Over 135 years after work began on a dispensary for the people of Zanzibar, the iconic Stone Town building has reopened as the Aga Khan Polyclinic.

The building’s foundation stone was laid in 1887, when Indian merchant Tharia Topan commissioned it to commemorate the 50th anniversary of Queen Victoria’s reign. Prominently situated on the waterfront, it incorporated African, Arabic, Indian and European features. It opened in 1900 as “The Khoja Haji Nasser Nurmohamed Charitable Dispensary”, where a single doctor and his assistants provided Western-style health services.

Zanzibar was then a British Protectorate, with clove production as its main economic output. With slavery abolished in 1897, and a consequent shortage of field workers, the rulers turned their attention to the health of the labour force. They established a locally financed Department of Sanitation and a Department of Hospitals and Medicine, and opened a public hospital in 1896.

However, Western medicine was not widely accepted in the country, with residents preferring a blend of Islamic, Hindu-Ayurvedic and African treatments, and women unwilling to be attended by male doctors. Breakthroughs like germ theory and vaccination did not find favour in Zanzibar. Meanwhile Christian health facilities were often linked with attempts at religious conversion. These institutions therefore mainly served Europeans and the Arab and Indian elite rather than Swahilis.

It took until the 1930s for Zanzibari women to begin training in Western medicine in Egypt, India, Britain and Uganda, and for fees to be eliminated for the poorest, but women remained reluctant to attend healthcare facilities.

By the end of the British colonial period in 1963, health facilities offering fee-based Western medical services included the General Hospital, 17 clinics, 10 government and private dispensaries and several health posts. In 1964, the Revolutionary Government replaced these with a public health system open to everyone, and the Old Dispensary stood vacant.

The Aga Khan Trust for Culture leased and restored the building in the 1990s, converting it into an Outreach Health Centre in 2022-23. The Centre, operated by Aga Khan Health Services (AKHS) with finance from the Agence Française de Développement, aims to enhance and maintain the health of all Zanzibaris.

Managed by family medicine specialists, it will provide emergency and urgent care, enhanced diagnostics, dialysis services and dentistry. It will host visiting consultants from the Aga Khan Hospital in Dar-es-Salaam and establish digital health connections with the Hospital, allowing consultations without the personal and environmental expenses of travel. The clinic offers employment and skills-building opportunities, with 70 percent of the staff being Zanzibarian.

The Polyclinic is part of a network of 25 Outreach Health Centres that provide frontline care to over a million patients per year as part of an integrated healthcare model in Tanzania. It is part of AKHS’s hub and spokes system, which begins with community-level health promotion and prevention activities. Patients are referred to local primary care clinics, needing to travel to secondary and tertiary hospital care only where the lower-level services need extra expertise or equipment.

AKHS runs about a hundred health centres and four hospitals in East Africa, including the leading private, not-for-profit hospitals in Kenya and Tanzania. Zanzibar’s new Polyclinic forms part of one of the most comprehensive non-profit healthcare systems in the developing world. Read more about the building’s history alongside the evolution of health care in Zanzibar.

Read the transcript of Princess Zahra Aga Khan’s speech.

Read the transcript of Her Excellency First Lady Mariam Mwinyi’s speech.

Read His Excellency Nabil Hajlaoui's speech.