Make Motherhood Safe for Tanzanian Women

by Kupona Foundation
Selina and her son. Photo credit: Sala Lewis
Selina and her son. Photo credit: Sala Lewis

Twenty-year-old Selina was pregnant with her second child when she went for an antenatal visit at her local health center. The center was one of the facilities in Dar es Salaam where Kupona’s sister organization, CCBRT, has been building capacity since 2010.

This is the work your generosity supports, providing desperately needed resources and training to maternal healthcare teams, who in turn, can provide quality care for mothers and newborns. As Selina entered the center for her first appointment, your impact was obvious.

“I was surprised by the cleanliness of the facility,” she says. ”And the fact that doctors and nurses had smiles on their faces as they distributed medicine and attended to patients. I felt comfortable waiting in the busy reception area, so as my pregnancy progressed, I continued to attend the clinics.

One day while I was at home, I felt contractions begin, and knew my baby was on the way. I rushed to the center, but there was heavy traffic on the road. I feared I would not be able to reach the center in time. As I arrived, I couldn’t wait any longer. Nurses rushed out to the gate to assist, and fortunately, they got to me in time. With their help, I delivered a healthy baby boy, just paces away from the front doors.” 

Selina and her baby boy might have had a different outcome at the same health center just six years earlier. Dr. Mbaga, medical officer in charge at the improved facility, shared, “A short while ago, this health center was under-staffed, ill equipped and almost empty. Now we have a thriving delivery unit and are leading clinical care standards in the region.” Dr. Mbaga credits CCBRT’s capacity building efforts with her staff’s improved confidence and ability to perform in emergency situations. Since the program began, emergency drills have become part of the routine at the health center.

“You can’t practice in an emergency,” says Dr. Mbaga. “At that stage, you work by instinct, but you need to practice to perform well under pressure. If the labor ward is quiet, we’ll gather together and work through an obstetric scenario, sometimes practicing three or four times until we get it right. Reviewing our clinical care like this, every day, helps us to improve constantly, and I see that my staff are much more capable as a result.”

This is the impact you support.

Safe birthing centers where mothers feel comfortable and confident that they are receiving high quality care. Medical teams that have been trained to handle complications and emergencies. Resourced, outfitted, clean healthcare facilities that are prepared to give the best care possible.

This Giving Tuesday, we hope you will empower us to reach even more healthcare workers, mothers and newborns.

Your contributions have helped maternal healthcare teams like Dr. Mbaga’s save lives and prevent birth-related impairments. We still have work to do,

Thanks to you, amazing progress has been made for mothers like Selina. But we won’t stop until every woman can deliver her child without fear of injury, impairment, or death.

Today is Bonus Day! Any gift made through GlobalGiving will be matched 50% by our friends at GlobalGiving and the Bill and Melinda Gates Foundation. If you haven’t made your year-end contribution, please do so today. Are you committed to helping mothers like Selina? Please consider becoming a recurring donor – recurring donations of up to $100 will be matched at 200% for the first month. This is an incredible chance to watch your impact multiply!

Thank you for your continued generosity and support,

Nurse Intisar (center). Photo by Sala Lewis
Nurse Intisar (center). Photo by Sala Lewis

“When I get a healthy baby I always clap and cheer, I just can’t help myself!” ~Sister Intisar

Intisar is a nurse in Dar es Salaam. The training she received thanks to your donations empowers her to save lives. After a few months of training and mentorship through our programs, Intisar felt equipped to use her freshly honed skills, receiving perfect clinical scores when she was assessed. One of her trainers called her "a champion of delivery and resuscitating newborns". 

Intisar says, “I want all mothers to have safe respectful care…I want every mother to enjoy giving birth – not regard it as a punishment…I’m happy to be able to pass the best practices on to even more nurses”.

What does she wish for the mothers and newborns of Tanzania? “Seriously, I want zero deaths.”

We’re not there yet, but together, we can help make Intisar’s wish a reality.

One week from today, on Giving Tuesday, you have the chance to further your impact. Thanks to our friends at GlobalGiving and the Bill & Melinda Gates Foundation, every unique donation made on November 29th (up to $1,000) through GlobalGiving will receive a 50% match until 11:59:59pm. In addition, all new recurring donations up to $100 USD per month per unique donor will have their first month matched at 200%.

Every donation you make to our program changes the lives of women in Tanzania, giving them access to the high quality healthcare they need and deserve. A donation on Giving Tuesday will go even further, equipping more healthcare workers like Intisar with the skills, equipment and supplies they need to manage deliveries safely.

This year, thanks to healthcare workers like Intisar, several of the hospitals we support have celebrated months without a single maternal death. We can’t stop now. Intisar’s wish for zero deaths is possible, but we can’t do it without you. Please consider making your Year End donation on November 29th, Giving Tuesday, to stand with nurses like Intisar, and make motherhood safe for every woman and newborn we serve.

Thank you,

Abbey Kocan

Meet Ruth. Photo Credit, Sala Lewis
Meet Ruth. Photo Credit, Sala Lewis

Together, we are making stories like Ruth’s a thing of the past

Thousands of expectant mothers in Tanzania do not have access to high quality maternal healthcare, either because they do not make it to the hospital in time, or, when they do make it, wards are overcrowded, understaffed, and under-resourced. With your generosity, collaboration with the Government of Tanzania and support from other partners, the situation is improving. However, we still have a long way to go.

Ruth, a patient at CCBRT’s Disability Hospital, shared her story with us. “I was 20-years-old when I learned that I was pregnant. I was so excited to welcome my child into the world. When the time came, I had labor pains for a day before I went to the hospital. It took me four hours to get there. When I arrived at the hospital it was too late. My baby didn't survive. I was heartbroken, and it seemed like things couldn’t get any worse. Then, I realized I was leaking urine.”

Ruth developed obstetric fistula during the prolonged delivery. A hole had formed between her vagina and bladder, leaving her with chronic incontinence. “None of my doctors explained what was happening, and I left the facility with no idea what was wrong.”

“My community turned their backs on me. A Good Samaritan let me live with her, and I started to look for treatment. I went to several hospitals, but nobody could help me.”

That was in 1985.

Almost three decades later, Ruth was introduced to one of CCBRT’s volunteer ambassadors, one of 1,600 volunteers around the country tasked with identifying and referring women with fistula for treatment. After surgery, Ruth participated in group and individual counseling sessions and received health education, family planning advice and physiotherapy. At no point did Ruth have to pay for her treatment, food or stay in the hospital. Ruth lived with fistula for longer than she lived without it, but now she says, “I am finally dry and on the path to recovery.”

For Ruth, access to high quality maternal healthcare could have spared her decades of suffering. Thanks to your generosity, we are changing the status quo for expectant mothers in Tanzania. With your help we’ve trained medical teams, purchased critical equipment and refurbished labor wards so that stories like Ruth’s become a thing of the past. Over the next year we will complete construction of our new Maternity and Newborn Hospital in Dar es Salaam, providing high quality care to women at risk of complications, those requiring emergency interventions, and sick newborns, ensuring they have the care they need to survive and thrive.

Photo credit: Sala Lewis
Photo credit: Sala Lewis

At Kupona, we’re passionate about opportunity. In our 2015 Annual Report, available now, you’ll find stories of individual lives changed, figures that depict the scale of our collective impact, and testimonies from members of our community, encapsulating a year where we embraced opportunities to unlock potential like never before.

Your support is saving lives

In 2015, your donations and grants from institutional partners helped support the safe delivery of 78,000 babies and the distribution of over $90,000 of equipment and supplies to healthcare facilities in Dar es Salaam. Your generosity also helped facilitate training for hundreds of healthcare workers nationwide. These interventions have had a measurable impact on the quality of healthcare available to expectant mothers and their newborns. Since our sister organization, CCBRT, began building capacity in public healthcare facilities in 2010, the maternal mortality rate in the Dar es Salaam region has fallen by 30%.

“Now, thanks to my training from CCBRT, I can deliver babies using the vacuum technique and handle emergencies like eclampsia and post-partum hemorrhage. My facility is performing so well now.”

Nia, Assistant Nurse In-Charge, Buguruni Health Center, Dar es Salaam


We’re shining a light on a silent tragedy

In addition to saving lives, improvements to maternal and newborn healthcare are making a direct contribution to the eradication of impairments like obstetric fistula. In May, with support from our friends at Johnson & Johnson, we co-hosted our first Twitter chat on International Day to End Obstetric Fistula with CCBRT, UNFPA and Fistula Foundation. We made over 3.8 million impressions as we shared our vision of a world without fistula, and some of the lessons we’ve learned from CCBRT’s high impact programs in Tanzania.

On the same day, we launched the Drawing Out Obstetric Fistula exhibition at the New York University Kimmel Center, shining a spotlight on the experiences of women living with and recovering from obstetric fistula.

We’re excited to announce that the Drawing Out Obstetric Fistula exhibition, originally scheduled to close on July 4th, has been extended until December 31st, 2016. We’ve been thrilled by the response to this project, and we couldn’t let it close just yet. Thanks to our friends at Johnson & Johnson, the UNFPA-led Campaign to End Fistula, Fistula Foundation, and New York University for their continued support. You can visit this powerful collection on the 6th floor of the NYU Kimmel Center on Washington Square South in NYC.

“The exhibition is a beautiful reminder that there is dignity and value in every person’s story. Not only does the artist capture the transformative power of a successful surgery, but also the inherent stigma-busting power of a woman who is unafraid to tell her story as someone living with or having lived with a fistula.”

~Zack Langway, Kupona supporter

Lives and communities have been changed by your support. You are the driving force that makes this progress possible. Thank you for standing with us to provide high quality maternal and newborn healthcare to the people of Tanzania.


Kind Regards,

Abbey Kocan

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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Organization Information

Kupona Foundation

Location: Saratoga Springs, NY - USA
Website: http:/​/​
Project Leader:
Abbey Kocan
Executive Director
Saratoga Springs, NY United States
2016 Year End Campaign
Time left to give
$52,299 raised of $65,000 goal
546 donations
$12,701 to go
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