We often focus on our maternal health work and the care mothers provide for children with disabilities in Tanzania. Many fathers also play a crucial role as caregivers. Today, in honor of Father’s Day, we’d like to recognize fathers by introducing you to Papa Saidy, who recently worked to ensure that his son could access the eye care services he needed.

As a single parent of an only child, four-year-old Saidy’s father pays close attention to his son’s growth. “I observed some changes in Saidy’s left eye,” he recalled. “He started having difficulty seeing at home, and his school performance began getting worse.”

In August 2018, Papa Saidy decided to bring his son to CCBRT, one of only three hospitals in Tanzania that offers specialized pediatric eye services. At CCBRT, doctors quickly diagnosed Saidy with squint and low vision in his left eye. Thanks to CCBRT’s on-site optical shop, Saidy was quickly provided with refractive glasses to correct his vision problems.

Visiting CCBRT for a check-up six months later, Papa Saidy shared his relief over finding a solution to his son’s visual impairment. “I’m glad because there has been so much improvement with his eye and no pain,” he said. “Even his performance in school has improved compared to before [coming to CCBRT].” Now, Saidy can both do his homework at home and play without difficulty. He’s a happy child, his father said.

“I’d like to thank CCBRT,” Papa Saidy shared. “Before, my son’s eye condition was very bad, but with the medications and glasses he received at CCBRT, we have a lot to be thankful for.”

Help make high-quality disability healthcare available to more fathers like Papa Saidy and their children by making a donation today.

Left, Papa Saidy holds his son as Saidy receives an eye consultation at CCBRT. Right, after his consultation, Saidy is fitted for refractive glasses to treat his low vision.

May 23rd is 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. In 90% of cases, the baby doesn’t survive the traumatic delivery.

With the support of incredible donors and partners like Fistula Foundation, Johnson & Johnson and Direct Relief, we work with our local partner organization CCBRT to prevent and treat fistula in Tanzania. Since 2003, CCBRT has provided more than 5,200 fistula repair surgeries to women and girls at its hospital in Dar es Salaam, Tanzania.

Today, in honor of International Day to End Obstetric Fistula, we’d like you to meet Jovitha, who recently received comprehensive fistula treatment at CCBRT.

40-year-old Jovitha works as an entrepreneur. She lives in Arusha with her husband and their three children.

The deliveries of her first three children were normal, which is why she was surprised and confused when she experienced a long and complicated labor with her fourth child in December 2018.

Jovitha was in labor for three days. Doctors at her local hospital chose to not perform a Caesarean section due to her track record of routine births. Her condition continually worsened, until she couldn’t push any longer, and her legs felt cold. Finally, she was taken to the operating theatre for an emergency C-section, but Jovitha’s baby didn’t survive the night.

Two weeks after being discharged from the hospital following her traumatic experience, Jovitha realized she felt wet. “Urine was coming out uncontrolled,” she remembered. “I couldn’t believe what I was seeing. I saw the whole bed, wet with urine, and I didn’t feel anything. I knew there was a big problem.”

While many women don’t know where to turn when they develop fistula – or even know what fistula is – Jovitha’s older sister quickly recognized Jovitha’s symptoms as likely indicators that she had developed fistula during her difficult labor.

Each year, as many as 3,000 Tanzanian women develop obstetric fistula, a childbirth injury caused by prolonged, obstructed labor. As many of these women have experienced, pressure from her baby’s head had obstructed blood flow in Jovitha’s birth canal, causing tissue to die. This formed a hole between her birth canal and bladder, leaving her incontinent.

“My experience – it’s unexplainable,” recounted Jovitha. “I hated myself for three months. I had urine flowing down my legs and I was extremely embarrassed. But I thank my family, especially my daughter. She was always there for me, washing and bathing me. Thankfully I had that support that so many other women don’t feel from their families and communities.”

With her daughter’s help, Jovitha researched fistula treatments on the internet – and found Kupona’s partner CCBRT.

“We took the contact information on the website and phoned CCBRT,” Jovitha recalled. “They responded warmly, giving me hope that I would be treated and healed.”

In March 2019, Jovitha received a bus ticket to travel to CCBRT from a local CCBRT fistula ambassador, completely free of charge. CCBRT uses M-PESA, a mobile money transfer system, to send funds for patients’ transport costs via a network of trained ambassadors.

Today, Jovitha is recovering from a successful fistula repair surgery at CCBRT.

While she recovers, she is also participating in CCBRT’s holistic care program, which teaches women and girls receiving fistula treatment at CCBRT about their condition, good nutrition, pelvic floor muscle exercises, sexually transmitted infections, HIV/AIDS, family planning options and other life skills.

CCBRT’s holistic care 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. The most exciting part for Jovitha is the ability to become a fistula ambassador after she goes home, where she plans to help other women living with fistula in her area access treatment.

“We live in town, but knowledge of fistula hasn’t reached many people,” Jovitha shared. “I’m excited to go home and see my family, but also to spread the news that CCBRT treats fistula for free, so that I can help other women.”

Want to help us eradicate fistula in Tanzania? Use the hashtag #EndFistula in your social media posts to help us raise awareness about this relatively unknown condition. Or, 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 surgically treat fistula, your gift gives women like Jovitha the foundation for a better life.

Guest post by Chloe Manchester

This will be my first year celebrating Mother’s Day as a mom myself.

Chloe and Aedan in February 2019

What a transformative feeling that is. In February, on a snowy morning in Portland, Maine, my husband and I welcomed our son Aedan into the world. My son’s birth was not what we had prepared for – in both beautiful and amazing ways, but also in ways that make me so grateful for the care that both he and I received. I witnessed first-hand the life-saving importance of timely, high-quality maternal health care, to which so many women around the world are not fortunate enough to have access.

But the life-saving services I received did not begin only when we entered the hospital, or when we were advised that a Caesarean section would be necessary to avoid potentially devastating outcomes, or during my long recovery in the hands of well-trained nurses and obstetricians. It started with family planning – a critical part of the maternal health continuum of care.

I believe that access to family planning services is a right. Not a privilege. Not a luxury.

The United Nations Population Fund (UNFPA) uses a phrase that really resonates with me – that motherhood should be by choice, not by chance. I was fortunate enough to have the resources, education and personal agency to be able to choose when to have a child. Being able to plan when we were going to have a child meant that I could finish graduate school, take the time to find a secure job with medical benefits, take a break from marathon training (yes – that’s important too!), feel emotionally prepared and set up our home. Every family deserves that choice, whether their plan involves children or not.

Tim’s Corner family planning clinic at CCBRT (photo credit: Sala Lewis)

This Mother’s Day, let us not take for granted how powerful all women are. Together, let us celebrate women all over the world who overcome insurmountable odds to pursue their ambitions, whatever shape and form those may take. An unwanted pregnancy should never have to be an obstacle in a woman’s life, and it should never, ever be a death sentence.

Chloe Manchester is a Kupona Foundation Advisory Board member. Chloe’s family, together with CCBRT and Kupona Foundation, and through the support of loved ones from all over the world, established the Tim’s Corner family planning clinic in 2013, to honor the legacy of Chloe’s late father and family planning champion, Tim Manchester. 

Learn more about CCBRT’s family planning work and Tim’s Corner here; read more about our maternal health work here; and donate to support the sustainability of our work to improve access to sexual, reproductive and maternal health through our website or Crowdrise page.

In early 2019, thanks to donor and partner support, Kupona’s local partner CCBRT launched a mobile info-line that provides pre-recorded Swahili audio content to callers completely free of charge – the first nationally available compilation of educational audio content about fistula. Called “Elimika,” the service has already been strikingly successful in reaching women living with fistula, like Asha. In its first month of operation, more than 300 calls were directed to CCBRT by the service, and eight patients were referred for treatment as a direct result of the service’s audio content.

Asha*, 44, is a mother of six from the Mara region of northern Tanzania, close to the border of Kenya. In 1996, when Asha was 23, she was excited for the birth of her second child. Her labor pains came on suddenly, and she found herself giving birth at home. Asha’s labor and delivery were long and painful; without a skilled medical attendant present, she developed obstetric fistula, a debilitating childbirth injury caused by prolonged and/or obstructed labor without timely medical attention. Afterwards, like many women living with fistula, Asha was unable to control her urine or feces.

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

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.  For six years, Asha suffered in silence, not understanding what was happening to her body. Her husband was confused – without an understanding of her condition, he was unable to help her heal, find treatment, or follow medical recommendations for women with fistula, such as abstinence from sexual activity. Asha suffered from fistula during four more births, with the injury becoming increasingly serious with every new baby.

In 2002, six years after she developed fistula and a year before CCBRT began offering free fistula treatment services, Asha paid a visit to a hospital in her district, hoping for a diagnosis. She was elated to find out that her condition had a name, and also a treatment – a surgery was needed, with a full recovery likely. However, she soon realized that the surgery would be impossible for her to afford with her income as a local farmer.

Soon after, thinking that his wife could never be healed, Asha’s husband abandoned her, leaving her to care for her six children while still suffering from a worsening condition with a treatment she could not afford. “I had never felt more worthless. I felt like I didn’t even belong in society anymore,” remembers Asha. “I was taking care of my children alone. The fistula was getting more serious, and I was suffering. God was my only hope.”

All that changed in February 2019, when she received a text message from the CCBRT Elimika service, asking her to press a free number on the phone to hear a recording about health.  Listening to the recording, she couldn’t believe it when she heard an announcement about fistula, telling her to call CCBRT if she needed information about access to fistula treatment – she called immediately.

Asha remembers this day as “the beginning of [her] new life chapter.” Soon, she was on a 23-hour bus ride from Mara to Dar es Salaam, completely paid for by CCBRT. When she arrived at CCBRT, where her meals, treatment, and accommodation were all free as well, she was amazed to find a community of women going through similar situations.  Asha finally felt like she belonged again.

While her surgery was complicated due to the severity of her fistula after four births, it was successful. Now, she is in the recovery stage. “I don’t even have words to explain how grateful and thankful I am for CCBRT. I thought I was going to die, and leave my children to suffer alone,” says Asha. She can’t wait to recover fully, so she can go back home and see her children, healthier and happier in the new chapter of her life.

*name changed to protect patient’s privacy

International Women’s Day (IWD) is an annual opportunity to celebrate women and girls around the world. This year, as part of its IWD 2019 celebration, Kupona is participating in the GlobalGiving Girl Fund Campaign to raise support for The Mabinti Centre (“Mabinti”), a socio-economic empowerment program providing women and girls recovering from fistula repair surgery with trainings in practical vocational, life, and business skills. Mabinti seeks to equip women recovering from obstetric fistula with the tools and knowledge they need to rebuild their lives and become financially independent after experiencing the trauma and stigma of obstetric fistula.

In honor of IWD and Kupona’s participation in the Girl Fund campaign, today we’re sharing the story of Jesca, formerly a patient at CCBRT, then a Mabinti trainee, and now a full-time Mabinti employee.

Meet Jesca

When Jesca went into labor with her first child in 2006 at age 16, she had no idea how the experience would change the course of her life. Sadly, after a prolonged and difficult labor, Jesca lost her baby – and discovered that she had developed an obstetric fistula.

An obstetric fistula is a birth-related injury usually caused by prolonged or obstructed labor without access to high quality maternal healthcare. One of the most debilitating symptoms that can accompany an obstetric fistula is chronic incontinence. This can contribute to the social stigma and marginalization often experienced by women suffering from the condition. In Tanzania, an estimated 3,000 women develop obstetric fistula every year.

In Jesca’s case, her partner left her due to the incontinence caused by her fistula. Luckily, Jesca’s parents supported her in seeking care at Kupona’s local partner CCBRT in Dar es Salaam, Tanzania. CCBRT provides hundreds of women each year with comprehensive, holistic fistula care, free of charge. In February 2007, Jesca underwent a successful fistula repair surgery at CCBRT.

After her surgery and recovery, Jesca tried to support herself and her family by selling fried cassava and taking a job as a security guard, but her income wasn’t enough to meet her and her family’s needs. Fortunately, in 2009 CCBRT founded The Mabinti Centre to support women and girls like Jesca, who were seeking to start new lives after experiencing the trauma of obstetric fistula. Unhappy with the work she had been able to find after her repair surgery, when Jesca heard about Mabinti’s new program she decided to apply. She was accepted as a trainee in 2010.

“I changed my life at Mabinti,” says Jesca. “I’ve really enjoyed spending time at Mabinti and working in an environment where everyone is ready to learn and to succeed in life.” As a trainee, Jesca spent a year at Mabinti learning sewing, beading, crochet, bookkeeping, English and entrepreneurial literacy. After she graduated from Mabinti in December 2012, Jesca kept working at Mabinti through 2012, before ultimately being hired as a full-time employee in 2013.

Being hired full-time “was a new chapter in my life,” says Jesca, who is now 29-years-old and happily married. “The Mabinti Centre has played a big role in my success – I now live in my own house!” Despite the challenges she has faced due to her difficult labor, she says, being at Mabinti gave her hope for the future.

Today, Jesca is happy with her work and remains optimistic about the future: “I thank Mabinti for the trainings and skills they’ve offered me. I now feel confident in what I’m doing. Even if I don’t work at Mabinti forever, I’ll still be able to work for myself because of the knowledge that I’ve gained here.”

Your support helps us reach more women and girls like Jesca with the skills and resources they need to thrive. You can learn more about Mabinti’s work and donate on our GlobalGiving project page: “Give Women Recovering from Fistula a Bright Future.”

Happy International Women’s Day 2019 from all of us at Kupona and The Mabinti Centre!