Lack of health care is another major problem for people in rural areas. Tanzania’s health system is severely under-funded. Fourteen out of every hundred children die before they reach the age of 5, mostly from easily preventable and treatable water-borne diseases. Maasai people are amongst the most marginalised in the country, with poor access to the existing facilities. WTWT are working with the community to improve this situation. Both the community and WTWT have provided funding to complete a dispensary/small hospital in Bulati village and to improve the maternity facilities at Nainokanoka Health Centre.
Most villages in the area now have access to basic health care and some emergency treatment locally. The remote village of Irmelili, amongst steep hills, unfortunately does not have vehicular access or any health facilities. For these people the nearest medical help is only accessible by walking or being carried for over 6 hours, down steep rocky paths. This often means that ill children, women with problems in childbirth and the elderly die before reaching medical facilities. The community have requested a dispensary in their village for primary health care. They plan to request permission from the Ngorongoro Conservation Area Authority and then look for funders. WTWT would contribute.
Health Education and FGC
In response to local requests we are running a Community Health Education Programme (CHEP), managed by NDI Coordinator Laangakwa (NDI is one of our link organisations). CHEP includes information about: nutrition, hygiene, sanitation, sexual health, HIV/AIDS, FGC (Female Genital Cutting, locally called female circumcision), child marriage and domestic violence. The education is run in a participatory way, weekly classes with drama, songs, films and visual aids. The programme is organised by our local Maasai staff with support from local medical staff.
CHEP has now been running for a year and a quarter and the report looking at measurable changes in behaviour is dramatic and encouraging:
Since the start of the programme in October 2016 some of the most notable changes are:
• The percentage of pregnant women receiving antenatal care before third trimester has gone from 26 – 92%
• The percentage of children vaccinated has gone from 30 – 97%
• The percentage of women of the reproductive age using family-planning methods has more than doubled from 24% to 52%
We work in collaboration with Dr. Shemaghembe, the Medical Officer covering the wards on the east side of the Ngorongoro crater. He has worked very hard to increase the number of outreach vaccination clinics. He also plans outreach antenatal clinics.
We are using the principals of ‘Tostan’s’ non-formal education: www.tostan.org adapted by our communities for the culture in their area. This broad education has been shown to transform communities and lead to sustainable social change, including whole community abandonment of FGC. Two of our WTWT staff attended the first workshop run by Tostan in March 2015 and one staff member of Ngorongoro Community Network (NCN) in July 2016. NCN plan to start a CHEP programme in collaboration with NDI in the neighbouring ward of Alailelai.
We are hugely grateful to WMI (Womens’ Microfinance Initiative) http://wmionline.org/ for their financial support of CHEP for the women whose loans they fund. With this support were able to double the number of classes in 2015 and reach twice as many women. In 2016 they gave us another grant enabling us to increase the classes to three per village and add classes for the Traditional Birth Attendants (TBAs) at their request. All participants share what they have learned with their families and wider community. Important information leading to improvements in health is spreading.
In traditional Maasai society ‘Female circumcision’ is an ancient, respected practice and a ‘social norm’ which graduates a girl to womanhood and marriageability. For this reason information on the harmful effects is given by our local Maasai staff working creatively with the whole community to challenge and empower them to change in a positive way together.
In 2013 our staff ran workshops on HIV/AIDS and FGC, funded by WTWT, for members of all sectors of the community. At the end of the workshops all of the participants expressed a desire to stop the harmful practice of FGC. Our guest teachers were from the organisation SAFE Maa, a branch of SAFE Kenya www.safekenya.org They are having success in Maasai communities in Kenya, with many girls now progressing to womanhood without cutting. Our local staff are now working with the community through CHEP towards stopping ‘female circumcision’, whilst keeping their important ceremony for the rite of passage to womanhood. In this way, no one in the community will be disadvantaged or disrespected by not under going FGC. Since our first workshops and the ongoing CHEP the practice of FGC has been reducing. An increasing number of respected Elders and Traditional Birth Attendants have publicly pledged to stop the practice.