Guest post by Dr. Brenda D’Mello, Technical Lead for CCBRT’s Maternal Health Efforts
Expectant mothers and newborns can’t wait. We need PPE to keep our staff and patients safe.
My colleagues and I are on the frontlines of maternal and newborn healthcare services in Dar es Salaam, Tanzania delivering services in Dar es Salaam to over 10,000 people every month. Our maternal newborn and child health team trains midwives, performs deliveries, and welcomes over 80,000 newborn babies into the world every year. Work in Dar es Salaam has always been challenged by shortages in staff, supplies, equipment and, in this large vibrant city, substantial overcrowding. In the context of Covid-19, this work has become even more challenging. While some non-essential services can be scaled back in the face of a pandemic, childbirth and related life threatening emergencies are on their own timeline that cannot wait for the situation to improve.
As the healthcare system adapts to these unprecedented times, one of CCBRT’s partner facilities, the busiest maternal and newborn healthcare facility in this region, was forced to pivot to become a Covid-19 treatment center. This funnelled demand for maternal and newborn healthcare services to smaller downstream facilities, stretching the capacity and making distancing between patients and staff impossible. Additionally, shortages of protective equipment and supply chain gaps caused by the global lockdown have severely stretched an already fragile health system.
CCBRTs response to the COVID 19 pandemic recognizes how critical a healthy workforce is for continued service delivery. We prioritize quality care for pregnant women before, during and after labor, ensure babies are still delivered safely and that our patients and staff are protected through this pandemic.
Urgent help is needed to keep our colleagues and patients safe as we deliver essential services across the Dar es Salaam region. A donation of $30 will equip one midwife with the necessary PPE to perform a safe delivery. $10 will equip a mother and her baby with masks. As we grapple with the change in practice, a small recurring donation will help my team and I at CCBRT ensure the safety of healthcare workers and the continuity of maternal and newborn services through this new season.
Our hearts go out to you and your families during this global pandemic and we are wishing you well. The Kupona Foundation team would like to update you on what is happening in Tanzania at CCBRT following this outbreak of COVID-19.
COVID-19 affects us all and we must be united in our response. Kupona Foundation is committed to supporting our sister organization in Tanzania, CCBRT, during this difficult time. Despite the risks and challenges, CCBRT’s frontline health workers continue to provide life-changing and life-saving care for the most vulnerable, notably women, children, and people with disabilities.
CCBRT’s Response to COVID-19
CCBRT management has set up a team led by Dr. Bedan Gichanga, the Chief Medical Officer (CMO), to lead and coordinate its efforts in COVID-19 planning and preparedness. The team is closely monitoring the viral spread and categorizing the crisis to respond appropriately. This has resulted in a multi-level emergency protocol informed by the Tanzanian Ministry of Health, the status and developments in Dar es Salaam, and the phase of the epidemic. This multi-level response is to ensure that CCBRT can continue to provide its life-changing services without creating undue exposure to both its staff and patients.
Safety measures CCBRT has implemented thus far
- Regular briefings and education sessions about COVID-19 to front line health workers and to other staff both in Dar es Salaam and Moshi.
- Promoting hand hygiene and investing in additional infection prevention measures at entry points and within the campus (sanitizer, treated running water and soap).
- Limiting visitors to in-patients to 1 at a time.
- Promoting cashless payments via mobile money.
- Setting up an isolation room(s) in readiness/ preparedness for any activity.
- Conducting temperature checks for all incoming staff, patients, and visitors at all entries to the hospital.
- Instructing any staff members who are not well to stay home and directing staff members who are or who may be in a risk category to contact HR in advance for planning purposes.
Program related updates
- CCBRT is minimizing the number of women they are treating for obstetric fistula.
- At the clubfoot clinic, new cases have been deferred to July.
- Previously scheduled trainings and outreach programs (screenings) have been postponed.
Immediate Effects of the COVID-19 pandemic
- Suspended the travel of two Ophthalmology and Orthopedics specialists who were visiting from other countries.
- A decrease in sales at the Mabinti Centre, both at their workshop and in the retail shop.
- Suspended all scheduled trainings at the CCBRT Academy.
- Reductions in capacity on the ground, as a number of CCBRT’s expatriate staff have had to leave the country, including three of the five members of CCBRT’s fundraising team.
- Reduced capacity for provision of high quality maternal and newborn healthcare in CCBRT-supported sites as staff are pulled for COVID-19 preparedness.
Anticipated Long Term Effects
CCBRT anticipates that the Tanzanian economy will take a significant hit due to reduced tourism, (Tanzania’s biggest foreign exchange earner), and potential closures such as those we are experiencing in the United States, and expects to see further decreases in the number of expatriates staying in-country.
In Tanzania, we know the health system is much less elastic than in the U.S. and elsewhere with most of the healthcare infrastructure already at capacity and not meeting demand in full. Their epidemic is just starting with only 19 reported cases as of this weekend, and one death. CCBRT represents one of the facilities we know is trusted to provide high quality care. Part of the impact of an epidemic is that these facilities are put under severe pressure leaving existing care to lag and morbidity and mortality to rise as a result of COVID-19 as well as existing and significant unmet health needs.
We are anticipating a significant reduction in patient revenue at CCBRT and decreases in partner and donor revenue due to COVID-19, at a time when donor and partner support is needed more than ever.
How can you help?
We are thankful for the continued support of the Kupona community, even as we all experience our own personal and professional challenges during this unprecedented time of uncertainty. Unrestricted support is vital as we navigate this pandemic and prepare for the after effects that may unfold. If you are in a position to do so, you can support our frontline health workers by making an unrestricted gift, helping us provide the Personal Protective Equipment (PPE) and additional support that our health workers need to stay safe and continue to serve the most vulnerable in the community.
Thank you, and be well during these challenging times.
In celebration of International Women’s Day on March 8th, we want to celebrate the courage, perseverance, and strength of the women we serve in Tanzania, and the healthcare workers who support them.
Radhia first took her Mabinti Centre (‘Mabinti’) training course in 2012 and joined Mabinti as a full-time staff member in 2013. Her activities at Mabinti include cutting and measuring all of the fabric for bags and clothing and visiting the Kariakoo fabric market to barter for and purchase more fabric. Radhia is also the resident expert on making Binti dolls. Since 2013, Radhia has taught all new Mabinti trainees and staff members to make Binti dolls. Making the dolls is her favorite work task, and it is also what she believes she is best at.
Radhia developed obstetric fistula after giving birth to her first child. When she went into labor, her husband took her to the hospital where she labored for two days with no progression. Tragically, her baby died while she was at the hospital. Radhia’s husband left her immediately after she lost her baby. The doctors at the hospital recognized that Radhia had developed fistula during the prolonged labor, and referred her to CCBRT for treatment. At CCBRT, she underwent surgery and comprehensive treatment to repair her fistula. She was invited to join the Mabinti Centre training course shortly after she left CCBRT as a patient.
At the Mabinti Centre, Radhia completed the one-year training course, where she learned how to sew, make batik print, bead, and make clothing patterns. She also attended educational sessions on family planning and entrepreneurship. Radhia excelled in the training and was a great team member. After the course, she was invited to join Mabinti as a full-time employee. She was thrilled to be offered the job because she had never had a job before. Radhia especially enjoys her time at Mabinti because of the opportunity to spend time with other women who lived with fistula, the financial stability, and the opportunity for ongoing education and growth through frequent workshops on health, family planning and entrepreneurship.
In 2017, Radhia got pregnant again. As an employee at Mabinti, CCBRT’s expert OB/GYNs monitored her pregnancy closely to ensure that she received the proper care as a high-risk pregnancy after fistula. Dr. Brenda, head of the Maternal Health Capacity Building Program, personally monitored Radhia’s pregnancy, and recommended she give birth in Amana Hospital, one of the health centers in CCBRT’s Maternal Health Capacity Building Network. Radhia underwent a C-section, and safely gave birth to a healthy baby. She is incredibly grateful to CCBRT for treating her fistula in 2012, giving her employment at the Mabinti Centre, and providing expert support and care throughout her second pregnancy and childbirth. She never expected to be financially stable or to have a (now 3-year-old) child. Radhia encourages all women to reach out for help if they suspect they have fistula, and hopes that other women can find opportunities like she has at Mabinti.
New York City – The Kupona Foundation (‘Kupona’) Board of Directors announced today that Abbey Kocan will step down as Executive Director of Kupona after almost seven (7) years of service. She will be succeeded by Susana Oguntoye, who was previously Director of Monitoring, Evaluation & Knowledge Learning at Africare.
Robert Schwed, President of The Board of Directors, said, “On behalf of the entire team at Kupona, I would like to thank Abbey for her dedicated service and leadership. Since 2013, Abbey has built and led a team that mobilized over $7M for Kupona’s sister organization, CCBRT, the largest provider of disability and rehabilitation services in Tanzania and a key partner to the Tanzanian government in the fight to improve maternal and newborn healthcare. Abbey also drove the mobilization of medical and technical advisors to help CCBRT move toward a sustainable operating model. After Abbey informed us of her decision to leave her position, the Board conducted an extensive search to find the right person to lead Kupona and to work closely with the leadership of CCBRT. We are thrilled that we have been able to recruit Susana.”
Susana Oguntoye brings nearly two decades of experience with health research and policy, most recently working on design, monitoring, evaluation and implementation of health services programs, with a particular focus on international development and global health systems. At Africare, Susana built and managed operations for six countries and led monitoring and evaluation in 14 countries in sub-Saharan Africa. Raised in Nigeria and Germany, Susana holds a Bachelor of Science in Molecular Biology & Immunology from King’s College, University of London, and a Master of Public Health degree from the London School of Hygiene & Tropical Medicine.
“I feel exceptionally fortunate to be given this opportunity to become part of the Kupona Foundation and CCBRT family,” said Susana. “It means the world to me to be able to impact so many lives and renews for me the reasons I chose, so long ago now, to work in public health, and on health disparities in particular. I thank Abbey and the Kupona Board of Directors for putting their faith in me and look forward to working together with CCBRT to ensure high quality healthcare reaches those most in need.”
Abbey shared: “It has been an honor to be a part of this community, to work closely with CCBRT’s leadership and colleagues across the organization, and to be able to see the direct impact that our donors and partners have on thousands of children, mothers and adults living with disabilities in Tanzania every year. I am grateful to have had the opportunity to work with so many inspiring donors, partners, peers, Board members and advisors. I am incredibly excited that Susana will be taking the helm. Her skills and experience are exactly what is needed at this point in the organization’s life cycle. I see great things ahead for CCBRT and Kupona under Susana’s leadership in the United States.”
Abbey and Susana will work side by side during a period of transition starting in March 2020.
About Kupona Foundation
Kupona means ‘to heal’ in Kiswahili. Kupona Foundation is a nonprofit dedicated to delivering high quality healthcare to those who need it most. Kupona focuses on Tanzania, a country rich in potential but severely impacted by extreme poverty, a challenge compounded by one of the highest population growth rates in the world. Kupona’s partner, CCBRT (Comprehensive Community Based Rehabilitation in Tanzania), is a leading healthcare provider specializing in disability, rehabilitation and maternal and newborn healthcare. A key player in the Tanzanian healthcare system, CCBRT has over two and a half decades of service to the Tanzanian community and partnership with the Government of Tanzania.
Did you know that an estimated 2 million children in Tanzania are in need of pediatric eye services? Many of those children will lose their sight or suffer with a visual impairment, which will affect almost every aspect of their future — their ability to play, go to school and lead a productive life. Thanks to the support of our donors and partners, children like Elizabeth are able to receive the sight-restoring treatment they need.
CCBRT was established in 1994 as a community based rehabilitation program committed to serving people with correctable blindness in Dar es Salaam. Today, CCBRT’s largest service area remains its work in eye care. CCBRT’s ophthalmology department focuses on services in high demand in the Tanzanian community, including cataracts, glaucoma, trauma, tumors, trachoma, and diabetic eye disease. On average, cataract surgeries account for 50% of the eye surgeries provided at the CCBRT Hospital.
“My little sister and I were fighting over something, and accidentally, she poked me in the eye. My eye started reacting, and I had to be taken to the CCBRT clinic. I was told my eye was damaged and needed to be removed,” Elizabeth recalled.
In 2018, CCBRT performed over 6,800 eye surgeries and nearly 69,000 consultations at its hospital in Dar es Salaam. CCBRT is one of only three facilities in Tanzania that offers pediatric eye services and is the only facility in the country that makes artificial eyes from scratch for children like Elizabeth.
“I experienced many challenges before the operation. In class, my performance was dropping. Sometimes I wouldn’t be able to attend class for a month, or even two. I also stopped playing with my friends. I was worried I would hurt my eye. But ever since the operation, I’ve felt like a normal person. Some people don’t even notice I have an artificial eye. I’m grateful, because now I am on track with my studies,” Elizabeth told us. Elizabeth’s future is brighter thanks to the support of donors like you.
The tragedy of obstetric fistula is unimaginable. As women have told us, “There’s nothing worse than sleeping on a soiled bed at night.” Fistula persists in Tanzania because of a lack of timely access to high quality maternal healthcare. Too often, a woman can’t access health workers with the skills and tools they need to manage her obstructed labor. Sometimes, the woman reaches the hospital, but the team isn’t equipped to quickly mobilize to provide a safe C-section in order to save her baby, and prevent the traumatic birth injury of obstetric fistula.
In the last decade, CCBRT has trained more than 6,000 healthcare workers in safe maternal and newborn care, and provided surgery and comprehensive treatment to over 7,000 women with obstetric fistula. The comprehensive program focuses on treating the entire woman rather than simply repairing the physical condition alone – improving patients’ health outcomes and economic well-being after surgery.
“They operated on me four times, but I did not recover. That’s when I gave up, I thought I would never recover from fistula. I lost hope because I couldn’t attend mass at church, or participate in any activity with my fellow women. When I reached CCBRT, I was no longer the only one suffering from fistula. I met many other women like me. CCBRT has transformed my life. Right now, I am learning how to be a seamstress at Mabinti,” Angela told us.
On Thursday, October 10th, we celebrated Kupona’s 10th Anniversary at The Penn Club in New York City and raised over $37,000 to support our partner CCBRT in Tanzania.
You — our Kupona community — should feel tremendous pride in what you’ve helped us achieve over the past ten years, especially if you consider this:
- 18 million people die annually due to surgically treatable conditions, and millions more suffer with preventable disabilities.
- In Tanzania, 830 women do not survive due to complications related to pregnancy and childbirth EVERY DAY. An estimated 80% of these deaths are preventable.
Why is it that being born with a correctable impairment like pediatric cataracts, or safely giving birth – things that happen all over the world – are so challenging and so dangerous in Tanzania? The following three challenges are among the greatest drivers:
- There is a shortage of trained surgeons and skilled surgical and medical teams able to provide the services needed. For its population of over 55 million people, the World Health Organization recommends 10,700 specialist surgeons – and Tanzania has only 177.
- There is a lack of awareness. Many people don’t know that their child’s impairment can be treated, or don’t realize that a laboring mother may not be able to safely deliver her baby at home. Myths and misconceptions about the causes of disability create social stigma.
- It is very difficult to access treatment. For many families, the time and cost of traveling to a health facility to seek treatment for themselves or their child will be at the expense of putting food on the table or educating their children.
In the past ten years, Kupona has helped CCBRT conduct over 100,000 surgeries in Tanzania, and we’ve helped launch a maternal and newborn healthcare program that has increased a mother’s chance of survival by over 40% in the Dar es Salaam region. As Dr. Brenda shared, “Fistula is 100% preventable, and that’s where the CCBRT Maternal Health team comes in. We give women the right to a clean and safe birth and a healthy baby.”
The numbers are impressive, but when you consider that they represent lives, families, children, and healthcare professionals, they carry a whole new weight. CCBRT CEO Brenda Msangi brought the numbers to life: “We’ve done over 100,000 surgeries…this is not just a number, this is seeing a little boy smiling for the first time after a cleft repair, or seeing a woman with fistula who has been leaking urine for 8 years, being dry after surgery, and going back to her community and being accepted by her community. This is a little toddler taking steps for the first time using her prosthetic. This is the real impact that we are privileged to see at CCBRT.”
Thursday’s celebration included a Tanzanian dance performance by Curious on Tanzania, and gave guests the opportunity to cast their vote to direct a $9,000 grant from the Johnson & Johnson Foundation to one of CCBRT’s high-impact programs. The winning program? Maternal Health & Obstetric Fistula. Thanks to Johnson & Johnson and all of our generous event sponsors for their support. You can check out more photos from the event here.
We are so grateful for this community, and to everyone who has donated, volunteered or partnered with us over the last decade. A special thank you to our 10th Anniversary Host Committee for their generosity and for helping mobilize such an incredible group of people.
We invite you to stay involved with this work. Why? Because it’s your support that is changing the lives of thousands of people in Tanzania every year. Here’s how you can help:
- Donate today! We have a goal of raising another $10,000 to celebrate 10 years of changing lives.
- A gift of $300 will provide sight-restoring surgery for a child born with congenital cataract, enabling him to see the world around him and get an education.
- A gift of $615 will equip 15 health workers with advanced training at the CCBRT Academy.
- A donation of $5,000 will provide critical start-up operational funding for five safe C-sections for mothers and babies in our new Maternity & Newborn Hospital.
- Visit CCBRT: Reach out to express your interest in joining us for a “Seeing is Believing” trip in 2020 or 2021.
- Learn more: Read about your impact in our 2018 Annual Report.
- Stay in touch: Follow us on social media or sign up for our mailing list We’re on Facebook, Instagram, LinkedIn, and Twitter
- Spread the word: Share this post or tell five friends about the event, and invite them to help us reach our goal with a life-changing gift. As Betsy shared in her opening remarks, we can each “Do what you can, with what you have, wherever you are.”
Thank you all for your generosity and support over the last ten years.
On Tuesday, September 10th, Kupona Foundation hosted our fourth Upstate New York event at The Docksider Restaurant in Lake George, NY.
Thanks to the generous support of our Saratoga Springs community, we raised over $28,000 to provide life changing healthcare services to children living with disabilities, women and newborns, and life-saving training to empower frontline healthcare workers.
Guests enjoyed picturesque views of Glen Lake with a delicious buffet and cocktails served by our friends at The Docksider. Handmade items from The Mabinti Centre were available for purchase, and guests bid in a silent auction on a stunning hand thrown vase from local artist Linda Demers of Oakley Way Pottery, with all proceeds going to support the women and children we serve in Tanzania.
We are so grateful for this community of supporters and friends. Thank you to everyone who attended on Tuesday, donated in honor of the event, and to each and every one of you who has supported our Upstate New York events in the past. A very special thank you goes to Tom & Laurie Longe and to Steve & Debby Seaboyer for their generosity and for helping mobilize such an incredible community of people in Upstate New York.
On Tuesday evening, Steve Seaboyer welcomed guests and thanked them for their many years of support before introducing Kupona’s Executive Director, Abbey Kocan. Abbey shared an update on the impact that the Upstate New York community has had, thanks to their generosity. These accomplishments include helping to provide:
- Comprehensive, holistic fistula surgery and treatment for 3,358 women living with obstetric fistula, (a traumatic birth injury that results from prolonged, obstructed labor).
- Sight restoring surgeries, such as cataract surgeries, for 28,500 children and adults, who are now able to go to school, be active in their communities, and support their families.
- Critical training and capacity building for over 5,000 community health workers.
Abbey also expressed her excitement about the planned opening of the new CCBRT Maternity and Newborn Hospital in 2020, which will provide 12,000 safe deliveries for mothers in need every year, and the CCBRT Academy, which officially opened this week. The CCBRT Academy will play an important role in strengthening human resources for health in Tanzania and more broadly in the East African region. The continued generosity of Kupona’s supporters will help us to equip clinical and managerial teams with the live-saving skills they need to provide expert, quality care to those most in need. By training healthcare workers to train others, we ensure that quality healthcare will be available for years to come.
We invite you to stay involved with this work. Why? Because it’s your support that is breaking the cycle of poverty for thousands of people in Tanzania every year. Here’s how you can help:
We have a goal of raising another $5,000 to enable us to invest in what it will take to ensure that the opening of our new Maternity & Newborn Hospital in 2020 is a success, and to reach more children with the life-changing care they need today.
- Donate today! A gift of $160 will support a child living with a disability like clubfoot, improving his mobility and give him the chance to learn and play.
- Join us with a donation of $5,000 to help make the necessary investments in critical start-up costs for the new maternity hospital.
- Learn more! Read about your impact in our 2018 Annual Report.
- Follow us on social media. We’re on Facebook, Instagram, LinkedIn, and Twitter
We’re proud to call Saratoga Springs home and we are so grateful for the generosity and support of this community. Thank you.