Mercy Esther was eight years old when she left home.
Raised by her grandmother in rural Tanzania, Mercy Esther and her siblings were born into poverty, sometimes without money for food, let alone schoolbooks. When their grandmother was approached with a job offer for Mercy Esther in Kenya, and the promise that money would be sent home, she accepted. The money could help Mercy Esther’s siblings. They might have a better future.
The job offer turned out to be a lie – the first of a string of broken promises that would deprive a young woman of her childhood and her family.
Mercy Esther was born with a deformity in one foot, causing a pronounced limp. On the streets of Nairobi she and other children were forced to beg. She was told to pretend she could not walk, to elicit sympathy from the public. Each day, what money she collected was taken from her.
One day, while begging, Mercy Esther was approached by a woman who offered her domestic work and more promises: a new home, a wage and good treatment. She went with the woman, but instead Mercy Esther was abused and received no money for her labor. It would be six years before she ran away.
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With the support of the Nairobi police and Kenyan and Tanzanian governments, Mercy Esther returned to the country of her birth, but without details of the village where she was raised, authorities put her in the care of WoteSawa Domestic Workers Organization, which runs a shelter for trafficked children in Mwanza, on the shores of Lake Victoria, in the north of the country.
“All are equal”
“Tanzania is a beautiful and a peaceful country, but there is a dark side,” said Angela Benedicto, the organization’s founder and executive director.
“Many people live in poverty, and forced labor is a very big problem,” she added. “The most common form of human trafficking in Tanzania is domestic servitude, young girls forced into domestic work. They face abuse, exploitation, and are not paid for their work.”
Around one million children – mostly girls – are engaged in domestic work in Tanzania, according to the non-profit Anti-Slavery International.
WoteSawa was set up in 2014 and every year takes in around 75 children who have escaped trafficking. Space is tight: children sleep two to a bed. Some stay longer than others, says Benedicto, particularly those involved in criminal cases, as prosecutions can take time. So far, the non-profit has helped hundreds of survivors, but the needs are greater than the resources available. Benedicto dreams of building a bigger haven for more children.
Her mission is to empower domestic workers and advocate for their rights. It’s an issue that’s close to her heart; she is herself a former domestic worker. “I faced abuse and exploitation, but I was able to speak out,” she explains. “Many domestic workers, they can’t speak out. Who is going to speak (for) them?”
“I’m using my story to tell them, ‘Don’t give up.’”
WoteSawa means “all are equal” in Swahili. At the shelter children are housed and provided with counseling and legal support. They also receive an education in literacy and numeracy, and vocational skills such as needlework. Reintegrating children back into education works in step with efforts to reunite children with their loved ones, “so that when they go back to their families, they can help not only themselves, but they can help their families,” said Benedicto.
Fighting trafficking through education
Lydia lives in the Ngara district in the mountains of Western Tanzania. She left home to become a domestic worker aged 16, but was beaten by her employer and not paid for her work. She escaped and was helped by WoteSawa, where she learned how to sew. Lydia returned to her family with a sewing machine provided by WoteSawa and today she is a dressmaker with dreams of a shop of her own.
“She is making enough money to provide for her family,” said Benedicto. “Her dream is to help other young girls to know how to sew. She has a plan to give back to the community.”
As well as helping survivors of trafficking, WoteSawa works to prevent it from happening. Benedicto coordinates with bus depot agents on the lookout for young children, and with local police who have powers to intervene.
“My mission is to make sure (the) offense of human trafficking is stopped – totally. And it is through education we can achieve (that),” said police commander Juma Jumane. “We have to educate families. We have to educate the victim, him or herself. We have to educate also society in general.”
“Her future is bright”
When Mercy Ester arrived at the shelter she was reluctant to share the name of her village because she feared being trafficked again if she returned there. But eventually she changed her mind.
CNN met Mercy Esther through the Poland-based Kulczyk Foundation, which supports WoteSawa.
WoteSawa was able to find her family, and took her grandmother and siblings to the shelter. It had been eight years since they had last seen each other. “It was so emotional,” said Benedicto. “They cried, they hugged. I think every one of us was so emotional. We were in tears of joy.”
Mercy Esther is still uncomfortable with the idea of returning to her village and has chosen to stay at the shelter until she is older, and skilled enough as a seamstress to start a business to help provide for her family.
“Her future is so bright,” said Benedicto. “I can see that she will be a light to her siblings.”
Source: cnn.com
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Inside Tanzania’s Life-Saving Birthcare Model
Tanzania is winning the battle against maternal and newborn deaths, as the latest numbers reveal a significant decline.
“Tanzania is committed to reducing maternal and newborn mortality and ensuring safe deliveries as part of the national development plan. The Safer Births Bundle of Care is one of the key strategies supporting this effort,” said Dr. Benjamin Kamala, the Senior Research Scientist at Haydom Lutheran Hospital and Principal Investigator for the program, leading its implementation across five regions in Tanzania.
A groundbreaking study published in the New England Journal of Medicine shows that the innovative health program in Tanzania – centered on regular, on-the-job training for healthcare workers – reduced maternal deaths by 75% and early newborn deaths by 40%. The three-year study, conducted across 30 high-burden healthcare facilities in Tanzania, tracked approximately 300,000 mother-baby pairs under the Safer Births Bundle of Care (SBBC) programme. The programme focuses on improving care for mothers and babies during the day of birth, the critical time when a woman goes into labor and delivers her baby.
Maternal health is a key focus of the United Nations Sustainable Development Goals (SDGs), specifically Target 3.1, which aims to reduce the global maternal mortality ratio to fewer than 70 deaths per 100,000 live births by 2030.
Tanzania’s program combines continuous, simulation-based training for frontline healthcare workers alongside innovative clinical tools to improve labour monitoring (fetal heart rate monitoring) and newborn resuscitation.It also uses data to drive ongoing improvements, ensuring that healthcare workers have the skills, confidence, and competence to manage birth-related complications for both mothers and newborns.
“We work closely with healthcare workers, equipping them with the necessary tools to improve the quality of care, ensuring they can effectively manage both mothers and babies during and after childbirth,” Dr. Kamala said, which helps them build on over a decade of innovative research and collaboration to improve care during childbirth.
“To give you a sense of the scale of the burden of maternal and newborn mortality in Tanzania when the Safer Births Bundles of Care program was in early development in 2015/16, there were around 556 maternal deaths per 100,000 live births and 25 neonatal deaths per 1,000 live births,” he said.
The published study demonstrates the “transformative impact” of the Safer Births Bundle of Care program conducted across 30 hospitals in five high-burden regions of Tanzania, where there were about 300,000 mother-baby pairs.
Maternal deaths at the start of the program were recorded at 240 per 100,000 live births, with postpartum hemorrhage and hypertensive disorders being the leading causes of death, he said. Over the 24-month study period, this number dropped to approximately 60 per 100,000 live births, representing a 75% reduction. The number of newborn deaths – which are primarily due to breathing difficulties and complications related to prematurity – declined by 40% – from 7 deaths per 1,000 live births to 4 deaths per 1,000 live births.
“These results are remarkable,” Dr. Kamala said.
According to Dr. Kamala, the 75% reduction in maternal deaths was not expected, and a key lesson was the important role of the in-situ team simulations – including for postpartum bleeding – with reflective debriefings that trained facilitators led.
“This seems to be a major part of the success of the program,” he said. “We are delighted by these results and hope that other countries adopt and scale the Safer Births Bundle of Care program… Beyond the numbers, the Safer Births Bundle of Care program has fostered a dramatic culture shift in our healthcare system,” he said. “Healthcare workers are now more confident and better equipped to handle birth-related complications for both mothers and babies.”
Maternal death drop
Dr. Kamala attributed the 60-70% reduction in newborn deaths in Geita and Manyara to several factors.
“Firstly, Manyara was the first site for implementation, giving the region more time to adapt and experience the impact of the program. Most importantly, both regions had a high burden of stillbirths and neonatal deaths, making them ideal targets for focused intervention. As a result, newborn deaths decreased by 60-70%, showcasing a clear positive impact on newborn survival,” he said.
Dr. Kamala said another possible explanation is the differences in the culture of practices, where some health facilities reported inaccurate data due to the fear of blame and shame. However, with the project’s implementation, reporting became more accurate after mplementation. Some regions, such as Tabora, reported an increase in the number of referrals to the study hospitals from other care centers after the program was implemented. These were more likely to be late admissions, which increase the likelihood of poor health outcomes, he said.
After the implementation of the program, there was a 40% decrease in newborn deaths within the first 24 hours after birth, according to the study.
Dr. Kamala said Tanzania’s remarkable progress in reducing maternal mortality by 80% is driven by strategic investments and innovative programs focused on improving maternal and child survival rates.
“Over 2,000 new healthcare facilities have been developed, free health services are being provided to expectant mothers and children under the age of five, and emergency obstetric care – including better transport to hospitals in rural areas are helping to ensure timely, life-saving interventions.
“Most importantly, the Ministry of Health works in collaboration with healthcare workers, hospitals, and development partners to strengthen the skills of frontline healthcare workers, which has been a key factor in driving this progress.
“Political leadership, alongside strategic partnerships and financing, has been crucial in driving progress in maternal and newborn health,” he said.
The program was made possible by the support of the Global Financing Facility for Women, Children, and Adolescents, Norad, UNICEF, and Laerdal Global Health, as well as the Ministry of Health and Haydom Lutheran Hospital. Their partnership and investment enabled the scaling of the Safer Births Bundle of Care to 30 hospitals and supported the research. “The government has now scaled the program to over 150 sites, and there are plans for further expansion to three regions this year and then nationally,” he said.
Dr. Kamala outlined key policy recommendations for other governments can adopt to prioritize maternal health.
“Firstly, it focuses on cost-effective and relatively simple interventions that are essential to preventing maternal and newborn deaths. For example, stronger primary healthcare that is delivered in the community and a well-trained healthcare workforce are also critical. Additionally, working in close collaboration with national, regional, and local health authorities is key.”
He said Tanzania’s approach, where the Safer Births Bundle of Care program was successfully scaled and sustained by aligning the initiative with national guidelines for obstetrical and newborn care. In addition, the creation of mentorship programs and regular supervision has helped to sustain the results.
Looking ahead
Tanzania now plans to expand to three new regions in 2025, followed by a nationwide rollout.
The success of the program has attracted interest from other countries, with Botswana, Ethiopia, Lesotho, and Namibia expressing interest in adapting the program to their healthcare system. In Nigeria, the program has already been launched in two states, Gombe and Borno, marking a significant step in its scaling.
Source: allafrica.com
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