Dr. Harusha Simplice is the only obstetrician-gynecologist at Sengerema Designated District Hospital, serving over 700.000 people. After becoming a general practitioner Dr. Harusha secured his specialist training through Touch’s Treat & Train program, which improves medical education and patient care in the Lake Zone.
A Burundian refugee forced to flee to Tanzania as a teenager, Dr. Harusha Simplice always knew he wanted to be a physician. According to his mother, at the ripe age of two he used to comfort his friends and family by reassuring them that one day he would be a doctor. His father also wanted to be a doctor, but he was never able to practice as he died in an accident two months after graduating from medical school. When Dr. Harusha was in his final year of schooling his mother was diagnosed with cervical cancer and died just a year later. It was his mother’s death that cemented his desire to help women and strive to one day become an obstetrician-gynecologist.
After graduating, Dr. Harusha began practicing medicine at Sengerema Designated District Hospital. Five years later, Dr. Harusha, now a father of two boys with another one on the way, decided he needed to find a way to receive specialized training to become an obstetrician-gynecologist and pursue his aspiration of helping women. At this point Dr. Harusha encountered Touch Foundation, just as we were in the process of expanding our Treat & Train program to Sengerema Designated District Hospital. Through Dr. Harusha’s perseverance and partnership with Touch, he was able to receive the education required to specialize in Obstetrics and Gynecology.
Today, Dr. Harusha is the only trained OBGYN at Sengerema Designated District Hospital. This 300-bed hospital serves over 700,000 people and delivers about 25-30 babies per day. For Dr. Harusha, it is not uncommon to attend to multiple women giving birth in the same room with the help of just two nurses. In fact, in Tanzania the shortage of healthcare workers is a main contributor to the high maternal death rate.
In early October, Dr. Harusha completed a training held by our partner MeduProf-S on SonoSite ultrasound machines in order to perform heart disease and obstetric ultrasound screenings during maternity checkups. For all of the clinicians present at the training, this was their first experience with an ultrasound machine. In the United States, women usually receive an initial screening at the beginning of their pregnancies to confirm a viable pregnancy. Most women in the United States will receive numerous ultrasounds throughout a pregnancy, and at least 1 anatomy screening at 20 weeks to ensure healthy development. Most Tanzanian women have never received an ultrasound screening during their pregnancy, but this is changing as women are increasingly requesting them and the technology is becoming more widely available. Dr. Harusha’s training, and others like it, will not only give women access to ultrasounds to ensure the health of their developing babies, but will also screen them for any heart anomalies, which can go undiagnosed until delivery, putting the mother at risk during labor. Following the training, the SonoSite ultrasound machine installed at Sengerema hospital, and three additional machines were installed in other high-risk area health centersDr. Harusha truly believes in the sustainability of the unique education model of Touch’s Treat & Train program. He continues to learn new skills which are valuable for him and also valuable to the medical students he is training and to the women he is attending to. For Dr. Harusha, continuing his education and partnership with Touch is empowers him to achieve his goal of saving the lives of women and children.
To ensure that every mother can enjoy a healthy pregnancy and every child survives beyond their fifth birthday worldwide, the UN and World Health Organization launched the Global Strategy for Women’s, Children’s and Adolescent’s Health (2016-2030). This Strategy is promoted by Every Woman Every Child, a global movement mobilizing new collaborations and partnerships between governments, multilaterals, the private sector and civil society to achieve the Sustainable Development Goals (SDGs).
Today a woman in Tanzania is still 80 times more likely to die from pregnancy related causes than a woman in the United States. Multipartner collaboration and collective action are needed to address the root causes of such a huge disparity. On September 19, 2017, Touch Foundation announced our first Every Woman Every Child commitment at the annual Every Woman Every Child Private Sector-Innovation high-level event, held during the 72nd session of the UN General Assembly. We have committed to raising $1 million dollars, combined with other committed funds, to expand the Mobilizing Maternal Health program across eight districts of Tanzania over the next four years to save the lives of mothers and newborns.
Touch Foundation, together with our partners including the Tanzanian government, Vodafone Foundation, Pathfinder International and D-tree International, will provide over 11,000 pregnant women and their newborns facing a medical emergency with safe, fast, and free transportation. Using mobile phone technology, our transport system is designed to take emergency calls (911-like) from remote areas on its toll-free line, triage a patient remotely 24/7, dispatch an ambulance or community taxi to bring the patient to a health facility, and monitor the patient’s progress from the moment help is called until their discharge. In addition, we will continue to improve the quality of health services in rural areas by training healthcare workers and building infrastructure like c-section theaters and neonatal intensive care units. Our evaluation of the first phase of this program in one of the pilot districts proved that this approach could reduce maternal mortality by at least 27%. Many more mothers and newborns will be saved as we scale up our evidence-based program.
Touch is enthusiastic about our commitment to Every Woman Every Child. We believe this international network will provide valuable global context to our programs and overall work, as we continue to align our mission with promoting the Global Strategy Principles and SDGs. Redoubling our efforts globally, together with our partners, we are moving towards creating the world in which, as the former UN Secretary General Ban Ki Moon put it, “no woman, child or adolescent would face a greater risk of preventable death because of where they live or who they are.”
Rheumatic Heart Disease is a preventable cardiovascular condition that is rare in the U.S. but still causes hundreds of thousands of deaths each year in low-resource settings with weak health systems. It begins with a case of untreated strep throat.
A case of strep throat is no stranger to school-aged children in the United States. If treated with antibiotics, this common bacterial infection is relatively harmless and uncomplicated. But for people in countries like Tanzania, it’s not that simple. Cases of strep throat may be left untreated because basic health services cannot easily be reached and, over time, this spirals into an inflammatory reaction of the heart valves called acute rheumatic fever, which then induces rheumatic heart disease (RHD). RHD disproportionately affects young adults in the prime of their lives and can be especially fatal for pregnant women.
Renae Stafford, Touch’s Program Director of Academic and Clinical Services, co-authored an article published in March in Global Health that compiles information to help us better understand how to treat and prevent RHD in Tanzania and Uganda.
The study found that nearly 2% of schoolchildren in Tanzania and Uganda are affected by RHD. Moreover, deaths from RHD persist even in the presence of care with up to 27% of patients dying in surgical wards. Poor infrastructure and medical supplies, insufficiently trained healthcare workers, and other weaknesses in the health system contributed to these poor outcomes. Additionally, a lack of patient knowledge, stigma, and a history of poor interaction with healthcare workers mean that patients often don’t seek care until it’s too late. Ultimately, the Global Heart article stresses that there remains a great need for high-quality, up-to-date data on RHD, especially within low-income countries like Tanzania.
At Touch Foundation, we are committed to working with our partners to protect people in Tanzania and internationally from dying from this preventable yet fatal cardiovascular condition. With the support of Medtronic Foundation, Touch is tackling RHD by ensuring the health system is equipped to prevent, diagnose, and treat patients, especially vulnerable children and pregnant women, by conducting health worker training, upgrading equipment at health facilities, and hosting strep screening days at schools. Read more about how we are addressing non-communicable diseases like RHD here.
Read the full article: Annesinah H. Moloi, Sumaya Mall, Mark E. Engel, Renae Stafford, Zhang Wan Zhu, Liesl J. Zühlke, David A. Watkins, The Health Systems Barriers and Facilitators for RHD Prevalence, Global Heart, Volume 12, Issue 1, 2017, Pages 5-15.e3, ISSN 2211-8160, http://dx.doi.org/10.1016/j.gheart.2016.12.002.
On May 18th, 2017 Touch Foundation and Vodafone Foundation hosted a symposium in New York City. We invited expert panelists to share innovative evidence-based approaches to improve maternal and newborn health in sub-Saharan Africa and other low-resource settings and achieve the Sustainable Development Goals.
The first panel focused on the impact of an emergency referral and transport system (EmTS) on maternal lives saved in Tanzania, which was launched in 2015 by Touch Foundation, Vodafone Foundation, ELMA Foundation, USAID/PEPFAR, and Pathfinder International as part of the Mobilizing Maternal Health (MMH) program. In the first year, the EmTS resulted in a 27% decline in maternal mortality rates and saved many more newborns in two districts. The panel stressed the importance of high-quality data collection to enable quick fixes and targeted resource allocation. The panel stressed, in relation to the EmTS, the importance of critically analyzing the data in order to achieve buy-in from all partners including the Government of Tanzania and to scale in the future. In addition to data, the program’s tangible impact on Tanzanians has bolstered government and community trust.
The second panel, Innovative Approaches to Barriers to Care, featured panelists examining a range of innovative approaches to remove barriers to quality health care for women and newborns. Mutually beneficial partnerships, a systems approach to integrating devices and interventions, and locally-led innovations were three key approaches discussed. The panelists, leaders of international NGOs and medical device companies, emphasized that productive partnerships depend on a generous understanding of each other’s relative strengths and interests. They also recognized that strong health systems and consistent product innovation can promote self-sufficiency. Lastly, they highlighted that there is an opportunity to support local innovation through North-South partnership, resource allocation, and an environment that enables risk-taking.
For further reading on this topic, please see our Mobilizing Maternal Health Impact Report. To read the full Symposium Report Out, click here. Thank you to all those who were able to attend and a special thank you to our moderator, Lord Michael Hastings of Scarisbrick CBE, Global Head of Citizenship for KPMG, and to our panelists: James BonTempo, Chief Strategy Officer, D-tree International; Dr. Siobhan Crowley, Director of Health, ELMA Philanthropies; Dr. Ntuli Kapologwe, Director of Health, Social Welfare & Nutrition Services, Tanzania’s President’s Office of Regional Administration and Local Government; Massimiliano Pezzoli, Country Director, Touch Foundation; Lee Wells, Director, Vodafone Foundation Ventures & Head of Programmes, Vodafone Foundation; Robert Miros, Chief Executive Officer, 3rd Stone Design; Lois Quam, President and Chief Executive Officer, Pathfinder International; Stephen Rudy, Chief Executive Officer, Gradian Health Systems; Andrew Storey, Director, Maternal and Newborn Health, Clinton Health Access Initiative
Five billion people live without access to safe, affordable surgical and anesthesia care. These operating room services are crucial to treating people with cardiovascular conditions, bone fractures, pregnancy complications, and many other health issues. If these services are inaccessible it can lead to an avoidable disability or premature death. This situation is far too common in Tanzania where surgical and anesthesia care is lacking and the country is facing a large shortage of healthcare workers with the needed skills.
Allan Joel is an ambitious 29-year-old nurse anesthetist trained to meet all of a patient’s anesthesia needs before, during and after surgery or the delivery of a baby. Allan developed a passion for medicine in 1989, the year his father was diagnosed with diabetes. He witnessed his father suffer from inadequate medical care and decided at a young age to pursue nursing so that he could help his father and others in need. After graduating from nursing school, he applied for a nurse midwifery position at Sengerema Hospital, a 325-bed rural hospital serving 800,000 Tanzanians. Limited funding and resources at the hospital prevented Allan from getting a position and forced him to reconsider his career.
Touch accepted Allan Joel’s application to work as a medical scribe aiding the Treat & Train program. While Allan worked as a medical scribe, he was able to spend all of his free time volunteering in the ICU and operating theaters at Sengerema Hospital. In the ICU and operating theaters, Allan was exposed to anesthesiology and realized the impact he could have on patients’ lives in this field. Inspired to learn the skills necessary to provide life support in a safe surgical environment, Allan applied for a one-year nurse anesthetist certification at Bugando Medical Centre. With the help of a Touch-funded grant, he graduated in September 2016 and promptly returned to Sengerema Hospital to begin working in the operating room.
Mortality and morbidity related to anesthesia and surgery are all too common in Tanzania. We recognize the importance of a safe and sterile surgical environment to protect everyone, including patients, healthcare workers and students, from infection, injury, and other harm. Touch, together with hardworking individuals like Allan Joel, is working to improve access to safe surgical care and save lives at Sengerema Hospital and our other partner health facilities.
With Touch’s help, Allan was able to start a career in the field of anesthesiology. Although Allan’s work comes with many challenges, including working with only a limited number of trained specialists and equipment, his dynamic drive to find solutions has made him an integral part of the hospital. He has already devoted seven years of his life to improving the care of patients and aims to return to school next year to qualify as an Assistant Anesthesiologist. Touch is proud to support the ambition of young healthcare workers and improve the lives of Tanzanians by providing greater access to quality skilled providers and safe surgical care.
Veronika Method, 23 years old, delivered her first four children in her home without any medical assistance. Veronika delivered her twins at Nyamizeze dispensary, but was told by local healthcare workers that she needed to be transported immediately to the hospital if she wanted her newborn twins to survive. Worried about the safety of her newborn twins, Veronika put her trust into a system completely unknown to her. To Veronika’s surprise, the nurses at the dispensary arranged for her and her neonates emergency transport with the help of the capable dispatchers. This is a system set-up as part of the Mobilizing Maternal Health program with Vodafone Foundation. Yesterday morning, Veronika became our 2,000th emergency case. The twins, Kulwa (4.4 lbs) and Dotto (3.5 lbs), are currently still in the NICU undergoing intensive treatment in the baby warmers and CPAP breathing machines.