1.0: INTRODUCTION:

1.1. BACKGROUND HISTORY:

The Evangelical Lutheran Church in Tanzania (E.L.C.T) Diocese in Mara Region is the owner of the hospital and runs it as a Designated District Hospital for Bunda District. The hospital is situated in Bunda Town on the Musoma Mwanza main road.

In 1982 ELCT Mbulu synod which was owner seeing the Lutheran Ministry in Mara region decided to look into the possibility of building a hospital in the region as there was no government hospital in Bunda district.

In 1988 the regional authorities requested the Synod to build a hospital and run it as a Designated District Hospital so that it could provide services to the people in co-operation with the Governments the synod agreed and asked the Norwegian Lutheran Mission (NLM) to participate in the project.

The NLM not only agreed to participate in the project by proceeding 20% of the contribution cost, but also obtained 80% of the cost from NORAD the local contribution to the project included procession of free land, access road, water rights from Balili spring in Balili hills, water storage tanks. The construction work started in August 1988. The hospital services began on the 10th February 1992 but the facility was officially opened in 27th September 1992, by the President of Tanzania, Hon. Ali Hassan Mwinyi.

Bunda Hospitals occupies an area of about 5,560sgm. It has capacity of 200 bets. It has a target population of about 300,000 people living in Bunda District. Because of its location, it is also accessible to other districts of Mwanza, Mara and Shinyanga regions.

The hospital budget is financed by the government under special agreement with the diocese and the church (being the owner of the hospital) is responsible for the capital expenditure. The hospital is one of the 20 ELCT hospitals in the country. It has a telephone, Fax and e-mail communication. Electricity is from National grid.

2.0: GENERAL REVIEW OF THE YEAR

2:1: HOSPITAL LEADERSHIP:

i)Head of the Institution (MOi/c)Dr. David C. Sinde

Qualifications: -MD, Adv. Diploma in Paediatrics

ii)Hospital MatronMs Sarah Ringo

Qualifications: NO, Nurse Psychiatrist

iii)Hospital SecretaryMr. Frank Saguti

Qualifications diploma in Business

iv)Hospital AccountantMrs Anitha Kitigwa

Qualification: Adv. Diploma in accountancy

v)Assistant to MOi/cDr. Stephen Mugema

Qualifications: AMO,Diploma in Psychiatry

vi)Assistant to Matron (Patron)Mr. Boniface Nyanda

Qualifications: NO, Nurse Psychiatricst

vii)Hospital ChaplainRev. Okully Mwanga

The Hospital is run by management committee of 6 people (MOi/c, Assist MOi/c, Matron, Her assistant, Hospital secretary and an accountant.

The Assistant to the Medical Officer In charge is responsible for clinical services: clinicians, Laboratory, Radiology and Pharmacy department. Following amendment done by Diocesan Health Board, the accountancy, Chaplain’s office are now independent departments answerable to the Hospital Board which in turn is responsible for policy making (guideline) and budget approval. Routinely it met twice. 4 members come from the Government (RMO, DMO, DC, MoHRepresentative) while 6 are from the church ( the Bishop being the chairperson).

The facility has another organ called Hospital Advisory committee which is made of members from the hospital management committee TUGHE representative, hospital chaplain and District Medical Officer. Normally it seats before the Board meeting.

2.2BROAD OVERVIEWS;

Since the very beginning in 1992 it has been obvious that there was a great need for the services prouder by this hospital, not only did the hospital mostly has many more inpatients than it was designed for but also many patients are coming from outside our natured catchment area. The reason for this is not only insufficiency in the other hospitals in the region but also that our hospital has a good reputation for providing good services to reasonable payments. We always tried to have the necessary medicines and equipments in stock. Ever if sometimes it was difficult with the availability.

Especially in the Paediatric Ward the number of patients was too high up to 80 children’s and the same number of mothers in the ward. Thanks that since late 2004, the new paediatric ward came into operation which is too spacious and can accommodate such a big number of children and their mothers. Malaria still dominating as a cause to such admissions. Also TB is an increasing problem in connection to the increase in HIV/AIDS.

On the side of our economy, this year the government grant (salaries) was provided in due time although there was a delay with the increase in salary scale ( we received our arrears in April 2007). The problem is still that there are not enough drugs available from the regular government distribution through MSD in Mwanza where the prices are better and we have our account for grant for drugs and that money can only be used there. Fortunately we were granted some money from NLM/NORAD for purchasing of drugs.

3.0: FINANCE:

The Hospital financial year follows the national financial calendar year which ends in June. Bunda DDH being the Designated District Hospital, the Ministry of health and social Welfare is supposed to cover the running expenditures of the hospital and ELCT diocese of Mara Region is responsible for capital expenditure. The grant covers personnel emolument, and cost sharing has indeed helped to fill in gaps though not fully. Many thanks go to the NLM/NORAD for its kind consideration in giving us financial support through a strategic plan of 2002 – 2005 December.

4:0 STAFF (see appendix 4,0)

The staff situation in 2006 was not good especially with nurses and clinical officers. We faced a high staff turn over ( moving to Government health facilities). We made efforts to recruits more but still the number is labile as they come in and shortly they move out especially between April and July every year.

The hospital has 4 seconded AMOs 9 from Bunda council) and 1 AMO) From the MOHSW. It is out staffs by Medical attendants, most of whom do not like to undergo any in-service

Professional training

5:0 CURATIVE SERVICES:

5.1: GENERAL OPD (See appendix 5.1 (a)

Our OPD had been very busy, with several problems for example system of registration, and statistics are inaccurate. The OPD is opened from Monday to Sunday 24 hours. The patients are preferably seen first by Cos whenever necessary, they are referred to the Doctors. However these doctors have regular OPD service on Monday, Wednesdays and Fridays. We have care and treatment clinic (CTC) which started in June 2005. There is a great response from the community – See appendix 5.1(b). The site is equipped with a IV set which tries to keep our clients less tired when waiting for service

5.2 INPATIENT DEPARTMENT:

BDDH has 200 registered beds in 4 wards: Male, Female, Maternity and Paediatric. Malaria has continued to be the leading cause of inpatient deaths. Clinical officers ward rounds are done daily, doctors rounds are usually done three times a week (Mondays, Wednesday and Fridays) (See appendix.....)

5;3 THEATRE: See Appendix 5,3

The theatre has two main operating rooms and two smaller rooms for minor or unclean procedures, the two main rooms: One is for non-septic cases where the other one is for septic cases is.

The hospital benefited from KCMC based visiting Orthopaedic surgeon who was here in June 2006and happened to perform 18 surgeries.

The theatre was also used by Dr. Kiberiti, eye specialist who visited our hospital October in this year. Also a team from Marie Stoppers Musoma did elective Bilateral tubal ligation (BTL) 11 operations.

Types of anaesthesia given include :

a)General anaesthesia using either Ketamine or Ether

b)Regional anaesthesia ( mainly spinal)

5;4 TUBERCULOSIS AND LEPROSY

See Appendix 5,4

5; 5PSYCHIATIRC/MENTAL HEALTH

Mental health is among components which makes the totality of human Health being.

STAFF PSYCHIATRIST

There were:

  1. A.M.O Psychiatrist
  2. Nursing Officers – 4 at district headquarter 3 in the rural health facilities, 20 Mental Health trained providers

MENTAL HEALTH SERVICES IN THE DISTRICT:

Psychiatric unit0 we have only clinics

Health centrers 1

N.G.O. 0

VA – 1

Privates – 1

Rehabilitation – 0

Prison Services – 0

OBJECTIVES FOR 2006:

  1. Provide continuity of patients care
  2. Commemorate mental health day
  3. Orient CHMT members on mental health
  4. Train 15 clinicians on mental health (management approach)
  5. Purchase of Psychotropic
  6. Prepare annual M.H report
  7. Supervise M.H. activities in FLHU

IMPLEMENTED OBJECTIVES

No. 1,2,4,6 above were implemented

SUCCESSES:

  1. Most of patients who attended for M.H care got the services
  2. It was noted that a kind of drug abuse called “KUBER” now is sold in shops and are used by community members the events was noted during commemoration of mental health day and was reported to DMO and M.H.O
  3. A cassette on depression ( kilio moyoni) was provided by MEHATA to the District.

PROBLEMS:

  1. Lack of funds were the obstacle to implement some of activities as planned eg. Mental health day, supervision and drugs purchase
  2. Commemoration of mental health day was done
  3. Low number of trained staff with multiple tasks making time shortage to attend big number of patients who attend clinic for care.
  4. Increased number of mentally ill patients in the community but not attending to hospital for care eg. Drug abuse and alcoholism

FUND USED:

  1. Basket fund – 1,442,500 for training and commemoration of mental health day
  2. MEHATA National – facilitators allowance 20,000 x 5 days = 100,000/=
  3. BDDH MSD allocation – some of psychotropic’s used at headquarter level

OBJECTIVES FOR 2007:

  1. Provision of continuity of patients care
  2. Orient CHMT on mental health
  3. Train is more health providers of FLHF on mental health (management approach)
  4. Supervise mental health activities in FLHF
  5. Commemorate mental health day
  6. Purchase of psychotropic’s for Bunda District
  7. Plan for 2008 mental health activities
  8. Prepare and submit annual report by Feb. 08

REASONS FOR INCREASE OF PATIENTS:

  1. Social stresses – Hardship life style
  2. HIV/AIDS Infection
  3. Cultural issues eg. Using snuff for treating febrile conditions in children’s

SUGGESTIONS:

  1. Awareness raising to the community on mental health and that treatment is available in hospitals
  2. Incorporation of mental health staff to PHC activities to make the totality of care.

5.5 EYE WORK AT BUNDA DDH:

Eye work at Bunda Hospital, started early in 1992 when the hospital was opened, and is run by an Ophthalmic Nursing Officer. Eye clinic is conducted once in a week – every Wednesday but services not limited to emergencies. Because of an increase in member of cataract patients we have been getting aid from Eye surgeon who has been sponsored by Christofel Blinder Mission (CEM) from 1998 up to 2006 in May, when stopped after getting our own eye surgeon in Mara Region accorded to Vision 2020.

Few years ago I had an Ophthalmic assistant ( being a Nursing Officer) who was trained at Mvumi by the hospital to assist the unit , fortunately has gone for higher studies.

STONT POINTS:

I run the Eye clinic with no constraints comparing to other places now than before According to the WHO resolution on Vision 2020, Mara Region launched its programme on the 2020 resolution last year. Our Eye surgeon has his direct referral sites in all Mara districts as well as Bunda. Me as a District Eye Coordinator work well with him when visits our district.

WEAK POINTS:

No more necessary drugs are available now; formerly we have been getting them from CBM & Missionaries from MEDS Kenya. Lack of necessary equipments like a trial case ( frame , lenses) Magnifying loupe snellens’ chart, an ophthalmoscope and a separate room for Eye work ONLY. (This was also recommended by a member from MoH a few days ago). And the clinic should have been operating daily. Lack of transport to visit the direct referral sites and manpower (if possible one Oph. Assistant)

6.0 PREVENTIVE AND HEALTH PROMOTION ACTIVITIES:

Services started in February 1992. Major activities of this department include the following:

  • Group health education conducted daily
  • Registration weighing and individual health education for both mothers and children
  • Antenatal examination, advice, health education, HIV counselling and screening
  • Family planning
  • Outreach to nearly villages

7.0: SUPPORTIVE ACTIVITIES:

7.1:LABORATORY:

Laboratory staff consists of one (1) Laboratory Technician, 6 Lab. Assistants (one of them is undergoing on upgrading Lab Technician course at Bugando Medical Centre) and an attendant.

We have started going to Bugando hospital to collect safe blood for blood transfusion ( the system which has recently been launched by the Ministry of Health and Social Welfare) Whenever we go for safe blood, unscreened donated blood from relatives is taken to the Bugando Medical Centre Safe blood Service Centre for screening using a more sensitive accurate method.

Problems we encounter are:

  1. That, no special funds for going to Mwanza to collect blood this being not a revolving service. We usually fail to go for blood regularity because of lack of funds.
  2. Quantity of blood (units) especially the common used type (Group o) is very little and therefore doesn’t suffice our needs. (See appendix 7,1)

7.2: X - RAY:

We had one X- ray personnel till August 2006 when she went for upgrading. The department was thereafter an experienced attendant – Mr Julius Mkoma who worked tirelessly till April 2007 when a retired Radiological Assistant came to join us from Mwananchi Hospital Mwanza.

Ultrasound Services were conducted by Mr Revocatus Kato (who had gone for short course on Ultrasound) and Dr Kitigwa who took over whenever Mr. Kato was away ( see appendices Appendix 7,2)

7.3: PHARMACY AND INFUSION UNIT:

The pharmacy consists of the main store, sub store and dispensing room. The department used to be under Dr i/c but with effect from July 2006 the assistant to Doctor incharge is therefore the supervisor (incharge)

The staff consists of three pharmaceutical assistants, (one of them undergoing pharmacy. Tech. Course at Bugando Medical Centre) and one NO and a Health attendant ( having a one year course in Pre – Nursing) dispensing whenever there was a need.

The main sources of drug supplies are:

i)MSD – Mwanza

ii)Donations ( From Local and Abroad)

iii)Privatepharmacies – Mwanza and Musoma

iv)MEDS – Nairobi Kenya

The Infusion making plant continued to operate namely we produced Normal saline, Dextrose, Dextrose saline, Darrow’s solution. (See appendix 7,3)

7.4: MATRON’S OFFICE:

The office is headed by NO who is assisted by one NO. They share calls in order to organize the nursing staff, to solve acute problems and supply form stores items that unexpectedly get finished. She is also the incharge of the irregular functioning kitchen of the hospital.

7.5: TECHNICAL DEPARTMENT:

The technical department is busy with maintenance; all technical matters including electricity, motor mechanics, plant mechanics, Medical equipment, plumbing carpentry, machinery, painting etc

It is headed by a senior electrical technician. Other members of the team are two plumbers, one driver, one carpenter and one electrical technician.

7.6: HOSPITAL HOSTEL:

The hospital has a three (3) roomed house functioning as a hostel mainly for staff/guests. One has to pay Tshs 20,000/= (twenty thousands) for the whole house in one night (no catering services).

7.7: BICYCLE KEEPING(SECUITY) PROJECT:

The TANA (Tanzania Nurses Association) Hospital branch decided to start keeping relatives/clients bicycles to ensure their security. They charge 100/= per bicycle per visit and the money collected go to TANA’s account. Our clients have appreciated this service because previously they used to suffer from bicycle thief in the hospital.

8.0: INFRASTRUCTURE:

NLM/NORAD succeeded to complete:

a)A 12 all self contained roomed Private ward

b)2 residential blocks – each block occupying 6 people (2 rooms for one person)

9.0: VISITORS

The hospital was visited by...... people from within and outside our country:

  1. Eng. Joshua Z. Mgeyekwa
  2. Dr. Baluhya R.M
  3. Chandi Marwa
  4. Bisare Ngocho
  5. Rubanzibwa PRM
  6. Kyange, E
  7. Samson Lugaisa
  8. Joshua Mushdwa
  9. Jonathan Wang’uba
  10. Katibu Mkuu
  11. Sospeter Sagara
  12. Eng. Chiragwile J.CM
  13. SGT clephace alphonce
  14. PTE John Mazoya
  15. PTE yagulala Makoye
  16. PTE Philbanus Agalla
  17. [[TE Damstam Ndoba
  18. Rachel Marwa
  19. Gregory Mhamela
  20. CN Hamza
  21. Mrs Elizabeth Malele
  22. LoyLoy Thomas Sebaya
  23. Godwin Mwanzasu
  24. Mr. C. Silaa
  25. Heri S. Samillani
  26. Musami L. Mussami
  27. Koka, E.E.A
  28. Kisima M
  29. Josiah, a
  30. Kilanga P.J
  31. Isezo L.Isezo
  32. Paschal Sango
  33. Nkonoki. E.T
  34. Bunyinyiga
  35. ASP Kulule Siwingwa
  36. Joshua Mushendwa
  37. Amina sospeter
  38. Jonathan Wang’uba
  39. Mch. Rune Mahias
  40. Isezo L. Isezo
  41. Dr. Kitigwa CMJ
  42. Dr. Maziku M.S
  43. Flavian N. Chacha
  44. Jeremia B. Ngocho
  45. B.J. Mloere
  46. Sossy Munubi
  47. Ahmed Makongo
  48. Joseph M. Manyonyi
  49. Juma Kingo
  50. Mashauri JM
  51. Adelaida Masige
  52. Dr. Elibariki Mugulli
  53. Dafrosa J. Kidando
  54. Julieth aligawesa
  55. Thereza Nangale
  56. Isabela Kipesile
  57. Mawazo J. Kapesi
  58. Lucy Leonard
  59. Jackson Anyingisye
  60. Llllllllllllllydia eliudy
  61. Dr. K. Mugoya
  62. Tumaini Charles
  63. Dr. Vida Makundi Mmbaga
  64. Nzilenta P. Tizeha
  65. <Maria Keating
  66. Nicole Poole
  67. Samwel O. Sassi
  68. J.K.O Kaduga
  69. S. Margaret Ishengoma
  70. Josepha N. Marimbe
  71. Samsona Lugaisa
  72. Joshua Mushendwa
  73. Ask. Sospeter Sagara
  74. Matatiro Mwirinyi
  75. Jonathan Wang’uba
  76. Katibu Mkuu –DMM
  77. Chiragwirle J.CM
  78. Victora D. Sitta
  79. A. Mwakasita
  80. Revocatus Ntenga
  81. Mr&Mrs John F. Nyagabona
  82. Mch. Mussa E.B
  83. Jonathan Wang’uba
  84. Ian Sandvik
  85. Rune Mjolhus
  86. Dr. Theodore Tigahwa
  87. Dorah Mutasa
  88. S. Chogo
  89. Kristian Laland
  90. Eng. Josua L. Mgeyekwa
  91. Ntwa Mwandemani
  92. Ivar Tolo
  93. Robert M. Kaunda
  94. Lilla Vaggense
  95. Clement Z. Kwayu
  96. Richard Mwakatundu
  97. Jkenyon
  98. Gideon Mbalakai
  99. Jonathan Wang’uba
  100. Haiba aSaidi
  101. Chrisian E.R Kudilla
  102. Kristopher Hartwig
  103. Mary Emmanuel
  104. Mereciana Mhanusi
  105. John Yona Nhungo
  106. Ask. Sospeter Sagara
  107. Sarah Ringo
  108. Mtatiro mwin\ringyi
  109. Jonathan Wang’uba
  110. Chiragwile JCM
  111. Gibson Mollel
  112. Saguti, F.L
  113. Rev. Okully K. Mwanga
  114. Samson Lugaisa
  115. Rev. Mussa E. Bigambo
  116. Saara ;airrjamen
  117. Tomes Bengtson
  118. Anna Marie Egiland
  119. David Smatana
  120. Rune Mjolhus
  121. Marietha Haule
  122. Jennie Honland, MD, MPH
  123. Rachel Siegl
  124. Dorothy Don
  125. Madoro E.M. Max
  126. Rune Mathias Mjolhus
  127. Rev. Simon Mantago
  128. Dr. Henry Yoggo
  129. Irren W. Clore
  130. Kassi, Tumpale
  131. Inger Schiere Johana
  132. Bodil Kjolm
  133. Mognhilel N. Ostertun
  134. Ask. Sospeter Sagara
  135. Mch. M.E.Bigambo
  136. Monila E. Moyo
  137. Felix Kagisa
  138. E.M. Mwai
  139. A. Oluma
  140. G. Joshua
  141. Robert M. Kaunda
  142. John Massoro
  143. Dr. Geofrey N. Sigalla
  144. Mavere Tukai
  145. Claudie Gasana
  146. Essau Amenye
  147. Dr. S. Gendo
  148. E. Silaa
  149. H. Samillani
  150. Mch. Mussa E. Bigambo
  151. Pascal Karomba
  152. Bituro T.D.Nickson
  153. Hamisi H. Chuwa
  154. Sospeter N. Sagara
  155. Mratiro Mwirinyi
  156. Jonathan Wang’uba
  157. Mch. M.E.Bigambo
  158. Samson Lugaisa
  159. Zakaria Nkya
  160. Wensaa Muro
  161. Jonathan Wangu’uba
  162. Tuloson B.N
  163. H. Chilemo
  164. Ramadhani amairi
  165. Dr. L.B. Mtani
  166. Prof. A.L. <a;;ua
  167. Dr. J.A. <mdp;wa
  168. Yohana Sehaba
  169. Lecotitia Lyimo
  170. Labbi Magese
  171. Deodatha Mugishi
  172. Fabian Fundi
  173. Ernst A. Rettedal
  174. Kashaga Edgar
  175. Dr. Deogratias M. Soka
  176. Kelvina haule
  177. Renatus Masanja
  178. Masunga L. Maduhu
  179. Rose M. Ruge
  180. Makuma JBF
  181. Dismas Simuda
  182. Magfalena Kiango
  183. Guri G. Vespestad
  184. Ask. Sospeter Sagara
  185. Eng. Chiragwile, J.C
  186. Gibson Mollel
  187. Dr. Kitigwa CMJ
  188. Rev. M.e Bigambo
  189. Isilimura, \FRM
  190. Dr. Makunja AJ
  191. Dr. Sekilasa
  192. Dr. S. Gemdo
  193. Lllllweyo Jremeia
  194. Msekwa Malaugu
  195. Joseph Matera
  196. Salum Ogigo
  197. Mrigo James
  198. Senyael M. Urasa
  199. Nyanda O. Sweya
  200. Mch. Mussa E. Bigambo
  201. Pendo Nyanda
  202. Denis Mwalongo
  203. Steinar Aassland
  204. Else Marie Voll
  205. Dr. Zubeda Ngware
  206. :ogjtmess <assai
  207. Alex I. <saila
  208. Koka, E.E.A
  209. :Layon FM
  210. A. Masige
  211. <irpgprp C.B
  212. Frederique M. Payton
  213. Dr. Magdalina songora
  214. Asapa J. Nyeremba
  215. Dr. Clepinus B. Rugakingira
  216. Dr. Jacquilline Kato
  217. Dr. Materu
  218. Aken Mbaga
  219. Benynice allen
  220. \Ask. Sospeter Sagara
  221. Rev. E.M. Bigambo
  222. Jonathan Wang’uba
  223. Eng. Chiragwire,JCM
  224. Dr. Kitigwa CMJ
  225. Joshua Mushendwa
  226. Longinus biseko
  227. Anna K. Mwijage
  228. Dr. J.M.Khan
  229. Kumbi Juma
  230. Baraka Makowe
  231. Agness Rubane
  232. Harne J. Mwankenja
  233. Ismaiel N. Kangej
  234. Nathan L. Mollel
  235. Emmanuel Ridhard
  236. James M. Boyi
  237. Yohana K.T Mkwizu
  238. V. Mdeng’a
  239. Christian Kudilla
  240. Ask. Sospeter Sagara
  241. Rev. M.E. Bigambo
  242. Jonathan Wang’uba
  243. Mtatiro Mwirinyi
  244. Eng. Chiragwile, J.C.M
  245. Dr. Kitigwa CMJ
  246. Gibson Mollel
  247. Mobini Sanga
  248. A. Makongo
  249. Martin thambikeni
  250. Chiku A.S Gallawa
  251. Dr. Gawa Lucas
  252. Rev. Heslon L. Byangwamu
  253. Rev. M.E. Bigambo
  254. Alexander N. Chiyo
  255. Rosemary Aaron
  256. Jhn Pemba
  257. Mobini Sanyu
  258. Joseph Manyonyi
  259. Dr. H. Bisanda
  260. Rose Iumbo
  261. Dr. J.M Khan
  262. H. Chilemo
  263. G. Lukonge
  264. Sylvia S. Mungure
  265. Harne John Mwamkanja
  266. Deusdedith S. Shija
  267. Dr. Kiberiti
  268. S.,atamdolp
  269. Ask. Sps[eter Sagara
  270. Katibu Mkuu – DMM
  271. Samson Lugaisa
  272. Jonathan Wang’uba
  273. Eng. Chiragwire
  274. Joshua Mushendwa
  275. Redidulf Lillebo
  276. Elizabeth Wandau Murai
  277. Rigeun Gjerdy
  278. Ina Murai
  279. Rura shodji
  280. Daniel Mwema
  281. David Mulke
  282. Gunnar Hamnq
  283. Wilson Marie
  284. Johanes arktins
  285. Kirsha Underland
  286. Ophelia Hascarenhas
  287. Paschal Masatu
  288. Alistidia Philipo
  289. Richard R. Leo
  290. Ernestina Malyamuhindi
  291. Bakari Msulwa
  292. Madoro M. Max
  293. Muse Mwisawa
  294. Jenny Willingham
  295. Victoria Rendle
  296. Vigoga Ananson
  297. Michael Wienchol
  298. Henry Sanmeshed
  299. Sedekia Yovitha
  300. Gideon Mgweno
  301. Dr. Mtebe Majaigo
  302. Sarah Ramirez
  303. Mashauri JM
  304. Kateire VM DLT
  305. Dynes Lyimo DRCH
  306. Dr Protas Ndayanga
  307. Steven Tilubuza
  308. Dr. Mtebe Majigo
  309. John Massoro
  310. Dr. Mashinji Vincent
  311. Fadhili E. Majimbwi
  312. Roman V. Mallya
  313. Rev. Sospeter Sagara
  314. Mch. M.E. Bigambo
  315. Mtatiro Mwirinyi
  316. Rev. Mantago simon
  317. LT (Rtd) Lazaro Ndossi
  318. Zipora Kaijage
  319. MCH. Mussa E. Bigambo
  320. Mchg Simon Matago
  321. Askofu Sospitar Sagare
  322. Ronny Haland
  323. Hirwid Krogedod
  324. Jan Furika Vuruguand
  325. Lars Skjaidand
  326. Kjartan Rob
  327. J.N.Marimbe
  328. Dr Mtemlachi
  329. Dr Linda Turner
  330. Dr Maruy Rose Giattas
  331. Elese Jensa
  332. Brieget Komte
  333. Dr Mascinja C.H.
  334. Dr .S.Gendo
  335. Micahael Mewshaw
  336. Robert Kibwana
  337. Bingile Mkandya
  338. Oliech E.R.
  339. Bob de Wolte
  340. Caniela Abaye
  341. Protas Ndaylgh
  342. Vincent Mashinji
  343. Slavius Chogo
  344. Lydia Tiigwera
  345. Ngollo Ngusa
  346. Stanslaus Charles
  347. Christian E .P.kudila
  348. Mch Ragigy
  349. Heri Mchunga
  350. Dr.S.Gendo
  351. Chiku Gallwa

EPILOGUE AND ACKNOWLEDGEMENT