As we approach a new, worrisome phase of the COVID-19 crisis, there are many changes in how the world approaches global health. Not only has the pandemic exposed the broken sutures among key players in the sector, it has also underscored how essential the often-forgotten local communities are in achieving health equity. At the onset of the pandemic, many foreign staff and volunteers were understandably evacuated back to their home countries before borders closed, leaving local staff and communities to take charge. While the global health community lauds itself as a vanguard of justice and equity, such a move during a once-in-a-generation health crisis proved that the sector, while still beneficial, largely relied on the efforts of the community rather than the traditionally more visible foreign professionals.

In fact, for far too long, the wealth of local expertise, knowledge, and passion has been sidelined by international teams and often Western-based headquarters. During the pandemic, aid agencies and development organizations in the Global North have had their own woes too as the US and Europe reported record highs in average new cases and COVID-related deaths. As a result, local staff have, therefore, had more say and freedom when faced with situations that need immediate action. This necessary expediency as a result of the pandemic has meant that local communities have now taken a seat at the decision-making table. It is our hope that they will stay there.

Local organizations across the Global South have shown resilience in tackling this global health crisis and sustaining access to critical health services, including essential surgery. In response to the pandemic, there have been incredibly innovative solutions led by local communities, building upon multi-sectoral partnerships and therefore bypassing the often NGO-rife global health space.

As noted in Harvard Business Review, “about one-fifth of these innovations have come from low- and middle income-countries.” Safe Hands Kenya (SHK) saw 40 private companies and social enterprises form an alliance to rapidly respond to the pandemic last year. The initiative leveraged local knowledge and capacity to distribute masks, hand washing stations, and disinfectants while conducting awareness campaigns on how to prevent COVID-19 infection. SHK bypassed most restrictive aid processes to reach over 1.3 million people in a month. This innovative model has now been nominated by Fast Company as one of the World Changing Ideas of 2020. Health practitioners must recognize the importance of regional and local multi-sectoral partnerships, as even though they can translate into a multitude of challenges and complexities, they can also tap into local leadership and knowledge to provide solutions for the problems communities seek to solve.

For forward-looking nonprofits, not as much has had to change. Watsi, which directly funds patients who need life-saving surgeries through crowdfunding, adopted a local and patient-first model from their founding in 2012. They focus on actively listening to a patient’s own story and needs, and then work to provide direct funding for their cost of medical treatment. Watsi partners with leading local medical providers to refer patients in need of surgery through a system of trust and transparency that supports the local hospitals to set their own priorities on what will have the most impact on patients’ lives. This has led to an open and effective relationship between Watsi and its medical partners in communities around the world, which ensured limited disruptions to patient care during the pandemic.

Additionally, with the majority of their funds coming from individual contributions, Watsi has been able to sustain its model through COVID-19 as harder-to-pin down grants remained scarce.

Global health has always been about eliminating health disparities in vulnerable communities. While this is possible through global cooperation, it can only be achieved by making space for local voices and perspectives in both the development and implementation of solutions. How can we ensure that local communities lead the discussions at the table? This calls for decolonization of the sector with changes such as funding models moving away from bureaucratic, top-down traditional models.

For Kupona Foundation, a nonprofit committed to delivering high-quality healthcare to those who need it most in Tanzania, the pandemic has highlighted the need for unrestricted funding. Kupona’s local partner, Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), a leading specialist healthcare provider in Tanzania and a lynchpin in their healthcare system, had to prioritize the needs of the community while directing funds towards infection, prevention, and control efforts, as well as staff coverage and salaries due to increased sick and bereavement leave, depleting financial reserves.

As many conventional funders direct their aid to specific projects, and restricted funds to specific COVID needs within the pandemic, this has stifled the broader work of some health organizations such as CCBRT, with salary and administrative costs that still have to be met.

Now more than ever, nonprofits in the Global South must have the discretion to channel funds where necessary and most impactful as evidenced by some funders who have wisely provided much-needed unrestricted mini-grants within this crisis period.

As we navigate out of the pandemic, we wish to hear more directly from the people in whose communities global health organizations work. Additionally, innovation and partnerships must be based on shared values, trust, social justice, and mutual accountability to deliver collective impact to those who need it most. Moving forward, it is our hope that the local communities will take center stage in all conversations as they advocate for change driven by local needs, and not a global solution in search of a problem.

ABOUT THE AUTHORS

Mackinnon Engen serves as the Executive Director of Watsi. As a global health and humanitarian professional, her experience spans the UN, international and local NGOs, and academic sectors across Asia, Africa, Europe, and the Americas. Her research includes topics of organizational leadership and effectiveness, economic impact of health interventions, emergency food security, and the humanitarian impact of climate change.

Susana Oguntoye serves as the Executive Director to Kupona Foundation. She has almost two decades experience in health research and policy, as well as design, monitoring, evaluation, and implementation around health services development, with a particular focus on international development and global health systems strengthening.

Brian Njoroge is a Partnerships and Communications Officer at Kupona Foundation. He is a 2020-21 Princeton in Africa Fellow and is interested in working in marginalized communities to create change through policy and critical development.

Kate Schwed is an External Communications Advisor at Kupona Foundation. She is a freelance copywriter based in Brooklyn, NY.

*published in One.Surgery’s Hold On, Dear Life! Our wonderful 13th issue of Voices of Surgery in September 2021

Dear Friends, 

In a time when the pandemic has hit small enterprises hard, Kupona Foundation has been no exception. Since March 2020, Susana Oguntoye has led the organization and engaged with all of Kupona’s stakeholders, spearheading the Kupona Foundation community and pushing for support for CCBRT. In October 2021, Susana will start a new exciting role in global health in the private sector and will no longer serve as Kupona’s Executive Director. She says, “I am very sad I am no longer able to serve as Kupona’s Executive Director and I have decided therefore not to leave. I will instead immediately transition to Kupona’s Board of Directors.”

Transition in Leadership

Kupona will remain in good hands with the Board of Directors, which both Susana and the former Executive Director of Kupona, Abbey Kocan, have joined. Abbey brings a wealth of knowledge on Kupona operations. She served as Kupona’s Executive Director for nearly seven (7) years through April 2020, consistently providing formative and strategic leadership, including on the ground in Tanzania to CCBRT. 

“This is a critical moment within the pandemic for CCBRT and Kupona Foundation. We expect to consider recruiting a new Executive Director in the near future.”, says Kupona’s Chair of the Board, Robert Schwed. 

Continued Impact

CCBRT continues to be a leading light in healthcare in Tanzania, seeing roughly 500-700 patients every day. The new CCBRT Maternal and Newborn 200-bed Wing has been up and running since April 2021 and can support up to 5,000 deliveries a year. In this moment, we can all continue to support by giving. Kupona will continue to provide a direct channel to support CCBRT’s life-changing programs for women, newborns and people with disabilities, including thousands of children every year.  

Dear Friends, 

As we wind down 2020, we at Kupona are reflecting on what a year it has been. This was a year dominated by the worldwide pandemic and its effects. Nevertheless, we have been able to do what we do best: provide quality healthcare to mothers, babies, and people living with disabilities in Tanzania. 

First, on behalf of CCBRT, we would like to thank you for your support which has ensured that we continue making an impact despite the ongoing pandemic. As we reflect and celebrate this holiday season, here are some of the things we want to look back at in 2020:

Change in Leadership

Earlier this year, Abbey Kocan stepped down as Executive Director of Kupona after almost seven years of service. She was replaced by Susana Oguntoye, who holds nearly two decades of experience in global health research and policy and joined us from Africare where she was the Director of Monitoring, Evaluation & Knowledge Learning. 

Kupona also welcomed three fellows. Through our partnership with Johnson and Johnson and Princeton in Africa, we hosted three fellows to help us with Resource Mobilization and Digital Communications. Jillian (who left us in August 2020), Michelle and Brian (who joined us then) have brought energy and expertise to our work, and we ask you to join us, thanking them and their sponsors for their invaluable support!

Continued Impact

Despite the challenges due to the pandemic, we have managed to continue providing essential services to the vulnerable communities that need them the most. CCBRT supports over 80,000 deliveries each year and anticipates this will grow with the opening of the new Maternity and Newborn Wing in the Spring of 2021. We understand that mothers and babies cannot wait, and have held the frontlines, providing high-quality and respectful maternity care to 60% of all mother-baby pairs across the Dar es Salaam region (with a population of 6 million+).

Additionally, CCBRT continues to champion disability rights,  changing the lives of children such as Sharon and Jennifer through corrective surgeries and treatment. 

Read about the impact you helped us achieve in Kupona and CCBRT’s 2019 Annual Reports.

Next Steps

With the opening of the new 200-bed Maternity and Newborn Wing in early 2021, CCBRT will provide services to more people than ever before. This will help us extend essential services across Tanzania, and you can support us here. 

Every gift you give changes lives. We aim to raise $30,000 by December 31and any amount you give will be matched dollar for dollar!

We have so far raised more than $15,000 and we are thankful for your support this year. You are the driving force behind this life-changing work, and we are so grateful. Donate today, and join us in transforming healthcare to unleash the potential of thousands of people in Tanzania.

Happy holidays to you and yours!
P.S.: You can also change lives while protecting yourself by purchasing a mask from us. The women recovering from obstetric fistula at The Mabinti Center now make 2-layered masks using beautiful fabrics to keep Tanzanians and CCBRT staff safe, in addition to hand-sewing bags, pillows, and other household items. The Kupona Team got a shipment of Mabinti masks, so please reach out to us if you are interested in purchasing any, or you know of anyone else who might want some.