HABARI

Issue No. 15, April - June, 2016

A Quaterly Newsletter from Tanzania

A word from the Directors desk

Our Esteemed HABARI readers,

I am pleased to share with you the April-June issue of HABARI newsletter which gives a highlight of
Amref Health Africa Tanzanias programme portfolio. In this version, you will find highlights from Sexual
Reproductive Health (SRH) and Rights project, female genital mutilation (FGM), water and sanitation and
hygiene (WASH) and other Amrefs initiatives.
Amref Health Africa is contributing to local, national and international health impacts focusing on
transforming lives of disadvantage communities through multiple efforts, and these success are the result
of great support from government and all our stakeholders and community.
There are some great stories to keep you connected with Amref Health Africa and we would very much
appreciate your feedback. Let me also share with you Tanzania Country Offices Annual Report for the year
2014-2015. Please, read the report here: http://amref.org/amref/en/about-us/where-we-are/tanzania/
Wishing you a very happy reading!
Dr. Florence Temu - Country Director

To my young sisters, Say no to SUCH A PAINFUL CUT! Nembalo Nyangandu

It was by sheer luck that my parents protected me from the cut and
I am pretty sure that if my parents would have received advice and
encouragement from community members I wouldve undergone painful
circumcision said Nyangandu. I am 19 years old now, some of my
classmates in school have undergone Female Genital Mutilation (FGM) and
I couldnt imagine how my life would look like if I had gotten the cut. Apart
from the excruciating pain they experienced there are other issues such as
immediate danger of bleeding to death, painful sexual intercourse, HIV
infection and sexually transmitted diseases, adverse obstetric complications
including losing a lot of blood during delivery Nyangandu added.
With all these dangers, I dont understand why at this age such an old
practice continues to be practised. I think the compassion element is really
missing in our society and many dont have knowledge and awareness of
the impacts of FGM Nyangandu added with surprise.
I urge young women to step forward, dont be shy, have a voice about
injustice, some of us have had a chance to participate in FGM awareness
sessions conducted by Amref Health Africa in Kilindi and we are now aware

of the effects of FGM. We should impart this knowledge to the community at

large and fight against this harmful practise. My young sisters, before you are
forced or are encouraged to undergo FGM, think of the consequences of SUCH A
PAINFUL CUT advises Nyangandu.

Safe motherhood? Seeking Immediate health care is key!

Seeking medical advice early was never my priority and I only visited health care
facilities in case of terrible situations said Mariam Maulid (38years old) who has
been married since 1997 from Milongoli village in Tandahimba. I dont have a
child, I once conceived and 4months later I experienced a very shocking pain followed
by severe bleeding. I later found out that I had a miscarriage and from then I havent
been able to conceive. I usually experience pain and irregular bleeding from time to
time, but I never bothered to seek medical attention Mariam added.
One of Amref Health Africas trained community health worker visited me, his
name is Amani Bakari whos task was to conduct household visits and educate and
give appropriate advice on the importance of seeking medical attention immediately
after experiencing abnormal condition . Amani is doing a great job as he emphasizes
and focuses on pregnant women and children under five who are at a greater risk of
suffering from health complications. I took his advice positively and with support

from Community Emergency Referral Fund (CERF), I visited Tandahimba

hospital where the health provider identified that I was pregnant and I needed
intensive care. As you can see I am on complete bed rest now for the entire term
of my pregnancy. Without Amrefs trained CHW Amani and support from CERF, I
wouldve lost this child too Mariam said.
Milongodi village in Tandahimba is one among the villages, that is
benefiting from Tandahimba Integrated Malaria, Maternal, Newborn and
Child Health (TIMMNCH) project. The Community Emergency Referral Fund
was initiated to facilitate quick referal for pregnant women and children
who have been identified with danger signs with assistance of CHWs. Many
thanks to Amref Health Africa for implementing this and we are so grateful
to GlaxoSmithKline who are funding the TIMMNCH project.

Issue No. 15, April - June, 2016

Empowered youth always make informed decisions,

Meatu DMO, Dr. Assey John Sixtus
Before the Afya Kwa Vijana Project, Sexual and Reproductive Health (SRH)
services in Meatu District were severely limited and this prevented youth from
making informed decisions about their reproductive health rights. Health
facilities in the district had no designated area for provision of youth friendly
services (YFS) and health care workers lacked knowledge on the delivery of
YFS. Schools also had no programme to address SRH education; contravening
recommendations by the Government, community and health professional
attitudes towards SRH service. It discouraged youth from seeking services
and the Council Health Management Team (CHMT) lacked the capacity to
effectively establish, monitor and supervise SRH services in health facilities
saya Dr Assey John Sixtus.
He further anticipate that the project, through various trainings,
orientation and meetings conducted with health care providers, teachers
and youths, has changed the scenario. Our health care providers (HCPs) now
have the confidence, courage and competence needed to attend youth related
SRH services positively and productively. This is evident from the testimonies
we receive from youths applauding the HCPs on the good services they provide.
These services range from the tone, appropriate use of language, friendly

talks, helping hand, supportive youth based counselling , privacy etc. some
of which the youth complained of a lot before this project Dr Assey John
Sixtus added. We are thankful to Amref Health Africa for this project and my
support is full granted during the implementation of these interventions, he
concluded.

Dr. Assey speeking to Taturu community during a sensitization meeting

conducted by Amref Health Africa

The CUT should remain for Men, EDUCATION for Both - A Maasai girls perspective
Ngeseli Kutandawa (16) a maasai girl has succeeded in reaching form four in
Kwamatuku secondary school in Handeni District in Tanga region. We caught up
with Ngeseli who explained to us how proud she is of her achievement and some
of the challenges and obstacles faced by Maasai girls in obtaining education.
I can proudly say that, I am very happy getting permission and opportunity to
go to school. In my village to attend school is a miracle, Maasai parents usually insist
on marriage or in taking care of livestock until they decide to get us married. I recall
talking to my parents and convincing them that I wanted to go to school just like
other non Maasai girls. They were very supportive though they were scared of the

Ms. Ngeseli with her fellow students-School Health Club Members

communitys reaction. Our community believes that, Maasai Girls were

born to get married and the dowry will enhance the wealth of their
family. But thanks to God my parents stood confidently by my decision
and allowed me to join secondary school. I am now in form four,
expecting to sit for my final exams soon said Ngeseli.
She went on to explain further I am the only maasai girl remaining
in my class, there were some other girls in my class but they suddenly
quit and I am pretty sure that their parents decided to marry them off
or that the community has reacted negatively to their decision letting
them attend school against the norms of their culture.
My request to the government and to other NGOs which are
implementing development projects, is to kindly raise awareness on
the importance of educating girls; early marriages and other harmful
practices such as FGM go against womens rights. FGM is very common
in our community, not only are girls forced to undergo FGM, they are
stopped from attending schools and married off at a very young age.
The maasai community give emphasis on the boys because they are
seen as a means of continuity in the lineage while the girls are on
transit Ngeseli said.
I would like to thank Amref, for introducing Sexual, Reproductive
Health and Rights which are very essential to youth, some of the
trainings conducted in our school have enhanced my capacity on certain
health issues including the impact of early marriages, FGM, and what
my health rights are. We have the heath teacher whom we consult
and we have the school health club where we share a lot of issues and
experiences. I strongly believe that we will be the Agent of Change
when we go back to our community and spread the knowledge we have
gained Ngeseli concluded.

Issue No. 15, April - June, 2016

Learn & Practice- Feasible Through E-learning

Ms Leah Doglas attending a mother and her new born at Ndanda Hospital

Leah Douglas Matiani (F) 33 years old, a second year student and nurse midwife at
Sokoine regional hospital in Lindi is upgrading her skills through e-learning programme,
while working at Ndanda Hospital.
I am happy with the programme since I can continue with my work and at the same
time take care of family while studying. Initially, It was difficult to undergo further upgrading
of skills as the hospital could not afford to let go of a resource full time due to severe shortage
of nurses. Eventually, in the long run the patients would suffer the consequences of lack of
nurse midwives or nurse midwives without the appropriate skills said Leah.
I was able to enroll in the e-learning program and the best part was that I could apply
my theoretical knowledge in a practical setting.
I have learnt great skills and techniques, such as the vacuum delivery procedure, which
I did not know much about earlier. Now after the e-leaning programme I am able to perform
this procedure with confidence. I can also diagnose and manage abnormal pregnancies
without help added Leah with pride.
One day there was a woman who was in labor with her first pregnancy (prime gravid)
with all signs of safe delivery. In such a situation, the patient is supposed to deliver in half an
hour, but she stayed in the labour ward for more than an hour. Upon examination I could see
crowning but the woman was unable to push and there was an immediate danger to the
baby due to suffocation. I decided to apply my skills I got in my diploma education through
e-learning by using the vacuum method to help the mother to deliver her baby safely with
the support of my supervisor. Before upgrading, surely, I could not dare handle such a case,
but now I am confident and I can handle cases like these. I have also learnt how to manage
a ward, have broadened my knowledge in computer applications and my plan is to continue
with further studies untill degree level concluded Leah.

Making WASH in Schools more sustainable

The availability of Water Sanitation and Hygiene (WASH) facilities at schools for
both students and teachers is of critical importance, especially for girls of menstruating
age. WASH facilities are also important at hospitals, health centers and clinics, as this
is key to preventing infections and other diseases. Sustainable WASH conditions also
improve the general well-being of children, teachers, and their families. However,
ensuring sustainable WASH facilities in schools remains a huge challenge especially in
rural areas where they have poor living conditions.
Samwel Kimambo, the head teacher and Mariana Peter Asenga school health
teacher from Kwekivu Primary school in Kilindi had time to share their feelings about
the KWEKIVU school WASH situation. WASH in Schools is not considered as a priority
for most communities and municipalities. The situation in many places are terrible to the
extent that there are no toilets for the students and teachers to use. In other situations,
the physical infrastructure may exist, but it is not well maintained and are not user
friendly especially for girls who needs convenient latrines for privacy. In our school we
have almost 450 students with very poor WASH facilities, we had 3 pit latrines which
were shared by all students. As the situation became worse, parents and the school built a
temporary pit latrine, one for girls and one for boys the teachers stated.
We are very lucky to be one among the beneficiaries of Amref Health Africas SRH/
WASH project. There are planned trainings for health workers, community volunteers
and school teachers on Sexual Reproductive Health Rights, Female Genital Cutting and
Water Hygiene and Sanitation. The project will enhance our knowledge on SRHR, FGM
and WASH. Trainings are conducted in both practical and innovative skills in order to
provide sustainable WASH solutions in schools.
In some cases, awareness is raised for the accountability of functioning WASH

facilities among school children and teachers, which can lead to empowered school
communities taking responsibility and subsequent actions to improve the situation
themselves. I trust that Amrefs programmes in Kilindi and in other regions in
Tanzania will help in raising awareness about the importance of ensuring access
to WASH and sanitation in school settings among decision-makers, planners and
practitioners working in and with schools.

A temporary pit latrin constructed by parents to secure the well being of their
children in school

Issue No. 15, April - June, 2016

Photo Galler y
Under the theme Forward Ever Excel and Tell
Amref Health Africa Tanzania conducted the
2014-2015 annual review meeting (ARM)
in Morogoro Region. During the ARM, Amref
Tanzania staff shared project implementation
progress, challenges, achievements, best
practices and way forward.

Under the theme, Investing in teenage girls

UNFPA in collaboration with the Government
of United Republic of Tanzania and other
stakeholders including Amref Health Africa joined
the international community in commemorating
the World Population Day (WPD) on 11th July,
2016 at Mnazi Mmoja grounds in Dar es Salaam.
During the celebration, Amref Health Africa
Tanzania offered sexual reproductive health
services to youth, and HIV voluntary counseling
and testing to the public.

I feel overjoyed to have acquired adequate skills

through e-learning while still working. This will
help me provide better services to the community. To
me, having enrolled into the e-learning programme
was the best decision ever, many thanks to Amref
Health Africa and the Ministry of Health for this
programme, said Mabel Mfaume Nambwindi (F)
43, second from right in the picture.

Our parents are now knowledgeable on the impact

of female genital mutilation (FGM) and we are
happy that we are free from the CUT, we will be
more happy if Amref could extend the project to
reach more Maasai communities and to STOP FGM
of all young Maasai Girls. 3 young Maasai Girls