Make Motherhood Safe for Tanzanian Women

by Kupona Foundation
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Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Make Motherhood Safe for Tanzanian Women
Abbey meets with women recovering from fistula
Abbey meets with women recovering from fistula

Bringing a silent tragedy into the spotlight

The first time I met a woman who was recovering from obstetric fistula surgery, I was faced with a reality I had been sheltered from for far too long. Four years later, while the level of awareness around this condition in the developed world has grown, there is still a lot of work to be done before this critical global health challenge is given a permanent place in the spotlight.


Imagine if, while giving birth, you or your partner faced a complication requiring emergency medical care. Imagine if that care was unavailable, and you lost your baby. You grieve for the loss of the child who was so close to living. You, or your partner, suffer silently, trying to find a way to cope with the physical trauma that leaves you incontinent, unable to work and further devastated by judgment and abuse at the hands of your friends and family.

“I lived like this for 10 years, with my mother. My neighbors told me I smelled, and forced me to stay inside. When my mother passed away, I had no one left to talk to, and nobody to look after me. I went to my father’s sister for help, but she told me I was cursed. She chased me away from her house and refused to let me live there. I was fired from two jobs, both times because of the smell.” – Hadidjia, fistula survivor

A Silent Tragedy

At Kupona Foundation we often refer to obstetric fistula as a silent tragedy, affecting members of our global community who struggle to make their voices heard even before they are faced with unimaginable trauma. It is made even more difficult to endure by the myths and misconceptions that are held up as fact in their communities. The women living with this condition are hidden from view. As a result, those with the power to change things are oblivious to their struggle.

Today, International Day to End Obstetric Fistula, Kupona Foundation, in partnership with Johnson & Johnson, UNFPA’s Campaign to End Obstetric Fistula, Fistula Foundation, New York University’s Kimmel Center for University Life and the College of Global Public Health, launch the Drawing Out Obstetric Fistula exhibition at the NYU Kimmel Center in New York City. The collection of work by artist Jac Saorsa is designed to shine a light on the experiences of women living with and recovering from obstetric fistula, to raise awareness about the condition, and to mobilize support for the programs and partnerships that work to restore women’s dignity. The women featured all received treatment from CCBRT, Kupona Foundation’s sister organization, at its Disability Hospital in Dar es Salaam, Tanzania.

Since 2009, Kupona Foundation supporters have contributed over $1.3 million to the treatment and prevention of fistula.Together, we have rebuilt the lives of 3,987 women, and with our support CCBRT has grown to become one of the largest providers of comprehensive fistula treatment in the world. Our hope is that these drawings will open your eyes not only to the reality facing the women living with obstetric fistula, but also to the opportunity facing every one of us to change the status quo.

We imagine a world free from fistula, can you?

Fistula can be treated, prevented and ultimately eradicated. All it takes is a community of individuals and institutions coming together and taking action. By attending this exhibition you will become a vital part of this community.

Thank you for your support.


The Drawing Out Obstetric Fistula exhibition is free to the public from May 23rd-July 4th, Mon-Fri 9am-8pm, Sunday 1pm-8pm (closed Saturday) at the NYU Kimmel Center, Washington Square S, New York, NY. All visitors must present photo ID at reception.Learn more about the exhibition:

On May 23rd at 11am ET, Kupona Foundation will host a Twitter chat with support from Johnson & Johnson to mark International Day to End Obstetric Fistula. Please join this important global conversation by following the hashtag #FistulaDay

by Jac Saorsa
by Jac Saorsa
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Photo credit: Mark Tuschman
Photo credit: Mark Tuschman

Dear Friends,

In 15 days, Kupona's sister organization, CCBRT, will celebrate the 15th anniversary of the opening of their Disability Hospital. 

Since 2001, the hospital has conducted hundreds of thousands of life changing surgeries, equipped medical teams to provide high quality care, and dedicated countless hours to build capacity in partner healthcare facilities. Today, CCBRT is Tanzania’s largest provider of disability and rehabilitative services, and thanks to your support, CCBRT is now changing the lives of over 1 million people every year.

The next chapter promises to be even more exciting. Together, we are moving closer to a Tanzania where access to quality healthcare is universal. Together, we are unlocking new opportunities for people like Malela.

Help us raise $150,000 by March 26th.

Over the next 15 days, Kupona will support CCBRT’s efforts to raise $150,000 in celebration of the last 15 years of life changing service. We need your help!

As a Kupona supporter you have an incredible opportunity to amplify your impact. Give through our GlobalGiving Microproject on March 16th, and our friends at GlobalGiving will match your donation with Bonus Funds. Help us continue serving people like Malela  for the next 15 years:

  • $25 provides 5 physical therapy sessions for one patient. 
  • $50 provides food for 20 patients at our Disability Hospital for one day
  • $150 provides corrective treatment for a child with clubfoot, enabling them to walk to school.
  • $710 provides corrective surgery and comprehensive rehabilitation for a woman living with obstetric fistula.

Thank you for your support along this journey.

Warm regards,

Abbey Kocan

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Photo credit: Benjamin Eagle
Photo credit: Benjamin Eagle

Dear Friends, 

In February 2012, Kupona Board member Dr. Yoni Barnhard visited Amana Hospital in Dar es Salaam, and shared his experiences in a series of GlobalGiving reports.

An American OBGYN, Dr. Barnhard found himself in an overcrowded, under-staffed, under-equipped delivery ward, and reported that, despite the desire to save their patients, the staff at Amana didn’t have the resources they needed to do so. The consequences were often tragic.

“Amana. Second largest district hospital in Dar es Salaam. 29,000 deliveries each year. Do the math. Teeming with births. Just 6 birthing beds. Not actually birthing beds. Metal tables with a hole at one end. Fresh blood dripping through. A bucket underneath. No full-time OBGYN. No full-time anesthesiologist. No air conditioning. 92 degrees outside. Hotter inside. This is where we start.”

Four years later, we’ve come a long way from where we started. Thanks to the tireless efforts of CCBRT’s Maternal and Newborn Healthcare team, in close partnership with the Government of Tanzania, Amana is unrecognizable. Kupona’s dedicated donors joined a committed network of supporters and partners including Vodafone Foundation, Global Affairs Canada (GAC – formerly DFATD), and CBM Australia. Today, thanks to your generosity, expectant mothers are entering a very different hospital.

“The challenge is not practicing good obstetrics. The challenge is practicing better obstetrics with limited resources.”

Relieving the Pressure

Dar es Salaam’s healthcare system was designed to support a city of 750,000 people; hospitals and clinics now serve a population of over 4.4 million. Severe overcrowding hampers healthcare workers’ ability to give every patient the attention and quality of care they deserve. When Dr. Barnhard visited Amana four years ago, the hospital conducted 2,000 deliveries a month. He counted three nurses helping 41 women in labor.

Capacity building and training at smaller pre-referral healthcare facilities across the region means that families now place their trust in a greater number of facilities, decongesting wards at district and regional hospitals and relieving the pressure on healthcare teams. Today, Amana Hospital conducts 1,000 deliveries a month, giving staff more time to focus on each patient and respond efficiently to emergencies. In 2012, the labor wards were so crowded women were delivering five to a bed, or on the floor. Today, more women deliver one to a bed, though there are still space constraints in some of the wards.

“When it comes to saving a life, one can do far more with a single unit of blood than an ultrasound machine.”

The Tools to Save Lives

In 2012, Anna1, a 29-year-old pregnant woman, and mother of 6, arrived at Amana displaying severe preeclampsia symptoms. Her attending healthcare worker ran from room to room borrowing the medication needed to save her life. It wasn’t enough, and she died a few hours later. Anna’s death could have been prevented. Today, eclampsia and emergency kits are readily available, stocked with the medication and supplies needed to avoid preventable tragedies. Today, her six other children would still have a mother.

The leading cause of maternal death in Tanzania is post-partum hemorrhaging, and this is unlikely to change without addressing the severe shortages of safe blood supplies. In 2012, little was being done to overcome these challenges. In 2015, CCBRT’s Capacity Building Program began working with the Regional Health Management Team in Dar es Salaam to establish four satellite blood banks, increasing the availability of clean blood in the region. In addition, there are now two full-time OBGYNs at Amana, and training is available for surgical and medical management, giving staff the knowledge to confidently and competently save lives.

Lasting Change You Empowered

Improvements2 across the board at Amana mean that staff are equipped, trained, and available to tackle emergency cases, prevent birth injuries like obstetric fistula, and identify and refer newborns with impairments like cleft lip or clubfoot. A healthy child born to a healthy mother is less likely to be caught in the cycle of poverty, and more likely to pursue education and employment later in life.

In 2012, Amana Hospital’s delivery ward was a sea of women in all stages of labor, with an overwhelmed staff fighting an uphill battle to treat and save the patients in their charge. Today, with your support, we are seeing a new reality for the women of Tanzania, and in turn, for their children. There is still room for improvement and growth, particularly in early labor wards which are still crowded. There is also an emerging need for a space where mothers can nurse their sick newborns. However, CCBRT is ready to meet these challenges, spurred on by the success you’ve supported. Four years later, the future for Tanzanian families looks much brighter.

  1. Name changed to protect patient’s identity
  2. Following a recent assessment, Amana achieved 78% of quality standards for Basic Emergency Obstetric Care, measured by Standards-Based Management and Recognition (SBMR) assessments, developed by Jhpiego, an affiliate of Johns Hopkins University” compared to Amana’s baseline score of 9% in 2010. 
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Photo credit: Maddie Johnson
Photo credit: Maddie Johnson

Dear Friends,

In December, we launched our final fundraising push of 2015. Thanks to you, and other like-minded donors, we raised over $2,250 during the GlobalGiving Year End Campaign. Our wider campaign was the most successful in our history, with over $29,000 raised for the people and communities of Tanzania. We couldn't have done it without the support of our GlobalGiving community. 

What does $2,250 mean for the mothers of Tanzania?

$2,250 will fund the equipment necessary for 18 safe emergency C-sections, giving 18 mothers and their babies a real chance at surviving a complicated delivery. For 19-year-old Hanaa, trained, equipped medical staff might have saved her unborn son and spared her the trauma of developing an obstetric fistula.

When Hanaa went into labor with her first child, medical staff at her local dispensary told her she had to go to the district hospital for delivery. That facility didn’t have the proper equipment. On the second day, she was referred to the regional hospital, which was equipped to perform the C-section she needed. It was too late. Her son was delivered stillborn.

After her traumatic C-section, Hanaa realized that she was leaking urine, and was diagnosed with an obstetric fistula, a condition caused by her prolonged, obstructed labor. An ambassador from our sister organization, CCBRT, was working at the hospital. The ambassador paid for her transportation, and she arrived at CCBRT’s Disability Hospital eager to receive treatment. Now, after surgery and rehabilitation, Hanaa has hope, has recovered, and is dry.

Hanna’s message to the medical staff and donors who helped her is one of gratitude, but also a call to action. She says “I will pray to God to bless them, and to help them serve more people.”

Hanaa’s story is not unusual in Tanzania, but thanks to your support, it is becoming increasingly less common. Your generous gifts at the end of last year will continue to provide access to the high quality maternal healthcare services the women of Tanzania need and deserve. With every dollar you ensure that no woman needs to face the same trauma as Hanaa. Together we are unlocking new opportunities and fresh starts for healthier, stronger mothers, families, and communities.

Thank you for your support in 2015. We can’t wait to see what 2016 will bring.

Best wishes,


Photo credit: Maddie Johnson
Photo credit: Maddie Johnson
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The happy new family. Credit Kimberly Hoover
The happy new family. Credit Kimberly Hoover

Two months ago, our Executive Director Abbey gave birth to a beautiful baby boy, Bryce Edward Kocan. When she took a moment to compare her childbirth experience with that of a Tanzanian woman the reality was both sobering and heartbreaking.

“After my water broke, our baby’s heart rate began dropping dangerously every time I had a contraction. We had the undivided attention of 2 nurses and 1 doctor for over an hour. That’s when we knew it was serious. Our “plan” for a natural birth melted away. All that we cared about was the health of our son…It took about 36 hours for the reality of what could have been to sink in…If my experience had been the same as that of a Tanzanian mother, Mike and I would almost certainly be mourning the loss of our son today”

Read more about Abbey’s experience in her latest HuffPost article.

Your support is improving the quality of care available to mothers and their newborns in Tanzania, ensuring Tanzanian families have the same access to the quality of care Abbey received in the U.S., and the same opportunity for a happy ending.

You’re breaking records, and changing lives

Your donations allow Tanzanian medical teams to be trained and mentored by highly skilled surgeons and doctors, equipping healthcare facilities to manage deliveries safely, and embedding high quality care in the Tanzanian healthcare system for generations to come.This past May, you stepped up to make our Mothers’ Day Bonus Day campaign the most successful in our history. Now, as we enter the holiday season, we’re hoping to maintain your record-breaking momentum, and raise support for the families of Tanzania.

We are participating in GlobalGiving’s Year-End campaign, with bonus prizes available to the organizations that raise the most money, from the most donors. We need your help to unlock these amazing prizes! Make a donation via our GlobalGiving project page before midnight EST on December 31st and we could be eligible for up to $3,000 in bonus funds!

Your support is the gift that keeps on giving.

A donation may feel like a small drop in the ocean but single drops create a ripple effect. Your gifts enable people to access high quality healthcare, in turn strengthening their families, giving them access to education and employment, and empowering their communities.

Ensure the impact you made this year continues to reach the people that need it most. Together, we can empower individuals and communities living in poverty in Tanzania to realize their full potential.

Happy Holidays!

The Kupona Team

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Organization Information

Kupona Foundation

Location: Saratoga Springs, NY - USA
Facebook: Facebook Page
Twitter: @KuponaFdn
Project Leader:
Susana Oguntoye
Executive Director
Washington , DC - District of Columbia United States
$147,351 raised of $400,000 goal
2,144 donations
$252,649 to go
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