On September 16-17, 2026, clinicians from across East Africa gathered at Muhimbili National Hospital (MNH) in Dar Es Salaam, Tanzania, for a two-day training focused on strengthening tracheostomy care for cancer patients.
A tracheostomy is a surgically created opening in the front of the neck into the trachea, or windpipe, through which a tube is placed to help a person breathe. Patients with Head and neck cancer (HNC) commonly undergo tracheostomy at Muhimbili National Hospital MNH due to difficulty in breathing and swallowing. Complications from tracheostomy can be life threatening yet avoidable. Because patients and caregivers may need to manage the tube both in the hospital and after discharge, consistent training in routine care and emergency response is an important part of preventing complications and supporting safe care.
The training was part of the Global Cancer Program study, Implementation of a Multi-Faceted Intervention to Improve Tracheostomy and Gastrostomy Care for Cancer Patients in Tanzania (ITaG), which aims to improve care and reduce complications following tracheostomy and gastrostomy tube placement. The study is led by Dr. Msiba Selekwa of Muhimbili University of Health and Allied Sciences (MUHAS) and Dr. Aslam Nkya of MNH, former GCP fellow, with mentorship from Drs. Mary Xu and Katherine Van Loon of UCSF and Drs. Elia Mmbaga and Beatrice Mushi of MUHAS. The training brought together 40 participants from 13 institutions, supported by a multidisciplinary group of instructors including ENT surgeons, nurses, a speech and language therapist, and an ICU intensivist. Four CHESA Fellows from Tanzania and Uganda also participated as facilitators.
Across the two days, participants moved between classroom teaching and hands-on practice with unique case studies. Sessions covered routine tracheostomy care, emergency recognition and management, tube changes, suctioning, stoma and skin care, swallowing and communication, ventilator weaning, patient and family education, and quality and safety. Practical sessions included five skills stations each day, emergency simulations, role-play, and group case discussions. Training models built by UCSF medical students, Nina Patel and Hudson Lin, were used throughout the hands-on sessions.
Participants emphasized the value of the practical approach:
- "This training has enabled me to be aware of emergencies and overcome my fears toward tracheostomy care."
- "I feel very inspired leaving this training. The knowledge from the instructors and sessions has empowered me to bring this teaching back to my hospital to train other nurses taking care of tracheostomy patients."
- "In our unit, whenever a patient develops a tracheostomy complication, we always call our nurse fellow who attended the first tracheostomy training you ran last year... he has been a helper in most of those scenarios. So, when I heard there was another second training, I was excited and looked forward to attending, so that I too could become competent in managing these tracheostomy-related complications."
The impact was also evident to the CHESA Fellows who helped facilitate the training.
- "This was a truly much needed session. Seeing the level of confidence and skill that the participants demonstrated before and after the training was remarkable, which is most likely going to be transferred into their routine practice as they care for patients with tracheostomy."
The emphasis on spreading knowledge beyond the initial training is central to the project. Each participating institution received training models to support continued teaching of colleagues, and patient self-care educational materials were also distributed. The team will next follow participants at their home institutions to assess how the training and models are being used.
Future components of the ITaG intervention will include discharge care kits and development of standard operating procedures for tracheostomy care at MNH, with the potential for adoption by other hospitals in Tanzania and beyond.
The training reflects a broader effort to strengthen not only individual clinical skills, but also the systems, tools, and local capacity needed to support safer tracheostomy care for cancer patients over the long term in Tanzania.