Village Orientations

We are Sharon and Rick Slettehaugh, volunteering for two months with MIHV in Karatu, Tanzania with their Child Survival Project. Our perspectives may be different than many who volunteer here, as we are retired from the business and education fields, and don’t have public health or medical backgrounds.

We have been in about 40 countries, including several in the developing world. These include Laos, Cambodia, Borneo (Malaysia), Thailand, Brazil, Jamaica, Mexico, Dominica and Peru. We have seen life in small villages similar to those being served by MIHV, so we have some reference points.

We’ve only been here two weeks and have a lot to learn. Our intention is to make periodic entries to this blog as we gain more experience. We will describe what we hope to do here further down.

The goal of the project is to improve the health of infants and children under five and women of reproductive age in the Karatu district. So far, we are extremely impressed with the comprehensive, collaborative approach taken, working with the government and other groups. The staff is wonderful to work with, and the country director, Jolene Mullins, is a dynamic leader. From our perspective, they have made remarkable progress towards the project’s goals on a very limited budget.

Some of the statistics of what the people are facing here are on the MIHV website. Here is a little more information. By at least one measure, Tanzania is the fourth poorest country in the world. On the Human Development Index, they rank 164th out of 177 countries measured.

Being here has given us a much fuller understanding of the challenges faced. This last week has mostly been spent in two villages. In both cases staff was continuing to develop Survive and Thrive Groups, just one aspect of the effort here. These groups help unmarried mothers learn more about care for themselves and their children. These particular sessions are building on past training done by MIHV, including two days of additional work with traditional birth attendants (TBAs) and a third day with the TBAs and young mothers together.

The TBAs are truly remarkable women. To put this into perspective, we had to drive between 45 and 60 minutes to get to each village, which are only 20-23 miles away. The roads are unpaved, often rutted, rocky, very rough, and should only be driven with a decent size four-wheel drive vehicle. Ours is a 1995 Toyota Land Cruiser. When the rainy season comes, some villages become isolated as the roads are impassible.

The village homes are widely spread out among fields, and divided into sub-villages. In the second village we visited there was no electricity and we didn’t see a car or truck. Cell phones work everywhere, but to get anyplace, people generally walk or use a bike, the latter being beat-up versions of the old bikes we grew up on. Even with a mountain bike, the roads would be extremely challenging.

Although the Tanzanian government and MIHV are working hard to encourage women to get to clinics for deliveries, for many of them this is impossible. The reasons include the roads and available transportation, long and sometimes difficult distances to clinics, needing to plan ahead for the delivery and hoping the due date is accurate, along with the impossibility of leaving family behind.

The TBAs are not paid for their work, except if the delivering mother and family can afford to offer a chicken or other goods. Although TBAs are give safe delivery kits by the project, sometimes the TBA must buy supplies from her own funds. Some have even been known to take in a young mother and child if the woman is unmarried and the family is not able to care for her. As you might imagine, TBAs often have to go long distances, sometimes in the dark of night where wild animals could present a danger. Add to this that they teach women of all ages before and after delivery on health and safety issues. Their roles are definitely challenging.

Traditionally, TBAs’ knowledge was passed on from one woman to another within the family or village. It is obvious they are eager for the training they receive from MIHV, and happy they can bring more skills and tools to their work. Some have limited literacy or less than adequate Swahili, yet they show incredible motivation to learn.

A previous training from MIHV was on antenatal, delivery, neonatal and maternal care. The mortality rates for both are high, with a large percentage of them preventable. For children under five, 51% of deaths are from acute respiratory infections/pneumonia, 31% from malaria, and 3.6% from diarrheal disease. The education provided by the government, MIHV and other non-governmental organizations can eventually reduce the numbers dramatically.

MIHV wants to introduce a system for income generation in these groups. By doing so, the young mothers will be able to help support their families, hopefully help TBAs cover their costs, employ good health practices and encourage the mothers to stay in their villages rather than seek their fortune in Karatu town. The income generation part of the Survive and Thrive Groups is the focus of our time here.

Karatu is the gateway for Ngorongoro Crater, the Serengeti and other famous parks nearby, with an estimated 500,000 tourists each year. The town has only about 15-20,000 people, and most of the handicrafts sold in the tourist shops come from Kenya. The women of Karatu District produce traditional crafts, including baskets and bead work that can be sold to visiting tourists. The goal of MIHV is to develop skills in the groups to perfect the crafts, help the women start agricultural projects or small animal husbandry, provide the knowledge to manage these small businesses, and have the enterprises self-sustaining. Our hope is to contribute to that effort.

It is a privilege for us to be here with MIHV.