In northwest Tanzania, the risk of dying during childbirth for women and their babies is being addressed through more vital pathways to care, benefitting the lives of refugees from Burundi and the host community alike. Elda Kyando, medical team leader at Nduta Camp in the district of Kibondo for Doctors Without Borders (MSF), has witnessed the significant impact on the health of pregnant women and newborns through the ever-growing trust placed in the Maternal and Neonatal Health services MSF and its partners provide.
"I am happy to see mothers coming to the hospital for delivery and leaving with happy faces, embracing their newborns," says Elda. "We have maintained access to health care services to the population of Nduta refugees and the surrounding community. We continued to provide inpatient care in the emergency room (ER), adult ward, and paediatrics, including intensive care, neonatology, and maternity care.
"I have three children, all of whom I gave birth to at the hospital in Nduta, Tanzania. When we come from the village to the camp, we are given a permit and accommodation close to our residence,” says Lilian from the neighbouring village of Malolongwa. “The services are good, and the staff is friendly. You are listened to and very well cared for," she says.
MSF’s 15-bed maternity department focuses on the medical conditions known to significantly increase the risk of maternal mortality, including postpartum haemorrhage, eclampsia, sepsis, obstructed labour, and unsafe abortions. For patients needing referral to the district hospital for a higher level of care, MSF and its partners designed a robust referral pathway that ultimately emphasises saving time to increase patients' chances of survival.
Since January 2024, MSF has supported 624 referrals to Kibondo Hospital for people living in Nduta camp and the district, particularly for high-risk pregnancies requiring emergency surgery.
The hospital had no matching blood, and it was difficult to find a donor. We managed to quickly send three units of blood from our blood bank, which allowed the hospital staff to save the woman's life."Elda Kyando, medical team leader at Nduta Camp
Maintaining a stable blood bank has been crucial to mitigate bleeding risks during or post-delivery in both hospitals. Elda recalls, "One night, I received a call from Kibondo District Hospital about a patient we had referred who was severely bleeding. The hospital had no matching blood, and it was difficult to find a donor. We managed to quickly send three units of blood from our blood bank which allowed the hospital staff to save the woman's life."
“We have also seen the important impact of community health promotion programs in empowering individuals to take charge of their health, leading to improved health outcomes," she says. Indeed, implementing health promotion programs increased maternal and neonatal health awareness in and around the camp, fostering trust in existing services and encouraging women to seek timely health care.
Despite the several persistent health challenges in Kibondo for both refugee and host communities, investing in maternal and neonatal services and prevention will lead to a real improvement in access to healthcare for mothers-to-be and their newborn babies.
MSF in Tanzania
In 1993, MSF initiated its first emergency programs in Tanzania to aid refugees from Burundi, Rwanda, and the DRC in Kigoma. From 1995 to 2001, various health interventions were implemented, including malaria control, water provision, and primary healthcare in Kasulu, Mtwara, and Kigoma. These projects were followed by others, focusing on emergency preparedness against cholera epidemics, malaria outbreak responses, and HIV/AIDS treatment and prevention. In 2015, MSF started working in Nyarugusu and Nduta refugee settings in Kibondo, where its teams opened a 175-bed hospital offering primary healthcare and health promotion.
In 2023, MSF continued to support the Ministry of Health in responding to cholera and Marburg fever outbreaks and other health emergencies, including malaria response and mass vaccination. In southern Tanzania, Lindi Region, MSF launched a program at Liwale district Hospital to improve access to primary and secondary health care for pregnant women and children.