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  • Notes from the Field: Simple Solution Saves Mothers’ Lives in Rural Tanzania

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    Congolese refugee, Suzanna, with her daughter Lea at Nyarugusu Camp, Tanzania.

    Six months ago, 30-year-old Suzanna came to the health facility at Nyarugusu Refugee Camp to deliver her child. She arrived during the early stages of her labor, but after giving birth to her daughter, she bled heavily. She then went into shock and fell unconscious. Fortunately, health staff at the camp facility had access to what’s called the non-pneumatic anti-shock garment and wrapped her in it. Soon after, her blood pressure returned to normal and she woke up; she was surprised, and thrilled to see her daughter. “Without the garment,” she told us later, “my life would have been lost.”

    There are many challenges in the settings where we work, but it is so encouraging when you see highly effective, simple solutions put into action. That was definitely the case when I visited the Kigoma region in Tanzania recently with our director of reproductive health, Sandra Krause. Hosted by Dr. Abdelhadi Eltahir and Jayne Lyons of Pathfinder International and Dr. Ernest Athumani of the Tanzania Red Cross Society, we were there to look at how they are introducing the non-pneumatic anti-shock garment to the region.

    Postpartum hemorrhage—excessive bleeding after childbirth, like that suffered by Suzanna—is the leading cause of maternal death worldwide. Most of these deaths occur in resource-poor countries and are almost always preventable. And now health care providers in even the most remote areas have another means available to them to prevent these needless deaths—the non-pneumatic anti-shock garment, or LifeWrap, which was recently featured in the New York Times. Like a wetsuit, this garment can be wrapped around a woman who is hemorrhaging and who is in, or at risk of, shock. In places where the nearest health facility is miles away, on unpaved roads, and where motorized transportation is not common, this medical innovation has enormous potential and is already saving women’s lives. It is also invaluable in understaffed health facilities, where doctors and nurses are stretched thin, and clients may have to wait hours for care. Most importantly, the garment buys precious time—time that the hemorrhaging woman needs to survive.

    Partnering with the Tanzania Red Cross Society, Pathfinder International has trained 119 health providers to use the garment and distributed more than 80 of the garments to both refugee camp health facilities and surrounding clinics in the Kigoma region. The garment is also being used in the district hospital’s ambulances, for women who need it en route to the health facility. This effort is part of a larger initiative Pathfinder is leading to address postpartum hemorrhage worldwide and complements programs they have in Bangladesh, India, Nigeria and Peru. 

    The program in Tanzania is unique because for the first time ever, the garment is being used in a refugee setting. It is also rare that such an initiative encompasses both refugee camps and the host communities around the camps. In many countries where refugees flee, they are resettled in marginal areas that are remote and poorly served. The health facilities in many of these refugee camps are actually better supported and supplied than the clinics in villages nearby. This initiative is important because it gives back to Tanzanian communities that have hosted the camps for decades.

    We visited several refugee and host community health centers and clinics, and all of the health staff we met were enthusiastic about the garment and its potential to save lives. One clinical officer recalled a young girl, 16 years old, who had died after giving birth a few years ago and who would probably still be alive today if the garment had been available at the time. The girl lived on a farm far away and got to the health center too late; she died soon after she arrived. The officer said that after the project’s efforts, they are now better prepared and able to do more to save such girls and women. There’s proof that he’s right: Over the last year, they have not had a single maternal death in the area.

    With the non-pneumatic anti-shock garment, extra training, more availability of essential medicines and other improvements in maternal health services, the health providers in Kigoma are better equipped to ensure that women can deliver their babies safely. 

    To be sure, health care providers here still face many challenges. Long distances, limited communications, poor roads and inadequate supplies are all hindrances to safe pregnancies. Take, for example, cell phone coverage: One of the health facilities we visited was in a town that had cell phone service, but only atop certain trees—people climbed one tree for the mobile service Vodacom, another for AirTel, and another for Tigo.

    But in a place that has yet to see a lot of technical change, it’s amazing to see how one modern medical technique is starting to take root, and already having an impact.

    View pictures from the trip to Tanzania.