Make Motherhood Safe for Tanzanian Women

Dear Friend, 

Tomorrow is Bonus Day! Beginning at 9:00 am ET on July 18th, your donation goes further to support health workers like Dorcas and the mothers, babies and families they serve. Gifts from $100 to $1,000 will receive up to a 50% match

Dorcas is a valued member of our partner CCBRT’s Maternal Health Capacity Building Team (MHCB),whichworks to strengthen health systems in Dar es Salaam by expanding the knowledge of clinicians and quality of care. On a recent visit to Tegeta Dispensary, a clinic that provides antenatal care for expectant mothers, she met 17-year-old Jane, who was expecting her first child. Jane’s mother explained that they had been to the clinic before, and had been told that Jane needed a male partner with her to receive services. “I told Jane and her mother that nothing like that is needed to access services,” remembers Dorcas. “Even when their partners are not around, women should still be able to access the care they need.” 

That same day, Dorcas met another couple. It was soon apparent that the man was not the baby’s father. During her two prior visits to Tegeta Dispensary, the mother had been told that she needed a male partner, just as Jane had. Dorcas realized what was happening: the clinic had misinterpreted best practice knowledge advising that male partners should be encouraged to accompany their expectant partner on visits to receive information on how to best support mother and child.  However, male partners are by no means necessary for a woman to receive care. 

Dorcas quickly informed regional and district authorities, who are taking action to remedy the incorrect rule. Dorcas emphasizes how this situation reinforces the importance of the MHCB Program. “This challenge was only discovered working alongside the providers on the frontline. Health education messages can get modified without direct observation and quality control,” explains Dorcas. “That’s why CCBRT’s Capacity Building Program is so important – on-site coaching and practice facilitation has proven to be the best practice for behavior change, so that every mother in need can access the best care.”  

Your support makes Dorcas’ work possible. You are helping Dorcas empower health workers with the tools they need to empower expectant mothers and their partners with the information THEY need to demand high quality care. I invite you to join us for this special matching opportunity tomorrow, to make your gift go further. The higher the amount, the higher the match! 

Thank you so much for your support!

With gratitude, 
Abbey Kocan

Executive Director, Kupona Foundation

Dear Friends,

Today we’re celebrating the sixth annual International Day to End Obstetric Fistula.

Obstetric fistula is a devastating childbirth injury caused by prolonged, obstructed labor without access to timely, high-quality medical care. The injury leaves women with chronic incontinence, leaking urine, feces or both due to a hole formed between the birth canal and bladder or rectum during childbirth. In 90% of cases, the baby doesn’t survive the traumatic delivery.

The condition and stigma surrounding it often cause women to be isolated or rejected by their families and communities. Women in disadvantaged communities live with the condition for years – or even decades – because they’re unaware that fistula can be treated, or unable to access treatment.

That was true for 82-year-old Msonde, who lived with fistula for 60 years after developing it during the delivery of her second child in 1958. It wasn’t until last year that she learned from her niece that she could receive free fistula treatment at our local partner CCBRT. In August, Msonde traveled to CCBRT and underwent surgery that successfully repaired her fistula.

"When I arrived at CCBRT, I could not believe it was possible, but I found many women undergoing fistula treatment," Msonde said after her surgery. “I wish my husband could still have been alive. We are old now, but he could have been able to see me walking freely.”

In Jovitha’s case, she developed fistula after being in labor for three days during the delivery of her fourth child. Tragically, her baby did not survive. Despite quickly learning that she had fistula, the trauma of the delivery, loss and injury deeply affected Jovitha’s mental health and self-esteem.

“My experience – it’s unexplainable,” Jovitha shared. “I hated myself for three months. I had urine flowing down my legs and was extremely embarrassed. But…thankfully I had that support that so many other women don’t feel from their families and communities.”

Fistula is treatable through surgery and rehabilitation. What’s more, it’s preventable – through access to high-quality maternal health services.

This International Day to End Obstetric Fistula, we’re asking for your help to eradicate fistula in Tanzania.

Share your support for the global movement to fight fistula by using the hashtag #EndFistula in your posts or stories on social media.

Join the movement. Make a donation in honor of a strong woman or mother in your life. By giving Tanzanian maternal health workers the training and resources to both prevent and treat fistula, your gift gives women like Msonde and Jovitha the chance for a better life.

Regardless of income or location, we believe that NO woman should live with obstetric fistula. We hope you’ll join us in making that dream a reality. Thank you!

Sincerely,

Abbey Kocan

Executive Director, Kupona Foundation

P.S. Read Jovitha’s full story here, and learn more about Msonde’s journey here.

Dear Friends,

This Thursday, May 23rd is International Day to End Obstetric Fistula. While as many as 3,000 Tanzanian women develop fistula every year, many in Tanzania have never heard of it; the condition is still surrounded by lack of awareness, confusion and stigma.

Asha, now 44, developed fistula during the birth of her second child in 1996, when she was 23.

Without a skilled medical attendant present, Asha’s second labor and delivery was long and painful. Afterwards, like many women living with fistula, Asha was unable to control her urine or feces.

It would be six years before Asha even learned the name of her condition, which continued worsening as she gave birth to four more children. Unable to afford fistula surgery at her district hospital with her income as a local farmer, 16 more years passed before Asha learned about our partner CCBRT’s free fistula services.

In February 2019, after 22 years too many, Asha underwent a successful fistula repair surgery at CCBRT.

Realizing she could finally access treatment was “the beginning of a new life chapter,” Asha said. Read Asha’s full story here.

Obstetric fistula is preventable with access to timely, high-quality maternal health services. No woman should live with fistula for 22 years, or even two months.

Tomorrow, on International Day to End Obstetric Fistula, we’re raising awareness about fistula and mobilizing support to eradicate fistula in Tanzania. Stay tuned to learn how you can help, and visit our website, Facebook or Instagram for more stories from women affected by fistula and the health workers working tirelessly to prevent it.

Sincerely,

The Kupona Foundation team

Dear Friends,

With your support, our local partner CCBRT's Maternal Health Capacity Building (MHCB) team has worked hard to reduce the occurrence of postpartum hemorrhage (PPH) in Dar es Salaam. Their interventions have quite literally saved lives; however, PPH remains the leading cause of maternal deaths in Tanzania.

We want to make every birth a safe birth. To do that, we’ve moved beyond addressing “low hanging fruit.” Instead, we’re looking at old problems with new eyes.

Recently, working with frontline health workers, MHCB’s typical bottom-up approach identified a new approach to managing PPH: ensuring the adequate availability of blood at health facilities.

Lack of blood contributed to almost 50% of maternal deaths in Dar es Salaam in 2018. Years of blood shortages mean that some Tanzanian doctors have become overly frugal with their use of blood, leading to poor medical practices and contributing to unnecessary deaths, even before women go into labor. As MHCB Program Manager Dr. Brenda told me, “If you treat [maternal] anemia casually, you end up with a casualty.”

MHCB has worked closely with the Tanzanian Ministry of Health and National Blood Transfusion Service to come up with a creative solution: establishing satellite blood banks to more effectively collect blood throughout the region and to more efficiently distribute blood among health facilities that critically need it.

As a result of the new satellite blood banks, Dar es Salaam now collects more blood than Tanzania’s other regions. A renewed focus on training for clinicians to reinforce best practices has led to improved use of blood, and fewer cases of obstetric hemorrhage and preventable maternal deaths.

Now the official government model for all of Dar es Salaam Region, the satellite blood banks will become a life-saving model for all regions in Tanzania – a testament to the importance of listening to and supporting frontline health workers to make motherhood safer in Tanzania. Thank you for helping us continue this life-saving work.

Warmly,

Abbey Kocan

Executive Director, Kupona Foundation

Dear Friends,

Each year in Tanzania, 11,000 women die due to complications in pregnancy and childbirth, and 40,000 births result in a stillborn baby. We can save these lives. Our greatest resource in doing so? Front line health workers.

Studies of Tanzania’s over-congested, under-resourced health facilities have blamed “personnel motivation” and staff’s “low productivity” for many of the failures of the country’s health system. In contrast, our collaborative Maternal Health Capacity Building (MHCB) program focuses on encouraging, empowering and enabling front line health workers. 

Dr. Timothy is one of our expert emergency obstetric care trainers and clinical coaches. He spends at least three days a quarter at each of our 22 partner facilities, working alongside health worker to address skill gaps through coaching, mentoring and engaging health workers to identify problems and implement solutions.

In the past five years, the generosity of donors like you has enabled MHCB to train more than 5,000 maternal and newborn health workers, empowering them with the skills and confidence they need to save lives. The result? A 40% reduction in maternal deaths and a 14% reduction in stillbirths in MHCB’s 22 partner facilities.

What’s more, health workers trained by MHCB have a heightened sense of ownership. As one manager put it: “If today, there were 10 maternal deaths, I know that it doesn’t have to be like that tomorrow. MHCB works hand-in-hand with us to identify problems and implement solutions.”

Your continued partnership has helped us save thousands of lives. As you celebrate mothers this month, I invite you to also celebrate the healthcare providers in your life and the healthcare providers in Tanzania, who are working tirelessly to create a better, safer tomorrow for mothers and newborns. A gift of $50 provides the resources necessary for four safe deliveries. A gift of $100 trains two maternal health workers to save lives at birth.

Happy Mother’s Day, and thank you!

Sincerely,

Dr. Brenda D’mello

OB/GYN, CCBRT MHCB Project Manager and Technical Advisor