RESPONDING TO GOD’S CALL IN THE CHURCH HEALTH MINISTRY. Dr Tendai Paul MANYEZA: is a missionary called to serve at Old Mutare Mission Hospital of The United Methodist Church in Zimbabwe.

Picture: Dr Manyeza’s Family. Standing: Tapiwanashe (third Child), Rutendo (first Child) and Tendai (Jr) (second child) Seated: Dr Tendai Manyeza, Nyasha (son), Natallia (my wife). My very supportive family is my source of pride in my ministry. My wife Natallia, is a pastor at one of the United Methodist Circuits in the district. Rutendo (our daughter and first child) is due to write her advanced level examinations in October 2010 and will be in college next year 2011 if she makes it in her examinations. Tendai, (Jr) is doing form three this year (2010), Tapiwanashe is doing Grade 7 and will join secondary school next year 2011. Nyasha, our last born is doing Grade five this year (2010). My wish is to afford my children good education. I was called to serve in the church health ministry as a missionary from March 2008 after my training and commissioning in New York. It was a touching moment on the day of commissioning when the hands of the bishops were laid on my head. I felt the Lord giving me a responsibility to go and minister to His people in the healing ministry.

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The Missionary class of March 2008, at Stony Point in New York, USA. Dr Tendai Manyeza is in the standing row (sixth from the left of the picture). Old Mutare Mission Hospital. Old Mutare Mission hospital is the smallest of the three United Methodist Church (UMC) hospitals in Zimbabwe situated in the eastern part of the country, close to Africa University. It was established in the early 1900. It started as a small clinic, developing (over the years) to the present 70 bed facility. The unit was built for 5 000 people. It now caters for a population of 12 000 people, mainly from surrounding farms and rural areas. I am the only doctor with a complement of thirteen nurses and 30 support staff. The hospital supervises five rural health centers in the province. The hospital operates on a very tight budget whose source of income is from hospital fees collected. Because the population is poor, the majority people cannot afford medical care. But we don’t turn patients away because they cannot afford to pay the fees. This results in overstretching / high turnover of the very limited resources (medicines and other supplies ) which the hospital is not always in a position to re-stock timeously due to financial constraints. The infrastructure is now old and needs to be revitalized.

The buildings in the picture are (from left to right) the administration office. Very close to it is the laboratory. Next to the laboratory is the dental unit. (These three units are still relatively new). Next to the dental unit is part of the hospital building. This building complex houses a small OPD, a 15 bed male ward, a 15 bed female ward, and a 6-bed children’s ward. On a slightly different note, and still talking about the healing ministry, somewhere on the mountain (in the background) is the famous site called “CHIN’ANDO” which means a “sacred prayer site” started by some local United Methodist women years back. It is very popular among the United Methodist community in the country. Many come from the United Methodist churches around the country to spend a day or two at the site in prayer. There are reports of people who have had their prayers answered after visiting this site. Testimonies are given of people who conceived after visiting the site. Others give testimonies of having received healing after prayer sessions at the place. Everyone, including men now visit the site.

The picture shows the rest of the hospital building that houses the wards and the outpatient unit. Also shown is part of maternity block (grey top). The hospital building needs to be face-lifted by painting the inside and the roof. The ceiling also needs attention (replacement and painting). The maternity unit is the relatively newer part of the hospital. It houses the operating room, that we wish to equip. The floor-tiles now need replacement. There is also need to paint both the inside and outside walls. The water pipes too, need replacement.. The maternity unit is now overstretched because there is no maternal and child health (MCH) unit. Antenatal and postnatal patients who are supposed to use an MCH unit for their routine visits end up crowding the maternity unit. The waiting mothers’ shelter is old and has been condemned by the Ministry of Health. But we are still using it because we are not yet in a financial position to build the recommended type.

The picture shows more of the maternity block (with the grey top part). The old waiting mothers’ shelter is in the background ( almost whole grey building with gable ends facing the picture).

A view of the hospital from the north-western side showing the greater part of the maternity unit. Workload 2009 OUTPATIENTS 69 846 ADMISSIONS 10 588 MATERNITY DELIVERIES 1 446 TRANSFERS 628 PROCEDURES 289 The busiest units are the outpatient department where in 2009, 69 846 patients were seen. Of these 10 588 were admitted for various medical problems. The majority of the admissions were for HIV related illnesses. In maternity we delivered 1 446 babies by normal vertex deliveries only. Because the operating room (in the maternity block) is yet to be equipped with an operating bed, autoclave, anesthetic machine and the appropriate instruments, we send those patients who require operative delivery to the provincial hospital that is about 20 minutes away. Our threshold for transfers is very low thus the rather high number of transfers shown. The ambulance gets worn out fast and that’s why it now needs replacement.

The procedures stated in the table above refer mostly to repairs of minor cuts, incision and drainage of abscesses and evacuation of retained products of conception following miscarriages. Common medical conditions

1. Respiratory infections (including TB) 2. HIV / AIDS 3. Malaria 4. Gastro-intestinal conditions like diarrhea. 5. Skin conditions 6. Chronic medical conditions(diabetes mellitus, hypertension, asthma, arthritis etc).

Below is a picture of patients waiting for their turn to be seen by the doctor in the outpatients unit of the hospital.

HIV / AIDS: The hospital has a walk-in Voluntary counseling and Testing(VCT). It coordinates support groups and home based care activities. Orphans and vulnerable programs (OVCs), prevention of mother to child transmission (PMTCT) and outreach activities (where health education, testing, immunizations, family planning distribution) are some of the activities the hospital is involved in.

SUCCESS STORIES My focus is on improving those activities that have the potential of boosting hospital income and these include the following:

a. Procuring of an x-ray machine: I am glad to report that God has answered one of our prayers. An x-ray machine is currently being installed at the hospital for the first time ever since the hospital was opened. We thank God for making this dream come true.

I wish to thank Dr Mefor of Mutambara Hospital, who, after his hospital had received two xray machines from his partners, decided that the second machine be donated to our hospital. I also wish to thank Dr Cherian Thomas of UMCOR health at the General Board of Global Ministeries (GBGM) and ‘my mom’ Julie Warren and ‘my dad’ her husband, for helping raise the funds for the installation, totaling about US$17 000.00. I am confident that it will be fully operational by end of October 2010 when the cadre sent to train in how to operate the machine is back. PRAISE GOD. b. Equipping t he dental unit. The unit is now almost fully equipped.

Thanks to our Swedish partners who came (as VIM team) to provide dental services in July 2010, and left the dental surgery in a better shape. We now only need a compressor and refurbishment of the dental chairs.

We have managed to secure the services of a dental therapist—Praise God for that, because staffing this unit has been a real challenge. He is to join us hopefully in 2011. The United Methodist Dental unit has promised to help with his upkeep. Dental services are in demand.

Below is a picture of the dental unit built by the Swedish

partners in 1998. They built the surgery and a staff house. Because of the shortage of staff accommodation at the hospital, we had housed two nurses in the dental house. The coming of the dental therapist will pose another accommodation challenge.

The picture above is the dental unit . It has two surgery rooms.

SOME OF THE THINGS WE HOPE TO ACCOMPLISH

a. Equipping the laboratory with a hematology machine, a CD4 count machine

and a biochemistry machine. I know these are special pieces of equipment that are fairly expensive and yet very crucial diagnostic aids to any doctor. I believe one day we will have these.

The laboratory was built by DANIDA a few months before they left the country. Unlike the other centers that received the laboratory and staff houses, our hospital only received the laboratory because at that time the donor was under pressure to wind up the program.

Picture shows patients at the reception area of the laboratory. We only have a laboratory assistant. But we made arrangements for the Africa University laboratory scientist to visit our hospital every Wednesday to process routine specimens. She also bleeds patients (about to be commenced on anti- retroviral treatments ART) for CD4 counts. We are very grateful for this service as it has resulted in our hospital initiating over 300 patients on ART in the last eight months.

b. Setting up a cafeteria service: This is a new area with lots of prospects as an income generating venture. We intend to furnish the intended place with tables and chairs and provide proper serving units of food to clients and relatives.

c. Equipping t he operating room. I hope to equip the operating room with a

table, autoclave, anesthetic machine and operating instruments. This we hope to do in stages. While providing the needed service to patients, the hospital will get income from operations, to run other essential services.

The above is a picture of the operating room showing and old autoclave machine (extreme right). The operating room the table (with the blue top in the lower left corner) is not the ideal. The machine next to the autoclave is a framework of one type of anesthetic machine which I had hoped to fit with the necessary components.

d. Procuring essential office equipment (6 computers for our key units, storeroom, maternity, matron, doctor, administrator, clerk), 2 printers, a lap-top with an LCD projector for teaching purposes, a photocopier and a fax machine). I love teaching so the LCD and laptop are to enable me (or any visiting lecturers) to deliver presentations to staff and students. The income so generated will enable me to provide quality service to my patients (buying drugs and other essential medical supplies / consumables, food for patients, dry cleaning of linen). It is also hoped that we will slowly raise money for the necessary renovations to the hospital, attend to the water piping system and the necessary plumbing, enable painting and tiling of the necessary units, equip the operating room, furnish the dining room, build and equip the kitchen, repairs to the staff houses and improve maternity services.

The income will also enable us to build, equip and furnish new structures (5 staff houses, OPD, wards, MCH unit, Waiting mothers shelter, chapel and a guest house), buy new machinery (laundry, drier and ironing facilities). This is how You can help 1. Pray for us, 2. Volunteer to help with construction and painting, 3. Volunteer to train medical and ancillary staff, 4. Donate funds towards specific projects, 5. Send medicines and medical supplies,

You can make Donations through OLD MUTARE HOSPITAL REVITALIZATION ADVANCE # 982168. You can donate through Tendai Manyeza’s Advance # 3019567 You can make Check payable to UMCOR Health, P O Box 9068, New York, NY 10087, USA. Tendai Manyeza: Medical Officer, Old Mutare Hospital, P O Box 853, Mutare, ZIMBABWE Postal Address: P O Box 807, Mutare. ZIMBABWE. Email: manyeza@mweb.co.zw Phone: Cell- 263 772 350 098.