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THE UNITED REPUBLIC OF TANZANIA
MINISTRY OF HEALTH AND SOCIAL WELFARE
CLINICAL OFFICER TRAINING COLLEGE – MTWARA
COMMUNITY FIELD WORK REPORTHELD AT
MBAWALA VILLAGE.
PREPARED BY; 2ND YEAR COTCMTWARA STUDENTS
Neema K Duma
Oscar Hologo
Ezra Lungwa
Atuganile Mwansasu
Moshi R Moshi
Hassan M Hassan
PREPARED TO;ACADEMIC OFFICER, COTC MTWARA
© 27th April 2014

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TABLE OF CONTENTS
Background and Acknowlegement…………….. (i)
Introduction……………………………………, (ii)
Abbreviations………………………………….. (iii)
Field work Objectives………………………….. 1
Findings and Interventions…………………….. . 2
Conclusion/Recommendation……………………3

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Acknowledgement
We are sincerely gratefultoour academic officer Dr Ramadhani, Dr
Shengena, Dr Nandi, Mama Pila, Mr Mwakilema and Mr Abbasi, for their good
support in finding good areas for field, constructive, critics and encouragement
during preparation and supervision of this field work.
Our appreciations arealso directed to theadministrationof COTC MTWARA
under our PrincipalDr. Fabian Mghanga for supporting and their contributionin
assisting us in preparation and conduction of our field work.
Also we would like to give special thanks toour warden Dr Don Mlelwa
for his generaloverview on how to performfield work.
Specialthanks goes to In chargeof Mbawala Dispensary:-
Dr. Saraphina Josephat(Dr in-charge)
MwanaidiChibwana (Sr./nurseincharge),
Mr. Salum S Chipatu (MedicalAttendant)
SalumMfaume(HBC)
and all other staff members for their care, hospitality and good cooperation and
participation in thewhole field work activities, including Community Leaders
such as:-
Yusuph Liyoko(Chair person on Health Committee)
Venas Kihamba (VillageExecutiveOfficer) and all community members.
Also were are gladly to give specialthanks toDr. Edward Nzigilwa and Mr.
Ramadhani for their knowledgeon computer use.
Lastly we thank ourselves, for having good interpersonalrelationship and
cooperation.

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Background
Mbawala dispensary is about 150metres from Newala road, it`s accessible
for all the seasons of the year.
Mbawala dispensary established in 2002 with their efforts of mbawala community
members and aid from AMREF as well as ukaid, it started to provide health
services with one health care provider, at that time mbawala dispensary was
responsible for providing health care to few villages such as Mbawala, Mduwi and
Nachenjele.
Currently Mbawala dispensary expanded in terms of providing health care
services for about six villages and increased number of health care providers to
about four staff members,
The dispensary has two blocks, one health worker’s residentand the restone
block for administrativeduties and care of patients.
The block for health worker’s residenthas two sides one for the doctor incherge
and the other side for nursing. In each side of the block there is two bedrooms, a
toilet, kitchen and one tank for water reserve.
Mbawala villages successes to establish Health committee under chair person
Yusuph Liyoko and secretary Dr. Saraphina – inchargeof mbawala dispensary and
other community members.

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Abbreviations
 ALU = Artemether Lumefantrine
 AIDS =Acquired Immunedeficiency syndrome
 ART I= Acute Respiratory Tract Infection
 AFB = acid fast bacilli
 ASA = Acetylsalicylic Acid
 CHF = Community Health Fund
 COTC = Clinical Officers Training centre
 CTC = Care and Treatment Clinic
 HMIS = Health Management Information System
 HIV = Human immune deficiency Virus
 ITNs = Insecticides Treated Nets
 IPT= Intermittent preventive therapy
 MOHSW = Ministry of Health and Social welfare of Tanzania.
 MSD = medical store department
 MTUHA = Mfumo wa Taarifa za Uendeshaji wa huduma za Afya
 mRDT = Malaria rapid diagnostic test
 MUAC = mid upper arm circumference
 OFC = Occipital frontalcircumference
 OPD = Out patient department
 PITC = Provider initiative test and counseling
 PPF= procainepenicillin fortified
 RCH = Reproductive child health

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 SP = salfadoxine pyrimethane
 STIs =Sexual transmitted infections
 STDs = sexual transmitted diseases
 TB = Tuberculosis
 UTI = urinary tractinfection
 VCT = Volunteer counseling and testing
Introduction
Mbawala village is about 25km away from Mtwara Town, it is the union of six
villages which are Mmwindi, Nachenjele, Mihembe, Mduwi, Mailikumi, and
Mbawala.
It is approximately to have about 6815 of people in the year 2013/2014 and it
has only one Dispensary which is known as Mbawala Dispensary.
Mbawala Dispensary is located at Mbawala village,where by it provided health
services to the people from all six villages of Mbawala.
APPROXIMATELY POPULATION OF MBAWALA VILLAGE IN 2013/201
NAME OF
VILLAGE
No OF
PEOPLE
>5YRS >1YR PREG ABORTION SVD
MBAWALA 1540 308 62 62 54 49
MMWINDI 1311 268 52 52 46 42
NACHENJELE 1287 257 57 51 45 41
MIHEMBE 853 171 34 34 30 27
MDUWI 920 184 37 37 32 29
MAILIKUMI 904 181 36 36 32 29
JUMLA KUU 6815 1369 278 272 239 217
4
The common diseases affecting the habitat of Mbawala villages as Top Ten
diseases established from March 2013 to April2014 from MTUHA books are
Malaria, ARTI, Pneuomina, Acute Diarrhoea, Eye Infection, UTI, Anaemia,Worm
Infestation, Broncho Asthma and Wounds.
Also it offers some laboratory Investigations such as mRDT for Malaria.
The common drugs used are Inj Quinine, Tabs ALU, Tabs Paracetamol, Tabs
/syrup Co-trimoxazole, Tabs ASA, Inj PPF, Tabs Metronidazole, Doxycycline

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capsules, Haematenics such as Folic acid and Ferrous Sulphate pills,
Amoxicillin capsules, and Inj X-Pen.
Mbawala dispensary divided into different department such as OPD, RCH
clinic, CTC clinic, drug dispensing room, injection room, store, vaccination room
TB clinic and Delivery room.
COMMUNITYFIELD WORK OBJECTIVES
Community field work objectives are to;
Identify health problems in the community
Plan interventions for solving community health problems
Conducthealth education and health promotion activities
Asses nutritional status of the children
Perform simple disease survey
Practice administrative duties of dispensary in collaboration with the
dispensary in-charge

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COMMUNITYPROBLEMS IDENTIFICATIONAND INTERVENTIONS
In our field work at Mbawala village, we were able to do some meeting with few
people from two villages (Mbawala village and Mduwi village) among those six
villages. We were able to find out the problems facing them, as weel as
follows:-
Water; In Mbawala village water is available to the community where by its
obtained from the taps but not all the times as well as from the wells. Due to
that, it found unsafe drinking water, and result to water born disease for example
skin infections and diarrhoea.
Due to that problem we were able to provide health education on how to
protect sources ofwater suchas water wells and importance of using protected
and treated water and ways on how to treat their water from being free from
organism/germs by doing the following;
Boiling method; Water should boiled before drinking as this helping killing of
germs found in the water.
Using three pot system; as this enabling the filtration of water and made it safe
for usage and finally to put Water guard on their water before drinking as this
helps the killing of germs found and make it safe for usage.
Problem of not using treated nets; This is another problem facing the
community of Mbawala where by the people are having poorbeliefs concerning
the use of treated nets when sleeping by believing that it causing impotence for
men and instead they use their nets to protect their crops from insects and the
results endanger their health and cause disease such as Malaria to the
community. Most affected are pregnant women and children under 5years.

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Due to this we advised them the importance of sleeping undertreated bed nets
so that to prevent them from Malaria and also the use of Malarial prophylaxis for
pregnant women by giving SP as IPT.
Also the problem of Local beliefs which facilitate early involvement of sexual
activities as a result of transmission of STIs and early pregnancy; young girls
and boys were brought on unyago and jando whereby they taught on big matters
above their ages.
Due to this, we were able to educate society that they should teach things which
are on their level and not otherwise.
We provided health education concerning the
STIs, and STDs, and the ways of protecting and preventing them such as;
;
Abstainance; we advised youth to delay in sexual activities before right time.
Condoms;To ensure proper use of condombefore and after coitus as well as
good disposing. Use one condomfor every single intercourse.
.
Being faithful and having only one safe sexual partner.
Lack of awarenessonHIV/AIDS and TB;We have found that many
people have misunderstand concerning HIV/AIDS and TB due to lack of health
information. So we provided adequate health education on
the issue of HIA/AIDS for their meaning, symptoms, signs, the ways of
transmission, treatment and supportive care treatment at home. How non-HIV
people live and share other things with PLWHIV/AIDS, for discouraging the
stigma and Discrimination and we encouraged testing and counseling, hence we
performed PITC and increased number for VCT.
But still HIV/AIDS affects pregnant women as they experienced difficulties
situation at their place they live due to discrimination and stigmatization and
even abuse language from their relatives and even their husbands. Thus we tried
much to reduce that stigma and discrimination as well as encouraging women to
report at the clinic with their husbands as early during pregnancy for further
counseling. We assisted to HIV pregnant women to start clinic at CTC as soon
as possible for PMTCT by giving ARVT and ensure compliance with good
suuportive therapy at their homes.
Also we provided health education on TB, on meaning of TB, symptoms, signs,
ways of transmissions, Treatment and supportive treatment at home. For

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assuring that patients with TB can be treated and cured as well as having good
compliance.
Insufficient medications. Therewerescars of drugs in the
dispensary which madesome difficulties in our attempt to help client as some
times due to this patient thoughtthat we are hopeless to them. We managed
to advice people whatis reality and insist them to contribute in CHF to reduce
the discrepancy of drug availability in their dispensary
NUTRITIONAL STATUS OF THE COMMUNITY
Working at Mbawala dispensary we had a chance to assess nutritional status
of children under five years of age. Where 130 children were selected randomly
from a group of childrens reported at the dispensary for their monthly visit using
simple random technique. From these childrens we assessed the following;
MUAC, OFC, Weight for age, height for age and weight for height.
The followings are Data collected
From the total of 130 children, girls are 86 and boys 54.
The data obtained has the interpretation as follows;
Weight for age: Normal = 73
: Underweight =47
: Overweight = 10
Height for age: Normal = 58
: Abnormal = 72
MUAC : Normal = 92
: Over = 28
: Under = 10
MONTHLY CASES REPORTED OF CHILDREN WITH
MALNUTRITION FROM JAN 2013 –APR 2014 AT MBAWALA DISP
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Practice administrative duties of dispensary in collaborationwith the
dispensary in-charge
We learnt administrative duties suchas division of labor, filling
HMIS/MTUHA lager books for record keeping and running the dispensary as well
as attending patients at OPD and prescribing medicines. With this also we had a
chance to know how to receive and dispense drugs and how to write referral letter.
We learnt how to fill RCH card number 4 and 5 on RCH clinic in monitoring
progress of wellbeing of the fetus and pregnant women, and counseling and family
planning respectively. And we had delivery about seven pregnant women by SVD,
and among them only two experienced complications such as placenta preavia
which was total and PPH. Case of placenta preavia was referred to the regional
referral Ligula hospital for further managements. ForPPH were able to manage at
our dispensary but was referred to Ligula hospital for BT.
Also CTC cards no1 and no2 and how to attend HIV patients ant to give ART.
These done under supervision of our dispensary incharges.
We learn social and cultural life in the village. There were various foods
which for the first time we saw them there. This made us experience new things in
life.
We learnt how to live in groups and the importance of team working. As we
were five we live as a single family and managed to share thoughts, notions, ideas
and grievances all the time to solve encountered challenges and come up with
relevant and appropriate decision according to the need arise.
We had an experience on the need and importance to know and being
exposed in different ways of living and in different areas as one can appreciate the
reality in life and be courage that any where provided people are living there is
possibility of earning life and having a gainful income to run the future.
N B R R Y N L G P
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T V C N B R R
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CONCLUSION/RECOMMENDATION
A trip to Mbawala was a successfuland helpful part of learning as it made
us in position to practice and experience the actual life that will be part of our
life in future. We again like to thank the administration of MTWARA COTCand
Mbawala people for their contribution that make us attempt our duty
Due to the problem stated above, the government should enable and supportfor
providing health education and formulated slogans which will lead to behavior
changes to the community so as to improve and control over their health status.
water should be treated before being distributed to the community for
usage
Also should reduce the price of the water guard to the amount that can be
affordable to the people or if possible should give freely to the
community.
Since their environmental well maintained, so government thorough the
environmental health officer should give some supportin order to
maintain that condition by individually or/and community as well.
MSD should increase drug supply to the hospital inorder to fulfill the
demand of the society.
Also MoHSW should expand the laboratory and its equipments inorder to
perform many investigations such as X-R, FBP, B/S for malaria parasites,
AFB, RBG/FBG, Urinalysis and Stoolanalysis microscopically, as well as
Hb estimation
Government should improve and repair the buildings, in order to facilitate
provision of good health services.