Asha’s* Story (*name changed to protect privacy)
When she was 38 years old, Asha gave birth at home. She was in labor for three days. Tragically, the baby did not survive. After this terrible ordeal, Asha realized that she could no longer control her urine. Her husband left her, unable to deal with the problem. “I did not understand the condition or know whether it could be treated.” Consequently, Asha lived with obstetric fistula for 15 years.
Asha faced daily struggles and was ostracized from her community. “I wanted to pray in my local mosque, but was unable to because people complained about the smell. It made me feel isolated and depressed.” It wasn’t until her stepson heard about CCBRT’s fistula program on the radio that she thought her condition was treatable. A CCBRT ambassador helped to arrange Asha’s journey to the hospital after receiving the money for the ticket from CCBRT via M-PESA mobile money. Asha is incredibly grateful to CCBRT. “Thank you very much to CCBRT…thank you very much for giving me my life back.”
While there have been recent changes in Kupona Foundation’s leadership, the focus on saving women like Asha, and close connection to CCBRT’s activities remains.
Ms. Abbey Kocan took over as Executive Director of Kupona Foundation in early September when Kupona’s founding Executive Director, Ms. Katie Flanagan, stepped down to spend more time with her family. Katie will join Kupona’s Board of Directors in 2014. Abbey spent five months leading the development of CCBRT’s five-year strategy in Dar es Salaam in 2012. She is honored to have the opportunity to build upon the solid base laid by Katie to help CCBRT achieve its strategic priorities over the years to come. CCBRT’s CEO, Mr. Erwin Telemans, joined Abbey in New York City last week for a series of meetings with partners and donors to share updates on activities, construction and immediate funding priorities.
One of those priorities is the expansion of CCBRT’s obstetric fistula ward. Due in large part to an awareness raising campaign and the innovative use of mobile money to reach the poorest women living in remote areas, 595 women received life changing fistula operations in 2012 - over 50% more than in 2011. With up to 3,000 new cases of fistula each year in Tanzania, most often due to prolonged obstructed labor, there is a growing need. CCBRT has a goal of increasing surgeries to 1,000 per year. Doubling the ward capacity will help achieve that goal. Starting at prevention, construction of the CCBRT Maternity and Newborn Hospital remains on track. The new hospital is expected to open in the second half of 2015. Combined with ongoing maternal health capacity building efforts in 16 lower level facilities in Dar es Salaam, Kupona Foundation and CCBRT will continue to work toward preventing obstetric fistula and other disabilities, sparing women like Asha from years of pain and suffering.
Your support of Kupona Foundation and CCBRT is critical to achieving our shared vision of a Tanzania where people have access to quality disability services as well as safe maternal and newborn healthcare. Your gift counts. Thank you.
As many of you have likely seen or read, Kupona's implementing partner CCBRT welcomed some very special visitors earlier this month. On July 2nd, the First Ladies of Ghana, South Africa, and Mozambique toured CCBRT along with other distinguished guests from the African First Ladies Summit hosted by The Bush Center and ExxonMobil. A day later, CCBRT was honored to receive President and Mrs. George W. Bush themselves on a tour of our main campus, with a special presentation in our fistula ward.
These visits came at the end of what has been a very busy and exciting few months for Kupona and CCBRT. Even as construction on the new Maternity and Newborn Hospital continues, we have seen a dramatic expansion of support for and awareness of our efforts to improve maternal health across the Dar es Salaam region. In April a film crew visited CCBRT to shoot footage for a documentary about access to essential surgery in the developing world, and in June, Kupona Board member hosted a reception that raised enough funding for a full-time nurse-midwife for one year. Add in celebrations of the first ever International Day to End Obstetric Fistula, an EUR 8.5 million grant from the German Development Bank KfW, a series of efforts in promoting "LEAN" management across the organization, and it is clear that CCBRT is better poised than ever to have a serious impact on the health infrastructure in Tanzania.
Last Friday, April 5, marked the beginning of the 1,000-day countdown until the target date for achieving the UN Millennium Development Goals. We know it is going to be extremely difficult, if not impossible, to achieve the expectations in Tanzania set by MDG #5: to reduce the maternal mortality ratio by three quarters and to achieve universal access to reproductive health. However, over the last several years, as Kupona/CCBRT's work in women's health has grown to include a partnership not only with the Government of Tanzania but also with a variety of stakeholders in the Tanzanian health infrastructure, we have been encouraged and motivated by the progress being made.
Our program to address Dar es Salaam's key problems in maternal health began in 2010 with a comprehensive program including training, investments in infrastructure and equipment, continuous follow-up, mentoring and coaching in 16 public facilities, and at the same time improving the engagement of the community in maternal health care.
This has resulted in:
The progress is tremendous, and we have every reason to believe that 2013 will see similar accomplishments. Still, we heed the call from the UNFPA and others to step up our efforts to improve maternal health. Not only will our capacity building program implement more trainings, infrastructural improvements, and awareness raising activities, but our new maternity and newborn hospital will take firmer shape, with construction (begun in December 2011) continuing impressively, and recruitment of key personnel to lead the hospital beginning over the next several months.
We cannot stress enough how critical your support has been to improving the situation facing mothers in Tanzania. We look forward to your continued support and look forward to sharing the additional achievements it makes possible.
Some of you have heard the story of Beatrice, who received surgery at our hospital in Dar es Salaam for fistula, completed a one-year training course in craft and business skills at our Mabinti Center, and in May, safely gave birth to a healthy baby boy. In 2012, CCBRT treated more than 500 women like Beatrice, repairing their fistulas and giving them true second chances to live their dreams.
Kupona Foundation and our implementing partner CCBRT have been working together since 2009 to transform and improve maternal health care in Tanzania - to prevent fistula and ensure that joy and safety during pregnancy and childbirth is possible for ALL Tanzanian women. Our capacity building initiatives have helped to improve care at 16 existing health facilities in the Dar es Salaam region and highlighted CCBRT as a leader in the area of maternal health. But in 2012, our vision began to take concrete shape with the construction of the new CCBRT Maternity and Newborn Hospital. All funds for the construction and equipping of the new hospital have been committed and progress has been incredible since breaking ground in December 2011. In fact, the kitchen and canteen facilities will be ready for use in the first part of this year, and three of the building blocks have been constructed up to roof level. Twice in 2012, His Excellency President Kikwete of Tanzania visited the progressing site of the new hospital, and we continue to be motivated by this high-level support.
Here in the United States, Kupona's mission to expand private support for CCBRT also reached new heights, with our final tally in 2012 reaching over $219,000 - more than two times our total in 2011! And every dollar will be used on the ground in Tanzania to save the lives of mothers and babies.
We know that, even as our physical facility takes shape, the pressure mounts: we must recruit qualified staff, improve of the regional referral system to prevent overcrowding at the new hospital, and secure funding for recurring operational expenses. In 2012, we worked closely with some fantastic partners to develop a human resources strategy, an assessment of the current referral system, and an evaluation of family planning services in the region. This year will be one of translating valuable information into action and leveraging the gifts of all of our supporters for maximum impact in the lives of Tanzanian mothers and babies. We cannot thank you enough for helping us to come this far, and cannot wait to share with you all that 2013 will bring!
The creation of a new, regional level maternity hospital is a cornerstone of our initiative to reduce maternal and newborn mortality and disability in Tanzania. To date, we've received funding for four building blocks, and nearly half of the funding for two additional building blocks (a funding gap of $3.3 million remains). Four buildings will allow our implementing partner, CCBRT, to address the region's most urgent gaps in maternal and newborn health care by providing emergency obstetric care services for high-risk pregnancies, as well as neonatal care for newborns with complications. These four blocks will have a maximum capacity to treat up to 12,000 referrals (including 5,600 cesarean sections), 3,600 newborns with complications and 8,400 healthy newborns.
Enabling works began in December 2011 for the new hospital, and foundations for all six building blocks have been laid in the hope that sufficient funding can be secured to construct all six blocks, allowing for an increased number of delivery suites, obstetric beds, and neonatal cots, as well as the ability to offer preventative care, health education and family planning services, and early identification of at-risk mothers.
With construction in full swing, we are focusing our efforts NOW on securing sufficient qualified staff to run the new hospital. CCBRT is working with a consultant to develop a comprehensive human resource strategy and effective recruitment procedures, including identifying training schools and offering scholarships to boost the numbers of graduates. The shortage of medical staff in the country is a real challenge, but we remain committed to building up the required skills locally, through our current ongoing trainings at regional facilities, the planned in-service training center at the new maternity hospital, and a developing Consortium project through which members of a group of university-affiliated medical centers in the U.S. will share their experience and expertise with Tanzanians through mentoring, supervision, simulation training and surgical skills. The Consortium’s program will implement evidence-based comprehensive emergency obstetrical care (CEmOC) protocols and patient safety programs, with the goal of saving lives now and providing the next generation of Tanzanian medical practitioners the education to save lives in the future.
The emphasis on developing skills locally is just one reason why we are thrilled to announce that Dr. Yoni Barnhard has joined the Kupona Foundation Board of Directors as our new President. Many of you will remember Dr. Barnhard's powerful stories from past GlobalGiving project reports (his "A Slice of Dar" can be found in three parts here). Under his leadership, we know that we will grow Kupona's financial support for CCBRT's work in Tanzania, and bring the vision of the Consortium to fruition - making a substatial and sustainable impact on the lives of women and children.
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