“Critically ill patients are not just luggage”: Researchers in Tanzania reveal the hidden dangers of in-hospital transport

A new study from Tanzania has revealed how something as simple as moving a patient between hospital wards can become a matter of life and death. Published in the Journal of Health Services Research & Policy, the study explores the experiences of health workers responsible for transporting critically ill patients, and exposes major gaps in how hospitals are designed, equipped, and organised to keep those patients safe. Read the full research here.

A neglected part of hospital care
Critical illness is a life-threatening condition affecting millions worldwide each year. In hospitals, these patients often need to be transported between departments, from the ward to radiology, from surgery to recovery, or from the emergency unit to intensive care. Each transfer is a vulnerable moment when vital monitoring and support can be interrupted.

The researchers conducted in-depth interviews with 15 doctors and nurses from five hospitals across different levels of the health system. Their analysis identified three clear themes in the experiences of health workers:

1. The design and organisation of hospitals did not facilitate quick, short, and safe transport for critically ill patients.

2. Hospitals lacked the resources needed for safe and effective transportation.

3. There were weaknesses in the preparation for, conduct of, and handover of information concerning the transportation of critically ill patients.

Together, these themes reveal a system struggling under the weight of infrastructure limitations, resource shortages, and inadequate processes.

“Critically ill patients are not just luggage”
Across hospitals, staff described how buildings were spread across multiple sites and levels, with no lifts and outdoor walkways. Uneven roads and corridors caused equipment to disconnect mid-journey. In some cases, patients had to be carried upstairs by relatives or staff, an undignified and unsafe practice. As one nurse put it: “Critically ill patients are not just luggage.”

Health workers also described shortages of essential resources such as oxygen cylinders or emergency drugs. Many hospitals had no clear protocols or training for intra-hospital transport. Communication between departments was unreliable, and receiving wards were often unprepared when patients arrived. Documentation was inconsistent, and handovers were rushed or incomplete.

These findings show how everyday weaknesses – poor infrastructure, lack of equipment, unclear roles – can directly threaten the lives of patients who are already critically ill.

A call for Essential Emergency and Critical Care
The study’s conclusions echo the principles of Essential Emergency and Critical Care (EECC): that every hospital must be ready to provide simple, reliable, and continuous care for critically ill patients, not only in intensive care units but throughout the hospital.

Improving the safety of patient transport doesn’t require high-tech solutions. It requires the basics: working communication systems, access to oxygen, clear transport protocols, staff training, and reliable handover routines. These are all low-cost, high-impact changes that can prevent deterioration and death.

Moving forward
This research highlights that the safety and dignity of critically ill patients depend not only on what happens at the bedside but also on what happens in between, in the corridors, stairways, and hospital compounds where they are moved.

For health systems in Tanzania and beyond, strengthening these simple structures and processes represents an achievable, essential step toward better outcomes.