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1.0 INTERNAL MEDICINES

Internal Medicine department is among the major 13 clinical departments at Muhimbili National Hospital. Forty percent of the admissions per week are admitted in medical ward. Many of these patients are referred from the surrounding hospitals or regional hospitals, a few are self-referrals.

Internal medicine department has bed capacity of 210 beds; total admission per day is about 40-60 patients. The number of the wards within the department are ward 3, 4, 5, 6, 7, 8 TB ward and ward 1 which is high dependence ward.

1.1 Clinical Services

The Internal Medicine department also takes great pride in providing unparalleled comprehensive and innovative patient care. Each of the Department’s subspecialty practices are recognized as programs of local, regional and national distinction because of their novel diagnostic and therapeutic patient care offerings. It performs approximately 156,000 procedures encounters to the inpatients at and sees over 300,000 patients in outpatient clinics each year. Each section of the department has its own subspecialty clinics and consultation service.

1.2 Clinical Teaching

The internal Medicine department in collaboration with Muhimbili University of Health and Allied Science (MUHAS) is known for its excellent undergraduate and residency program in Internal Medicine. The Residency Training Program is the premier educational component of the department. The program offers clinical training in an academic setting. The educational mission of the Department continues to train exceptional healers and the future leaders in academic medicine.

The success of our education and clinical care missions are in large part due to our large and varied patient population. Muhimbili National Hospital serves as a tertiary referral setting for intriguing and often unique patient populations. Our goal has been and continues to provide a program dedicated to excellent teaching while providing the highest standards of clinical care. An added benefit of our education program is the opportunity to provide a significant portion of the clinical teaching for students enrolled in Muhimbili University and Allied Health Science clearly one of the premier medical schools in the Republic of Tanzania.

1.3 Research

Internal medicine department at Muhimbili National Hospital provides research opportunities for trainees interested in a career in academic medicine and clinical medicine. The Department has special expertise in research in the following thematic areas in Infectious disease, Pulmonology, Gastroenterology, Diabetes and endocrinology, Nephrology, Neurology, Hematology and Dermatology.

1.4 Patient Care

The Department of Medicine takes great pride in providing unparalleled comprehensive and innovative patient care. Each of the Department’s subspecialty practices are recognized as programs of local, regional and national distinction because of their novel diagnostic and therapeutic patient care offerings.

1.5 The Department’s Division

The Internal Medicine department at Muhimbili National Hospital is organized into 12 sub units which are:- Respiratory, Diabetic, Gastroentorology, Nephrology, Neurology, Dermatology, Rheumatology, Geriatric, Hematology, Oncology, Health check and Infectious clinic, (HIV and STI clinic and TB clinic which is conducted at IDC). The Department also offers private services including inpatient and out patients. The sub units are comprised of many outstanding leaders in their respective professions with regional, national and international stature.

1.5.1 Pulmonology /Respiratory Unit

We are dedicated to providing excellent care for patients with critical illness, lung diseases. We are proud to offer state-of-the art medicine within the guiding principle of CuraPersonalis: “care for the entire person”. Our physicians are deeply committed to our mission of high quality patient care with dual goals of top quality academic medicine and research.

1.5.1.1 Patient Care

Respiratory unit is responsible for taking highly super specialized respiratory care to both in and outpatients.

In the outpatient arena, we have specialty clinics in Bronchiectasis, Pulmonary Hypertension, Sleep Disorders, Chronic Obstructive Pulmonary Disease, Asthma, Multi-Disciplinary Thoracic Oncology, sarcoidosis, sleep disorders, pulmonary hypertension and infectious lung diseases. These clinics are supported by state- facilities such as: Pulmonary Function Laboratory, Exercise Laboratory, and Bronchoscopy Suite. Other activities done in this unit are Nebulization of patients, taking pleural biopsy, pleuralcentesis and inhalation training via spacer.

1.5.1.2 Education

Within our mission of Academic Medicine, we are committed to providing excellent patient care and training future doctors.

1.5.1.3 Bronchoscopy

We perform specialized diagnostic and therapeutic techniques, in addition to standard video-assisted flexible bronchoscopy. Interventional Pulmonology Our interventional pulmonologists are experts in complex procedures necessary to alleviate airway obstruction and to treat pleural disease, including argon plasma.

1.5.1.4 Pulmonary Function Laboratory

Pulmonary Function Tests (PFTs) are done to measure lung volumes and flows by body plethysmography and spirometry, respectively, and to determine diffusing capacity. Airway resistance and respiratory muscle force measurements, methacholine challenge testing, oxygen saturation, and arterial blood gases are also performed in this lab. Our pulmonologists may order any combination of these tests to determine the cause of respiratory problems.

1.5.1.5 Pulmonary Hypertension Program.

This is a comprehensive care program for patients with pulmonary hypertension. Sleep Disorders Center Our Board-Certified Sleep Specialists evaluate and treat patients with sleep apnea, snoring, parasomnias, insomnia and other sleep disorders. Our Sleep Laboratory provides full polysomnography, CPAP and BiPAP titration, mask fittings, MSLT and MWT. Four channel ambulatory recordings are also performed.

1.5.2 Gastroenterology Unit

With nationally and internationally known experts in endoscopy and gastroenterology, and the knowledge and expertise that comes from physicians that perform approximately 4,000 procedures annually, the Division of Gastroenterology at Muhimbili National Hospital offers the most advanced diagnostic and treatment techniques available.

1.5.2.1 The unit performs the following activities

  1. Clinical Services.

    For In-patient services there are 16 beds for both male and female, 2 major ward rounds per week (Tuesdays 9am- 1pm & Fridays 9am- 1pm)and for Out-patient services there are General Gastroenterology clinics (Wednesdays 9:00am- 1pm & Thursdays2pm- 4:30pm), Hepatitis clinic (Mondays 2pm- 4:30pm), IBD/Colorectal clinic (Fridays 2pm- 4:30pm), Surgical GI review clinic (Tuesdays 8am- 1pm) and Gastro IPPM (Mondays-Fridays)as per specialist schedule.

  2. Endoscopy Services:

    These are on daily basis from Monday to Friday 8am – 2pm; on call services for emergency endoscopy: 2pm-> (Monday –Friday) and 8am-> (Saturday & Sunday), Diagnostic endoscopy - Upper and Lower GI, Therapeutic endoscopy which includes - Haemostatic control for GI bleeds (sclerotherapy, ligation and coagulation), Polyp removal (Polypectomy), Percutenous Esophageal Gastrotomy (PEG) Insertion, Esophageal Dilatation and Stenting and ERCP that includes CBD stone extraction & Biliary stenting.

  3. Imaging Services:

    These are Ultrasound services (at the Gastro Centre) Diagnostic and Guide biopsies and CT scan, MRA, MRCP} Integrated with Radiology Department.

  4. GI Functional Studies:

    (On process to be established) that include 24 hours Gastric PH impendence monitoring and Esophageal and Anorectalmanometry.

  5. GI Specialized Laboratory Studies:

    ( On process to be strengthened) include Histopathology for GI conditions, Seromakers for GI infections, Autoimmune Diseases and Tumors, Quantitative assays for Hepatitis B and C and GI Hormonal and Enzymatic assays.

1.5.3 Endocrinology and Diabetes Unit.

The Unit of Endocrinology & Metabolism is dedicated to the diagnosis and treatment of diabetes and other endocrineand metabolic disorders, conducts basic and clinical research on hormone-related diseases, and trains medical student both undergraduate and postgraduate.

The Division of Endocrinology and Metabolism provides consultative, diagnostic and therapeutic services for the full range of endocrine problems. Our doctors specialize in the management of thyroid disorders, diabetes, pituitary disorders, adrenal disorders, and disorders of male and female hormones.

Diabetes outpatient clinic receives referrals for newly diagnosed and existing diabetic patients and offer a long term follow up service including the screening for and treatment of chronic diabetic complication.

Guiding Principles

Integrity

MNH has a social responsibility to improve the health of future generations. Guided by fundamental ethical principles of access and equity and in compliance with related laws and regulations, MNH will work with integrity in the pursuit of high quality clinical services. Respect Our patient and our workforce are our greatest resources. We are committed to a patient centred hospital environment and workforce built on respect for diversity, trust, communication, and institutional teamwork at all levels within the organization. .

Respect

Our patience and workforce are our greatest resources. We are committed to a patient centred hospital environment and workforce built on respect for diversity, trust, communication and institutional team work at all levels within the organization.

Quality

MNH will accomplish objectives by using all available resources to continually ensure best value for patients and stakeholders. This strategic planning process directs available resources to achieve strategic goals in the most cost effective manner. MNH shall collaborate with the Ministry of Health (Government), Muhimbili University College of Health Sciences (MUHAS), Muhimbili Orthopaedic Institute (MOI), Ocean Road Cancer Institute (ORCI), the Dar es Salaam Municipal and other referral hospitals to deliver the highest quality services within existing resources.

Security

MNH is committed to ensure the security of the Hospital. MNH will work proactively with patients, employees, and Hospital security officials to maintain a secure work environment for patients, staff, and Hospital assets.

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