For more than four decades, a training centre in the northern Tanzanian town of Moshi has quietly shaped prosthetic, orthotic and wheelchair services across Africa.
The Tanzania Training Centre for Orthopaedic Technologists—widely known as TATCOT—has educated professionals who returned home to fit prostheses, fabricate orthoses, establish workshops, teach new students and develop rehabilitation services in countries across the continent.
Its influence reaches far beyond its buildings at Kilimanjaro Christian Medical Centre. TATCOT’s history is part of the history of modern African prosthetics and orthotics: a story of international cooperation that progressively developed into African leadership, regional knowledge exchange and locally grounded professional education.
Responding to a regional shortage
TATCOT was created at a time when many African countries had extremely limited access to trained prosthetic and orthotic personnel.
People living with amputations, poliomyelitis, cerebral palsy, paralysis, clubfoot, trauma and other neuromuscular or skeletal conditions required technical rehabilitation services, but many countries lacked structured professional education.
Sending every prospective clinician overseas was expensive and unsustainable. Training outside Africa could also expose students to materials, technologies and service models that were difficult to reproduce after they returned home.
Tanzania and the Federal Republic of Germany therefore agreed to establish a regional institution capable of educating orthopaedic technologists within an African clinical and economic context.
According to TATCOT’s institutional history, training of the Tanzanians who would become the centre’s future teachers began in January 1981. On 23 February, the two governments signed an agreement to establish the centre at Kilimanjaro Christian Medical Centre in Moshi.
Germany provided financial, technical and human-resource assistance through the German Technical Cooperation Agency, then known as GTZ. Tanzania’s contribution was coordinated through the Ministry of Health.
The purpose was not simply to construct another workshop. It was to establish a sustainable African training institution serving English-speaking countries across the continent and neighbouring regions.
The first students arrive
German experts Sepp Heim and Wilfried Raab arrived in August 1981 to support the early development of the programme.
In October, TATCOT admitted its first class: 14 students representing seven countries. Teaching initially took place in the existing orthopaedic workshop at KCMC while the centre’s own premises were being constructed.
Building work began in November 1981. The ground floor was completed in June 1982, allowing the centre to move into its new facilities. A second intake of 11 students from six countries—including Pakistan—followed in October that year.
The upper floor was completed in June 1983, and the building was formally opened the following month by Tanzania’s Minister of Health, Dr A.D. Chiduo.
From the beginning, TATCOT combined classroom education, workshop fabrication and clinical exposure. Its location within KCMC gave students access to patients and an established orthopaedic department, ensuring that technical instruction remained connected to clinical need.
This relationship between theory, fabrication and patient care became one of the institution’s defining strengths.
The first graduates and international recognition
The first 13 students completed TATCOT’s three-year training course in June 1984.
In January 1985, the International Society for Prosthetics and Orthotics recognised TATCOT’s diploma-level training under the professional classification system used at that time.
Academic recognition within Tanzania also advanced. In 1986, the Muhimbili College of Health Sciences, then part of the University of Dar es Salaam, accredited the Diploma in Orthopaedic Technology and assumed responsibility for supervising the programme.
The first group to receive the University of Dar es Salaam diploma graduated in July 1989.
These developments were important because they placed prosthetics and orthotics within a formal educational and professional structure. Students were no longer learning only through an informal apprenticeship. They were completing an assessed programme encompassing anatomy, pathology, biomechanics, clinical evaluation, prescription, fabrication, fitting and workshop management.
The transition to Tanzanian leadership
TATCOT’s early international support was essential, but the centre’s long-term importance depended on its ability to develop African educators and leadership.
Sepp Heim served as principal during the institution’s formative period. In 1986, he was succeeded by Harold G. Shangali of Tanzania.
That transition represented an important stage in TATCOT’s development. The institution was no longer simply an internationally supported project operating in Africa. It was becoming an African-led centre responsible for shaping its own educational priorities and regional relationships.
Germany concluded its main phase of collaboration in 1990, although German organisations continued supporting staff development, student sponsorship and specific projects.
TATCOT’s sustainability came from the capacity it had developed locally: Tanzanian teachers, administrators, clinical supervisors and workshop professionals who could operate and expand the institution.
Shangali later became an influential international figure. In 2004, he was elected president of ISPO—the organisation’s first president from a developing country. His election demonstrated how leadership cultivated in Moshi had begun to influence the international profession.
Appropriate technology for African services
TATCOT developed around the principle that effective technology must be appropriate to the user’s body, environment, activities and available service infrastructure.
A device that performs well in a highly resourced hospital may be impractical in a rural setting where replacement components, specialist tools and maintenance services are unavailable.
Students were therefore taught to consider affordability, repairability, local material availability and environmental conditions alongside biomechanics and clinical performance.
A local component-production unit was completed in 1990. This supported the development and manufacture of components closer to the communities in which they would be used.
TATCOT also became an important venue for debates about appropriate technology. In September 2000, it hosted an ISPO consensus conference addressing orthopaedic technology for lower-income countries.
This was not an argument for providing lower-quality care. It was a recognition that quality must include sustainability. A sophisticated device that cannot be maintained or replaced may ultimately be less useful than a robust solution supported by a functioning local service.
Expanding the educational pathway
As regional needs developed, TATCOT introduced additional routes into the profession.
A Certificate Course in Lower Limb Orthotics Technology began in 1993, followed by a Certificate Course in Lower Limb Prosthetics Technology in 1994. These programmes were intended to increase the number of personnel capable of delivering commonly required services.
TATCOT also expanded into degree-level education. A Bachelor of Science programme in Prosthetics and Orthotics was inaugurated through Tumaini University in October 1999, with the first students graduating in 2002.
ISPO recognised the degree-level programme in 2006 under its former Category I classification.
The introduction of the BSc marked an important shift. It created a higher professional pathway for African prosthetists and orthotists and strengthened the foundation for clinical leadership, research, teaching and service management.
A world-first wheelchair technology course
One of TATCOT’s most notable innovations came in October 2000, when it introduced what the centre describes as the world’s first Certificate Course in Wheelchair Technology.
The programme was developed in partnership with the UK-based organisation Motivation. It combined TATCOT’s experience in technical and clinical education with specialist knowledge of wheelchair design, production, seating and service delivery.
The objective was not merely to teach students to manufacture wheelchairs. Appropriate wheelchair provision requires assessment, selection, fitting, posture management, user training, maintenance and follow-up.
In 2002, Tanzanian President Benjamin Mkapa opened TATCOT’s new Mawenzi Wing, which provided facilities for the wheelchair and BSc programmes.
ISPO subsequently recognised the wheelchair-technology course in 2005 under the professional classification used at that time.
The programme reflected an important understanding: mobility services should not be divided into isolated product categories. Prostheses, orthoses, wheelchairs and supportive seating all form part of a wider rehabilitation system centred on participation and independence.
Becoming a centre for regional knowledge
TATCOT’s role extended beyond its formal qualifications. The centre hosted courses and conferences on subjects including knee disarticulation, poliomyelitis, lower-limb amputation, spinal orthotics, cerebral palsy, upper-limb prosthetics and clinical teaching.
In April 2004, it was designated a World Health Organization Collaborating Centre for orthopaedics and rehabilitation.
Its responsibilities included improving and standardising education in East Africa, supporting short- and long-term training programmes, linking P&O services with primary healthcare and community-based rehabilitation, evaluating appropriate technologies and developing approaches to service costing and outcome measurement.
A gait laboratory and e-learning facilities were completed in 2006 with international technical support. In 2007, TATCOT introduced a distance-learning course in spinal orthotics, expanding access for professionals unable to leave their home services for prolonged residential study.
The centre also hosted the All Africa Wheelchair Congress in 2007 and the Federation of African Orthopaedic Technologists Congress in Arusha in 2011.
These events helped turn Moshi into a meeting place for African rehabilitation professionals to exchange knowledge and discuss the realities of service delivery across the continent.
Graduates across Africa and beyond
TATCOT’s published figures show the geographical reach of its alumni.
As of December 2017, the institution reported 602 graduates from four listed programme groups. They represented 43 countries, including 32 African nations.
The recorded graduates included professionals from Tanzania, Kenya, Uganda, Malawi, Zambia, Zimbabwe, Sudan, Somalia, Ethiopia, Namibia, Liberia, Sierra Leone, Rwanda, Nigeria and many other countries.
These figures are historical rather than a current total and do not appear to encompass every educational pathway offered by the institution. Nevertheless, they illustrate TATCOT’s supra-regional role.
Its graduates did not remain concentrated in Tanzania. They returned to hospitals, rehabilitation centres, universities, government services and humanitarian programmes across Africa. Some became educators and service leaders, multiplying the impact of their original training.
TATCOT’s most important product has therefore never been a particular prosthetic component or orthotic design. It has been professional capacity.
TATCOT today
TATCOT remains based at KCMC in Moshi and operates under Tanzania’s Ministry of Health. Its educational relationships include the Muhimbili University of Health and Allied Sciences and Kilimanjaro Christian Medical University College.
Its current published programmes include diploma education in prosthetic and orthotic science, certificate training in lower-limb prosthetics and orthotics, wheelchair technology and blended or e-learning courses in specialist areas.
The current Diploma in Prosthetic and Orthotic Science continues to combine theoretical, technical and clinical education. Subjects include anatomy, physiology, pathology, radiology, mechanics, biomechanics, workshop technology and prosthetic and orthotic clinical practice.
Importantly, its published admissions information explicitly invites qualified prosthetic and orthotic users to apply. That is a meaningful statement about participation: people who use assistive devices can also become the professionals who design, provide and improve them.
An African institution with a global legacy
TATCOT’s foundation involved substantial international cooperation, but its history should not be told solely as a donor achievement.
Its lasting success came from Tanzania’s decision to host and sustain a regional institution, from the African educators who took responsibility for its future and from the students who carried its knowledge into their own countries.
The centre demonstrated that high-level prosthetic, orthotic and wheelchair education could be developed within Africa, responding to African clinical needs and resource environments while contributing to international professional standards.
As digital design, 3D printing and new component technologies enter African rehabilitation services, TATCOT’s founding principles remain relevant. Technology must be clinically appropriate, economically sustainable, repairable and supported by competent professionals.
More than 40 years after its first 14 students entered the KCMC workshop, TATCOT remains a symbol of what long-term investment in African rehabilitation education can achieve.
Its legacy lives in every graduate who returned home to establish a service, train a colleague, fit a device or help a person with a disability participate more fully in family, education, work and community life.
- TATCOT Official Website and Institutional History
- TATCOT Partnerships and International Recognition
- TATCOT Diploma in Prosthetic and Orthotic Science
- Kilimanjaro Christian Medical Centre
- Muhimbili University of Health and Allied Sciences
- Kilimanjaro Christian Medical University College
- Ten Years in the Development of TATCOT – Prosthetics and Orthotics International