Neema's Story
Neema and her newborn after their check up

Neema and her newborn after their check up

Upon discovering she was pregnant with her third child, 33-year-old Neema decided to enroll in FAME’s prenatal program. She’d already had two C-sections. After regular attendance at our prenatal clinic, our medical team decided to be cautious and schedule her for a C-section at 39 weeks. Surgery day arrived and she was rolled into the OR. With Dr. Lisso and our American surgery volunteer, Dr. Kelly, scrubbed in and the anesthetist by their side, the team was ready go. Within minutes of starting the surgery, they found themselves in the throes of a medical emergency. Neema was suffering from Percreta: her placenta had grown through the uterine wall and she was suddenly losing a tremendous amount of blood. The team had to get the baby out fast and stop the bleeding. They called the lab for more blood. A healthy, crying baby was lifted out and whisked away by a nurse while the doctors began closing the uterus. The anesthetist continued giving Neema blood and monitoring her closely. With the surgery completed and Neema stable, the team wheeled her back to the ward for close observation. She soon began bleeding again and the team raced her back to the OR, where they had to perform a hysterectomy. After several hours and six units of blood, Neema was stabilized for good. She and her husband, newborn, and two other children experienced a joyful reunion. “I was so scared after the doctors told me I had to return to surgery because I was losing too much blood,” she told our team during her follow-up visit. “But they counseled me a lot and I agreed because I didn’t want to die and leave my baby and my kids. I thank God for leading me to FAME because I don’t know where I would be today if I hadn’t [come].”

Kathrine Kuhlmann
Postpartum bleeding + FAME Africa

Originally Posted on Days For Girls website here. To learn more about Days for Girls, visit DaysforGirls.org.

DfG volunteer, Alexa, with a new mama in our current labor ward.

DfG volunteer, Alexa, with a new mama in our current labor ward.

Over the years, Days for Girls has learned that our DfG Heavy Flow Kit works not only to help women and girls manage their menstruation, but is also a wonderful answer to help women also manage the bleeding they have after childbirth (lochia) that can be very heavy and generally lasts about six weeks and sometimes even longer. 

Knowing this sparked an idea with one of our amazing supporters and volunteers, Alexa Renehan.  She also supports the work of the rural hospital, FAME Africa, that is located on a hilltop in northern Tanzania.  Alexa knew they were just opening up a maternal care center there and thought the new mothers could benefit from a DfG washable pad.

She introduced the DfG Africa team to the FAME Staff who were excited to learn about our DfG Heavy Flow Kits.  A partnership was formed and a local enterprise in Tanzania was started to make the DfG pads that are sold to FAME for them to share with new mothers after their deliveries. 
 
With limited access to maternal care, Tanzania has an estimated maternal mortality ratio of 556 per 100,000 live births and perinatal deaths continue to comprise a significant portion of under-five deaths. This highlights the importance of responding early in pregnancy and continuing to follow up afterwards to potential issues that arise. The subject of postpartum bleeding is not widely discussed so adding this into their discharge program has made a big impact.  

“Women in Tanzania complain of getting rashes, vaginal infections, and UTI's from the low quality disposables available here. Wearing these irritating disposables for 6 weeks straight while healing and caring for a new baby has the potential to create undue stress and discomfort. I am so proud we are able to offer this option to the mothers in our area."


-Leesha, FAME clinical educator for maternal health | midwife| DfG Enterprise Leader

 In April, Alexa, traveled to South Africa and Tanzania with Days for Girls team members to see this new partnership. While visiting FAME in Tanzania, she met with new mothers and learned how life changing and affirming it is for new mothers, like Editha (above) to have the proper care before, during AND after birth.

This year, FAME will expand its work with maternal and child health by opening a 24-bed Maternity Center with a Level 2 Nursery, operating room, and 4 delivery rooms to accommodate the increasing number of women who now come from outside their district of Karatu, Tanzania.

 About FAME Africa and DfG’s Partnership:

The Foundation for African Medicine and Education (FAME) was founded in 2002 by Dr. Frank Artress and Susan Gustafson. The Foundation's mission is to provide quality healthcare and education to severely under-resourced populations in rural Tanzania. Days for Girls began a joint partnership with FAME in 2018 to supply DfG Heavy Flow Kits and our Ambassador of Health (AWH) education to all postpartum mothers who delivered at FAME. Some of FAMES staff were trained to teach our DfG AWH curriculum to new moms so they know how to care for their DfG Kit. In addition, jobs were created in the community when a local enterprise was started. This enterprise, Boma Africa, not only sales their DfG Kits to FAME but also to other organizations and people in the area.

 
Kathrine Kuhlmann
"I work directly with patients every day." - Safi, RN

Based on interviews with Safi, FAME RN and Ward 1 Supervisor

 
Safi in our general inpatient ward, Ward 1.

Safi in our general inpatient ward, Ward 1.

Safi’s desire to become a nurse started when she was young, growing up in Same, south of Mount Kilimanjaro. “One day, I was becoming very sick,” Safi reminisced. “I was prescribed medicine to take orally. I hated taking medicine orally, so I chose to hide the medicine under my mattress instead of taking it. I was still sick because I wasn’t taking my medication, so I had to go back to the clinic. They prescribed me a new medication, but it was an oral medication again. I finally told them that I didn’t want to take any oral medication, which worked out because then they gave me an injection. Since then, I wanted to work in medicine so I could talk with patients about their needs and concerns.” Following secondary school, Safi attended school to become a Nurse Assistant. She met Frank and Susan while Dr. Frank was still practicing at a clinic in Arusha, just before they opened the FAME Medical Outpatient Clinic in Karatu. A friend of Frank and Susan had told Safi they were looking to hire nurses, so she applied to be a member of the original team. She helped open the outpatient clinic as a Nurse Assistant in 2008. In 2009, Frank came to her to tell her the good news that FAME wanted to sponsor her to go back to school. At that point, she was ready to go back to school to upgrade her degree. She went back to school for three years and returned to FAME as an RN. “My experience at FAME 100% helped me in school,” Safi said. “I really enjoyed the courses and I was performing well.” Safi came back to FAME in 2012 just as the Inpatient Hospital was getting started. In 2014, she became the Ward 1 Supervisor. “I like being a nurse because I work directly with patients every day,” she said. For over a decade, Safi has been working at FAME, listening to each patient’s needs and supporting her nursing team in the Inpatient Ward.

 
Kathrine Kuhlmann
"FAME was a catalyst for me." - Martin, Lab Attendant

Based on interviews with Martin, FAME Lab Attendant

 
Martin talking with a patient in the laboratory after taking a blood sample.

Martin talking with a patient in the laboratory after taking a blood sample.

Working at FAME is a family affair for Martin. His father, John, is a member of FAME’s original 20- member staff. Since 2008, John has been on the Grounds and Maintenance team and has been the head of the team for the past seven years. Martin grew up in Karatu and did his schooling just a couple kilometers from FAME. When he was out of school, he started working on the grounds team at a local coffee plantation for about six months before he decided to come to FAME and see if there were any opportunities for him here. In 2014, he was hired as a groundskeeper alongside his father. Martin was planning to work for as long as it took to save money to attend medical school. Fortunately, luck was on his side. At that time, we hadn’t yet installed our digital recording system in the laboratory. When Anthony, the lab manager, started looking for someone to help input the lab’s records, he saw Martin as a smart young man with a lot of promise. He requested to pull him from the Grounds and Maintenance team and brought him to the lab where he would start his career in the lab inputting records into the computer. After a few months, FAME gave him a chance to apply for a scholarship to go to school to become a Lab Attendant and join the laboratory team. Martin had been interested in studying medicine, but it was his initial opportunity to help out in the lab that peaked his interest in the field. “In primary school, I was dreaming of working in medicine,” Martin said. “I always think about how long it would have taken me to collect enough money for the school fees and how I can ever thank Frank and Susan. FAME was a catalyst for me because they sped up my dream.” Martin traveled to Dar es Salaam for six months to study. “School was good because I had some prep,” Martin said. “I already had some experience doing things in the lab that other students didn’t.” When he returned from school, he joined the lab team full time as a Lab Attendant. He enjoys working with FAME’s medical staff because, “everyone at FAME works as a team and everyone is happy.” In the future, he hopes to further advance his capacity by returning to school in a program to become a Lab Technician for FAME. Martin started his journey at FAME hoping for any working opportunity nearly five years ago. Now, he’s a Lab Attendant in one of the most advanced labs in the country, all spurred by trust that led to a simple data entry job.

 
Kathrine Kuhlmann
"You're a lady. Work extra hard." -Dr. Anne, AMO

Based on interviews with Dr. Anne, FAME Assistant Medical Officer

 
Dr. Anne seeing a patient at Rift Valley Children’s Village during our mobile neurology clinic.

Dr. Anne seeing a patient at Rift Valley Children’s Village during our mobile neurology clinic.

Dr. Anne first heard about FAME while she was working part time at a health center in Dar es Salaam. She was scrolling through Google, looking for a full-time job when she came across a listing for FAME. The job description had noted that being a female Clinical Officer was an added advantage. When Anne saw that, she wanted to apply because “I knew they appreciated females.” She submitted her application and came to Karatu for the first time for her interview. She was initially nervous about leaving the big city of Dar es Salaam for rural Karatu, but after her tour and short orientation, she felt at home in the FAME environment. She knew she needed to make a good impression to get the job, so she researched FAME and prepared herself for their questions before going in front of a panel of six to eight FAME employees for her full interview. She joined the team shortly after in 2012 as a Clinical Officer (CO). In 2016, FAME offered Dr. Anne a scholarship to return to school to become an Assistant Medical Officer (AMO). Prior to Dr. Anne, FAME had sent Dr. Ivan and Dr. Ken to the same two- year program to upgrade from CO to AMO. Dr. Anne was a bit nervous about going back to school, so she reached out to Ivan and Ken for advice. “They told me, ‘You’re a lady. Work extra hard.’” She followed their advice. Dr. Anne reflected on her two years filled with a lot of studying and very little sleep. “When I got to school, everything looked difficult. Then I really knew [Ken and Ivan] were right; I needed to work hard. I only had four hours of sleep most nights.” Her diligence paid off when she received her final marks. She finished the program #1 in her class. “I didn’t even know my results until a doctor phoned from the Ministry of Health to congratulate me,” she said. “I am so humbled and privileged to have received that scholarship. FAME has made me what I am. I could still be a Clinical Officer, not knowing any skills like ultrasound, neurology, skills [learned] from volunteers.” Her decision to move to FAME is one she doesn’t regret. “I told my mom and dad not to worry because here I have Frank and Susan like my second parents. I feel at home here. FAME is where my heart is.” Dr. Anne returned to FAME after her AMO program in September of 2018. Since then, she’s been working with a lot of our visiting volunteers. “I’ve gotten a lot of exposure here. We have many volunteers that I can learn from. I enquire often to learn new skills,” she said. “I worked with the Neurology team and with Dr. Kelly in the operating theater. I’m learning outside of my comfort zone.” Dr. Anne expressed deep gratitude to everyone who made it possible for her to go back to school. “The best way for me to repay FAME is by working hard and being flexible. I am here to support and assist the whole team.”

 
Kathrine Kuhlmann