A New Chapter for Maternal Health in Esilalei

This month marked a monumental milestone for the community of Esilalei, nestled on the border of Manyara Ranch, with the official opening of a long-awaited maternity unit. What once stood as an empty shell of a building—abandoned after funding disappeared during the COVID-19 pandemic—has now been transformed into a fully functioning, welcoming, and dignified space for mothers to give birth safely.

Under construction. November 2024.

The original structure, left without electricity or plumbing, sat unfinished for years. But thanks to the dedication of a committed team and generous supporters, we were able to complete the building and breathe life back into its walls. This included vital infrastructure work such as installing electrics, plumbing, painting the facility, and adding both stairs and a ramp for full accessibility.

Inside, the unit has been thoughtfully equipped to support mothers through every step of their journey. A calm and spacious waiting room with benches welcomes women and their families. Nearby, there is a well-prepared area where vital signs such as weight and blood pressure can be checked before labour begins.

Adding a warm and meaningful touch to the waiting room is a beautiful mural of a giant baobab tree, hand-painted on the wall. This tree will grow with the community—each time a baby is born in the unit, their handprints will be added to the branches. It’s a living symbol of life, growth, and connection. At the opening, we proudly added our own handprints to get it started.

Namnyak, Monica, Caroline and Hannah add their handprints to the tree.

The heart of the unit features a labour room with a birthing bed, an oxygen concentrator, a resuscitaire, and a steriliser—critical tools that ensure both mothers and newborns receive timely, life-saving care. After delivery, mothers can recover in a comfortable ward with two beds, allowing for rest and privacy. Hygiene and sanitation are a top priority, and the facility includes two bathrooms complete with toilets and showers. Waste disposal buckets have also been provided to ensure cleanliness and safety.

And the most joyful news of all—within just 48 hours of opening, the first baby was born at the new clinic. A strong and healthy 4.2kg boy named Jerry made his arrival, and both he and his mama are doing wonderfully. His handprint will be the very first leaf on our baobab of new beginnings.

The opening ceremony was a heartfelt and inspiring event. The Esilalei village chairman welcomed guests, and the district director joined with government representatives from neighbouring villages to celebrate. The strong turnout from the local community reflected just how meaningful this development is to everyone it will serve.

We were honoured to have several key partners in attendance. Board members from Mwandamo, including Mahela, a practicing midwife, and Monica from the Ewang’an Foundation, brought their expertise and enthusiasm. Marias from the Royal African Foundation also joined us, showing cross-organizational support for this important project.

Mahela, Hannah, Caroline and Monica. 22nd May 2025.

This maternity unit is more than a building—it’s a promise to the women of Esilalei that they deserve safe, supported, and dignified births. It’s a symbol of resilience, of what can be accomplished when communities and partners come together with a shared vision. We believe that every mother should have access to high-quality care, no matter where she lives, and this facility is a powerful step in that direction.

As we look ahead, we remain committed to supporting this maternity unit with ongoing training, maintenance, and resources. But for now, we pause to celebrate this hard-earned achievement. To everyone who played a role—thank you. Your efforts have given life not only to a building, but to the many futures it will help bring into the world.

Empowering Conversations with Young Women at Orkeeswa Secondary School

A few weeks ago, Caroline and Hannah had the privilege of sitting in a circle with ten remarkable girls aged 14 to 20 at Orkeeswa Secondary School in Monduli, Tanzania. The focus of the gathering was to discuss menstrual health—an essential but often overlooked topic—and to introduce the upcoming launch of Mwandamo USSD, a mobile platform designed to improve access to menstrual cycle information.

The conversation was rich, open, and deeply inspiring. What struck us most was the depth of knowledge these young women already had. It was clear that Orkeeswa’s Wellness Programme, led by the passionate and dedicated Memusi Saibulu (who also joined the session), is doing incredible work to educate and support students on issues of health and well-being.

These girls spoke candidly about their personal experiences, asked thoughtful questions, and supported each other with compassion and confidence. It was more than a learning session—it was a celebration of shared knowledge, sisterhood, and empowerment.

At a time when so many young women around the world still face stigma and silence around menstruation, it was heartening to witness a space where girls could speak freely and feel seen, heard, and respected.

As we prepare to launch Mwandamo USSD, we are more energized than ever. Seeing how empowered these young women are when equipped with the right information reaffirms our mission. Access to accurate, culturally relevant menstrual health resources is not just a need—it’s a right.

We’re grateful to the Orkeeswa community for their warm welcome and inspired by the leadership of Memusi and her students. The future is bright when young women are informed, confident, and empowered.

Opening Up the Conversation on Women’s Health—One USSD Menu at a Time

Afya ya Mwanamke, Nguzo ya Jamii. (A women’s health is the foundation of the community.)

At Mwandamo, we believe every woman deserves the right to knowledge, dignity, and accessible care. Based in Northern Tanzania, our mission is to transform women’s health through education and care, improving health outcomes for girls and women across the region.

We’re excited to share the first step in this mission: a USSD-based platform designed to break the silence around menstrual health, empower girls to stay in school, and open up conversations about reproductive health.

Why USSD? Because it works. While smartphone use is growing, over 70% of Tanzanian women still rely on basic mobile phones. That’s why we chose to develop a USSD (Unstructured Supplementary Service Data) system—a simple, menu-based technology that works on any phone, with no need for data or apps. Best of all, using the USSD service will be completely free for users—ensuring that cost is never a barrier to access. By dialing a short code, users will be able to access trusted, culturally-sensitive information about their menstrual cycle, ask questions anonymously, and find supportive resources.

This isn’t just about information—it’s about empowerment. In many communities, girls miss school during their periods due to stigma or lack of knowledge. Many women don’t have access to accurate, shame-free reproductive health education. Our USSD tool helps change that by putting power into the hands of users, one message at a time.

We’re proud to be building this platform in partnership with Primetel Health (https://health.primetel.tech), a health-tech consultancy that specializes in accessible digital tools for underserved populations. Together, we’re designing a solution that’s simple, secure, and built for real-world use in the communities we serve.

And this is just the beginning.

Over time, the USSD platform will evolve—not only as a source of reliable information, but as a channel that can connect women directly to the healthcare services they need. From identifying symptoms to locating nearby providers, the system will grow to support users throughout their health journey.

The next step in our USSD journey is to introduce a pregnancy tracking menu within the USSD platform, allowing expectant mothers to receive timely, stage-specific updates and reminders throughout their pregnancy. We also plan to roll out the platform across rural communities by employing two dedicated Community Health Workers. These CHWs will host women’s circles—safe, supportive gatherings where they can introduce the USSD tool, answer questions, and foster open conversations around menstrual and reproductive health.

As we prepare to pilot this platform in the coming months, we’re working closely with local schools, clinics, and community leaders to ensure it reflects the lived experiences of Tanzanian women and girls.

Because when we open up the conversation, we open up possibilities—and with the right tools, every woman can thrive.

Caroline, Emmanuel (Primetel Founder) and Hannah. Primetel Clinic, Monduli, 10th April 2025.

Sesilia

Mwandamo Women CIC’s work with the Maasai community in Oltukai Village began with a simple yet profound idea: creating a women’s circle. This circle provided a safe space to discuss topics often shrouded in silence, such as pelvic floor anatomy and menstrual cycle knowledge. These gatherings aimed to empower women with understanding and agency over their own bodies—a vital yet frequently overlooked aspect of health in the community.

After one such circle, Sesilia, a 37-year-old woman, approached Caroline and Hannah. Her pain was evident not only in her words but in the way she carried herself. As she described her severe period pains and years of heartbreak due to recurring miscarriages, her anguish was palpable. Among the Maasai, the inability to carry a child is often surrounded by shame, and Sisilia bore this emotional burden heavily.

Caroline, as a midwife, suspected that Sesilia might be suffering from endometriosis, a condition that’s poorly understood and rarely diagnosed in rural areas like Oltukai. Determined to help, we embarked on a fundraising campaign to bring Sesilia and a few other women with similar symptoms to the Avinta Clinic in Arusha. The journey was not easy, but the support from Mwandamo Women CIC and RAF’s network made it possible.

Sesilia is first on the left. This image was taken on the first visit to Avinta.

At the clinic, after several rounds of testing, Sesilia finally received a diagnosis: endometriosis and bilateral tubal bloackage. The doctors explained that this combined condition had likely caused her repeated miscarriages. They also delivered a painful truth—it was highly unlikely she would ever be able to carry a child to term. However, they mentioned that in-vitro fertilization (IVF) might be an option, though it was expensive and not widely available in Tanzania.

Faced with this reality, Sesilia made a courageous decision. Instead of dwelling on what she could not have, she chose to focus on her health. With medication, her pain significantly reduced, and the knowledge of what was happening in her body brought her much-needed relief from years of stress and uncertainty.

Months later, a miraculous turn of events unfolded. Sesilia’s close friend discovered she was pregnant with her third child. Deeply moved by Sesilia’s journey, she made an extraordinary decision: she declared that this baby would be for Sesilia. In the newly refurbished maternity room in Oltukai—a project completed through the joint efforts of Mwandamo and the Royal African Foundation—Sesilia’s friend gave birth to a healthy baby girl.

When the baby was placed in Sesilia’s arms, she felt an overwhelming sense of healing and love. Years of loss and heartache seemed to melt away as she cradled the newborn. She named the baby girl Paulina, a name she had chosen long ago for the daughter she had wished so hard for.

Sesilia’s journey to motherhood was unconventional and marked by immense challenges, but it ultimately led to a beautiful, happy ending. Her story is a testament to the power of community, resilience, and love, showing that even in the face of despair, hope can be found in the most unexpected ways.

Sesilia and Paulina sitting outside their home.