Tanzania: Deliver Life

2016-2020

Bringing new life into the world should be a time of love and hope for mother and baby, wherever they happen to

live. But every minute a mother loses a newborn baby from infection caused by lack of clean water and an unclean

environment. In Tanzania alone over 3,000 children under the age of five die every year due to preventable

diseases caused by poor water and sanitation. This senseless loss of life needs to stop.

Through WaterAid’s Tanzania: Deliver Life Program, you have the opportunity to change the birth stories of

thousands of mothers and babies in the Geita and Nyang’hwale districts (Geita region) of Tanzania and to give

new-born babies a better start in life. By investing to this project, you will help us dramatically improve the water

and sanitation conditions at twelve rural health clinics that together serve a population of over 666,000 mothers,

babies, children and men.

With your support, women in these two deeply impoverished regions will be able to give birth in clinics equipped

with clean water and basic sanitation facilities. Mothers will be able to bring their young children to be treated

safe in the knowledge that medical staff will have washed their hands properly and sanitized medical instruments

and clinic surfaces.

The provision of basic water and sanitation infrastructure, and hygiene promotion at these twelve health clinics

will significantly reduce the spread of life-threatening infections.

What is more, the impact of your investment will be multiplied as this program is jointly funded by the Canadian

Government through Global Affairs Canada.

A bright future begins with a healthy start. We hope that you can be a part of this exciting program to transform

the lives of some of the poorest and most marginalized families in Tanzania.

We are so pleased to have Merit Travel Group as a primary supporter of this program. Please read through the

following proposal and let me know if you have any further questions.

Best wishes,

Nefertiti Saleh

Let’s make history

WaterAid/James Kiyimba

below according to the donor’s priorities and interests

The crisis We would never dream of bringing our own children to

be treated at a health clinic without clean running

water and safe disposal of human waste. Yet, millions

of mothers and fathers around the world have no other

choice.

In absence of clean water and basic sanitation

services, clinics cannot be kept clean — medical

equipment and bedding go unwashed and medical

waste isn’t safely disposed of.

When attending to deliveries, midwives are unable to

properly wash the rags they use to stem bleeding and

the sheets that babies are born onto. Without clean

water, midwives aren’t even able to wash their hands

between deliveries. These practices increase the risk of

bacterial infection (such as sepsis), and can be fatal for

mothers and their new-born children.

In a nutshell, when water and sanitation conditions are

not properly managed in a clinical setting, the risk of

cross-infection and disease outbreaks grow

exponentially.

As a result, health facilities, which are supposed to

promote good health and recovery, end up

compromising the health of both patients and staff.

The statistics paint a tragic picture. According to the

World Health Organization, 398 in 100,000 woman in

Tanzania will die during or shortly after their pregnancy

in contrast to 7 per 100,000 in Canada. The infant

mortality rate in Tanzania is 51 per 1,000 live births, in

comparison to an estimated 4.6 per 1,000 in Canada.

WaterAid has made significant progress in Tanzania in

the last 34 years, reaching over two million people with

access to basic water and sanitation services. But work

remains to be done, especially in the northern rural

Geita region.

The situation in this region is severe, with fewer than

half of health clinics having access to clean water.

Despite this, Geita, being a newly established region

has not received much investment from the

international development and aid community to

support the efforts of government to reduce maternal

and child deaths.

As such, through this program you have an

extraordinary opportunity to create an immediate and

lasting change in the lives of mothers and their babies.

Mothers with babies waiting for treatment at

Kashishi Health Centre in Geita District, Tanzania. WaterAid/James Kiyimba

One mother who knows the devastation of losing a newborn to infection caused by dirty water is Aisha

Mkude. Aisha is 38 years old and a mother of three children, all girls. She did have a boy, her youngest,

but he died in January 2014. Aisha delivered her youngest child at Mlali Health Centre in Tanzania’s

Morogoro region. The clinic, which serves eight surrounding villages, was part of WaterAid Canada’s

Clean Water for Health Pilot Project (2011-2014), which brought clean water, basic toilets and hygiene

training to the clinic and its staff. Sadly, Aisha gave birth six months before the rainwater harvesting tank

was finished.

A mother’s story: a tragic reality

“There wasn’t enough water at the health clinic

when I gave birth. After delivery, I washed myself

and my child with water that my brother’s wife

fetched for me from the river. At that time, it was

dry season, so they had to dig part of the river to

get some water. The delivery of my child went

smoothly.

The problems came afterwards.

After two days my child started to experience high

fever. I saw the doctor and she examined my child

only to find that he was discharging foul smelling

liquid from his umbilical stump. She prescribed

some medicines, which we started using. But after

two days, the condition got worse and that is how

we lost our baby.

He lived for only seven days . If there would have

been enough clean water at the clinic, this could

have been prevented.”

- Aisha Mukde, Tanzania

Aisha Mkude outside her house in Lugono

Village, Mvomero District, Tanzania WaterAid/Eliza Deacon

You can be part of the solution The Tanzania: Deliver Life program is part of the Canada-Africa Initiative to Address Maternal, Newborn

and Child Mortality in sub-Saharan Africa in which WaterAid is proud to be participating. With your

support, this four-year program (2016 to 2020) jointly funded by the Government of Canada, aims to

directly reach 211,299 women, 220,861 children under five years old and 234,043 men in the Geita

and Nyang’hwale districts of Tanzania.

WaterAid will work with community members, local partner organizations and government officials to:

Improve the quality of health services for mothers, newborns and children by constructing

water and sanitation infrastructure in twelve health clinics and providing training to ensure it

is used and managed in a sustainable manner.

Raise awareness amongst community members, especially mothers and pregnant women

about the availability of local health services and the importance of good hygiene practices.

Encourage local and national governments to be responsive to maternal, new-born and

child health needs, and to integrate water, sanitation and hygiene into planning at all levels

of service delivery.

Your support will help to:

Construct handwashing facilities and laundry basins for use by patients and clinic staff.

Install taps, wash basins and showers in maternity wards and hand washing stations inside operating wards.

Provide access to clean water supply by

drilling borehole wells and providing training

for ongoing operation and maintenance.

Investigate the feasibility of extending water

services beyond the healthcare facilities by

constructing community water points that

are fed by the same water source.

Deliver training to midwives, nurses and doctors on sanitation and hygiene best practices, including medical handwashing.

Train community-based health workers, including village health committee members and local government representatives, on hygiene promotion and behavior change.

Improve sanitation services through the

construction of ventilated improved pit

latrines.

Construct or rehabilitate incinerators for

safe disposal of medical waste to reduce

the spread of infectious diseases.

Together we make a lasting difference Making sure services and behavior change are sustainable and long lasting is a always a challenge. It requires more

than selecting appropriate technologies, holding training exercises, or encouraging community ownership.

Hygiene and sanitation behavior changes will only become permanent with continual promotion of good practices in

combination with an understanding of why people change their habits. Permanent services will only be established if

the systems and institutions required to manage, finance and support them are created, strengthened and

maintained.

We aim to address all of the issues that have an impact on the sustainability of our programs, be they social,

financial, environmental, institutional, legal, capacity-related or technical. We are committed to ensuring permanent

services and behavior change through a mixture of approaches, including:

Promoting the participation of community members

in every aspect of the program from planning to

implementation and beyond.

Helping community members to understand their

right to water, sanitation and hygiene, and to build

their capacity to hold governments to account for

provision of such basic services.

Using locally-appropriate technology based on

careful environmental assessments and

consideration of local supply chains.

Focusing on districts/ regions where the need is

greatest and where governments will be responsive

to capacity-building and advocacy efforts geared to

magnify the scope of our work through further

investment

Partnering with health and education institutions to

ensure that sanitation and hygiene behaviour change

messaging is continuously reinforced.

Aiding district governments in creating locally-owned

district-development plans that include details on

how sustained universal access to water, sanitation

and hygiene will be reached.

Supporting execution of these plans through a

combination of service delivery, technical assistance,

budget support, monitoring and accountability

activities, and advocacy efforts.

Monitoring the water supply, sanitation and hygiene

services we have funded for at least ten years after

implementation, and integrating learning to strength

our programs.

Nine-year-old Ellen on the left runs with her brother

Eddson and sister Ester at their family plot in Mlali

Village, Mvomeru Disctrict, Tanzania WaterAid/Eliza Deacon

“I felt great because there was plenty of water”

Mary is a 28 year old mother of four and lives in

Morogoro, Tanzania. She gave birth to a baby

boy at the Mlali Health Centre in August 2014,

after the completion of a WaterAid-funded

program. Before we started working at the

centre staff bought over-priced water of

questionable quality from local vendors or

asked expectant mothers to carry their own

water to the clinic. Working alongside our local

partners, we constructed a rainwater tank and

pipes to ensure a plentiful supply of clean water.

As a result of WaterAid’s efforts and those of the

local community, Mary, and many other mothers

like her, have had safe and hygienic births at the

Mlali Health Centre.

“When I went to the health centre for my

delivery, I noticed that there were three other

women who had given birth before me, and

even so, the environment was so clean and all

the cloths were too.”

- Mary Musa, Tanzania

Mary Musa and her husband

Donard with their two week

old son, Eli. WaterAid/Eliza Deacon

We are committed to reporting to our supporters on the status of this project on a biannual basis. A

mid-term report will be sent at approximately the mid-point of the project (autumn/winter) and an

annual report at the conclusion of each year of the project (spring/summer).

We like to stay in close contact with those who choose to invest in our programs. We welcome your

emails and phone calls at any time!

A mother’s story: the way it should be

Report on progress

Budget A gift to WaterAid’s Tanzania: Deliver Life Program will help reach over 211,000 mothers,

their families and surrounding communities with vital clean water and better hygiene.

As part of a Canada-Africa Initiative* to Address Maternal, Newborn and Child Mortality in sub-Saharan

Africa, this program is jointly funded by WaterAid Canada and the Canadian Government through Global

Affairs Canada. WaterAid is responsible for fundraising 15% of the total program budget.

To date, WaterAid’s generous supporters have contributed XXXX in gifts and pledges toward making this

program possible. We invite you to join this special group helping to create transformative change through

access to clean, safe water and sanitation at health clinics.

Charitable Registration 119288934 RR0001. Images: WaterAid/Eliza Deacon and James Kiyimba

* The Canada-Africa Initiative to Address Maternal, Newborn and Child Mortality is a partnership among four Canadian organizations – Amref

Health Africa, Christian Children’s Fund of Canada, Centre for Global Child Health at the Hospital for Sick Children (SickKids) and WaterAid Cana-

da. With support of $24.9 million from the Government of Canada (85% of the total project budget), this four-year project (2016 to 2020) aims to

directly reach 1.7 million women, children and men across 20 districts in Ethiopia, Kenya, Malawi and Tanzania.

Tanzania: Deliver Life (2016-2020)

Total Budget

Global Affairs Funding (85%)

WaterAid Fundraising

(15%)

Construction of infrastructure at 12 health facilities: materials and labour

$1,285,524 $1,092,695 $192,829

Capacity building: clinic staff hygiene and sanitation training

$486,528 $413,549 $72,979

Capacity building: local government $415,255 $352,967 $62,288

Capacity building: community-based health workers $187,758 $159,594 $28,164

Hygiene and sanitation supplies for community based health workers

$91,948 $78,156 $13,792

Monitoring and evaluation activities $378,547 $321,765 $56,782

Project administration $174,121 $148,003 $26,118

Project transport and vehicle costs $98,000 $83,300 $14,700

WaterAid Tanzania costs $521,465 $443,245 $78,220

WaterAid Canada Program Personnel $447,931 $380,741 $67,190

Total Direct Program Expenses $4,087,077 $3,474,016 $613,062

WaterAid Canada operating costs (max. 12% of direct expenses)

$359,586 $305,648 $53,938

TOTAL $4,446,664 $3,779,664 $667,000

Midwife Esther Mongi examines 19 year-old Rose

Vincent, 9-months pregnant with her first child at

the Mlali Health Centre in Tanzania. WaterAid/Eliza Deacon

Together we make a bigger difference

We are so grateful that you’ve taken the time to review this proposal and consider how you may be able to help

achieve our ambitious goal of bringing clean water and sanitation to twelve health clinics in the impoverished

Geita region of Tanzania — together serving a population of over 666,000 children, women and men.

Equipping health clinics with access to clean water and basic toilets is just the beginning of how your gift will help.

In our experience, access to these basic services can catalyze a powerful ripple-effect of positive change that is

both immediate and lasting.

In the short term, your investment will allow the dedicated medical staff, who are already working under tough

conditions, to deliver treatment in an environment that is conducive to good health. It will mean that heavily

pregnant women don’t need to carry water to the health clinic to aid in their delivery. It means that newborn

babies are given a chance to survive and thrive beyond their first few days of life. In the long term, this same

investment can bring hope, productivity and prosperity to individuals and entire communities.

This program will mark a significant milestone for water supply and public health in the Geita region, toward

achieving WaterAid’s vision of universal clean water and sanitation access by 2030. We would love for you to be

a part of it!

Should you wish to learn more about how you can support this program or other WaterAid priority programs,

please do not hesitate to contact me.

Nefertiti Saleh Email: nsaleh@wateraidcanada.com Address: 321 Chapel Street

Corporate Partnerships Phone: 613. 230-5182 Ottawa, ON K1N 7Z2

Your support is crucial to ensuring that babies are given the healthy start they deserve.

Thank you for your consideration.

Photo gallery

Mothers with their babies at Nyang’hwale Health Centre waiting for treatment. The

latrines at the centre are very old; there is no running water, incinerator or electricity. February 2017. WaterAid/James Kiyimba

The only latrine at Kakora Dispensary was constructed using an old rainwater harvesting

tank. “ We urgently need water and adequate sanitary facilities in our dispensary

because if there is water our services will improve and we shall be able to wash our

hands before and after treating patients. I will feel like a real doctor.” February 2017. WaterAid/James Kiyimba

“In a week we get between 12 to 15 women who come here to deliver babies but the

absence of clean water makes our job very difficult.” Dr. Musa Hachili is the Assistant

Medical Officer in charge of Nyang’hwale Health Centre. February 2017. WaterAid/James

Kiyimba

Nyamalimbe Dispensary is located in Geita District and serves a target population of

26,802. The dispensary has no water, medical waste incinerator, or electricity.

Furthermore, it has no placenta pit and only one latrine for both staff and patients.

February 2017. WaterAid/James Kiyimba

“I would like my baby to be a nurse when she grows

up because there are not enough nurses here in

Nyang’hwale Health Centre” Monica Tito, 20 years old,

mother of two children.

February, 2017

WaterAid/James Kiyimba