Last night, Kupona joined with Gradian Health Systems and the International Collaboration for Essential Surgery (ICES) to host a screening of the documentary film “The Right to Heal.” This film, directed by the newest member of Kupona Foundation’s Board of Directors, Jaymie Henry, M.D., makes the case for improving access to basic surgical procedures in the developing world. Back in April, we were extremely fortunate to have Jaymie and her crew visit CCBRT to film our work. We are extremely excited to be a part of this project.
“The Right to Heal” will continue to film in various locations over the course of the year, and Kupona hopes to host another screening of the final product at a later date. For now, you can check out the teaser clip below and get involved in the movement at http://therighttoheal.org/. Click “Sign the Petition” to bring essential surgery to the forefront of the global health conversation!
Yesterday, our implementing partner, CCBRT, was honored to welcome President and Mrs. George W. Bush during a private visit to its facilities. The visit came following President and Mrs Bush’s key note speeches at the Bush Center’s Africa First Ladies Summit: “Investing in women, Strengthening Africa.” In line with the theme of the summit, CCBRT took this opportunity to outline its efforts to rebuild the lives of women with obstetric fistula, empower them both socially and economically through training at the Mabinti Center, and to improve the level of healthcare available to expectant mothers and their newborns.
During their visit to CCBRT’s obstetric fistula department, President and Mrs. Bush heard the story of Halima, who, at just 25 years old, lived with fistula for six months before finally receiving treatment at CCBRT. President and Mrs. Bush listened as Halima told them how she had been referred to hospital for treatment months earlier, but despite advice from doctors, her family took her to a traditional healer. Convinced she was bewitched, Halima lived with incontinence for another 2 months before she was identified by CCBRT’s community outreach team. Halima was finally referred to CCBRT for treatment free of charge, and was given support with the transport costs via Vodafone M-PESA. Clearly moved by her story, President Bush embraced Halima at the end of her testimony and thanked the 40 women that sang to greet the visitors.
On their departure, both President and Mrs. Bush praised CCBRT for our “devoted care” as we strive to help the poorest of the poor in Tanzania and to create a Tanzania where people have access to quality disability services and safe maternal and newborn healthcare.
Kupona is thrilled to announce that our implementing partner in Dar es Salaam, CCBRT, and its Mabinti Center have been chosen as two highlighted programs during the African First Ladies Summit ‘Investing in Women, Strengthening Africa’ on the 2nd July 2013!
The Summit, coordinated by The Bush Center, will bring together African First Ladies, government officials, private organizations, NGOs and academics to discuss best practices that can reap sustainable, replicable results, benefit women and strengthen society.
CCBRT not only invests in women in the present, but seeks to have a long term impact upon Tanzania by focusing its efforts on future generations. Summit attendees will learn about the huge success of our holistic obstetric fistula program as well as gaining an insight into our comprehensive maternal and newborn healthcare program and the work we do for children with disabilities.
CCBRT and Kupona are excited to welcome the delegation to Tanzania, and look forward to participating in this vital international discussion upon the importance of women as the key to unlocking development.
On Thursday, June 6, Kupona Board Member James Mann hosted a cocktail reception at his home for supporters of Kupona. The goal: raise money to fund nurse midwives in Dar es Salaam, Tanzania – a critical need in a region facing significant human resource challenges in health care. The efforts that night raised enough to fund one full time nurse-midwife for a year!
Many thanks to our host, James Mann, the supporters who attended the event, and Melanie Quinn Photography for capturing some great photos of the reception. You can check out a full album of images on our Facebook page.
The OB ward is long, barrack-shaped, concrete. Triage begins in a foyer. Perhaps 20 women in colorful khangas waiting for a nurse-midwife to check them in and do an initial assessment. Cervical dilation. Blood pressure. A few questions. Eventually these women will join about 45 others in various stages of labor and with a variety of high-risk conditions. Malaria. Previous C-section. Pre-eclampsia. There is so much going on in that small space. Read More
It is not possible to know what to do first.
Rose, age 20, did absolutely everything right – first prenatal visit at 12 weeks, six more during her pregnancy, all the right lab tests. She came in in early labor on 27 April. We saw her on 3 May. Along with 64 other women in labor. She was in the cot at the end of the ward.
There is no morning report or hand-off. It is not a problem, until it is a problem. With the limited resources available, people can respond to problems only when they occur rather than proactively preventing them.
Rose was in the normal labor pile, her prenatal record poorly filled out, partographs rarely used. It was not easy to decipher her story from the chart. Before we even got to that story, we heard a loud cry and saw Rose was about to deliver. She was walked through the double doors and helped onto a delivery bed. It took a long time for the head to deliver. It was immediately obvious. A fresh stillbirth.
The last exam was 24 hours earlier. 7 cm dilated. She should have been delivered long ago. Days ago. The last fetal heart rate was also taken 24 hours earlier. Eight checks in eight days of labor. None in 24 hours. In active labor. In a health care facility.
Much will need to change. And it can change. Must change.
The numbers frame the story. Rose is not just one of those numbers. She is the loud cry at the end of the ward.
The first time I visited a labor and delivery ward in Tanzania, I was six weeks pregnant. Even though I knew intellectually that my birth experience would be nothing like what I was watching, I could only react emotionally to the scene around me. So many women crowded onto so few beds in a wide-open labor room. Laboring skin to skin with other mothers-to-be, with spouses and other support waiting in the sun, sporadic attention from the overwhelmed nursing staff continuously circling the room, and almost absolute silence. These women made no screams of pain, and did not call out for a nurse or doctor. They just breathed, adjusted their positions as they were able in the limited space, and, when it was truly go-time, gave a cry that brought a nurse over to lead them to the delivery room.
In the delivery room, a smaller set of simple metal frame beds were lined up in rows. Women screamed through the final moments or hours of birth; nurses, assistant medical officers, and the rare trained MD hustled among the beds to catch and tend to babies as they arrived, and to do what they could to prevent death. There was no coaching through each push or discussion of epidurals. There were no calm explanations of what was happening, and there were no promises that everything would be ok. And everyone was fervently hoping for two things: that a c-section wouldn’t be needed, and that at least one bed would be available when it was the next woman’s turn.
We watched a safe delivery, a mother who would survive. When I made it back out into the Dar es Salaam heat, I gasped, “I don’t think I ever want to give birth”.
“When you have a baby, it will be nothing like that for you,” replied my guide. And of course, it wasn’t.
My guide was our absolute rockstar of a Technical Advisor for our capacity-building initiative, a Tanzanian Ob/Gyn named Dr. Brenda D’Mello. I’ve since visited several other regional health facilities where we are working. Overcrowding, lack of skilled personnel, and dread of an emergency are persistent problems, but the improvements made in the last couple of years are reasons for hope. On my most recent visit, Dr. D’Mello walked out of a ward smiling – we had just watched one of the nurses she had trained deliver a baby with “WHO perfection”.
The capacity-building initiative is one key piece of a program that Kupona has developed to address maternal and neonatal mortality in Tanzania. The second is the creation of a new, specialized facility to provide badly needed physical space and emergency obstetric care.
It can be paralyzing to consider the work to be done in Tanzania, particularly in its biggest urban area, to make childbirth a moment of safety and joy, rather than of fear. More skilled doctors and nurses, more supplies, stronger processes for identifying and referring high-risk cases, more accessible family planning – all of these needs are urgent. But our program, undertaken in partnership with the Government of Tanzania, is an answer to a heartbreaking problem.
Working from the U.S. to address problems in Africa often raises questions about program management and efficiency. But we have an amazing implementing partner in CCBRT, whose professionalism, commitment to quality, and respect in the community and internationally is unmatched. Our model and method are distinct, and create an opportunity for Americans to have an impact on the infrastructure of entire region of a country, indeed, of an entire country, without sacrificing transparency and cost efficiency.
I am a one-person staff in the US – all of the other personnel are where we believe they should be: on the ground in Tanzania, saving the lives of women and babies. But, to harness the power of American donors, volunteers, and other supporters to bring about true change, we need people who can lead our efforts to increase the profile of and resources available for the work we are doing. We know that there are individuals and networks unknown to us, who share an interest in and passion for global women’s health, East Africa, and innovation in development solutions. With the countdown on to achieve the UN’s Millennium Development Goals, we are confident that the calls to step up efforts to end maternal and neonatal mortality will be answered, and hope that Americans will be among those answering it.
When a patient leaves CCBRT, our hospital in Tanzania, after being treated for fistula, there is often great relief and hope. After her surgical fistula repair and recovery at the hospital, Beatrice also completed a one-year training course in craft and business skills at our Mabinti Center. In May, Beatrice was able to safely gave birth to a healthy baby boy, Pelis. Without the care that she received at CCBRT, this would have been unthinkable. Now, Beatrice counsels other patients with fistula and encourages them to seek treatment.
Kupona Foundation and our implementing partner CCBRT have been working together since 2009 to transform and improve maternal health care in Tanzania – to prevent fistula and ensure that joy and safety during pregnancy and childbirth is possible for ALL Tanzanian women. Our capacity building initiatives have helped to improve care at 16 existing health facilities in the Dar es Salaam region and highlighted CCBRT as a leader in the area of maternal health. But in 2012, our vision began to take concrete shape with the construction of the new CCBRT Maternity and Newborn Hospital. All funds for the construction and equipping of the new hospital have been committed and progress has been incredible since breaking ground in December 2011. In fact, the kitchen and canteen facilities will be ready for use in the first part of this year, and three of the building blocks have been constructed up to roof level. Twice in 2012, His Excellency President Kikwete of Tanzania visited the progressing site of the new hospital, and we continue to be motivated by this high-level support.
Here in the United States, Kupona’s mission to expand private support for CCBRT also reached new heights, with our final tally in 2012 reaching over $219,000 – more than two times our total in 2011! And every dollar will be used on the ground in Tanzania to save the lives of mothers and babies.
We know that, even as our physical facility takes shape, the pressure mounts: we must recruit qualified staff, improve of the regional referral system to prevent overcrowding at the new hospital, and secure funding for recurring operational expenses. In 2012, we worked closely with some fantastic partners to develop a human resources strategy, an assessment of the current referral system, and an evaluation of family planning services in the region. This year will be one of translating valuable information into action and leveraging the gifts of all of our supporters for maximum impact in the lives of Tanzanian mothers and babies.
For Beatrice and thousands of women like her, CCBRT is the final step in a painful journey, and the first step in a joyful one. In 2012, CCBRT treated more than 500 women like Beatrice, repairing their fistulas and giving them true second chances to live their dreams. But without your support, there would be no stories like hers. This year, your gifts trained doctors, nurses, and midwives. They renovated and equipped operating rooms and built a new, expanded ward for patients with fistula. And they are helping to build our new maternity hospital, so that we can prevent the occurrence of fistula and ensure that the joy Beatrice felt when delivering Pelis is a joy that ALL Tanzanian women have the opportunity to experience.
We cannot thank you enough for helping us to come this far, and cannot wait to share with you all that 2013 will bring!
On Thursday, September 27, Kupona hosted its Second Annual Golf Tournament at North Hempstead Country Club in Port Washington, NY. This year, South African pro-golfer Danie Steyn joined us for a “Pay the Pro” and to give tips to participants along the course. A great time was had by all, and with event sponsorships and other donations, we raised $30,750 for the CCBRT Maternity and Newborn Hospital!
This year’s tournament sponsors were:
Allen & Overy LLP
Mayer Brown LLP
Simpson Thacher & Bartlett LLP
Trident Investment Management
A huge thank you to everyone who made this event a success! We are especially grateful to our corporate sponsors for their support, to North Hempstead Country Club for their hospitality, Danie Steyn for his participation, and Ken Goodman Photography for capturing the day on film. For a more complete set of photos from the event, check out our Facebook page.