Obstetric fistula is just one of the preventable disabilities that is treated through our work at CCBRT in Dar es Salaam, Tanzania. Fistula is a debilitating condition that causes chronic incontinence as a result of prolonged obstructed labor without timely medical intervention. There are up to 3,000 new cases of obstetric fistula in Tanzania every year, and around 1,000 surgeries conducted nationally each year, tragically leaving a backlog of women who are living with the condition without seeking treatment.

Recent data recognized that our program at CCBRT is one of the largest surgical obstetric fistula repair programs in the world.

“This is exactly the kind of program we strive to fund at Fistula Foundation. CCBRT has emerged as a global leader in fistula treatment and as a trailblazer in the use of M-PESA for patient identification and transportation,” said Kate Grant, CEO of Fistula Foundation, which has provided financial support for CCBRT’s fistula work since 2009.

Treating obstetric fistula, while vital to improving the health and welfare of thousands of women living in extreme poverty and isolation, will not address the root cause of the problem. We are addressing the gap in accessibility to safe, quality maternal and newborn healthcare in Tanzania by building our new Maternity and Newborn Hospital, as well as through working with lower-level health facilities in the Dar es Salaam region to strengthen the maternal healthcare system.

We don’t just do the surgery. We start with raising awareness in the community, we break down the transport barrier to receive care, and we take a comprehensive approach to treatment, recognizing that the damage caused by living with obstetric fistula is not only physical.

Raising awareness in the community and breaking down the transport barrier

We maintain an extensive awareness raising campaign through radio, TV, fliers and a network of over 500 “ambassadors” who identify women with obstetric fistula and facilitate their referral to the hospital for treatment using Vodafone M-PESA (mobile money transfer). Using mobile money transfer breaks down one of the primary barriers to seeking treatment by enabling women to cover the transportation cost. In the first year that the M-PESA program was introduced, we saw a 65% increase in the number of patients seeking treatment. When a patient is identified, an ambassador calls the CCBRT Fistula Hotline number, the team confirms the diagnosis and then sends money via M-PESA mobile money to pay for transportation to the hospital. The ambassador buys the patient’s ticket and escorts her to the bus. When she arrives in Dar es Salaam, she is met by a member of the CCBRT team and escorted to the hospital for treatment.

A holistic, comprehensive approach to care

Beyond the physical injury, obstetric fistula has a tremendous psychological impact on affected women. The trauma of the delivery that caused the fistula to develop is devastating for many patients. Approximately 90% of women treated lose their baby, and many face marginalization and discrimination from their families and communities due to the fact that they are leaking urine or feces. Women with obstetric fistula are often unable to work, and many are forced into extreme poverty as a result of their condition. At CCBRT, we have established a comprehensive holistic care program to address the psychological condition of patients, improve basic health education and awareness and provide women with the tools and self-confidence to be able to reintegrate into their communities. We also provide group and individual therapy sessions and music and handicraft workshops to provide a creative outlet and arena to bond with other patients and develop a support network of women going through the same trying ordeal.

In a 2013 survey of former fistula patients, 92% of women said that the operation was life changing and 96% felt more accepted and supported by their communities. In 2014, we have a goal of treating over 750 women and giving them another shot at life.

Hello friends, followers and supporters,

We are back, after a hiatus from blog posts and social media. I took over as Kupona’s Executive Director in early September, and experienced a whole new level of “hitting the ground running.” Kupona’s founding Executive Director, Katie Flanagan, spent time with me transitioning until the day before she gave birth to a baby girl in late September. Our Third Annual Golf Outing was October 3rd, and we had inspiring visits from Erwin Telemans, CCBRT’s CEO and Dr. Brenda D’mello, Technical Advisor to CCBRT’s Maternal and Newborn Program in the first, second and fourth weeks of October.

As we re-launch the blog, I will be making a series of posts to introduce myself, share more detail around what we’ve been up to, address a series of questions that I have asked or been asked, and (re)introduce Kupona and CCBRT’s shared vision. To keep things interesting, I’ll make it a point to share photos as well – two recent construction photos are below, and you can view all of the most recent photos on Facebook. I have learned a lot in my first two+ months as Executive Director, and I am extremely excited about the work happening on the ground in Tanzania and the potential for us to directly support that work. We are changing lives.

Abbey

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.

Beatrice to other patients with fistula: ‘ Once I was just like you and now thanks to my husband and CCBRT I have a new life ’

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!