How Tanzania’s health centre kills two birds using one stone

SUNDAY June 4, 2023

By Deus Bugaywa

The Tranquility News Correspondent, Tanzania

Women have assumed the role of the Almighty of bringing in life on earth, if religious belief is anything to go by.

It is a momentous experience to mothers, hubbies and their families; yet to some, the sacred gift is tantamount to defying death.

Lack of health facilities, gender barriers towards accessing health services, especially in rural areas in Tanzania, are among key factors hindering safe delivery among expectant mothers.

Bugarama Ward in Kahama Rural District, Shinyanga Region, was not an exception, as delivery was synonymous to mortality.

Thanks to KOICA funded UNFPA, UN Women and Barrick Gold for upgrading the then Bugarama Dispensary to a health centre and equipping it with state-of-the-art facilities.

Surrounded by male-dominated community, the Bugarama Health Centre has also turned into a focal point for quelling gender inequality as well as gender-based violence.

“Delivering at the dispensary was too risky, next to death. The setting and poor facilities were jeopardising lives of expectant mothers,” Kashije Joseph, 38, recalls hurdles she went through twice when she delivered her first two children at the defunct dispensary.

Kashije had a different experience when she was blessed with her third bundle of joy. “For the first time, I felt the honour of bringing in life on earth,” she says.

Barrick’s subsidiary Bulyanhulu Gold Mine upgraded the then small Bugarama Dispensary to a health centre and furnished it with modern facilities as part of its Corporate Social Responsibility projects.

The upgrading involved construction of maternity ward, outpatient department (OPD), general ward, theater, radiology and mortuary buildings.

Before it was upgraded, the dispensary had the capacity of attending to between 15 and 25 patients daily, as opposed to between 50 and 100 out patients the health centre now attends to.

Between 250 and 300 expectant mothers give birth per month, with between 20 and 30 of them undergoing surgical operation.

Doctor Beata Eristides, the Bugarama Health Centre Acting Medical Officer, says the best she and her colleagues could do was to refer patients, mostly expectant mothers, to Kahama District Hospital for surgery and other advanced treatment during the dispensary era.

“Now we can operate about 24 expectant mothers per month, averting risks they could face on their way to the referral hospital,” she says.

The radiology premises enable the health centre to provide x-ray and ultrasound services accessed at Kahama District Hospital, 80 kilometers away, in the past.

Bugarama Health Centre serves as a referral point for 10 dispensaries and two other health centres in turn.

The mine has so far contributed to the building of 24 dispensaries in Kahama and Nyang’wale districts.

Bugarama, the mine hosting community, now stands out of the crowd in addressing gender issues, thanks to the UNFPA and the UN women’s joint programme carried out at the health centre.

Dubbed Realising Gender Equality, the programme has since 2020 been empowering women and adolescent girls from the same facility, reaching out to Shinyanga and Singida regions.

Taking into account of high poverty rate, low economic empowerment for women, prevalence of gender-based violence and other harmful practices, the two regions deserve the programme.

“Delivering at the dispensary was too risky, next to death. The setting and poor facilities were jeopardising lives of expectant mothers,” Kashije Joseph, 38, recalls hurdles she went through twice when she delivered her first two children at a Tanzanian dispensary that has been upgraded to a health centre.

The programme promotes economic empowerment for female farmers by introducing good practices for horticulture and sunflower production.

It also addresses gender-based violence and child marriage through multi-sectoral prevention and response.

UNFPA in collaboration with central and local government authorities launched a one stop centre at Bugarama Health Centre.

The centre caters for rights-based dialogues that promote community-led solutions to prevent and respond to gender-based violence.

Neema and Mihayo (not their real names), parents of a seven-year-old boy and a three-year-old girl, are among beneficiaries of the centre.

“Now we can operate about 24 expectant mothers per month, averting risks they could face on their way to a referral hospital,” Dr Beata Eristides, the Bugarama Health Centre Acting Medical Officer, says.

Soon after their marriage, Mihayo was not only addicted to alcohol, but also aggressive and violent towards Neema and their children.

Other women pleaded with Neema to join the Bugarama Knowledge Centre for community dialogues on gender-based violence.

She received psycho-social counseling and learned about her rights and opportunities for seeking support from social welfare and healthcare service providers at the health centre, who assisted her in filing a police report against her husband.

This was the first time a woman from Bugarama filed a domestic violence case against her husband. Mihayo was arrested and arraigned.

His judicial court trial simultaneously went along with a marriage counseling, leading the couple to compromise and the wife to withdraw the case in a month’s period.

Nonetheless, the Judge, who presided over the case, warned Mihayo that he risked a prison sentence if he continued with domestic violence and alcohol abuse.

Mihayo pledged before local authorities that he would become a responsible husband and father, and committed enough to financially provide for his family.

The born-again hubby and dad reunited his spouse and children, and resumed his security guard job, as the wife shares her story to encourage other women to speak out and seek assistance.

As a result of the maiden lawsuit Neema dared to file, many Bugarama Ward women have become aware of their rights since, and are raising awareness among community members on market days in their attempt to eliminate gender-based vices.

As we speak, women are trickling in at the centre to take part in the KOICA funded UNFPA and UN Women joint programmeΩ