I’m working in Tanzania for the summer on a paper out here. I spent last week travelling with the Women’s Dignity NGO in the Kahama region. The NGO work on maternal health issues and invited me to join them in the same week the African Union summit took place this year themed around infant and maternal health issues. I wrote this piece for the paper and am in the process of editing a short documentary.
Mothers at the Igwamanoni dispensary © Oliver Laughland
The road to Luhaga village is riddled with potholes that jolt our 4×4 in all manner of directions. Its fat tyres spray thick clouds of orange dirt high into the air; engulfing the cyclists we overtake who falter by the roadside. We pass cotton fields in full bloom and rectangular rice plantations attached to small plots of houses with straw roofs and bricks made from mud.
I’ve travelled to the north of Tanzania, to the Kahama district, with the Women’s Dignity (WD) NGO, on the week of the African Union summit in Kampala, Uganda. As the heads of state come to the meeting this year themed around women and infant’s health, I’m here to see the work this specialist NGO do to educate people from rural areas in the basics of maternal health.
Run almost entirely by Tanzanian women in regions across the country, WD are planning to tackle ignorance on maternal health issues village by village. I join them at the start of a two-week community sensitisation programme that sees representatives from the NGO travel to villages deep into the interior delivering a free afternoon’s worth of programmes aimed at engaging and educating villagers in a country where 580 women die in every 100,000 child births.
Hundreds, from several neighbouring villages turn up to Luhaga having been rounded up by village leaders. There’s a buzz of anticipation before dancers from the Kahama Medical Cultural Troop burst into the centre of the makeshift stage, performing an acrobatic dance routine to a pounding drumbeat. This is the essence of these meetings -making the content as engaging to attendees as possible.
As well as keynote speeches on research conducted by the NGO, the performers deliver dramas on the importance of taking women to hospital during childbirth and on how to treat preventable diseases.
Catherine Kamugumya, head of research at WD tells me: “We use these methods to actively encourage debate on maternal health issues. To hear what villagers have to think and educate them on how to achieve better healthcare for pregnant women.”
It seems to have worked. The meeting ends with a lively question and answer session where attendees are asked to explain what they have learned. “Men should take more care of their wives,” cries one man, “Pregnant women must go to the clinic to give birth,” proclaims another.
By the end, the charisma of the WD representatives is so infectious the village set up their own Community Emergency Fund. This a fund in which each household contributes a sum of money for a communal pot that allows any villager in need of emergency healthcare provision to pay for transport or any other costs.
But the signs of neglect for maternal health are ever present. We meet a girl who wishes to remain anonymous, she has travelled for miles with her father to get to the meeting after she heard about it on the radio.
She fell pregnant aged 17 but lost her child during a traumatic childbirth that lasted for over 24 hours. She developed a fistula during labour and, despite four months in hospital, still has the condition, which leaves her incontinent and outcast from her community, a year after her initial diagnosis.
Pregnant women at the Kahama District Hospital © Oliver Laughland
After advice from the WD representatives she vows to return to hospital to get treatment for what is a very curable illness. “I would tell all women suffering with fistula not to give up,” she tells me, “When I am repaired I want to continue building a family as being a mother is very important.”
As the meeting finishes we head to the local dispensary at Igwamanoni. It is here where pregnant women from around the area are encouraged to come both before and during childbirth to ensure safer pregnancies. A modest facility with just one bed devoted to women in labour, we are taken on a tour by head medical officer, Stephen Dalalai.
He pulls a large canvas book from his office, the labour registry that shows around 30 births occurring every month here. One a day. The dispensary covers just 5 villages. Dalalai says that of these 30 labours per month one or two will present complications that the dispensary cannot deal with. When this occurs he calls an ambulance from Kahama town hospital which will take two hours to arrive and then a further two hours to deliver the woman to hospital.
Just as we leave a girl no older than 18 arrives. Her labour has begun. She has come alone, no father or husband in sight, with a look of fear in her eyes. The door to the labour room shuts. Another day, another labour. What became of her we never found out.
