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!

Dear Friends,

Today on Bonus Day, I want you to meet a very special lady.

Msonde is 82-years-old; she had her first child in 1958. With the delivery of that baby, she developed an obstetric fistula that left her chronically incontinent. With access to high quality, emergency maternal healthcare, it is likely that this debilitating disability could have been prevented. With knowledge about her condition, Msonde could have received treatment to correct her fistula.

The tragedy is Msonde lived with fistula for over 60 years.

“I managed to live with fistula for such a long time because of my husband’s support,” she says. “He ignored our family and our community when they used to stigmatize me. He was an exceptional husband. He never stigmatized me as others did. He always stood by my side. I remember he used to quarrel with his relatives because of me, God rest him in peace.”

Msonde and her husband went on to have a total of five children, which she delivered in spite of her fistula, but there were still many trials. Most of the time, Msonde avoided community gatherings, and avoided drinking water because of her chronic incontinence, especially on days when she was supposed to attend church.

This year, Msonde’s niece who lives in Dar es Salaam came to her village as a CCBRT ambassador. She explained what fistula was, and shared that treatment was available and free of charge. Msonde could barely believe it, but she traveled over 700 miles to Dar es Salaam to be evaluated for treatment.

“When I arrived at CCBRT, I could not believe it was possible, but I found many women undergoing fistula treatment.”

Now sitting in recovery in the CCBRT Fistula Ward after a successful surgery, she raises her hands in prayer for her husband. “I wish my husband could have been alive. We are now old, but he could have been able to see me walking freely.”

Today, your donation will be matched 50% by our friends at GlobalGiving until midnight or the matching funds run out. That means that we can reach more women like Msonde with the high quality maternal healthcare, life-changing surgical and rehabilitative care and stigma-busting information they need.

No woman should live with preventable, treatable fistula for 60 years, or even 6 months. Our vision is a Tanzania without fistula, where every woman can walk freely and in the fullness of her potential. Please consider giving today before matching funds expire.

Thank you for your support.

Warm regards,
Abbey

Today, we celebrate the fifth annual International Day to End Obstetric Fistula. In the past five years, we have been encouraged to see this preventable, treatable childbirth injury receiving much needed attention and life changing action implemented across the globe.

We’ve witnessed an increase in cases at our partner hospital in Tanzania, CCBRT, as women realized that their condition was treatable, broke their silence, and were referred for treatment. Thanks to your generous support, and the support of our partners including Fistula Foundation, Johnson & Johnson and Direct Relief, over 4,370 women and girls received comprehensive treatment for obstetric fistula at CCBRT and partner facilities across Tanzania in the last five years. With the continued support of our global community, that number will continue to climb.

Helping to carry the burden

Women and girls with obstetric fistula need a comprehensive team of health professionals – from surgeons to counselors – for holistic recovery. Surgery can address the physical symptoms, but many women have also faced emotional wounds from abandonment, rejection, and traumatic loss. That’s why our program invests in training for nurses like Damaris.

“I always do the night shift, so I have lots of time to talk.” In fact, talking is part of her job. Damaris is one of very few nurses in Tanzania trained in counseling – an essential service for women and girls navigating their recovery from obstetric fistula.

Before joining the team on CCBRT’s fistula ward, Damaris completed counseling training at a nearby university. She explains: “Working with women recovering from fistula is emotional. After training, I can be strong to help carry their burden and help them move past their painful experiences.”

Damaris adds, “Even if women are physically healed from fistula, without counseling they are only halfway toward recovery. They need to know that there is life after fistula. They can return to their communities. They can connect with friends and family. They can start their own business.”

“They are women just like me”

Damaris recalls one patient specifically, with a complicated case of two fistulae. Damaris noticed her patient’s distress; she didn’t talk to anyone and spent all of her time alone. In counseling, the woman began to open up about her experience of abandonment, telling Damaris, “I’m not even wanted by my own mother and father.” But Damaris knew her patient’s future was bright. “I told her that everything was possible, that she would go back happy. And that I would support her every day until she went home dry.” The woman made a full recovery, and months later, she and Damaris still talk on the phone.

What inspires Damaris’ commitment to the fistula ward? “They are women just like me. Their stories should be heard. Even though I can’t solve everything, I know that talking makes a big difference.”

There is great need for psychological support for women recovering from fistula in Tanzania. Damaris hopes that CCBRT can continue to train more fistula nurses in specialized counseling skills – “especially nurses on the night shift!”

Today, and every day, we celebrate the strength of the women and girls we are proud to serve, and the healthcare workers like Damaris who work so diligently to provide the respectful and comprehensive care their patients deserve. Thank you for the part you play through your generous support of our work.

With gratitude,

Abbey Kocan

P.S., A note on data protection

At Kupona Foundation, we’re proud of the global nature of our community. We take the privacy and security of our partners and supporters around the world very seriously, and the new regulations coming out of the European Union have given us an opportunity to make our policies clearer. We wanted to let you know that when you make a donation to Kupona Foundation through our projects listed on GlobalGiving.org we receive access to the data you share. We store this information in our secure constituent relationship management system, Little Green Light, for record keeping purposes only. We will never contact you outside of the GlobalGiving reports and acknowledgement systems unless you have given us permission to do so. If you’d like to read more about our privacy policies, including how we use Little Green Light, you can take a look at our latest privacy notice, which is permanently available on our website. 

Dear Friends,

As I celebrate my third Mother’s Day as a mom, I remain incredibly grateful for the skilled healthcare providers who saved my son’s life the day he was born. If circumstances were different, my complicated delivery could have ended in tragedy. All too often, tragedy is the reality for families in Tanzania, as expectant mothers deliver in overcrowded facilities with under resourced staff.

One of the greatest obstacles to delivering high quality healthcare in Tanzania is a shortage of skilled, well-equipped healthcare workers.Tanzania alone can count on just 5.2 clinical health workers per 10,000 people: one fifth of the optimal ratio recommended by the World Health Organization. The health workforce that does exist has limited access to medical education and professional development.

With your support, our colleagues at CCBRT have been taking action to train and build the capacity of healthcare workers in Tanzania and further afield for many years. Until now, CCBRT’s efforts to strengthen the health workforce have been implemented in both CCBRT’s hospital in Dar es Salaam and at partner facilities across the country. They had no dedicated training facility, and no formalized central training program.

That’s all about to change.

Thanks to you, the Kupona community, and our partners Johnson & Johnson and the UCLA Anderson School of Management, we are celebrating the launch of the CCBRT Academy: a Centre for Excellence in Clinical Education.

“[The CCBRT Academy] is the realization of a vision that we have had for a long time,” says CCBRT’s Technical Advisor for Training and Capacity Building, Tilman Hannig. Through a unique combination of in-person training, online education and practical, hands-on experience, “it will allow us to better professionalize and develop our own staff, as well as health workers from beyond CCBRT.”

The Academy will be a learning environment of the highest quality to enrich educational experiences for the region’s healthcare heroes. We are excited to see the CCBRT Academy thrive, and address one of the most serious challenges facing the healthcare system in Tanzania. As Tilman says, “We have the space. Now we need to fill it with life.”

This Mother’s Day, we invite you to give today in celebration of mothers around the world, and the dedicated healthcare workers who help families to thrive. Today is your last chance to help us unlock prize funding, and to help Tilman and team fill the CCBRT Academy with life! Don't forget, GlobalGiving will award bonus prizes to the top five projects with the most unique donors before midnight tonight.

Thank you to the healthcare heroes, and to each of you, for helping make their work possible.

Wishing you a very happy Mother’s Day.  

Warm regards,

Abbey Kocan