No More Orphans – TST’s Newest Project

This summer, The Small Things was fortunate enough to be able to host interns Amanda Houser and Alison Anger, both Masters of Public Health students from Boston University. Through a partnership with the Nkoaranga Hospital’s Palliative Care Team, they were able to successfully launch TST’s newest project, No More Orphans (NMO). In the following guest blog, Amanda gives a behind-the-scenes account of this exciting project, with Part 1 describing their very first NMO Informational Seminar, and Part 2 highlighting the Training Session. Read on to hear more about the highs and lows of her experience this summer. 
No More Orphans (NMO) – Brief Overview
NMO is a community health initiative aimed at decreasing maternal mortality rates in Tanzania through the distribution of Misoprostol. This oral medication will work to prevent postpartum haemorrhaging, a leading cause of death for mothers in Tanzania, while saving the lives of many women in the surrounding community. Further, in keeping with TST’s goal of keeping families together, this project will ensure more babies are raised by their mothers, reducing the numbers of babies entering orphanages.

Part 1: NMO’s Very First Informational Seminar [Guest Blog by Amanda Houser]
Originally posted on That One Summer 
Ali and I had our first No More Orphans (NMO) informational session with the community’s Traditional Birth Attendants (TBAs) this morning. It started out a little (okay, a lot) hectic but it all came together in the end. 
We asked Esther, TST’s housekeeper, to make the chai  and mandazi for us to serve at our meeting, however only half the mandazi was cooked by the time we left for our meeting and she hadn’t yet started making the chai. The printer also ran out of ink and we were only able to print 11  informational brochures for our attendees.
Deep breath…
Fortunately, we knew the meeting wouldn’t start on time based on our experience here in this community. We even purposefully set the meeting for 10:00, knowing it wouldn’t start before 10:30. Good news, the meeting didn’t actually start until 11:15! Though, it didn’t help that once the chai finally arrived, we ran out within minutes. Can you tell we’re new at this?
Delicious mandazi. Better late than never!

Chai and mandazi break
Here’s the thing though, we had no idea how many TBAs would be in attendance. At the last community health workers meeting, we kindly asked these community leaders to relay the message to the TBAs in their village, notifying them about the No More Orphans Project, inviting them to attend our first informational session to learn more about how they can get involved. We estimated 30 attendees, and felt that was being extra generous. We couldn’t be sure news of the meeting would even reach the TBAs as we relied solely on word-of-mouth. And then when we woke up to pouring rain and muddy roads, we just assumed attendance would be low.
Boy, were we wrong. 
So, so wrong.
We had 41 women show up! 
Forty. One. 

Amanda and Ali’s Presentation

All 41 traditional birth attendants

I still don’t have to words to describe this morning. I feel extremely blessed to be a part of something with so much potential to make a difference in so many lives. Today’s meeting was monumental. We’ve finally reached the TBAs! It took some time (about a month) but now that we’ve found out who they are, we can begin teaching them how to use and administer Misoprostol and hopefully reduce maternal mortality! 
(I may be getting a little ahead of myself, since reality check, there is a still lot of work to be done. It just feels so great to be on the right track!)
Part 2) Training Day [Guest Blog by Amanda Houser]
Originally posted on That One Summer
We didn’t get to bed last night until around 2am. We also ran out of printer paper, and still needed to find a pharmacy willing to sell us Misoprostol at a price that didn’t make us feel sick to our stomach.
Frank, TST’s driver, picked me up at 7:30am this morning to go to Arusha but the first pharmacy I attempted to buy Misoprostol at was still closed, as were the next two we tried. We also had to go to three different stationary shops before finding printer paper. I had wanted to be back by 9:00, but at 9:30 I was still in Arusha, hadn’t found a pharmacy with Misoprostol, and our meeting was set to begin at 10:00. 
Cue the anxiety.
Frank convinced me to let him try one more pharmacy and thankfully it paid off. They were open, had Misoprostol, and for some reason agreed to sell it to me for a real bargain. I made it back by 9:50 and we quickly printed what we needed to start the meeting, left Ashley, another TST intern, to finish it up, and headed for the hospital to begin the training session. We were counting on head nurse Mama Sarah to translate for us but I guess she decided to take the day off.
Our facilitator Dr. Bakari wasn’t thrilled he had to translate but he ended up doing a really amazing job. Once again, the chai was late and the food even later. When our meeting finished around 12:30, the chai was cold and the food didn’t arrive till 2:00!
In the end though, everything worked out. We had 43 traditional birth attendants and they all left with two doses of Misoprostol. I’m still unsure of how this project progressed so quickly and a little overwhelmed by its potential. I have been talking about this amazing opportunity since March and it’s finally happened. The traditional births attendants are equipped to administer Misoprostol in an attempt to reduce postpartum hemorrhage and I am part of the reason precious lives will be saved.
That’s pretty darn cool if you ask me.