Give Women Recovering from Fistula a Bright Future

Dear Friends,

Tomorrow is Giving Tuesday, and this week, my team and I are reflecting on a year that has been difficult, yet so rewarding. Our CCBRT Maternal Health Capacity Building team feels we sometimes learn more than we teach. While working with our partners and health care providers we find new solutions to old challenges. Together, we are strengthening clinical skills, expanding the knowledge of medical teams, and equipping doctors and nurses with the tools they need to prevent debilitating birth injuries like obstetric fistula.

Recently, we conducted a refresher on-the-job training for healthcare workers that focused on postpartum hemorrhage (PPH). PPH is the leading cause of maternal mortality in Tanzania, accounting for more than 30% of all maternal deaths. The tragedy is that death due to PPH is preventable. The challenge is it requires an entire team to respond. Unfortunately, a full team of medical professionals is not always available. Staff shortages, gaps in training, and overwhelmed, overcrowded delivery wards in Tanzania are all factors that can contribute to a mother’s life being lost in just minutes.  

At one of the facilities where my team trains and mentors healthcare workers, the supervising medical officer identified that staffing was an issue and emergency cases did not have the support they needed. She wisely requested that we train non-maternal healthcare staff in PPH management. So, we conducted the training, even training outpatient nurses and staff from wards serving men only.

One week after the training, this medical officer called me with so much excitement. The night before, a patient had delivered her baby, but began to hemorrhage after delivery. The attending nurse shouted for help, but the doctor and only other nurse on duty in the ward were handling an emergency caesarean section in the operating theater. The nurse’s cries reached the neighboring wards, and ‘help’ came running from the outpatient and men’s wards. Thanks to the training they had received the week before, everyone knew exactly what to do. The team saved the mother’s life.

The medical officer told me that before her staff received the PPH training, they would have been afraid to respond to an emergency like this, but not anymore. Her staff were excited and motivated. She said ‘For them, it truly was a sweet victory.”

My team and I are always grateful for these moments. Equipment and innovation in low-resource settings are critical for progress, but at the heart of our success lies one indispensable resource: people. It is the people we train, their collaboration, their courage in the face of emergencies, and their dedication to their patients that will change the face of maternal healthcare in Tanzania. And it is your support that empowers us to keep going. 

We are more powerful together.

Tomorrow is Giving Tuesday in the United States. Here in Tanzania, we are also answering the call to give. I invite you to join us. Your gift of $100 provides training for two healthcare workers to save lives at birth, to prevent birth injuries like obstetric fistula, and to identify congenital disabilities like clubfoot for immediate referral and treatment. Thanks to our friends at GlobalGiving, there are matching funds available, so your gift goes even further! Just as one nurse cannot do the work of a full team, our success requires us all to work together for the mothers we are serving.

Thank you for supporting my team, and for helping us save the lives of women and newborns  in Tanzania.

Be well,

Dr. Brenda D’mello
Technical Advisor & Project Manager
Maternal Health Capacity Building Program, CCBRT 

CCBRT is Kupona Foundation’s partner organization in Tanzania.

“I was sitting with the other women on a chair when a nurse asked me to wait outside on the grass. She told me to never sit on the clinic chairs, because my fistula will get them dirty.”

This is where CCBRT fistula ambassadors first met 23-year-old Rehema.

She was attending a clinic in north-western Tanzania with her 3-month-old baby. Her obstetric fistula, a devastating yet preventable and treatable childbirth injury, had left her chronically incontinent. Leaking urine, a nurse sent this new mother outside to sit on the ground, while other mothers waited on chairs inside, shielded from the East African heat.

Rehema developed fistula while delivering her second child. There was a complication, and she did not have access to high quality emergency maternal healthcare. The good news was that her baby survived the complicated delivery; an estimated 90% of women living with fistula lose their baby during the traumatic birth. In the months that followed, Rehema struggled to live with chronic incontinence and daily stigma and criticism, while also taking care of a newborn.

Our dedicated colleagues presented Rehema with treatment options and assured her that her transportation and treatment at CCBRT could be provided free of charge. They arranged for Rehema to spend a night in a hotel near the bus station so she could easily take the bus to CCBRT early the next morning. That night, when a team member went to check on Rehema, they found her sleeping on the floor with her baby. She had been given adult sanitary underwear so she could travel while leaking, but three months of living with fistula had left a psychological mark. When asked why she was on the floor she replied, “I’m afraid to wet the mattress.”

The next day, Rehema and her baby left for Dar es Salaam. A few days later, the fistula team that referred her visited her in CCBRT’s fistula ward. She was beaming and was almost a different person than the one they had seen in a hotel room days before.

“I’m so thankful that you referred me here,” she told the team. “When I go back home no one will mock me again. Fistula kept me from going to the market, the farm or to [community events like] funerals, but after this treatment I’ll be comfortable mingling with other people. I really thank CCBRT for this help; I could not have afforded this treatment on my own.”

Rehema’s story is one of hundreds that we see each year. Without you, our donors and partners, we could not help women like Rehema. Without you, we could not make the necessary investments in strengthening maternal and newborn healthcare in Tanzania to prevent more women from developing obstetric fistula in the first place. Your generous donations change lives every day. Thank you.

We won’t stop until we’ve eradicated fistula in Tanzania. Join us on this journey. At midnight (ET) on Wednesday, September 12^th, our partners at GlobalGiving will launch a Global Bonus Day, running for 33 hours to accommodate time zones. Donations up to $1,500 per unique donor will help us earn a portion of the $50,000 Incentive Fund. Your donation will help unlock funds from 12:00am ET on Wednesday, September 12^th until 8:59am on Thursday, September 13^th. Your donation means we can reach more women like Rehema with the care they need, and ensure more women don’t experience the pain that Rehema endured.

Asante sana (thank you very much) for your support.

Abbey Kocan

P.S., Check out Kupona’s 2017 Annual Report to read more stories of the lives you have changed!