The settlement of Makunduchi lies in the far south east of the island. The town itself has a population of approximately 12,000 people who principally survive on fishing and seaweed farming. Despite the beautiful setting of this small town with its long white sandy beaches, there is very little tourist activity in this part of Zanzibar. Makunduchi is famous for the Mwaka Kogwa festival which takes place over 4 days in July. There is one primary and one secondary school.

The hospital was built between 1981 and 1993 and was funded by DANIDA. It was originally built to a reasonably high standard of construction but little has been done to the original fabric of the building in the ensuing 25 years. We conducted a full survey of the facilities in January 2007, a full report of which is contained on the website. Essentially the conclusions were that the facility is a valued resource, suffering from severe neglect but “with enormous potential”. Some of the main findings included:

• Nearly all medical equipment was as old as the hospital and in general was in a very poor state.
• Reorganisation of redundant rooms was required.
• The operating theatre required complete redesign.
• The treatment rooms, outpatient buildings and staff accommodation needed upgrading and renovating.
• Toilets and bathrooms were in a poor condition and were badly located.
• Both the incinerator and septic tank facilities were in need of repair.
• No laundry existed in the hospital.
• The clinical, managerial and financial systems within the hospital were in need of significant review.
• The district has an inadequate referral system and insufficient technical support and backup for its primary health care facilities and services.

As a consequence, many of the people of Makunduchi travel to Mnazi Mmoja, the main referral hospital in Stonetown, 55 km away, to receive medical care. Travelling however causes significant delays in the handling of emergency cases, inconvenience and cost for patients and also contributes to over crowding and inappropriate use of Zanzibar’s only referral hospital.

The majority of the population of the South District however cannot afford to travel such distances and consequently these people have no access to even basic healthcare.

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