Victims of “Tanzanisation”

In 1999, the long-standing partnership between SolidarMed and the Catholic Church in Tanzania fell apart. At its core, the conflict revolved around the “Tanzanisation” of St. Francis Hospital: who was in charge, who owned the hospital and what it should do. The victims of this traumatic episode were two Tanzanian doctors, Dominik Mboya and Kafuruki Shubis. The story of a rift. 

At the St. Francis Hospital in Ifakara, Tanzania, founded by the Swiss Capuchin Mission, the actors of Swiss development aid determined fundamental questions regarding the hospital’s management and medical focus. SolidarMed sent Swiss doctors who took on the medical leadership.

In the mid-1980s, these certainties and dependencies began to crumble. The Swiss Agency for Development and Cooperation (SDC) and numerous doctors motivated by development policy questioned the “neo-colonial structures” and advocated a gradual handover of responsibility to Tanzanian doctors, known as Tanzanisation. 

Two doctors who experienced this new approach first-hand were Dominik Mboya and Kafuruki Shubis, both trained in Ifakara. Kafuruki Shubis took up his first position at St. Francis in 1981 and quickly climbed the career ladder: he took over as head of the surgical department and was deputy medical director of the hospital between 1997 and 1999. Dominik Mboya joined St. Francis Hospital in 1986. Like his friend Shubis, he quickly rose through the ranks. First as head of the department of internal medicine, then as head of the diagnostics department and the medical audit panel.

“Tanzanisation of the hospital was communicated carefully and implemented step by step,” says Kafuruki Shubis. But the people in the Ifakara area associated the white doctors with quality medical care. One person who found the idea of Tanzanisation somewhat suspect was, of all people, the owner of the hospital, Bishop Agapiti Ndorobo. It was only through pressure from the SDC that he was persuaded to fill the vacant post of chief physician with a Tanzanian. The choice fell on Patience Kibatala. He was the son of Laurenti Kibatala - one of the most important figures in the Catholic parish. 

Kibatala's dip into hospital coffers finally led to the breakdown of the partnership between SolidarMed and the Catholic Church. A receipt with an obviously falsified exchange rate showed that Kibatala had enriched himself by thousands of dollars. Local SDC staff demanded his immediate dismissal, and the SDC and SolidarMed threatened the bishop with the withdrawal of support funds if Patience Kibatala remained in his post. 

Bishop Ndorobo backed his chief physician, considered the demand to be interference in the internal affairs of the Church and accused the SolidarMed team and other employees of cold-hearted slander. The situation escalated in a crisis meeting. “To hell with your money,” Bishop Ndorobo's voice boomed. SolidarMed was expelled from the hospital. The partnership ended in 1999.

For Kafuruki Shubis and Dominik Mboya, the conflict had personal consequences. The bishop suspected the two doctors of being the actual instigators and beneficiaries behind the conflict. The dispute escalated even further: Bishop Ndorobo filed a complaint with the police, accusing Dominik Mboya, Kafuruki Shubis and district doctor Fred Lwilla of attempting to murder him and Patience Kibatala. After a thorough investigation by the police, the accused were cleared of the serious charges. However, they were denied the opportunity to continue working at St. Francis Hospital. “We were the real victims of the Tanzanisation policy,” says Kafuruki Shubis.