By: Joanna Hoffman, Women Deliver
For the estimated 3,700 Tanzanian women who experience obstetric fistula each year, a daunting landscape of stigma and shame looms before them. Many are exiled from their families and communities, and are unable to work. Only about 1,000 of them will receive treatment. The rest are either unaware that treatment exists or can’t afford to access it.
This issue led Comprehensive Community Based Rehabilitation in Tanzania (CCBRT), the country’s largest provider of fistula repair surgery, to take action. CCBRT already provides services free of charge, yet the barrier of transportation costs remained. In response, in 2009 they began using Vodaphone’s mobile banking system M-PESA—M for “mobile” and PESA for “money” in Swahili—to reduce the burden of transportation expenses.
CCBRT sends money to volunteers through text messages on the M-PESA system. The volunteers then identify and refer potential patients for treatment, purchase bus tickets for them to travel to the hospital, and send them on their way to a bright future. After the patients reach the hospital, the volunteers receive a small incentive.
Since its inception, the UNFPA-supported program has increased the number of women accessing fistula surgery by 65%. In 2010, 54 ambassadors referred 129 patients for repair surgery, and almost half were then treated at CCBRT. UNFPA has also supported the renovation of a hostel near the hospital for women who are waiting for or recovering from surgery.
CCBRT’s Chief Executive Officer, Erwin Telemans, commented on the importance of these developments:
“Many women travel long distances to get treated. Having the capacity to offer special accommodation to women with fistula enables us to treat many more patients. It also helps encourage those who don’t have the resources or are too embarrassed to lodge elsewhere to seek treatment.”
Thanks to CCBRT and UNFPA, a fistula is no longer a death sentence and a mobile phone is no longer just a phone. For thousands of women in Tanzania, there is now hope for a brighter future.
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