Bumbuli hospital serves a catchment area of about 125,000 people, most of whom are of the Wasambaa tribe. Within this catchment area there are about eight functioning government or private dispensaries and nearly in every village has shop-selling drugs without prescription.
People residing in this catchment area are generally of low socio-economic status, most of them are subsistent farmers. They mainly grow maize, potatoes, beans and some few other food crops. Tea and tomatoes are major cash crops in the area.
Bumbuli is a fairly remote area, surrounded by hills reaching up to 1500 meters above sea level. It is however having a fairly reliable wireless telephone communication and electricity. It is linked to the road network of about 833 km, out of which 32 km are tarmacs extending from Lushoto to Mombo. The roads are in general passable through out the year but with difficulties in the months of February to May, when there are heavy rains.
The hospital receives water from its own well about 5 km away through a pipe installed in the early seventies. It has its own stand-by generator for emergencies when the general electricity supply is down.
Bumbuli Hospital supervises six dispensaries within the NED, the nearest is about 80 km away the most far about 250 km. One more dispensary in Mlalo is about to be registered. It has two leprosy camps, and a Clinical Officers upgrading training centre (COTC) which for long time was thought to be under the government, but of very resent realized to be under NED.
The realization of COTC under NED has brought major transformations in the leadership structure of the hospital. The COTC and the hospital, which were formerly lead by the principle of the college and the doctor in-charge respectively, are now merged together into a single head - the director of the hospital.
Though the service and catchment area of the hospital is broad the hospital has been in general terms experiencing a progressive reduction in the number of patients. However there also has been times when the number of patients increased. The following factors are ascribed to the progressive reduction in the number of patients:
- Liberalization of the health market with the resultant mushrooming of private health services providers- like dispensaries
- Presence of drugs selling shops(legal and illegal)
- Presence of registered and unregistered practitioners
- Presence of local healers
- Improved and cheaper government heath services
The times when the numbers of patients were high are well correlated with improved hospital services in terms of qualified personnel and good hospital administration