In 2000, the Chole Health Centre was established, including a small lab, in-patient facility and maternity room, and became a vital resource for people on Chole. It proved its value during an outbreak of an unknown gastro-intestinal disease in 2007, when more than 100 patients were seen during one week, nine were hospitalised on a single night and all received life saving drips.
In 2007, the last year for which statistics are available, it saw about 110 patients per month and provided a free monthly clinic for under fives; there were 37 births and two deaths, and the main diseases were malaria (48%) and gastro-intestinal / diarrhoea (9%). The Health Centre complemented the educational effort, with about 60 children a month being treated, and free ante natal care for all pregnant women.
The average cost per patient, excluding the clinics, was about US$7.00, and was hugely subsidised, with patients paying US$1.00 per visit, including prescribed medications; in 2007 the Harambee Committee provided Tshs 10.8m (£4,800, US$7,250), which only just covered salaries and drug purchases. Maintenance remained in arrears.
In 2008 the Harambee Committee faced a heartbreaking choice after the Women's Front of Norway ceased to support the Kindergarten. The District agreed to take over the Health Centre, closed it in January 2009 and reopened it in July 2009, with two District staff members, a junior nurse and laboratory technician. Both travel to Mafia each weekend, so the Health Centre is often closed on Thursday and re-opens on Monday. The drug supply is also limited, and important supplies often run out before the allocation at the end of each month.
Requests have been made for a doctor or a midwife to be allocated to improve services on the island, but it is clear the District does not have the resources to provide reliable health care from the clinic. As the funding position has improved a little the Harambee Committee has allocated a small amount to pay for cleaning, and the generous installation of a new solar power system by Solar Aid provides hope for further improvements, with a vaccine fridge for example now able to operate. If there are further funding improvements the Harambee Committee is likely to regard supporting the District in improving health care as an important future priority.