POVERTY: Poverty has led to the deaths of 200,000 youngsters in Tanzania in a decade

Lachlan Mackinnon
Sep 7 2010
TWO hundred thousand Tanzanian children have died in the last 10 years simply because they were poor, a charity insisted yesterday.
Save The Children accused the east African nation's government of ignoring deprived countryside kids and focusing limited efforts to cut child deaths on easy-to-reach youngsters in the better-off towns and cities.
More than half of the country's population are children and 54 per cent of them are malnourished.
Babies account for 30 per cent of child deaths.
While the overall under-fives mortality rate fell from 157 per 1000 in 1990 to 139 in 2000 and 104 in 2008, Save The Children say deaths among the poorest children have remained stubbornly high.
Ten years ago, world leaders agreed on a set of international targets to cut poverty - including a commitment to slash child deaths by 67 per cent by 2015.
But the east African country of Tanzania - like dozens of others - is off-track, an issue world leaders will discuss at a UN summit in New York later this month.
The Record travelled around Tanzania - home of the Serengeti national park - with Save The Children to inspect attempts to cut child deaths and to listen to kids' and mothers' often-heartbreaking concerns.
At Nyango District Hospital in Lindi, as in the rest of the country, pregnant women and under-fives are treated for free.
But the plight of Zinabu Jafari, 41, suggests the system is fundamentally flawed.
Her newborn twins weigh just 1.9kg and 2.5kg and are expected to die without specialist hospital treatment to increase their size.
Yet, for no apparent reason, Zinabu - whose husband left her when he found out she was having twins - has been told she will be discharged from hospital.
The gran-of-one, whose eldest child is 25 years old, said: "My first five children were born at home because there was no hospital.
"The only problem I had was with my fourth children when I bled for a month about five months into my pregnancy but I was OK after that.
"My seventh child was born seven years ago and I had no idea I was going to have twins this time.
"When the first one came out I was surprised my abdomen was still large and was amazed when another baby came out.
"I don't know what has happened to my husband, just that he is leaving.
"I am not sure about my children's future.
"I thought I was going to have one baby and now I have two.
"I have been told I have to leave the hospital and am concerned about having enough food for my family, producing enough milk for the babies and clothing my children."
Elizabeth Kanlanga, 28, had walked five kilometres to the hospital with one-year-old daughter Zulfa Ajali, who fell down a flight of stairs.
The child was not seriously injured but Elizabeth also raised concerns about the healthcare on offer.
She said: "Sometimes they do not examine you or your baby and give you the wrong medicine.
"And even though they say it's free, women going to the labour ward have to take their own gloves and basins with them."
Edna Hyela feels differently and insists progress is being made.
She has run a prenatal health clinic at the hospital since 1999 after working for 33 years as a midwife.
Edna said: "We ask the pregnant women about how they are feeling, what vaccines they have had and run tests to check for things like malaria, worms, bilharzia, syphyllus and high blood pressure.
"We give them counselling before the HIV test and the women are willing to receive their results."The rates have gone down since I started doing this job and we are able to give the pregnant women drugs to try to prevent the disease being transmitted to the babies."
Due to a chronic shortage of incubators, Save The Children are training medical staff and local volunteers on a technique to keep babies warm called Kangaroo Mother Care.
New mums are encouraged to hold their babies against their chest in the same way a kangaroo keeps its joey tucked in a pouch.
Somoe Salumu, 35, whose twins were born in hospital on August 18, and her mum Mwanamkulu Sulemani, who said she was born between 1948 and 1955, said they were comfortable using the method.
Somoe, who has 13-year-old twins and a five-year-old child, said: "I am happy to give birth to twins but I had no idea I was going to have them and it is a burden as I already have three children to feed.
"Life is difficult for us because we are very poor.
"I try to give my children and husband two meals of millet and cassava a day but there is not always enough food."
Shamba Donlat, a social scientist who helps at the hospital, told how the attitude of fathers made life harder for mums-to-be.
He said: "There is a taboo here about giving birth.
"The dad often has no idea where the mum goes to have their baby.
"Things are changing slowly but even now most children around the age of five are told how they should behave as a man or woman.
"This makes it hard for a woman to admit she is in labour and she has to find a female relative or neighbour to help her.
"Many women choose to give birth at home and this can be dangerous if there are complications such as heavy bleeding."
Many people live too far from hospitals to walk to them and Save The Children have helped support a network of local health clinics, known as dispensaries.
The Kilangala dispensary provides basic medical care for 80,000 people in the poor rural community.
They offer vaccinations for children, maternity services for pregnant women and teach locals how to prepare more nutritious meals to prevent them falling ill.
The main diseases locally are malaria, respiratory infections, pneumonia, meningitis, diarrhoea, skin infections, asthma and heart disease.
Clinical officer Fridoline Mrope, who runs the dispensary, said: "We don't have electricity, which makes it difficult to work at night, or running water to keep everything clean.
"The nearest water source is half a mile from here.
"There is also a lack of transport to bring sick people or women in labour to this unit or to take them to hospital for more specialised treatment.
"And we have no accomodation for staff which reduces the time the unit is open."
The acute need for medical services within walking distance is easy to identify.
Eisha Abadallah stumbled along the dusty road to the dispensary cradling her distressed two-year-old daughter Aisha Selemani in both arms.
Eisha said: "I'd left water boiling to make some tea and when I turned around Aisha had knocked the pot over and scalded her legs."
Tiny Aisha's distress could be heard outside Fridoline's office as he cleaned and dressed her wounds which will leave a permanent scar.
The dispensary also runs the Opendo - which means love - Care Group whose 30 members drawn from the local community are trained to spread health messages.
Secretary Mohamedi Hassan Njengu proudly told of their achievements, which included enouraging 33 out of 42 women to give birth at health centres instead of at home and ensuring all but two of the areaÕs 234 under-fives received essential vaccines.
Fellow group member Ally Hassan shows pregnant women and mothers of young children how to cook nutritious meals such as porridge or soups rich in starch, protein, fat, minerals and vitamins which can be fed to the family three times a day.
Ally said: "There's a high rate of malnutrion because many people sell what they grow instead of eating it themselves."
A children's group is also run from the dispensary.
While much of the emphasis is on having fun, youngsters are also taught about healthy eating, the importance of vaccinations and avoiding early pregnancy.
It is a lifeline for children who have lost one or both parents.
Dalini Rashid has lived with her grandmother ever since her mum and dad died 10 years ago.
The painfully-shy 17-year-old, who insisted she does not know how her parents died, said: "We learn all about different diseases like malaria and cholera and are taught about avoiding teenage pregnancies.
"Having a group means we can fight for children's rights and request things like uniforms and exercise books for school.
"My favourite subjects are english and science and one day I'd like to be a doctor."
Nozlati Hashim, who lives with her mum, echoed the need for young girls - especially orphans living on the streets - to be given information about avoiding sexual diseases and pregnancy.
In a soft yet confident voice, the 11-year-old said: "We're being taught how to prevent ourselves from getting infections like malaria, bilharzia and being aware of teenage pregnancy.
"When I grow I'd like to be a teacher so I can share my knowledge with children."
However, slightly-built Nozlati was unable to speak when asked about her father.
Tears streamed relentlessly from both of her eyes, even though she did not sob, as she whispered a few choked words.
The reason for her distress was shocking.
Her grandfather decided to build a mosque and sought advice from a witch doctor who told him he must kill his own son to be successful.
The grand-dad acted on those orders, robbing Nozlati of her bus driver father.
Azizi Ali Ligunga's keen eyes and mischievious smile belie personally tragedy.
His HIV-infected sister died aged 19 last year while his dad was killed by "recurrent illnesses" some time ago.
The 11-year-old loves attending the group because he "wanted to play with the other children" and access to school uniforms and textbooks.
He said: "My dream is to play for Simba Football Club one day and become as successful as my favourite player Cristiano Ronaldo."
Across the only proper road, Somoe Mohamed, 24, cradled critically-ill son Abdul Haniu outside her home.
The seven-month-old lay limp and lifeless in her arms, struck down by malaria.
Mum-of-two Somoe has already lost three children, who died - possibly of malaria - before they reached the age of one month.
She said: "Abdul was vomiting, had a fever, diarrhoea and was sleepy but now he receiving medicine his temperature is coming down and we are hopeful he will survive.
"I often have headaches too and have had malaria many times."
Half a mile away into the dusty undergrowth, Zuhura Mohamed, 27, appeared to be unaware her unborn baby had died inside her.
The mum-of-one attended hospital because of severe stomach pains, was told her baby was "hiding" and given a return appointment on September 2 when they will almost certainly chemically induce the infant.
She said: "They told me they could not hear the heartbeat and I told them I had not felt any movement for about two months.
"They told me the baby is hiding somewhere in the womb and asked me to return later.
"I am grateful to the health group for paying for my hospital treatment because I donÕt understand what is wrong with my baby."
Neighbour Mwanaharusi Said, 30, who gave birth to third child Taliki Said on June 27, had serious concerns about life for ordinary Tanzanian villagers.
While pregnant with Taliki, she had paid for hospital treatment for anaemia with cash given to her by the local dispensary which is supported by Save The Children.
Mwanharusi said: "My other children are seven and five and have frequently suffered from malaria."Their health is not looking good but I am grateful for all the support and love I have received.
"I have been shown how to make more nutritious food and I am feeling better than I used to and am producing more breast milk.
"But we still have a problem with water.
"The nearest well is two kilometres away and the water is not always clean.
"We also have a problem with schooling.
"The local government school is not big enough which means there are a lot of children who are idle and roam the streets."
Sanitation is also a problem in the village.
Many households do not have access to a toilet, meaning people have to either find a neighbour to share one with or go into the bushes.
And because water is scarce and soap too expensive, many Tanzanians cannot wash themselves, their cooking pots or clothes.
In an attempt to improve the lives of youngsters, children's councils have been set up in 228 electoral wards and there are plans to roll the scheme out further.
The forums, which have elected members, allow children to report concerns such as kids being subjected to excessive beatings by parents or teachers or not being sent to school or for vaccinations.
Shabani Mohamedi, 13, Habiba Humbili, 12, and James Macheo, 12, were fiercely proud of being voted on to Lindi childrenÕs council and insisted they faced many challenges.
Shabani, who wants to be an engineer, said: "There was one child who wasn't being sent to school by his parents who were sending her out into the streets to sell fruit.
"She is eight years old and feels sad she cannot go to school with the other girls.
"The adults do not treat us well sometimes.
"They often strike their children.
"Before we started the children's council, many parents would not send their children for vaccinations but we are helping to change this.
"If I was in charge of Lindi I would motivate parents to keep their children at school."
Habiba, who wants to be a nurse, said: "Sometimes when two children fight instead of dealing with the problem the parents start arguing and set a bad example.
"There is also a problem in school with boys getting priority treatment compared with the girls."It makes me sad because I need to be educated too."
James, who wants to be a doctor, said: "Sometimes parents are not willing to take their child to school and we go to them and try to convince them.
"But instead of listening to us they often tell us to go away.
"Some parents give their children corporal punishment but this has been reduced.
"Girls are sometimes treated worse because the boys can accuse them of doing something wrong and the parents believe boys more than girls.
"The best thing about living in Lindi is we can easily find education.
"But the parents are not always able to afford the school uniforms and that makes me sad."
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