It's good to have a reliable taxi driver in Sengerema. If anything happens you can always call him and get him to pick you up. Trust me when I say that standing as the only mzungo in pitch darkness outside the broken off-road, preparing to spend the night in the middle of nowhere is NOT funny... You soon realise it's essential to have a good realtionship with a taxi-driver. Find someone you trust (not to exploit you or to be drunk too often) and get his phone number. A really great guy is called Amili - he is super-punctual (which is rare in Tanzania) and drives safe. A ride from town to the hospital should cost around 1000 shilling. From town to Sengerema secundari it is 400. From town to District head quarters is around 500 (just to give you an idea of the price range).
A really good way to get around town is to use bicycle-taxis. You find young guys standing around everywhere with their old bicycles with padded seats on the back. They are actually quite comfortable and is probably the best means of transportation(apart from walking) if you want to blend in more. If you are wearing trousers, just sit with one leg on each side, but when wearing a skirt, don't even consider pulling it up over your knees and doing the same!!! Sit with both legs on one side, like ladies used to do on horses. It's not at all difficult. It's really a good experience and a lot of fun. The Tanzanians think so too, and they WILL laugh at you as you go by (who can blame them?!), but they will respect that more than if you go drive in taxi all the time. A trip from the hospital to town is 100 or 200. To go to Sengerema Sekondari from the hospital is 400 sh.
You can go from the market to the hospital and other remote chambas of Sengerema by dalla. It usually takes off down by the telecentre in front of Uncle Hotel. Needless to say, it only takes off once it is full. Just tell the driver where you want to get off. It costs about 150 sh. from town to the hospital - that is, IF you get there. These dallas are even more ruined than the ones going between Mwanza and Sengerema, so they usually break down half-way. Take a bicycle taxi or walk in stead.
You can also go to Sengerema by taxi, but it's about as expensive as it gets and if you don't completely trust your driver, I wouldn't do it. You can sometimes persuade a driver in Mwanza to take you all the way (20.000 sh). There are no taxis waiting on the other side. If you are going from Sengerema to Mwanza (10.000 sh), a taxi is a good option, because chances are you know the driver and then it is the most safe way to get there. Plus, you don't get completely squashed as you have the car to yourself and maybe a few friends. But people also notice these things, and if you stay in Sengerema for a long time and only use taxis, people will start talking. You get more respect from them if you use local transportation.
My best advice on how to get to Sengerema is to hitch a ride with someone. It is not as hard as it sounds. Remember, Tanzanians are very helpful and ex-pats are always happy to see another mzungo! Simply go to the ferry quite som time before departure and look after nice cars and ask the driver or another passenger if you can go with them. Sometimes it could be a good idea to give the driver 1000 sh, other times it's probably the worst and most insulting thing you could do. You just have to go by your guts. If you are a single woman, never go with a group of young guys who smell like beer! The safest thing is to look for well-to-do Tanzanians or mzungo.
You can also get to Sengerema with an off-road express (1000 sh). You get on the bus on the Mwanza side and stay on the bus throughout the entire trip. This has got to be the absolute most uncomfortable way to reach Sengerema, and together with the pick-ups also the most dangerous. The offroads are COMPLETELY overcrowded and the seats even worse than the ones in the dallas. Be prepared for the bus to break down at least one or two times on the way. During my 6 months in Sengerema I saw more accidents with these off roads than I care to remember, so consider the risks. Take a dalla in stead. When accidents happen, they are not as serious or dangerous in a dalla as in an offroad.
See my Mwanza transportation tip for more info.
To get to Sengerema from Mwanza you can a dalla-dalla, which is a small bus meant for 12 people, but 30 people usually get abourd before they take off. You take the dalla when you reach Kamanga. The drivers will be honking their horns and people will shout where they drive to, so don't worry and just do what people tell you to. The ride from Kamanga to Sengerema takes around 1 1/2 hour and in the rainy season around 2 hours or more. It's not at all comfortable and prepare yourself for a lot of bruises. But usually it is fun. Don't let them put your luggage on the roof as it will fall of. They drive like mad men, so hold on to your belongings. If it's at all possible try to get a seat in one of the first 2 rows. SItting in the back is NOT comfortable!