ENT facilities
The ENT department is located to the North of the main entrance and has an outpatient department (clinic), inpatient department, and an operating theatre. Mrs. Valleria L. Matei is head / senior coordinator of the ENT and Eye Departments and the outpatient department. Mrs. Salma Mongi is head nurse at the clinic and very helpful and friendly.
The clinic consists of three linked consulting rooms, a space where audiometric testing is performed, two doctors’ rooms and a waiting room. There is also a large teaching room and a smaller room for the residents. In the classroom there is a computer with internet, but wireless connectivity is still lacking.
The ENT Clinic pales before the Eye Clinic, where the facilities seem luxurious by comparison. The Eye Clinic is much closer to what would be expected in the Western World. The Eye Clinic sets a great aim/target to the ENT. The Eye Clinic has its own library and a large lecture hall, available upon request to others. One floor up is the clinic with three rooms with 8 beds and a separate treatment room for minor surgery under local anesthesia (e.g., biopsy).
The ENT operating room is close to the department and is part of a small theatre block, consisting of two operating rooms. The other operating room was used by the Eye Clinic before they built their own facilities, a brand new theatre complex consisting of four very well equipped, modern looking operating rooms.
ENT has the theatre to itself on Monday, Wednesday and Friday. Currently, the old Eye theatre is empty, but the ENT department has insufficient surgeons to fill it for the rest of the week. The old Eye theatre has no anesthesia machine, but there is a functioning surveillance monitor.
Anesthesia basically consists of induction with intravenous medication then maintenance with halothane. The respirator is a semi-open system. There is no propofol available for total parenteral anesthesia (too expensive). Monitoring consists of ECG, blood pressure, breathing frequency and oxygen saturation (see photo). At some point, the institution will need a capnogram and measurement of in-and exhaled air. The permanent ENT anesthesiologist is Dr. Nicolas Kitunga. There are also a number of anesthetists in the hospital who can stand in for him if he is unavailable. Dr. Kitunga has been officially retired and still working on contract basis for KCMC. That is also very common in Tanzania where the retirement is at age of 60. There is also a number of Assistant Medical Officers (AMO’s) in anesthesia at KCMC. Dr. Nicolas Kitunga is a quiet, friendly, highly skilled anesthetist with a good eye for training. He would like a two table system working. Actually, there already has been an operation in two theatres