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The impetous to write this blog was a result of being offered the opportunity to go to work in Tanzania as an "expert academic / clinician" midwife.  I felt that it was an opportunity  to keep family and friends in touch with what I am up to and to share a little of my life.

 

It starts with the preparation period, the packing, the journey and the wonderful experience I had in Africa. Unfortunately some of the private experiences of the women in Tanzania can not be discussed in a public forum. Some of the experiences were exhilerating and many devastating, but there is a some progress being made by NGOs such as GHAWA.

 

In rural areas about 80% of the labour force is provided by women and they produce 60% of the food, yet they do not have a say in their own wealth. In Tanzania about 60 percent of women live in absolute poverty. Certain kinds of work have been stereotyped as being ‘male’ or ‘female’, because of the socialization process on the division of labour which stipulates different roles for men and women. Most rural women carry water, firewood and farm produce on their heads, take care of children, cook and farm. There is the assumption that a woman’s primary commitment is to care for a family at home, in the ‘reproductive’ sphere of life; and that each woman depends on a male provider for cash needs.

This is often an arbitary assumption, and culturallydefined.  Women's skills are often undervalued. and considered unskilled, even those such as child care, subsistence farming, and  agro-processing. Like many societies in Africa, customary laws and practices remain discriminatory against women on issues of property inheritance particularly on land, as well as institutionalised violence against women e.g. wife battering, rape, female genital mutilation and the existence, side by side, of a multitude of statutory, religious and customary laws that might be conflicting.

 

Women do not even have decisions on reproductive issues for example most women cannot decide on the number of children in the family though they are the ones playing a big role in child rearing. However the Government of the United Republic of Tanzania committed itself to improve women’s status and legal standing.

 

Tanzanians have a low life expectancy (49 years), high death rate (15.1/1000), and high fertility rate (6.5). Women have been subject to sexual discrimination even before colonialism. Tradition sustains sexual discrimination today, which keeps women at a low social status and in poor health. Programs need to train women to become more assertive and teach skills which facilitate economic and professional development. Women need to be involved in development. Even though the Tanzanian government has a free health care system, insufficient transportation prevents childbirth emergencies from being managed. Yet, the national health policy calls for the elimination of discrimination against women in health care. Maternal and child health services focus on the baby's health. Breast feeding can further weaken a malnourished woman. Lack of transportation and low contraceptive prevalence (5-7%) restrict women's use of family planning services. Tanzania has officially adopted the Safe Motherhood Initiative, but commitment from all groups is needed. Many women suffer from domestic violence, but the issue is ignored. Some tribes still practice female circumcision. Another form of social control is childhood marriage, which both tradition and the law uphold. Early marriage and teenage pregnancies prevent women from completing their education. The government has a course to train traditional birth attendants which improves their standard of care. Customary marriage laws consider wives to be property. Divorce carries a considerable social stigma. In 1990, the Tanzanian government created a ministry to coordinate women and children issues. Obstacles to improving women's health are poverty, harmful traditional practices, customary laws that support discrimination against women, and Tanzania's poor economy.

I would like to think that the very short time I spent in Tanzania has contrinuted to some positive change by providing midwives with knowledge and skills to intervene earlier to save the lives of mothers and babies.