Give Women Recovering from Fistula a Bright Future

Dear Friends,

I’m excited to write to you today: your support, and the support of other like minded donors, over the past few weeks has raised over $22,000 to make life changing care available to the people we serve. Together with our partner CCBRT we want to say ‘asante sana’: thank you so much!

With just two weeks left in 2018, we’re reaching out to give you an update on what your generosity means. 

For women like Khadija, your support means a future full of potential, and free from the trauma of obstetric fistula. 

When Khadija went into labor with her first child, the nearby district hospital in Dodoma, Tanzania was not equipped to provide the necessary medical interventions. After hours of intense pain and prolonged, obstructed labor, Khadija’s traumatic delivery left her leaking urine due to an obstetric fistula, and she sadly delivered her baby stillborn.

When the leaking didn’t stop, Khadija returned to her local district hospital, where health workers diagnosed her fistula and referred her to CCBRT. After a long bus ride to Dar es Salaam, Khadija was examined and underwent a successful fistula repair surgery at CCBRT. She made a full recovery, and was offered the opportunity to join the Mabinti Centre’s newest class of trainees.

Three years later, Khadija runs a thriving small business in Dar es Salaam, which she and her husband plan to soon expand by hiring other women, in turn supporting economic opportunities for others.

“In my life I never thought I could stand alone and do many things,” she said. “CCBRT and the Mabinti Centre have really changed my life.”

Accessing obstetric fistula treatment was the critical first step in Khadija’s journey. Your generosity is crucial to providing both life-changing fistula care and empowering skills training to women like Khadija.

If you have already given during this year-end period, THANK YOU. If you who haven’t had a chance to make your gift, it’s not too late. Donations received through GlobalGiving between now and December 31^st will be amplified through GlobalGiving’s bonus funding. Your gift has the power to end fistula and change lives.

Thank you for your support. We couldn’t do this without you, and we are so grateful that you have chosen to be part of our community. Wishing you and yours a Happy Holiday season.

Warm regards,

Abbey

A guest post by Betsy Zink, Kupona Board of Directors.

“They say you can’t understand someone’s life until you have walked a mile in their shoes.”

This past October, I was privileged to do just that. As a new member of Kupona Foundation’s Board of Directors, I made my first trip to visit Kupona’s partner in Tanzania, CCBRT. In addition to visiting CCBRT’s campus in Dar es Salaam, I visited CCBRT’s clinic in Moshi to learn more about the community based rehabilitation work happening in that region.

On my first day at CCBRT’s Disability Hospital in Dar, I was struck by the devotion of the medical staff and hospital administration. It was inspiring to hear how they articulated their sense of purpose as healthcare providers. It also was clear to me that Kupona and CCBRT support a critical piece of the Tanzanian healthcare system.

On each of the wards, patients receiving treatments for obstetric fistula, orthopedic conditions, and congenital and visual impairments conveyed the same thing: they had no other means of receiving high quality disability or rehabilitative healthcare, and they rely on the services we provide. A similar sentiment was expressed when I visited CCBRT’s maternal healthcare capacity building sites and met doctors and nurses who are being trained and mentored to provide high quality, life saving maternal healthcare. They are so grateful for the support they are receiving and know that it is improving the entire Tanzanian healthcare system when they can better serve the people who are most in need.

And it was the people most in need that I was now seeking.
As Kupona’s staff had shared with me, we’ve had several partners refer to CCBRT as one of the “best run hospitals in Africa.” Walking through the halls of the clean, organized CCBRT facilities, I understood why. I’d seen patients in this comfortable environment, but wondered, “where are our patients coming from”? Answering that question directed the rest of my personal travel time in Tanzania as I tried to walk in the footsteps - if just for a short while - of those we serve. I plunked myself in a simple lodge outside of Arusha and vowed to “live locally” for the week.

Each day I set off on foot, with minimal shillings and a small backpack, and headed away from the nearest road to a local village. I spoke with shop owners, and women working in the fields. I visited schools, made friends, was invited into homes, tasted local dishes, learned about crops and asked folks about medical care, birth experiences, their families and challenges in their lives. My experiences and photos revealed something I knew all along: women are the heartbeat of Africa.  They are the workers in the home, fields and small businesses. Every time I stopped to take in my surroundings, I saw women hauling water, carrying firewood, harvesting, planting, selling, milking, cooking, washing and child rearing.

When the need to seek medical care means a woman must travel from her home, the ripple effect is destabilizing. Whether she is a woman with obstetric fistula who must seek surgical care, she is a mother experiencing complications in childbirth who requires medical intervention for a safe delivery, or a mother accompanying her child for orthopedic care or eye surgery, her absence is keenly felt by those at home and in her community.

Kupona, through CCBRT, supports affordable, comprehensive care for women and children. From transportation costs, to providing room and board, and throughout treatment, there is a focus on easing the family’s burden. For those needing outpatient care, trained therapists travel to homes to deliver training and patient monitoring, allowing mothers to stay at work and avoid costly travel.

On my last day of travel, I enlisted the help of a local fellow and his pikipiki (motorized scooter) to help get me to the bus stop. As we were driving, a woman suddenly stepped out and waved us down. She asked if I was the Fistula Lady. She had overheard conversations in the village that someone working with CCBRT and Kupona was in town and could help women with fistula, so she came looking for me.

She told me her sister-in-law had experienced terrible symptoms after a difficult labor and had delivered a stillborn child. Her husband, believing her to be ill or cursed, and embarrassed by her physical state, sent their two older children away to his parents, refusing to allow them to see their mother. My new friend was determined to help her desperate sister-in-law and asked for our help. She added that there were many more women in surrounding communities that were living with fistula, and they needed our help too. I thought about that forlorn mother who had been separated from her children after surviving such horrific and preventable trauma. I thought about her heartsick children and misguided husband and the grief that all of them must be feeling. And it was then that I vowed to continue the work Kupona and CCBRT are engaged in.

Keeping women whole, healthy and at the center of Tanzanian life is a worthy goal, and through Kupona’s support of CCBRT and its programs we are doing our part to achieve this goal. I invite you to join us. Email us with questions, visit our impact page to learn more or read our Annual Report.  Every woman, every child and every family deserves to have access to high quality healthcare that is affordable. And when a family or community loses its heartbeat, the ripple effect of that loss touches so many.

Asante sana,
Betsy

Dear Friends,

Women living with obstetric fistula are true heroines. After surviving prolonged and/or obstructed labor – often losing a child and sometimes narrowly escaping death in the process – they live for months or years burdened by chronic incontinence and all that comes with that condition: stigma, misconceptions and isolation. On average, fistula patients at CCBRT have lived with the condition for seven years. Many women don’t realize that they can be “cured” through surgery and rehabilitation. Of those who do, many do not know how to access treatment, or don’t believe they can afford it.

That’s where we come in.

Through our local partner, CCBRT, we provide life-changing, holistic treatment to women with fistula in Tanzania and raise awareness about fistula nationwide. In addition to providing surgery and physical rehabilitation, our expert staff offer health education, counseling, family planning consultations and crafts training. All services – including transportation to and from the hospital, food and accommodation during treatment – are provided completely free of charge.

With your support, we’re ensuring that women living with obstetric fistula have access to quality healthcare and inclusion. Your donation today will be amplified through GlobalGiving’s 2018 Giving Tuesday matching funds campaign.

Thanks to the generosity of donors like you, so far this year CCBRT has:

• Provided 488 fistula surgeries
• Reached 658 women living with fistula with holistic care services
• Trained over 200 Community Health Workers and others to become fistula ambassadors, who identify and refer fistula patients for treatment.

Walking through the hospital’s halls, CCBRT COO Brenda Msangi sees the profound impact that our high quality healthcare services have on our patients and their families every day.

As Brenda shares in this video, your support is instrumental, enabling us to provide the comprehensive care our patients need and deserve – but otherwise couldn’t afford.

For women affected by fistula, CCBRT’s services offer physical, emotional and financial relief – as well as hope for the future. Ninety-five percent of our patients in 2018 reported feeling more accepted and supported by their community after their surgery.

For these reasons, Brenda and I are asking you to please join us in giving the gift of health and hope to a woman with obstetric fistula by making a donation today. All donations we receive today, on Giving Tuesday, will help us earn a share of $150,000 in matching funds and bonus prizes from GlobalGiving – meaning that your gift goes further to change lives. Recurring monthly donations up to $200 will be matched at 100%.

Thank you for your incredible support and for being part of the Kupona family – we couldn’t do this without you.

With gratitude,

Abbey
Executive Director

Links:

• A video update from our partner's COO, Brenda Msangi

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!