clinics began providing free ARVs in 2004 with funding from USAID and the Clinton Foundation. The clinics care for over 5000 patients living with AIDS.

5. Home Based Care and Hospice Care: Selian continues to reach out into the community of patients with AIDS and other diseases to provide home based care, training for family members in home care, and to provide for end of life hospice care in the home. The team ministers to over 1000 patients in their homes.
To see a hospice slideshow, click here.

7. Support of People Living with HIV/AIDS:Selian continues to be the patron to and a primary supporter of the support group known as ALPHA+ or Arusha Living Positively with HIV/AIDS. This is the largest support group in Arusha and it regularly meets at Selian's Uzima (Wholeness) Center in Arusha. Many members participate in community AIDS education programs.

Hospice and Palliative Care

The ministry of hospice care continues to expand. The hospice program began in 1999 and was the first hospice in Tanzania. The program is home-based and the hospice team does home visiting to provide palliative and spiritual care to those who are terminally ill. Most hospice patients have AIDS, advanced cancer or terminal cardiac disease.

The program has expanded into many surrounding villages and congregations where volunteers are being trained to provide hospice care to those in need in their communities. In addition to the hospital staff and clergy, there are 130 lay volunteers who have been trained in home hospice care.

The hospice team was able to invite other church hospitals from Northern Tanzania to attend an introductory workshop on hospice care in 2002. This then gave rise to Selian Hospice becoming a training center for other hospitals. The training expanded to include all of the Evangelical Lutheran Church in Tanzania hospitals under the direction of Dr. Kristopher Hartwig.

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