Tell us about the community that you engage? eg. economic conditions, political structures, norms and values, demographic trends, history, and experience with engagement efforts.
Iganga District, Uganda is home to approximately 700,000 people, more than 85% of which live in rural areas relying on subsistence agriculture. It is the second largest and fastest growing district in the country, spanning more than 4,000 square kilometers, in which there are only 2 paved roads and a myriad of dirt feeder roads that wash out during the rainy season. It is largely a patriarchal society, and is home to Christians, Muslims, and Animists. Polygamy is prevalent, which, combined with an average fertility rate of 6.9, leads to very large families. Local beliefs relevant to maternal and neonatal health include preferring delivery with a traditional birth attendant, the desire to use herbs during delivery, the thought that only sick women should attend prenatal care, and post-birth practices of immediately washing the newborn, feeding it honey, and putting creams on the umbilical cord. Iganga is served by one, and only, hospital--the Iganga District Hospital--that provides services to 1.2 million people, although it was built to serve only 200,000. Very few rural health centers have electricity, and quarterly shipments of medical supplies last only a few weeks.
More important, however, is the will of the people to improve their own circumstances. For the past 3.5 years, SAFE has been working with a network of more than 700 people from village government and grassroots development associations, women's groups, and men's groups to engage the population at large, who help us design, implement, and manage all projects.
Share the story of the founder and what inspired the founder to start this project
As I entered the Iganga District Hospital Maternity Ward on January 9th, 2009, 3 women experiencing complicated labor were scheduled for emergency C-sections. As a collegiate Emergency Medical Technician, I was leading my third medical volunteer trip to Uganda and was at the hospital to perform a capacity assessment. I hadn’t intended to be providing medical care, but one woman, only 19, had nobody to support her, so I put down my clipboard and did my best, reassuring her that the doctor would be there soon. But it was 4 hours later when he finally arrived, at which point all the nurses had left. I was thus asked to be in the O.R. to care for the babies after they were delivered.
Three times I watched blue and lifeless babies make their way into the world. I performed CPR on each infant, hoping and praying for signs of life. Never have I worked harder or wanted anything so badly. And some of the best noises I’ve ever heard were the first cries those 3 infants wailed.
This experience and others like it during that trip sent me on a quest to learn everything I could about why maternal and neonatal mortality remained high despite attempts to reduce it. I conducted focus group discussions in-country and dedicated my 100-page senior thesis to studying the phenomenon. I learned that many programs fail to adequately engage target populations in the development of projects designed to benefit them, leading to underutilization and unsustainability. Understanding these gaps led me to evolve my college-based initiative, the Vassar Uganda Project, into Safe Mothers, Safe Babies.