This lack of access is compounded by limited, often inaccurate, information about healthy behaviors. We address both of these challenges in our projects. Each project has been developed in close cooperation with the people it will serve as well as local government officials and other stakeholders. All of them feature empowerment, especially of women, and all include a strong educational component. As is evidenced in all of our programming, we believe that education changes everything.
The Community Health Alliance Program began in 2014 with the purpose of integrating 21 underserved, remote Maasai villages with the formal health system to reduce the significant disease burden and high mortality rates in the communities. Thirty Maasai women were each selected by their village leaders and were trained as Community Health Workers (CHWs). These women provide timely life-saving treatments such as newborn resuscitation or control of post-partum hemorrhage, recognize when someone with an illness needs to be referred to a health facility, and treat minor wounds and injuries. The CHWs also provide preventive health education presentations to their fellow community members and in 2015 were given iPads preloaded with health education videos to facilitate these presentations. They continue to attend refresher trainings and in 2018 they received sturdy bicycles to expand their reach.
The Gender-Based Violence Program was developed to respond to the high levels of domestic violence in Tanzania. The program was designed to be culturally appropriate with the assistance of local counselors and women who choose to call themselves “survivors” rather than “victims.” The program has established 10 support groups each serving 10 women. The 100 survivors in the program receive twice-monthly group counseling and have embarked on economic strengthening projects that will generate income, autonomy, and dignity. Improvement in depression and anxiety is being measured by instruments developed by psychologists and statisticians. The women in this program are now called “entrepreneurs” and have each been trained in solid business practices and are involved in the production and distribution of items such as batik fabric and reusable menstrual pads. What was once a program of survival is now one of complete empowerment and economic opportunity!
The Improving Women’s Health Program began in 2013 and has trained 33 women as Community Health Educators (CHEs), each serving one ward of the Same District (population 269,000). The CHEs use interactive presentations as well as educational videos in Swahili to provide information on such basic topics as hand washing, purifying water, and mosquito nets use to prevent malaria. Each CHE conducts 12 meetings per month and their impact is remarkable! As of December of 2018, the CHEs have done 23,549 presentations and presented individual topics to 1,056,750 signed attendees in Same District since the program began! District-wide surveys have demonstrated the effectiveness of the presentations in improved health topic knowledge and attitude change. In fact, preliminary government health data found lower rates of malaria, diarrheal diseases, intestinal parasites and acute respiratory infection in Same District compared with neighboring control districts. Each CHE was provided a sturdy bicycle and helmet in 2018 to further expand their reach.
Safe Motherhood for Maasai Women and Children was established in response to an urgent request by the Maasai community of Nadaruru, which had exceptionally high maternal mortality rates. In 2011, with significant local support, Empower Tanzania constructed a clinic building as the site for the provision of a safe motherhood program. Ten women were trained as birth attendants by Tanzanian faculty. Two of the birth attendants staff the clinic building daily and provide education to pregnant women and their newborns. Twice each month, a medical team for Gonja Lutheran Hospital comes to the village to provide maternal checkups, immunizations of children, and other health services to community members. A similar clinic staffed by 10 trained birth attendants was established in the Maasai community of Pangaro in 2012. Both clinics have had solar lighting systems installed and a latrine was built at Nadaruru in 2013 and at Pangaro in 2016. In 2018, both of these clinics were passed over to local control—another example of sustainable aid facilitated by Empower Tanzania.
Palliative Care (also called “end-of-life” care) was an inaugural Empower Tanzania program. It began in 2007 with funding from the President’s Emergency Plan for AIDS Relief (PEPFAR) and trained 240 Community Health Workers from 24 villages in the delivery of palliative care services to terminally ill people in their villages. Over time the program added training in home-based care. Empower Tanzania completed its involvement in the program in 2015, but a limited version continues with the support of the Tanzanian Red Cross and the Centers for Disease Control and Prevention.
The exceptionally high pregnancy rate of schoolgirls in the rural communities of Same District has drawn concern from government, religious and community organizations. Empower Tanzania has been asked to help address this problem and its attendant risks of sexually transmitted diseases and the onset of sexual activity. Reproductive health education has been demonstrated in multiple research studies to reduce teen pregnancy and sexually transmitted diseases including HIV, as well as delay the age of onset of sexual activity. In 2018, a pilot program of reproductive health and relationships education was initiated for over 11,000 primary and secondary school students in 19 schools in and around Same, Tanzania. Videos in Swahili on puberty, menstrual periods, reproductive health, and relationships were produced and a curriculum and lesson plans developed for the program. Thirty-eight teachers were trained in the curriculum during a 4-day course in September of 2018 and, subsequently, 90 more were trained in their schools. This adds up to a ratio of 1 teacher per 100 students in the Same District will now teach course content during the 2019 school year in at least twice-monthly 40-minute sessions. Check back for highlights and outcomes as this program evolves.