Planning for FAME’s Future

FAME's strategic plan addresses the intersection of community need and the realistic application of resources available. It is FAME's vision for the future based on where we are best positioned to do more for the patients and communities we serve. Developed by FAME's leadership team in Tanzania, the plan builds on the foundation that was established 20 years ago, and identifies the actions and investment needed to achieve our goals over the next five years.

Strategic Priority 1:

Strengthening Surgery and Emergency Services

General surgery services continue to be resource-challenged in the Karatu region with limited access. Easily treatable conditions are fatal due to a lack of access to safe, affordable surgical and anesthesia care. Blood supply shortages, limited operating rooms, and a lack of doctors trained to perform general surgery also contribute to this. Working in hand with this is the urgent need for emergency services in order to allow FAME to treat more complex cases and reduce the number of referrals it makes. With the nearest dedicated emergency department three hours away, FAME’s emergency response work is filling a critical gap in our region.

$25 – Provide essential surgical supplies (sterile kits, sutures, wound care materials)

$2,000 – Support advanced training and mentorship for anesthetists, OR nurses, and surgical staff

$25,000 – Help equip FAME’s Emergency Room to meet rising trauma and referral demand

Strategic Priority 2:

Growing Pediatric Care

FAME’s investment in reproductive, maternal and child health has established its reputation as an institution committed to the well-being of newborns, children and families. FAME is now looking to further expand its competence in pediatric medicine in order to address the challenges that children, mothers and families face as they begin to grow.

$50 – Provide essential newborn care supplies (feeding support, medications, warming materials, family care kits)

$4,000 – Equip the Special Care Nursery with lifesaving respiratory support” Provide CPAP machines and neonatal equipment that help newborns struggling to breathe—one of the most urgent needs for premature babies

$15,000 – Fund dedicated NICU nursing coverage: Support two nurses on every maternity shift focused exclusively on premature and critically ill newborns, ensuring round-the-clock specialized care

Strategic Priority 3:

Expecting the Unexpected

COVID-19 has illuminated the impact of unexpected events, like a pandemic, to cause a costly shifting of priorities and resources. Mitigating the adverse effects of pandemics, climate change and other potential natural and/or political shifts requires a pre-planned response system.

$20 – Stock emergency PPE and infection prevention supplies

$2,500 – Strengthen FAME’s disaster response team through planning, training, and contingency systems

$50,000 – Support construction of a dedicated multi-function Isolation Ward for future outbreaks and emergencies

Strategic Priority 4:

Investing in Quality Data

Accurate data tracking and analysis are crucial to support continuous quality improvement (CQI) around patient care, patient satisfaction, management decisions, budgeting, government and donor reporting and fundraising. Additionally, FAME’s success over the last 20-years has had lifelong impacts on its patients and far-reaching impacts on the livelihood, health, and wellbeing of the communities it serves. FAME is committed to measuring this impact!
 

$100 – Support data tools for frontline staff (tablets, connectivity, reporting materials)

$1,500 – Build the capacity of FAME’s team to report and use data in decision making

It was a Sunday evening when pregnant Amani* came to FAME. She was not due for another three weeks and was experiencing heavy bleeding and excruciating stomach pain. She knew something was terribly wrong. Panicked, she called a family friend who drove her 30 miles to FAME.

At 34-years-old, this was Amani’s first pregnancy. She had started her antenatal clinics at a local dispensary close to her house, but her friend was adamant that she had to come to FAME. “She would not stop talking about FAME. She kept saying it was a beautiful place with good doctors, and affordable healthcare. I finally came to FAME when I was six months pregnant, and visited the Reproductive and Child Health clinic (RCH) for antenatal consultation. I was so happy with the service I received, so I kept coming back and planned to have the baby here.”

Once the pain became unbearable and the bleeding increased, Amani called a family friend and asked him to bring her to FAME. It was an emergency. From her FAME antenatal clinics, she knew the bleeding was a sign that something was terribly wrong.

At FAME, they were received by a security guard who rushed her to the maternity ward. Amani was terrified but the nurses were reassuring. The doctors determined that Amani's cervix was not dilating and that an emergency Cesarean delivery (C-section) had to be performed due to fetal stress.

“By this time I was in so much pain and scared. The woman on the bed next to mine had just come from a C-section, and the fact that she was still alive gave me hope!”

— Amani

As Amani waited to be taken into surgery, she struck up a conversation with the woman next to her, who’d just come from a C-section.

“I talked to her as I was intrigued that she was only gone a short time for the C-section. In the midst of my pain, I was asking her so many questions about her experience! What was the operating theater like? Was she asleep the whole time? Did she hear the baby’s first cry? She was tired but answered all my questions, and she reassured me that it was all okay and that I was in good hands.”

Amani’s surgery went well, and she is now the mother of beautiful baby boy.

“I am very happy. I am a Mama!”

*While the patient’s name has been changed to protect privacy, permission was secured to share her photos and story with FAME supporters, and to raise awareness of available medical care at FAME Medical

Viola* is in FAME’s inpatient ward with her 2-year old son who is suffering from Kwashiorkor,  a severe form of malnutrition that presents as swelling due to water retention from lack of protein in his diet. As a result of this, he is also suffering from kidney problems. Admitted next to her is Naeku, who sits with her 2-year-old. Her son is also suffering from severe acute malnutrition, caused by a deficiency of micronutrients, resulting in dangerously low weight and severe muscle wasting. 

Malnutrition is prevalent in Northern Tanzania, where rearing livestock is the main source of food . The nutritional status of pastoralists varies with the seasons, with high malnutrition during droughts, which have become increasingly worse, as FAME’s Social Worker, Kitashu Nganana explains:

“We have treated eight children already this month with severe malnutrition cases, and we keep receiving new patients every other day. The situation is dire.”

Viola came to FAME when her son presented with a swollen face, legs and an enlarged tummy. She was not aware that this was caused by malnutrition.

“I did not know what was happening. The boy was sick and I knew he needed to see a doctor, but I live with my grandmother and we don’t have money. We could not afford the journey to FAME. However, a well-wisher sponsored my trip and helped me get here.” - Viola 

The government of Tanzania, through its National Nutrition Strategy, plans to develop community-based programs to help rural communities address the causes of malnutrition. The government aims to reduce the rate of chronic malnutrition to less than 25% by 2025.

“I’m glad my son is getting help. I’m listening to the doctors and I’m learning about this disease. Now I can afford a smile, as I finally understand what’s wrong with him, and how I can help make it better.”

— Viola

Interested in supporting FAME and its work to provide pediatric education around malnutrition? Click here to donate: https://fameafrica.kindful.com/

*While the patient’s name has been changed to protect privacy, permission was secured to share her photos and story with FAME supporters, and to raise awareness of available medical care at FAME Medical

Lesika* is a young maasai girl from a village in Ngorongoro, five hours from FAME. She had only been married for a year, and she was excited to be expecting her first child. Her three girl friends were also pregnant, and their due dates were within weeks of each other. She was excited to share this journey with them, and was looking forward to parenting their children together. 

“My two friends got their babies in January, and another in February. I was looking forward to my turn! When the stomach pains started, I was very worried. It was not time for the baby to come. I prayed a lot, asking God to save my child.”

— Lesika

Lesika was brought to FAME by her husband and mother-in-law. She had been having excruciating stomach pain for three days. She was only 35 weeks pregnant. Lesika arrived at FAME and after a difficult delivery, gave birth to a son. He was born premature and weighed 2.9 lbs.

The baby was taken to FAME’s Special Care Nursery and put on the continuous positive airway pressure (CPAP) machine, to provide respiratory support. FAME’s Special Care Nursery is well-equipped and provides round-the-clock care for premature babies, as well as babies who have a low birth weight or need care for neonatal health issues. FAME has a team of 17 highly trained nurse-midwives who care for the babies and offer support to the mothers.

FAME had over 100 admissions to the special care nursery last year and is on track to support even more in 2022.

After 32 days, Lesika’s baby was doing great and finally able to breastfeed fully. He was also gaining weight and already up to 3.4 lbs. 

“I’m very happy. My husband is happier! I’m thankful to FAME, they have done so much for us. When I came here I was very sick, but now I’m healed and I have my child. I have named him Moses because I like the name. My husband will give him a Maasai name, as that’s the important one!”

— Lesika

“I can’t wait to go home and introduce my son to all my friends! I’m certain when our kids are older they will be the best of friends!”

Moses will need to reach certain milestones before he and Lesika can be allowed to go home. But Lesika enjoys spending time with her son at the maternity ward, and is happy to be a mom.

*While the patients’ name has been changed to protect privacy, permission was secured to share their photos and story with FAME supporters, and to raise awareness of available medical care at FAME Medical.

The five children that FAME successfully treated for rabies.

It was mid-March when an 11-year-old Maasai boy was brought to FAME. He came from a local clinic 45 miles away, after displaying symptoms of extreme fear of water, excessive saliva flow, respiratory difficulties, biting and aggression. The doctor at the local clinic asked his family if he had been bitten by a dog. The answer was yes, but did not seem relevant as that was over two weeks ago. The doctor knew right away, “he has rabies. You have to take him to FAME now.”

Two weeks earlier, Leboo* and his three male cousins were herding cows two miles from their home. On this particular day, a strange dog appeared out of nowhere and started chasing the cows. Leboo, being the oldest, ran towards the dog to scare it away from the animals. That's when it bit him. His cousins became involved in the scuffle as well. Two suffered minor bite marks and the other got a few scratches. The dog escaped.

It wasn't until two weeks later that Leboo became violently sick. He was rushed to the local clinic, where the doctor diagnosed him with rabies and urgently referred him to FAME for a rabies post-exposure prophylaxis (PEP) vaccine. Unfortunately, Leboo passed away an hour after arriving at FAME. His condition had become fatal once the symptoms began.

Volunteer Dr. Shama Cash-Goldwasser (center) is pictured with FAME's social worker, Nganana Kitashu (far left), during their trip to the village to find rabies-infected persons.

“Thank you to FAME and God. I believe FAME and God worked together to save our children. If you had not come for the children, we had no way of bringing them this far to the hospital.”

- Youngest boy's mom

"I am a single mom and I had no money to see a doctor. Thank you FAME for caring about us. Our village is quite far and secluded, and sometimes we think everyone has forgotten us. But not FAME.”

- Girl’s mom

“I was in shock. I was sad. I was confused. When they told me the boy had died, I just stood there. I didn’t want to cry, because I had to call his mother in the village and tell her. A few years ago, I was the one who had to tell her that her husband, my brother, had died. And now I had to be the one to tell her that her oldest child was dead.”

— Leboo’s Uncle

Leboo’s uncle had mentioned that there were other boys bitten by the same dog, but that they were fine. The medical staff at FAME knew it was only a matter of time before Leboo’s cousins began showing symptoms too. FAME’s social workers, together with volunteer Dr. Shama Cash-Goldwasser, drove to the local village to find the kids. They asked the parents if they could bring the kids to FAME, as they believed that the boys had been exposed to rabies as well. As they prepared to leave and bring the children to FAME, a neighbor ran up to the team and said that there were two young children from a different homestead who also had been bitten by a dog.

“We ran to the homestead. We found a 3-year-old boy and a 4-year-old girl; their mothers confirmed that they had been bitten by a strange dog, but since it was not a big bite, they didn't think it was serious. We informed them it was urgent that we take the kids with us to FAME, and that it was a matter of life and death.” - FAME’s social worker, Nganana Kitashu

Once at FAME, the five kids were admitted to the inpatient ward where they received free rabies vaccines and were monitored for rabies symptoms. After three days, they were safe to return home.

Rabies, locally known in Tanzania as kichaa cha umbwa (madness of dogs), is a deadly virus that spreads to people from the saliva of infected animals, usually transmitted through a bite. While canine rabies is almost entirely eliminated in many parts of the world. The United States reports between one and three cases of rabies annually. In 2021, there were five rabies deaths recorded, all occurring from bat bites, and the highest number in centuries (CDC). This is not the case for Tanzania. According to the World Health Organization (WHO), rabies is responsible for an estimated 1,500 deaths per year in Tanzania. This is especially common in rural areas, where there is often limited rabies vaccines available and poverty and access to health services present barriers to treatment.

Local dog ownership in Tanzania is limited and most dogs are roaming free. The Tanzanian government is finalizing a national rabies control strategy, which will involve a nationwide dog vaccination campaign, with the aim to eliminate canine rabies by 2030.

Rabies is a preventable disease when treatment is administered in time, but in those cases where an infected person begins exhibiting symptoms, it is nearly always fatal (CDC). For rural communities in Tanzania, rabies is particularly devastating as treatment is limited and often far away. FAME is proud of its teams’ rapid response and dedication to ensuring that life-saving rabies treatment is available to people living in the most rural parts of its catchment area.

“I want to thank FAME and everyone here. As a village, we are very grateful. We might have lost one son, but you have saved five of our children. Thank you for the quick intervention and for the free medication and transport to your hospital. Mostly, we are thankful for the education we have received about rabies. Now we know what it is and what to look out for. Next time, we will be ready!"

- Leboo’s uncle, pictured with FAME's Social Worker Kitashu (in black shirt), the mamas, and the children during their visit to FAME

*While the patients’ name has been changed to protect privacy, permission was secured to share their photos and story with FAME supporters, and to raise awareness of available medical care at FAME Medical.