Elias Sempindo, 72, thought he would spend his twilight years doting on his grandchildren; instead, the retired medical officer is back treating patients at a clinic in Morogoro, 190km west of Tanzania's commercial capital, Dar es Salaam.
"When I first served as a medical officer, I used to deal with ordinary diseases, but today I am dealing with HIV/AIDS and tuberculosis, which are very complicated," he told IRIN/PlusNews at a clinic in Morogoro. "I can't pretend it is easy, but it is what I have to do... it is a calling."
Sempindo, a clinical officer who retired in 1992, is part of a pilot project, "Retired but not tired", run under the Tunajali - Swahili for “we care” - programme by the NGO, Family Health International (FHI) and accounting firm Deloitte, funded by USAID.
“The increased uptake of HIV counselling and testing brought about by increased HIV/AIDS awareness campaigns has come with increased pressure on government health facilities," said Elisanguo Shao, director of the project. "If we have been that successful in encouraging people to go for HIV testing, then we must also find ways of ensuring they are treated."
As many as 1.5 million Tanzanians are HIV-positive; close to 300,000 are currently on HIV treatment, says the government.
According to the World Health Organization, Tanzania has one of the worst physician-to-patient ratios in the world, with just 0.02 doctors and 0.35 nurses and midwives per 1,000 people.
"Tanzania has a relatively young retirement age and this means many of those retired still have the energy and the skills to serve in various sectors, including the medical sector - this is the opportunity we have utilized within the retired officers' programme," said Dr Eric van Praag, FHI Tanzania country director.
Tanzanian health workers now retire at the age of 60; until 1999, they retired at 55.
Easing the burden
FHI facilitates the employment of the retired workers but they remain government employees and are recruited through government systems. Once employed, their pensions are suspended; they earn about 10 percent more than they would if they were directly employed by the government.
They work exclusively in HIV care and treatment clinics, freeing up regular medical staff to handle other illnesses. According to Shao, nearly half of all hospital visits in Tanzania are HIV-related.
"We train them in different aspects of HIV care, management and treatment so that they are up to speed with current requirements in managing the disease and other opportunistic infections that come with it," he said.
"They have greatly relieved staff and they have also imparted skills because they have the experience," said Meshack Massi, Morogoro regional medical officer. "They are a source of motivation to younger staff; now HIV patients and others do not have to wait for long to be served."
New challenge
For many of the older health workers, returning to work has been a refreshing change. "I think I made the best decision... I am delighted to see we are a source of encouragement for others," said Martha Ng’habi, a nurse at Morogoro hospital. "The desire to serve gives the strength to go on, even when your age is advanced."
So far, the pilot project – undertaken at the government's request - has hired 30 clinical officers and nurses in five regional hospitals in Iringa, Dodoma and Morogoro, areas with some of the highest HIV prevalence levels in Tanzania; the five facilities have more than 5,000 HIV-positive people under their care.
"Initially, the response wasn't overwhelming because many of these retired people resort to a quiet life and others join agriculture or they just want to run their businesses after retirement, but we have managed to get some of them," Van Praag said.
Expansion
Following the success of the pilot, the Tanzanian government has directed regional authorities to put aside funds to re-employ retired health workers to manage HIV care and treatment centres.
"The government is very enthusiastic about the programme and it will put money aside in its health budget to continue this programme once the donors and other private stakeholders pull out," Shao said.
"The government further has promised to recruit more healthcare workers and there are plans to increase the retirement age to deal with the health worker shortage," he added.
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"When I first served as a medical officer, I used to deal with ordinary diseases, but today I am dealing with HIV/AIDS and tuberculosis, which are very complicated," he told IRIN/PlusNews at a clinic in Morogoro. "I can't pretend it is easy, but it is what I have to do... it is a calling."
Sempindo, a clinical officer who retired in 1992, is part of a pilot project, "Retired but not tired", run under the Tunajali - Swahili for “we care” - programme by the NGO, Family Health International (FHI) and accounting firm Deloitte, funded by USAID.
“The increased uptake of HIV counselling and testing brought about by increased HIV/AIDS awareness campaigns has come with increased pressure on government health facilities," said Elisanguo Shao, director of the project. "If we have been that successful in encouraging people to go for HIV testing, then we must also find ways of ensuring they are treated."
As many as 1.5 million Tanzanians are HIV-positive; close to 300,000 are currently on HIV treatment, says the government.
According to the World Health Organization, Tanzania has one of the worst physician-to-patient ratios in the world, with just 0.02 doctors and 0.35 nurses and midwives per 1,000 people.
"Tanzania has a relatively young retirement age and this means many of those retired still have the energy and the skills to serve in various sectors, including the medical sector - this is the opportunity we have utilized within the retired officers' programme," said Dr Eric van Praag, FHI Tanzania country director.
Tanzanian health workers now retire at the age of 60; until 1999, they retired at 55.
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FHI facilitates the employment of the retired workers but they remain government employees and are recruited through government systems. Once employed, their pensions are suspended; they earn about 10 percent more than they would if they were directly employed by the government.
They work exclusively in HIV care and treatment clinics, freeing up regular medical staff to handle other illnesses. According to Shao, nearly half of all hospital visits in Tanzania are HIV-related.
"We train them in different aspects of HIV care, management and treatment so that they are up to speed with current requirements in managing the disease and other opportunistic infections that come with it," he said.
"They have greatly relieved staff and they have also imparted skills because they have the experience," said Meshack Massi, Morogoro regional medical officer. "They are a source of motivation to younger staff; now HIV patients and others do not have to wait for long to be served."
New challenge
For many of the older health workers, returning to work has been a refreshing change. "I think I made the best decision... I am delighted to see we are a source of encouragement for others," said Martha Ng’habi, a nurse at Morogoro hospital. "The desire to serve gives the strength to go on, even when your age is advanced."
So far, the pilot project – undertaken at the government's request - has hired 30 clinical officers and nurses in five regional hospitals in Iringa, Dodoma and Morogoro, areas with some of the highest HIV prevalence levels in Tanzania; the five facilities have more than 5,000 HIV-positive people under their care.
 If we have been that succesful in encouraging people to go for HIV testing, then we must also find ways of ensuring that they are treated |
Expansion
Following the success of the pilot, the Tanzanian government has directed regional authorities to put aside funds to re-employ retired health workers to manage HIV care and treatment centres.
"The government is very enthusiastic about the programme and it will put money aside in its health budget to continue this programme once the donors and other private stakeholders pull out," Shao said.
"The government further has promised to recruit more healthcare workers and there are plans to increase the retirement age to deal with the health worker shortage," he added.
ko/kr/mw
This article was produced by IRIN News while it was part of the United Nations Office for the Coordination of Humanitarian Affairs. Please send queries on copyright or liability to the UN. For more information: https://shop.un.org/rights-permissions
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