International Healthcare Partnerships

The Tanzania Link is a partnership between CNWL and Mirembe Hospital, Tanzania's national referral hospital for patients with mental health and substance use problems.   

Launched in 2010 it’s aim was to develop a mutually beneficial relationship with a health service in a low or middle-income country. 

 Tanzania is a low-income country with a critical shortage of mental health professionals and only 34 psychiatrists to serve a population of 70 million people.  

Furthermore, mental health is neglected in Tanzania because of high levels of stigma, a lack of awareness and considerable competing health demands. Roughly 60% of the population live in rural areas where there are no mental health resources, and the median age of the population is 17.5 years, yet there are virtually no mental health services for young people other than the small CAMHS unit at Mirembe Hospital.  

Since 2024 the Ministry of Health in Tanzania has agreed that all professional healthcare training should include a component of mental health training. Both CNWL and Mirembe have recognised that the Link is mutually beneficial and could make a significant difference to and impact on their services and staff.  

The Tanzania Link project has now been running successfully for 15 years and has gained recognition at the level of the Department for International Development (DfID) – now the Foreign, Commonwealth & Development Office (FCDO) and the Tanzanian Ministry of Health, Community Development, Gender, Elderly & Children as a model of good practice, with whom we have developed a good working relationship with the Mental Health Team. 

Mirembe Hospital is based in Dodoma, the legislative capital of Tanzania, and opened in 1926. It is Tanzania’s national referral psychiatric hospital with provision for general and forensic inpatients and a rehabilitation village.  

During the period of our partnership with Mirembe there have been up to 700 patients at the hospital with just two psychiatrists and 250 staff from a range of professions. This was an unacceptable level of over-crowding that resulted in many difficulties in managing vulnerable patients. More recently Mirembe has managed to recruit more staff and there are now four psychiatrists working at the hospital and they have managed to significantly reduce the bed occupancy at the hospital so there are now only 350-400 patients. This has greatly improved the capacity of Mirembe to develop the quality of its services and the therapeutic relationship between staff and patients. 

Since the Link was established, we have collaborated to create good working relationships and develop on the originally agreed set of planned priority areas. These included: therapeutic management of violence and aggression training, supporting the opening of a substance misuse (SMS) centre, IT development, developing the Occupational Therapy provision, and building nursing capacity and practice. 

In 2019 CNWL was approached by Voluntary Services Overeeas UK (VSO) to see if there was a way for CNWL to support their work with the Zimbabwe Prisons and Correctional Services (ZPCS) through their Zimbabwe branch, in improving the care that is provided to prisoners with mental health problems in their 2 mental health units at Chikurubi Prison in Harare, and Mlondolozi Prison in Bulawayo. In 2020 we agreed a Memorandum of Understanding with both ZPCS and VSO to work in partnership. However this coincided with the outbreak off the COVID pandemic and the severe cuts in overseas aid budgets through the UK government, which persist to this day, and this has seriously impacted on our ability to pursue this partnerships as planned. We have tried engagement with them through an online training programme but internet connectivity issues and cost have hampered this approach. We have learned through the partnership with Mirembe that these partnerships only really work if you can have face-to-face contact with one another and develop a personal relationship. We therefore hope to arrange a visit in late 2025 to get this partnership up and running. 

As with the partnership with ZPCS the partnership with Ngomahuru Regional Mental Health Hospital was initiated in 2020 by an approach from CNWL staff who had already established a link with Ngomahuru through their UK-based NGO, Zimbabwe Health Training Support (ZHTS). The situation at Ngomahuru is very similar that we first encountered at Mirembe Hospital in Tanzania – extremely limited staffing and financial resources, professionally unqualified staff, overcrowding bed occupancy, huge popular stigma, poor infrastructure etc. We agreed to enter into a partnership to help where possible, but this also coincided with the onset of the COVID  pandemic and subsequent financial constraints. We therefore hope to visit this partner in late 2025 to assess at first-hand what we can potentially work on through this partnership, given the current financial situation vis-à-vis grant funding.

The partnership with Tanka Tanka Hospital – the only mental health facility in the whole of The Gambia, was initiated by the CNWL International Healthcare Partnerships Coordinator, following a visit there in 2011, and subsequent contact through a CNWL colleague at the CNWL Recovery College who had received some emergency care from them while on holiday in the Gambia. This partnership was also initiated in 2020 during the COVID pandemic. At this point there was still grant-funding available to apply for, so we tried to apply for a grant to establish a work skills- related project for mental health patients to produce products which would be useful in limiting cross-infection – soap-making and re-cycling plastic bottles for the liquid soap, and producing facemasks from fabrics. Unfortunately we were not successful in getting the grant. In 2024 The CNWL International Healthcare Partnerships Coordinator collaborated through the NGO International Mental Health and Substance Use Support (IMHSUS), www.imhsus.org   with the Head of the Mental Health team at the Gambian Ministry of Health to develop a proposal to present to the European Commission for a major grant of 1 million euros for a 3 year-year project to establish employment, skills development for mental health clients and public education across the Gambia. This was rejected on a technicality but it led to a good relationship development with the Ministry of Health. We hope to maximise on this through a face-to-face visit in late 2025.