In October 1893, Chief Shangali of the Chagga peoples on Mt Kilimanjaro and members of his tribe sat under a tree in the area of Nkwarungo with German Missionaries from Leipzig. The missionaries treated them for ulcers and sores of the skin. Today, under these same trees, the care continues.

In 1906 Dr Herman Ploetze arrived in Machame as the first Missionary doctor and he set about building the beginnings of Machame Lutheran hospital. The hospital changed and grew over the next 100+ years. For many years the hospital was led and care given by mostly German medical mission personnel. In time care givers from other countries as well as Tanzanians began having a bigger role. The first Tanzanian Dr in Charge was Dr Iriaeli S. Moshi in 1976.

The hospital for many years served as the primary referral and specialist center in the Northern Tanzania area and beyond with more than 200 beds. In time, other hospitals were built and developed, and Machame has evolved into a 130 bed general medical-surgical community hospital serving the greater Kilimanjaro area.