“Feeling gratitude and not expressing it
is like wrapping a present and not giving it.”
William Arthur Ward
For many of us, the holidays kick off a season of thanks and giving. This November, we are embracing the spirit of the season, and expressing our gratitude with a new social media series, “30 days of Thanks.” We have much to be thankful for here at Brighter Tanzania Foundation:
Experiences: Welcoming 85 students into Saving Grace School who may have otherwise not had access to education.
People: Engaged staff, board members, and volunteers in the USA, and engaged students and communities in Tanzania working hard in their classes and community. Superb families and friends supporting activities both in and outside of the classroom, and volunteering across state and continental boundaries.
And so much more…
There is a saying that feeling gratitude and not expressing it is like wrapping a present and not giving it. We don’t want this Thanksgiving season to pass without taking time to extend our gratitude to all those who make this a vibrant community. Though there is not always a forum to share it, know we are inspired by your energy, attitude, and enthusiasm, and we thank you for the difference you make to our mission.
Look for our social posts, pictures and highlights daily throughout the month of November. Follow us on Twitter, like us on Facebook and watch for posts here celebrating BTF’s 30 days of thanks. We hope you’ll join us by sharing your gratitude with those who support the mission of BTF. Share a note of gratitude with a board member, volunteer, or teacher that you are thankful for, or give thanks by submitting your posts tagging us at BTF and using hashtag #BTF30DaysOfThanks.
Our 30 days of thanks are just getting started.
It is difficult for many of us to remember the days when information of all kinds wasn’t within reach of our fingertips, just a click or two away. Yet, many (44% globally) still do not have this connection. Its reach is inequitable, dividing developed from developing countries, rural regions from urban, young from old.
Photo Credit: Luke Chesser / Unsplash
In observing International Day for Universal Access to Information on September 28, UNESCO calls attention to these disparities and challenges us to “empower disadvantaged communities.” (1)
It was African civil society groups, pursuing greater information transparency, that requested this annual observation. (3) The international holiday is in its fourth year following the adoption of the concept of “Internet Universality” by UNESCO in 2015. (#AccessToInfoDay #RightToKnow)
African Advancement on Digital Rights
African states have a history of interfering with digital rights in ways that include restricting content, setting up financial barriers and passing regressive laws. In order to redress this inequity, the Collaboration on International ICT Policy in East and Southern Africa (CIPESA) was formed to promote the use of information and communications technology to support development and poverty reduction. Recently, the organization created the Africa Digital Rights Fund with the aim of awarding approximately 15 grants annually to organizations in countries across Africa. The grants are offered to initiatives that advance digital rights. This could include advocacy, litigation, research, policy analysis, digital literacy and security skills building. (5)
In this, its first year, CIPESA’s digital fund has awarded $65,000 to ten initiatives across 16 countries including Tanzania. (5) A sampling of these initiatives follows:
The African Human Rights Network Foundation, Tanzania - Sixty Tanzanian human rights defenders will be given training and opportunities to reduce internet security risks.
Centre for Human Rights, University of Pretoria, South Africa - This human rights center will document and analyze digital threats to civil society in Egypt, Sierra Leone, Uganda and Zambia.
Internet Society, Namibia - Journalists and editors will be provided assistance to fact check misinformation in the run-up to the November 2019 elections.
What is the Picture on Information Access in Tanzania?
In 2016 Tanzania passed the Access to Information Act in order to provide greater transparency and accountability of public officials. Supporters believe the legislation is important to fight corruption, participate in democracy, correct misinformation and access social and economic rights, education and literacy skills. (6)
However, some critics contend that exemptions and loopholes in the law make it difficult for those requesting information and easy for those withholding information. For example, the law allows an exemption for those cases where another law governs the release of information. International standards recommend that access to information laws should be given precedence to other laws. (8)
Internet access among Tanzanians has rapidly increased in recent years with the number of users rising by 16% in 2017. (9) Over the past decade, more and more Tanzanians have begun using cell phones as a result of cheaper phones and cell services. The majority of Tanzanians gain access to the internet through their phones. The inequity, however, remains stark. A mere 14% of the rural population has access to the internet in contrast to 55% of urban dwellers. In addition, fewer women than men have access. (10)
At a glance
Population: 5,970,646 (2018)
Official languages: Tigrinya, Arabic, English
Religions: Sunni Muslim, Coptic Christian, Roman Catholic, Protestant
Fertility rate: 3.9 children per woman
Life expectancy: 65.6 years
Literacy rate: 73.8%
Children under 5 who are underweight: 39.4%
Natural resources: gold, potash, zinc, copper, salt, fish
Form of government: presidential republic (1)
Image source: Wikipedia
Located on the horn of Africa, Eritrea lies between Djibouti and Sudan on the Red Sea. Ethiopia shares its western border. Eritrea boasts a long coastline of 1200 kilometers. Off of its mainland are 350 islands known as the Dahlak Archipelago.
Image source: World Atlas
Though a relatively thin stretch of land, Eritrea has three geographical regions, each with a different climate. Along the coast lies a strip of dessert. Because of its high salt content, the land is infertile and the climate arid. The northern portion of the Ethiopian plateau also known as the Central Highlands is the most fertile part of Eritrea. The climate is temperate and the land fertile. The western lowlands are semi-arid.
Of the large number of ethnic groups that reside in Eritrea, the Tigrinya is the largest. As a result, Tigrinya is one of three official Eritrean languages. The others are Arabic and English.
One of the cultural traditions for which Eritreans are known is the coffee ceremony. The ceremony takes place often at the end of a long day and the coffee and accompanying snacks are offered to family members, guests and neighbors. No quick run to Starbucks, this languorous ceremony can sometimes extend for several hours. A woman in the household roasts the green coffee beans over a charcoal fire, grinds the beans and prepares the coffee, often with sugar. She then serves the coffee in small handleless cups. Incense is burned throughout the ceremony to enhance the aroma. (4)
Eritrean cuisine has both Ethiopian and Somalian influences. A traditional Eritrean meal is tsebhi, a spicy stew made with mutton, lamb or beef. It is often served with taita, a sourdough flatbread, and hibbet, a legume paste. The meal is often served on one large, shared plate. Because of Eritrea’s colonial history, Italian food is also easy to find, especially in urban centers. (3)
With its access to the Red Sea and natural resources, Eritrea has been invaded and dominated by other peoples throughout history. In the late 19th century, the area came under Italian colonial rule until independence was gained in 1941. It then went through a ten-year period of British administrative control until the United Nations established it as an autonomous region in 1952. When Ethiopia annexed the region in 1962, a 30-year war for independence began. Finally, in 1991 Eritrea became a truly independent nation. Since that time, only one president has served - Isaias Afwerki. Tensions continue to remain high between Ethiopia and Eritrea. (1)
Following the battle for independence, an effort was made to increase the number of schools in both urban and rural areas. Still, the rate for children attending primary schools is 81%. The rate drops to 30% for lower secondary schools. Higher rates of absenteeism from school are found in rural areas with 31% of nomadic children not attending. One fun fact about the Eritrean education system is that children are taught in their mother tongues in primary school while instruction in secondary schools is in English. (5)
Advances and Challenges
Though Eritrea is a patriarchal society, the government has passed legislation protecting women’s rights. This includes the prohibition of female mutilation, gender-based violence and underage marriage.
Image Source: Jack Ninno/Unsplash
However, Eritrea faces a number of challenges both natural and man-made. Frequent droughts and dependence upon subsistence farming for 80% of the population continue to bring hardships to the population. In addition, the government is authoritarian and repressive. For example, Eritreans are faced with mandatory conscription into military or civilian service for indefinite periods of time. A large exodus of Eritreans has taken place because of human rights abuses, a lack of political freedom, militarization and a lack of opportunities. These migrants are especially vulnerable to human trafficking, an increasing problem. (2)
Consider this stunning statistic: almost 7,000 languages exist globally, and the majority of these are spoken by indigenous peoples. Sadly, indigenous languages are disappearing rapidly - at a rate of one language every two weeks! (1)
Indigenous peoples include the Cherokee of the United States, the Maasai of Tanzania, and the Tupi of Brazil. They are sometimes referred to as first peoples, aboriginal peoples, native peoples and autochthonous peoples. Though seemingly distinct groups of people with unique languages, they share many commonalities. They are descendants of and continue to identify with their land’s original inhabitants, maintaining the traditions that have been handed down to them through the years and taking pride in their identities. Sometimes viewing themselves as “spiritual landlords,” (3) they also have a strong connection to the land they inhabit.
Photo Credit: Ichio/Unsplash
Aside from their disappearing languages, they share common problems, too. Though they represent 5% of the world’s population, they account for 15% of the poorest. (1) They struggle to protect their identities, way of life, and right to maintain their traditional land and natural resources.
Photo Credit: Ruth Hazlewood/Unsplash
It is because of these struggles that the United Nations adopted the UN Declaration on the Rights of Indigenous Peoples in 2007. The declaration creates minimum standards for the “survival, dignity and well-being of the indigenous peoples of the world.” (3)
Although Tanzania was among the countries that voted in favor of adopting this declaration, it doesn’t recognize the rights of indigenous peoples in its own country. In recent years, groups of indigenous peoples have been evicted from their ancestral lands. (5)
Four Tanzanian groups identify as indigenous peoples, the Akie and the Hadzbe, both of which are hunter-gatherers, and the Barabaig and Maasai, which are pastoralists. The hunter-gatherers dwell in or near forests, gathering wild fruits, honey and roots. The pastoralists dwell in arid and semi-arid environments where the availability of resources fluctuates. They tend to livestock, are mostly nomadic, and maintain long-term social networks. (4)
The means of production and existence for Tanzania’s indigenous peoples are not seen as viable by the government or the rest of society, which has led to their marginalization. (5)
Photo Credit: Ian Macharia/Unsplash
This opinion is not shared by the International Institute for Sustainable Development, which states that indigenous peoples manage 28% of the world’s land using traditional methods that have proven sustainable. They also maintain 80% of the world’s biodiversity. (2)
In his article “No Sustainable Development Without Indigenous Peoples,” Jeffrey Y. Campbell said, “Indigenous knowledge systems and languages contribute directly to biological and cultural diversity, poverty eradication, conflict resolution, food security and ecosystem health, and serve as the foundation of the resilience of indigenous communities to the impact of climate change. “ (2)
Clearly, the disappearance of languages is but one of many assets the world stands to lose without protections in place for indigenous peoples.
June 16 is an important day in South Africa and elsewhere around the continent. On this day in 1976 thousands of black children in Soweto marched to protest the poor quality of education they were receiving and to demand that they be taught in their own languages. It ended in tragedy when police opened fire, killing hundreds. Since 1991, June 16 has been designated Day of the African Child by the African Union. In doing so, its founders hope to bring continued awareness to the dire situation of many children in Africa and the need for improved education systems. In 2019, migrant and refugee children are among the groups at high risk.
The International Day for the African Child celebrates every child’s right to a quality education. Photo Credit: Brian Odwar/Pixabay
It is estimated that 263 million children in Africa do not attend school. This includes 60% of young people, ages 15-17. (1) This plight exists for a number of reasons, but one leading factor is a large number of refugees, migrants and internally displaced persons on the continent. The crises that cause this mass migration include natural disasters, health epidemics, armed conflicts and economic woes. (2)
Children are disproportionately impacted. Approximately one in four children live in a country stricken by a humanitarian crisis, and an astounding 50% of refugees are children. (2) When a crisis erupts, children’s rights are often violated. This includes neglect in education, health, and an adequate standard of living.
Across the globe, at least one person is displaced every two seconds, according to the United Nations High Commissioner for Refugees. Photo credit: Gerd Altmann/Pixabay
In the United States, when we hear of refugee crises, we think of the turmoil along the Southern border. We hear about the influx of migrants in western Europe and of Syrian refugees in Turkey. Truly, the world is facing the highest level of displacement in history, according to the United Nations High Commissioner for Refugees. However, it is developing countries, mostly in Africa, that have opened their doors to 80% of the world’s refugee population. (7)
Sub-Saharan Africa is front and center in the crisis, hosting 26% of the world’s refugees. The influx has increased in recent years because of critical situations in Central African Republic, Nigeria, South Sudan, Burundi and Yemen. (6)
An estimated 13.5 million African children have been displaced because of economic distress, climate change and armed conflicts. (1)
In the past, Tanzania has welcomed refugees and migrants. Currently, 335,000 refugees live within its borders. A quarter of these displaced persons fled the Democratic Republic of Congo because of an ongoing armed conflict. Most of the remaining refugees fled Burundi after the 2015 elections stoked insecurities. The majority of the refugees live in three camps in the northwestern part of the country. (5)
In 2018, only 27% of needed donations for refugee assistance was raised. As a result, the needs of many, including children, were not met. This included safe water, sanitation, shelter and education. Overcrowding in the classrooms and a shortage of teachers have prevented refugee children in Tanzania from receiving an education. (5)
In 2019, the Tanzanian government began to pull back its welcome mat. New restrictions have been enacted that do not allow refugees to leave camps or make an income in open markets. The government has also begun repatriating Burundian refugees, refusing to grant them citizenship as it has in the past. (6)
For refugee children in Tanzania and elsewhere around the continent, each new movement chisels away at the chance for a deserved education.
Educate a girl; empower a community. Educating all children is vital, but educating girls has a proven multiplier effect and significantly impacts the economy. It is for this reason that so much attention has been paid to girls’ education in recent years, particularly in developing countries.
One young girl begins her education at Saving Grace School in Arusha, Tanzania.
Gender parity in education is improving, but we still have a long way to go. For example, in Tanzania, near universal enrollment in primary education has been achieved. Secondary education is another story. According to Human Rights Watch, only 60% of adolescents in Tanzania can access a lower secondary education. Of these teens, only one-third of girls who enter secondary school graduate. (8) (Read more: https://brighter-tz-fund.org/Blog/6366602)
It is not just for the sake of justice that organizations such as the World Bank are turning their attention and resources towards educating girls. [Over the past two years, the World Bank has invested more than $3.2 billion towards projects aimed at helping girls achieve a full education.(3)] Women with a primary education earn 14 to 19 percent more than women without one. (4) Women with a secondary education earn almost twice as much as those with no education. (1)
Source: The World Bank “Missed Opportunities, The High Cost of Not Educating Girls”
The impact on a country’s economy is significant. In its 2018 report, “Missed Opportunities, The High Cost of Not Educating Girls,” the World Bank estimated that if universal secondary education was instituted worldwide, lifetime earnings for women would increase between $15 and $30 trillion globally. (1)
A more focused study was conducted in Pakistan between the years 1990 and 2016. Its purpose was to learn to what degree the education of girls impacted the Pakistani economy. The results showed that a one percent increase in female participation in education and the labor force led to a 96% increase in GDP. Female education, the researchers noted, reduced the fertility rate and increased the number of females in the labor market. They suggested that the government increase spending on female education and focus on improving educational quality. (6)
Providing 12 years of education could translate into a variety of quality-of-life improvements. Educated women are more likely to advocate for themselves and for better services including health care, education and clean water. They tend to be decision makers both at home and in their communities.
A secondary education could also reduce the rate of HIV/AIDS, the risk of domestic violence, the occurrence of child mortality and malnutrition.
The benefits are generational. Educated women generally have fewer, healthier and better educated children. In sub-Saharan Africa, universal secondary education would cause child marriages to fall by as much as 64%. Furthermore, because universal secondary education would lead to reduced fertility rates, a reduction in global population would be another far-reaching outcome. Think about the secondary results in these improvements - in food supply, energy, the environment. The rate of return on educating girls goes far beyond numbers - its impact could stretch to every corner of the globe.
Maria Montessori could not have said it better: “Early childhood education is the key to the betterment of society.” Though Montessori made this pronouncement nearly a century ago, her conviction rings true today and is supported by a number of studies.
The Opportunity Project (TOP), in an unnamed Midwestern city, was one such study. Its purpose was to determine the long-term outcomes of economically disadvantaged children who received the intervention of a quality early childhood education program. These children were studied in tandem with a control group from a local school district. The children from both groups were followed from kindergarten through grade 4. (1)
Objective measures demonstrated higher rates of success among TOP students than the control group. By the fourth grade, the TOP students had scored “significantly higher” on math and reading tests. They had “significantly higher” attendance rates. They also had “significantly fewer” discipline referrals. (1)
Subjectively, the TOP students also seemed to outpace the control group. Teachers of both groups completed questionnaires each year through the fourth grade. The results demonstrated that the TOP students used more appropriate behaviors, surpassed peers socially, and were more emotionally mature than their classmates who had not received a TOP early intervention. (1)
The period between birth and age five is recognized by child development experts as a time of immense opportunity and also vulnerability. During this time, connections among neurons are being formed. (2) Evidence shows that brain development is rapid during this short period of time and impacts five domains: physical growth, cognitive development, social and emotional maturing, language acquisition, and self-help skills. Children are negatively impacted when stimulation and nurturing are lacking. (7)
Development of the brain is believed to be influenced by genes, the environment, and the interaction between the two. Trauma or adversity in a child’s early years can impact brain development. (2) However, evidence also demonstrates that early interventions through a quality preschool program can bring improvements. Children who receive these interventions are more likely to be successful later in school and in life.
Photo Credit: Mike Fox / Unsplash
Advocates believe that early education primes disadvantaged children to develop into successful adults, with higher earnings, better health, and lower levels of welfare dependence and crime. Another well-known study called the Perry Preschool Program studied 123 at-risk, low-income preschool students in Ypsilanti, Michigan. (3)
The students were randomly split into two groups, one which received a high-quality preschool education, and the control group which did not. The Perry Project provided instruction in communication and math skills as well as a focus on “non-cognitive” skills including sustaining attention and working cooperatively with others. Project leaders also went into the homes of the student participants and worked with the parents, offering encouragement and instruction to provide stimulating activities at home. (6)
This longitudinal study, begun in the 1960s, followed students to age 50. The results were unequivocal: 65 percent of the first group graduated from high school compared to 45 percent from the control group. In addition, those in the first group were more likely to be employed, raise their own children and own a home or car. Those in the first group were also less likely to be arrested or use drugs. (3)
Photo Credit: Emiliano Bar / Unsplash
Of course, it is not just providing early education that makes a difference, it is providing high- quality early education. What exactly does this mean? While schools come in many shapes and sizes, a few common denominators do exist. Read the features of a quality preschool below.
The teachers and support staff
The instructors or caregivers should be well trained, and the child-to-staff ratio should be small.
Warm and responsive interactions need to take place between the children and teachers in order for secure attachments to form. These attachments help lay the groundwork for future, healthy relationships.
The teachers should engage the kids in age-appropriate learning strategies.
Teachers should encourage independence and create language-rich environments.
Teachers should receive ongoing support and training. (4)
The physical environment
Stimulating and appropriate materials should be provided and organized in a way that encourages independence and exploration.
The space should be arranged to support interaction between the children, role playing, and literacy skill progression.
Children should have access to outdoor space. (4)
Aside from the tremendous benefits individuals receive from early education, society also benefits. According to UNICEF, the cost-benefit ratio of early interventions show that for every $1 spent, the returns are four to five times the investment. (7)
Now it appears that the return may be even greater. Researchers, including Nobel Prize-winning economist James Heckman, are taking another look at the Perry Preschool Project.
The project was started to increase the academic scores of disadvantaged children. Using this measure, the project was unsuccessful - the data did not demonstrate an uptick in academic scores as the children moved on to elementary school. As mentioned above, benefits did appear when the participants approached adulthood.
In addition to the success documented in the participants’ adult years, evidence is emerging of a new and exciting benefit. The children of the participants are now being studied, and it has been reported that they are doing better than the children of the participants in the control group. The participants’ children have better social and emotional skills, are more likely to be healthy, earn more, graduate from high school and go on to college. The benefits of early intervention have been passed on to the next generation. (6)
Researchers suggest that the original participants gained the skills necessary to form healthy families and maintain a stable income. The study may also demonstrate that it is ”non-cognitive skills” that are most important in determining success in life, skills like resilience and grit. (6)
“It is the gift that keeps on giving,” said Heckman in an interview with National Public Radio.
Whether that gift is given in Ypsilanti, Michigan or Arusha, Tanzania, generations of impoverished people stand to benefit from early education.
Impoverished children in Arusha, Tanzania receive early education at Saving Grace School.
In this blog, I’ve written about the intersection of nutrition and positive educational outcomes. I’ve written about the many afflictions with which the impoverished in Tanzania must contend - HIV, rickets, shunting, tuberculosis. I’ve written about the impact that a good teacher, books and a quality education can have on the life of a student. Now I have a story about one small child whose life makes it all real.
Abu arrived at Saving Grace School critically ill and developmentally delayed.
When Abu Msuya, at four years of age, arrived at Saving Grace School, he may have been mistaken as a young toddler by those who did not know better. Physically, he was malnourished and small, suffering from shunting. He was critically ill, with infections in both ears, bleeding from his nose, a rash on his face, and barely able to stand on his own. Developmentally, he was behind, unable to dress himself or use the toilet.
Abu suffered emotionally, too. His mother and father were both in poor health and lacking a steady income. Following Abu’s arrival, his mother died in childbirth. Abu has an adult brother, but he has his own family to support.
The teachers at Saving Grace welcomed Abu and made the school a home for him. They nurtured him, provided nutritious meals. Still, Abu suffered and seemed to be constantly ill. A trip to the doctor provided some answers. Abu was diagnosed with two ear infections which had developed into ruptured ear drums, tuberculosis, and rickets. He received medication and a doctor’s care. Yet, his illness continued. Finally, another disease was discovered and diagnosed - Abu was HIV positive.
Medical treatment has helped Abu recover from tuberculosis, rickets, ear infections, and HIV.
Enter into the picture Cathy Taylor, Abu’s sponsor. Brighter Tanzania Foundation runs a sponsorship program for individual students. The sponsor can choose a child in need from profiles provided by the foundation and donate money to help fund the child’s education and also motivate the student to stay in school and work hard. The sponsor is able to learn about the student through letters, photos, and updates about his/her progress. In some cases, the sponsorship takes the form of a mentorship. Cathy has become a mentor to Abu and much more.
Abu loves spending time with “Mama Cathy.”
Not only does Cathy pay for Abu’s education at Saving Grace, she also helps provide medical care. She regularly communicates with Abu’s doctor, has purchased a health insurance plan, and paid for a visit to the dentist. In addition, Cathy and her daughter, Elisa, have had an opportunity to visit Abu, cultivating a personal relationship with him.
“Mama Cathy” has become a special person in Abu’s life. And Abu has become a special person in hers. Cathy, a resident of St. Helen, Michigan, has traveled to Arusha for long stays each of the past three years. As some of the physical ailments have receded, Abu’s personality has emerged. Cathy has watched him thrive and become the happy, inquisitive, and sweet boy that he is today.
Cathy visited Arusha and spent time with Abu for five weeks in 2019.
Abu would likely be unrecognizable to anyone who saw him when he first entered through the school’s doors. He has grown bigger and his daily functioning is now age appropriate. Abu likes to kick the soccer ball and play on a scooter. He also loves to sing and dance.
Abu has experienced some setbacks along the way. In September, 2018, he was hospitalized for pneumonia. Following his recovery, Abu moved in with Grace, her husband, Joseph, and their three children. Abu now lives in a healthy, nurturing home environment. “The love that spills out in their home is unbelievable,” Cathy said. “They love him as one of their own.”
A few new local friends, named Sammy and Kennedy, also provide help, such as transportation to medical appointments, when needed.
“It is a huge circle of love that came together to help this little guy,” Cathy said.
Abu receives loving support from his sponsor, Cathy Taylor; Cathy’s daughter, Elisa Taylor; and Grace.
Abu has challenges in his future. Because of the HIV diagnosis, he will always be at risk for contracting and fighting infections. Due to the rickets, he will probably always be small for his age. Those who know him look at how far he has come in the past two years, and take comfort in knowing that he has lots of support and a fighting chance.
Cathy’s prediction: “I see nothing but brightness in his future!”
On this World Health Day 2019, the World Health Organization (WHO) directs our attention to their number one goal - achieving universal health coverage for all.
Global Health Care Needs
Many consider health care a human right. That right stands in stark contrast to the global reality. According to WHO, at least half of the world does not have full coverage of essential health services. In many cases, a lack of access is the cause. Unaffordability is another top reason. Millions of people each year are forced to choose between needed health care and other basic necessities - food, clothing and shelter. One hundred million people are pushed into extreme poverty annually because of health care expenses. Of those who can both access the care and pay for the services, many continue to face poor-quality options. (1)
Photo Credit: Pixabay
When we achieve universal health care, everyone will be able to attain accessible, quality health services without undue financial burden. Most importantly, everyone should have accessibility to primary health care - services that help people improve their health or maintain their well being rather than treat a single disease or condition.
Although a few communicable diseases such as HIV/AIDS, tuberculosis, and Ebola understandably receive much of the world’s attention, it is the noncommunicable diseases such as heart disease, cancer, and diabetes that take a greater percentage of lives prematurely. In fact, noncommunicable diseases kill 15 million people under the age of 70 each year. Investments in noncommunicable disease prevention through primary care could save millions of premature deaths each year. (4)
A Snapshot of Health Care in Tanzania
Tanzania faces many challenges in its health care system, a system that precludes many from receiving the above-mentioned, essential primary care. This includes a shortage of healthcare workers (one doctor per 30,000 Tanzanians), a lack of facilities in rural areas, long distances to the existing facilities coupled with poor transportation systems and roads, and underfunding ($51 per capita in comparison to $4,000 per capita in the U.K.) (6).
In 2015 the Ministry of Health of Tanzania assessed the state of its health care system through a year-long evaluation of health facilities using a five-star rating system. Of the 7,000 facilities evaluated, only 2% met the minimum standard of quality (three stars of more). A whopping 34% received 0 stars (8).
One area of concern is women’s health and obstetrics. In a recent study reported in BMJ Journal, 13,266 Tanzanian women of reproductive age were interviewed in order to analyze the obstacles to health care access for women. Two-thirds of the women cited at least one of the following hurdles:
Distance to the facility
A lack of someone to escort them to a facility
Lack of permission from a spouse
The study concluded: “The results of the present study provided evidence for additive effects of barriers to healthcare in low-income countries, such as Tanzania. Based on these results, improving access to health insurance and addressing social determinants of health represent the first steps towards reducing problems associated with accessing healthcare for women in low-income countries.” (3)
Photo Credit: Unsplash
A few statistics (2010) bring the challenge of inadequate medical access for women into greater focus:
Only an approximate 50% of deliveries were attended by skilled medical personnel.
A mere 40% of pregnant women received at least four prenatal visits with a skilled provider.
A dismal 45% of the country’s health centers have basic emergency obstetric care. (5)
It is not surprising then that in 2014 the maternal mortality rate was 398 deaths per 100,000 live births. Still, strides are being made to reduce such numbers. In 2005, that number was 605 deaths per 100,000 live births. (7) Compare that to the U.S. While having the worst rate of maternal deaths in the developed world, the U.S.still has a substantially lower rate at 26.4. Finland has the lowest rate at 3.8. (9)
Raising awareness of the global inequity in healthcare access is critical. Health care is not just a human need; it is a human right.
At a glance:
Population: 1,962,461 (2018)
Official Languages: Sesotho and English
Religion: Protestant (47.8%), Roman Catholic (39.3%), other Christian (9.1%), non-Christian (1.4%)
Fertility Rate: 2.59 births per woman (2018)
HIV/AIDs Adult Prevalence Rate: 23.8% (2017) / 2nd highest in the world
Life Expectancy: 53 years (2018)
Image Source: Wikipedia
Literacy Rate: 79.4% (2015) / Males 70.1%, Females 88.3%
Currency: loti / South African rand is also accepted as legal tender.
Form of Government: Parliamentary Constitutional Monarchy
Natural Resources: water, diamonds, sand, clay
Exports: clothing, footwear, wool, mohair, food and live animals, water, electricity, diamonds (1)
Lesotho’s most prominent features are its mountains and geographical position as a small, landlocked country.
First, the country’s lowest elevation is 1,400 meters above sea level, with 80% of its territory actually 1,800 meters or more above sea level. Indeed, Lesotho is sometimes referred to as “Mountain Kingdom” or “Kingdom in the Sky.” Lesotho is the only country in the world that sits entirely at or above 1,400 meters. The mountains and foothills of Lesotho are a source of great beauty but also cause isolation and limit the amount of arable land. (2)
Image by Markus Fischer on Pixabay
In addition, this small country is unique in that it is completely surrounded by the larger country of South Africa. As such, it shares the distinction of being a complete enclave with only two other countries in the world.
The area now known as Lesotho was settled by the Sotho people in the sixteenth century. In the 19th century, Moshoeshoe, known as one of its greatest and unifying leaders, ruled with exceptional diplomatic skill rather than military might. This was at least in part due to his limited military capabilities in contrast to the more powerful Zulus and Matabele. However, he also is known for developing strong relationships with the Christian and Catholic missionaries who moved into the area. Today the country predominantly practices Christian religions.
In his later years, Moshoeshoe sought protection from the British as the Boers moved into the interior of South Africa and Lesotho, seeking new territory. Lesotho remained a British protectorate until 1966 when it gained its independence and became a constitutional monarchy. Since that time the country has been marked by political instability including a military coup in 1986. (8)
The culture of the Basotho people centers on village life. Traditional forms of music and dance are incorporated into Basotho life. For example, the lesiba is a popular stringed wind instrument, especially commonplace among herders. Traditional dances include the “gum boot dance” and “Mohobelo dance.” (6)
Clothing is another reflection of Basotho life. One garment that is a staple for many in Lesotho is the Basotho blanket. The blanket often has colorful designs, is draped across the shoulders, and is pinned at the chest. People wear the blanket during important life events such as a marriage, but it is also an everyday article of clothing that keeps a person warm in the cool mountain air. The blanket is said to have originated in 1860 when King Moshoeshoe received a woolen blanket as a gift and began wearing it in exchange for his leopard-skin clothing. (5) The mokorotlo, a conical hat, is also commonly worn in Lesotho. (7)
Image by Simon Allen on Pixabay
Challenges in Lesotho
High poverty is one of Lesotho’s primary challenges. Estimates show that over 50% of the population lives in extreme poverty. Much of the population works in subsistence farming while as many as 35% of male wage earners travel to South Africa for work. (2)
One initiative seeking to assist in remedying the problem is the Lesotho Highlands Water Project. It is an ongoing and joint South Africa and Lesotho initiative. The project creates major dams, redirecting some of Lesotho’s plentiful water supply to South Africa, where it is more in demand. The dams also provide hydropower for Lesotho. The project developers intend to reduce poverty and improve the lives of people in both countries. (2)
Another challenge for the Basotho is their struggle with both HIV/AIDs and TB. Lesotho has the second highest prevalence rate in the world for both diseases. (3)
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