Information and stories on Tanzania

The Chimala Mission
Within the Mbeya Region of Tanzania lies the Chimala Mission. Founded in the early 1950s, the mission seeks to improve life for the people around the region. Despite numerous challenges, the mission remains a vibrant act of hope for the communities around it. The Borgen Project spoke with members of the Chimala Mission: Howell Ferguson, Zavier Hofstetter, Mattie Adams and Hailey Watson.

Starting a Mission

Tanzania achieved independence from Great Britain in 1961. Consequently, the country experienced several jarring transitions as it moved from colony to self-governing state. In 1964, the country, then called Tanganyika, merged with the Republic of Zanzibar. Today, it is the state of Tanzania

Amidst this transition, the country granted access to missionaries affiliated with the churches of Christ. The same year that Tanganyika merged with Zanzibar, missionaries began construction of a 50-bed hospital in the Chimala region.

Growing a Mission

During its first years of independence, Tanzania faced extreme poverty. It was “one of the poorest and most aid-dependent countries in the world.” While Tanzania’s poverty rate declined in recent years, it still hovers above 20%. Furthermore, the COVID-19 pandemic exacerbated poverty. Between 1965 and 2021, the Chimala Mission experienced spectacular successes, resulting in it meaningfully improving the lives of countless Tanzanians.

For the community, the hospital—long the focal point of the mission’s benevolent works—is a godsend. Since its completion, a rotation of American doctors works with Tanzanian physicians to keep the hospital staffed and growing. According to the Mission’s website, it now contains a “maternity ward, post-natal clinic, eye and dental clinic, isolation ward, family shelter, [and] morgue.” The hospital assists close to 60,000 people each year.

In the past two decades, the Mission expanded. For example, it started both a primary and a secondary school in 1999 and 2010, respectively. In 2019, the schools enrolled 700 children combined.

Also in 2019, the mission started its Manna Project. The Chimala Mission leases this 450-acre farm from the government of Tanzania. The Manna Project aims to make the mission more self-supporting, employing people from the community and improving farming methods at the same time. Despite some early setbacks, the mission’s Stateside Coordinator, Howell Ferguson told The Borgen Project, “We are continuing the farm program as best as we can using what we have.”

Discovering a Mission

In May 2021, a group of students from Freed-Hardeman University traveled to Chimala for 11 days. The students assisted the Mission, receiving education from its U.S. missionaries and learning about Tanzania’s culture. Some of their experiences with Tanzania’s culture were unexpected.

For example, FHU student Zavier Hofstetter told The Borgen Project that “We [Americans] like to have everything down to the minute: an hour for this task, another hour for a different one. In Tanzania, each task takes exactly however long it takes.”

Despite this, the group was able to help out in several ways during their stay. They spent their first few days acclimating to the mission’s campus and then dived straight into helping where they could. In addition to daily devotionals, the group helped at the elementary school, where they taught English pronunciation to fifth, sixth, seventh, and eighth-grade classes.

As an education major, Hofstetter found his time at the mission beneficial explaining that “it was amazing to see how a school system in Africa worked. The students were all extremely disciplined and eager to learn.”

In the Hospital

Several of the students also found ways to serve in Chimala’s hospital. In an interview with The Borgen Project, Mattie Adams, a nursing major said, “I learned so much from working in the Chimala Mission Hospital! It was such a blessing to see what great things the nurses and doctors were doing with more rudimentary tools than what we have in the states.” He continued, stating that he “got to experience what it was like to be a nurse in a different country than my own by doing hands-on work such as taking vitals, assessing patients, and watching live births.”

Public relations student Hailey Watson related a dramatic anecdote of her time helping at the hospital. A patient with multiple stab wounds needed treatment and was losing blood fast. Since the hospital did not have enough of the patient’s blood type, she, Hofstetter and fellow student Kayley Wadlington were all able to donate, and the patient stabilized and survived.

Looking Forward

There is no doubt that the Chimala Mission improves life for the communities around it. Though the mission is still growing, in the words of one Tanzanian proverb, “those who go slow never stumble.”

– Jonathan Helton
Photo: Flickr

Tourism in TanzaniaTourism involves traveling to locations other than one’s usual environment to participate in activities of interest. Tanzania contains many tourist destinations, including Mount Kilimanjaro, Serengeti National Park and Zanzibar beaches. As such, tourism in Tanzania remains essential to the economy of the nation and has a significant impact in more ways than one.

Tanzania’s Poverty Statistics

With a population of approximately 55.6 million people, Tanzania has one of the world’s most impoverished economies despite its previously high rates of growth and remarkable tourism industry. Tanzania’s GDP growth rate decreased from 5.8% in 2019 to 2% in 2020, meaning that Tanzania’s growth per capita became unprecedentedly negative. Furthermore, the Tanzanian poverty rate was 25.7% in 2020, which means that almost 15 million Tanzanians could not afford some or all of their basic necessities.

The Impacts of COVID-19 in Tanzania

Due to the COVID-19 pandemic, more than 140,000 people in Tanzania lost their formal jobs in June 2020. Additionally, more than two million people with informal, non-farming jobs experienced a decrease in income. Because of these pandemic job losses, more than half a million people could be pushed below Tanzania’s poverty line.

Furthermore, Tanzania’s rapid population explosion during the pandemic has resulted in an increase in the number of citizens living under the poverty line. Tanzania’s poverty rate increased to nearly 2% in the past year, meaning hundreds of thousands of people have been pushed below the poverty line since the pandemic began. According to the World Bank, “[b]ecause a large share of Tanzania’s population is close to the poverty line, even a mild economic shock can push numerous households into poverty.”

Moreover, the pandemic has halted many businesses, especially in the tourism and manufacturing sectors. However, with the new development of the COVID-19 vaccine, many people are starting to travel again, which may indicate that an economic turn-around could be in Tanzania’s near future.

Tourism in Tanzania

According to University of Dar Es Salaam students Nathanael Luvanga and Joseph Shitundu, Tanzania’s tourism industry contributes to the alleviation of poverty. In their study, they examined three popular tourist attractions in Tanzania and how the qualities of those three locations helped alleviate poverty.

The students found that tourism in Tanzania creates employment for those who live in poverty, including jobs operating hotels, providing tours, working at stores and handcrafting goods to sell to tourists. Job creation in the tourism industry is decreasing poverty rates because the skills needed to obtain employment are not specialized. This means that with proper training, anyone can excel as a tourism industry employee.

The Benefits of Tourism

As a result of positive tourism in Tanzania, the country has observed an increase in the number of people acquiring income from tourism-related jobs. With tourism and travel rates beginning to increase again, many are hopeful that more job opportunities in the tourism industry will arise.

Moreover, tourism strongly correlates with national and even international capital, which opens many opportunities to benefit impoverished citizens and further reduce poverty rates. Tourism was Tanzania’s “largest foreign exchange earner,” the second-largest GDP contributor and the third-largest employment creator, per a World Bank report. With access to numerous foreign markets, Tanzania is able to create employment opportunities for the impoverished, preserve cultural traditions through tourism, expand efforts to further develop the country and decrease poverty rates.

Tourism Alleviates Poverty

More than two million people have visited Tanzania each year to view its exquisite scenery and learn about Tanzanian culture, but tourists are unaware of just how important their visits are to alleviating poverty. Tourism creates jobs for those living in poverty, allowing many impoverished Tanzanian people to provide for their families, and therefore, lift themselves above the poverty line. Additionally, tourism allows Tanzania to use foreign capital to boost its economy, contributing to a rise in its GDP. National and international funding gained from tourism allow an expansion in efforts to eliminate poverty in Tanzania and generates more unique opportunities to benefit the impoverished.

Lauren Spiers
Photo: Flickr

improving women's rightsTanzania has struggled to effectively develop in the realm of women’s rights. Women and girls struggle with sexual harassment in schools, discrimination, violence and an everyday battle to have the same opportunities as men do. In Tanzania, 60% of women live in extreme poverty. This disparity arises partially because of “shrinking productivity in the agriculture sector,” where many women work. When women are not allowed access to work opportunities, higher poverty rates arise. This takes Tanzania further from its goal of ending domestic poverty and improving women’s rights.

The State of Affairs for Tanzanian Women

Almost two-thirds of Tanzanian farmers are women, but women lack the same opportunities to thrive as men. Women have less access to credit, fewer chances for skills development and less time to devote to their work. Women’s farms are often smaller than men’s, which directly correlates to agriculture output. Moreover, “gender norms” and a lack of legislative development limit women.

Another unavoidable issue Tanzania faces in the battle for gender equality is violence. Per the Tanzanian National Bureau of Statistics, 40% of women have faced physical violence, and a fifth of women report experience with sexual violence. Furthermore, “35% of women have faced physical or sexual intimate partner violence” and 40% of 15 to 49-year-old women have experienced physical violence since 15.

What is USAID?

USAID is the United States Agency for International Development, and it focuses on foreign aid and development assistance.  USAID focuses on building communities through economic growth, agricultural advancements, women empowerment, gender equality and much more.

It further believes that a country’s ability to reach its full potential significantly comes from equitable access to education, free speech and opportunity. Women, men, girls and boys all need to have equal resources and control over the community and land to prosper as a whole. Almost 200 “gender advisors and points of contact” work toward the common goal of providing every human equal chances through gender equality. USAID continues the work of improving women’s rights and has a great impact on gender equality development in many countries, including Tanzania.

USAID’s Impact

USAID has had a great impact on improving women’s rights in Tanzania. In 2017, it launched the “Let Them Learn” campaign, which allows for girls out of school to pursue their passions. The campaign also empowers girls to speak up about gender equality and the restraints that stop girls from excelling in school. USAID has been working to empower the female community in Tanzania in order to help women and girls obtain rights and deserved opportunities.

For example, USAID has been working with Women in Law and Development in Africa to connect survivors with services. This effort has helped more than 18,000 victims of sexual and physical violence. In order to improve the work conditions for women in Tanzania, USAID has also helped launch numerous programs that allow women to explore what fields their futures are in.

Whether in agriculture, the building of entrepreneurship skills or learning more about business development services, USAID has made it a mission for women’s voices to be heard and for women to have the chance at a prosperous future.

Haleigh Kierman
Photo: Unsplash

covid-19 and poverty in tanzaniaThe East African country of Tanzania is one of the largest nations on the continent. Despite a population of more than 58 million, Tanzania has reported fewer than 600 COVID-19 cases and just 21 deaths as of July 22, 2021. However, widespread denial of the gravity of the virus is making COVID-19 in Tanzania more dangerous. While Tanzania has experienced minimal physical health impacts of COVID-19 in contrast to other countries, the impact of COVID-19 on poverty in Tanzania has been harsh as the virus has slowed overall economic growth.

Tanzania’s COVID-19 Response

On March 16, 2020, Tanzania reported its first case of COVID-19. Months later, in April, the country’s bustling region of Tanga also reported its first case. To help prevent the further spread of the virus, the government in Tanga began working with the CDC to train health professionals “on case investigation, contact tracing, home and community isolation, quarantine, infection prevention control (IPC) and case management,” providing a strategy to respond to new cases.

Furthermore, the CDC aided Tanzania in hiring and training drug dispensaries to monitor the number of people looking for COVID-19 treatment. This allowed pharmacists to watch out for probable cases in their communities in order to ramp up precautions and prevent the spread of the disease. In total, the CDC helped train 116 healthcare personnel in COVID-19 response strategies, “creating a holistic, community response to detect and respond to the COVID-19 crisis.”

Unreported Cases and COVID-19 Denial

On the surface, Tanzania has done an exceptional job preventing the spread of COVID-19. However, a few less discussed issues have prevented the country from fully recovering. For instance, in June 2020, the country’s then-president, John Magufuli, stopped reporting COVID-19 data, claiming that the country was virus-free even though Tanzania had already reported 509 cases and 21 deaths. Magufuli asserted that a “three-day prayer had saved the country.” Similarly, the secretary of the Ministry of Health, Mabula Mchembe, disregarded accusations that the country’s denial of the virus was only causing more deaths. Overall, the Tanzanian government has “downplayed the seriousness of the pandemic.”

A New President Brings Hope

When the former president passed away on March 17, 2021, President Samia Suluhu Hassan replaced him as the first female president of the country. The mark of Hassan’s presidency also marked the release of Tanzania’s official COVID-19 statistics after “more than a year.” Hassan confirmed 100 new COVID-19 cases since the third wave of COVID-19 began in Tanzania. Bringing hope to Tanzania, President Hassan also allotted $470 million for the purchase of COVID-19 vaccines, helping the country’s citizens protect themselves from the virus.

The Impact of COVID-19 on Poverty in Tanzania

Tanzania has made significant progress in tackling COVID-19, but the pandemic has still worsened poverty in the country. Due to the extensive measures put in place to track the virus, including quarantine and lockdowns, roughly 140,000 formal jobs were lost in June 2020 alone. In addition, 2.2 million “nonfarm informal workers” experienced loss of income. Similarly, the poverty rate increased from 26.1% in 2019 to 27.2% by the end of 2020.

In 2021, however, Tanzania’s economic outlook is much different. In fact, Tanzania’s GDP is projected to rise by up to 5.3% this year due to President Hassan’s COVID-19 programs and vaccine distribution plan. President Hassan has promised to improve infrastructure and resource management, reflecting a vision of future economic growth in the country. As Tanzania moves in a more transparent and positive direction, hope is on the horizon for overall poverty reduction and economic growth.

Calvin Franke
Photo: Flickr

Neonatal disorders in TanzaniaIn Tanzania, neonatal disorders are the leading cause of death. Each year, 51,000 babies die within the first month. Nearly 66% of neonatal disorders in Tanzania are avoidable with proper access to essential care for both the child and mother. Recognizing this, Tanzania has plans in place to reduce both maternal and child mortality rates in the country.

Causes of Neonatal Deaths

The hospitals and pharmacies in Tanzania lack access to the proper equipment for cleaning, sterilization and treatment. Roughly 37% of pharmacies and 22% of health facilities do not have access to injectable antibiotics. Furthermore, about 60-80% of pharmacies and health facilities do not have resources for sterilization. In addition, 50% of health facilities do not have access to soap, water or hand sanitizer and 20% do not have disinfectant products.

This lack of resources has a significant impact on neonatal disorders in Tanzania. Infections are common among newborns and difficulties are frequent among mothers without proper attention and treatment in a sanitary medical facility. In Tanzania, asphyxia accounts for 22.3% of early neonatal deaths, respiratory distress accounts for 20.8%, preterm birth accounts for 12% and sepsis accounts for 11.6% of neonatal deaths. Furthermore, malaria, meningitis and pneumonia contribute to 7.4% of neonatal deaths. The added risk of maternal complications cause 8.6% of deaths among newborns.

How Poverty Impacts Care

Throughout the country of Tanzania, there are vast disparities in healthcare in different regions. This variance is because of varying economic development throughout the country. Areas that are more developed and advanced, with less poverty, can provide better assistance to patients because the areas have more resources to rely on. At the same time, mothers and children with improved chances of survival are able to economically contribute to decreasing poverty.

Tanzania aims to lower its neonatal mortality rate. Doing this will put the country at a lower risk of overpopulation and will reduce the 27.2% poverty rate, which affects hospitals’ abilities to care for and protect their patients. The health facilities cannot provide the necessary treatment, medical resources and medical staff without the necessary funds. Tanzania recognizes that an increase of neonatal deaths means the country will continue to struggle with poverty. The only way to address this is to focus on improving conditions for mothers and children.

One Plan II

Announced in 2016, the Tanzanian One Plan II places access to reproductive health services and reducing infant and maternal deaths as the priorities for the country. The ultimate objective of this plan is to improve the welfare and success of the country by improving neonatal healthcare. The original One Plan began in 2008 and established many of these same goals to be met by 2015.

The One Plan established the goal to lower the neonatal mortality rate to 19 out of 1,000 births by 2015, but this was not achieved. In 2015, neonatal mortality stood at 22%. However, there was progress in other areas as the number of women giving birth in the presence of a qualified professional increased from 43% in 2004 to 51% in 2010. At the same time, the number of women giving birth in proper health facilities also increased. In 2014, the maternal mortality rate was 574 deaths per 100,000 births.

A Hopeful Future

Since the start of the One Plan II and other similar plans, neonatal disorders in Tanzania have declined. The latest neonatal mortality rate is now 20 deaths per 1,000 live births. Additionally, the maternal death rate has continued to decline to 524 deaths per 100,000 live births in 2017. As the country makes this progress, it also hopes to see progress economically. Vaccinations, sanitization efforts and health facility progress allows Tanzania to not only improve survival rates but also fight the widespread poverty in the country.

– Delaney Gilmore
Photo: Flickr

human trafficking in TanzaniaEvery year, millions of men, women and children are trafficked worldwide. Forced labor, sexual exploitation and debt bondage are the most common reasons for this crime. Human trafficking happens in every country, even developed ones like the United States. Trafficking is modern-day slavery and affects women and girls disproportionately. About 71% of trafficking victims worldwide are women and girls. Profits reach around $150 billion per year for traffickers globally, with $99 billion of that earned through commercial sexual exploitation. Experts believe 20-40 million people are in modern slavery, but the number is hard to estimate because many cases go undetected. Human trafficking in Tanzania is a current problem in the country, but there is hope for improvement.

Victims of Human Trafficking in Tanzania

The country reported that it was able to identify 165 potential victims of human trafficking in Tanzania in the most recent reporting period, compared to 161 in the previous reporting period and 13 in the period before that. About 90% of the victims in those periods have been female, a population particularly vulnerable to trafficking.

Efforts Against Human Trafficking In Tanzania

Tanzania is currently classified as a Tier 2 Watch List country in terms of human trafficking. This means it is failing to meet minimum standards for preventing human trafficking but is nonetheless making a diligent effort. For example, it has increased funding for its national anti-trafficking committee and its victim assistance fund.

However, Tanzania’s recent efforts have been disappointing compared to those of previous years. Charges and punishments have remained light for traffickers compared to perpetrators of other major crimes. Many traffickers are not convicted, and if they are, their punishments are fines and short prison sentences. The country has not implemented victim identification or protection programs, leaving victims vulnerable to further exploitation. Tanzania has also made no recent efforts toward investigating fraudulent labor groups or commercial sex acts.

These lapses would typically result in regression to a Tier 3 country. However, Tanzania is working to conform to the U.S. Trafficking Victims Protection Act. The guidelines of this act, when implemented, will allow the country to meet minimum trafficking prevention standards. As it stands, Tanzania remains on the Tier 2 Watch List for the third year in a row.

Hope for the Future

The Trafficking Victims Protection Act involves many measures to protect victims with the support of trained workers. Trained workers will be able to identify the country’s more vulnerable populations, including orphans and impoverished children. In line with a Tanzanian anti-trafficking law from 2008, identified victims of human trafficking in Tanzania also receive professional counseling and a place to stay for the period immediately after their escape from a trafficking situation.

The Trafficking Victims Protection Act also involves more investigation of traffickers and corrupt systems. It will increase the likelihood of proper punishment for traffickers and will replace small fines with larger penalties befitting the seriousness of the crime. Tanzania saw great improvements in its trafficking situation before the COVID-19 pandemic hit, giving hope for the upcoming reporting periods.

– Haleigh Kierman
Photo: Flickr

Children In Tanzania In 2016, estimates determined that three out of every four children in Tanzania experience poverty or are underprivileged. This means that most children in Tanzania do not experience high-quality living conditions. For example, children in Tanzania frequently lack access to healthcare, education and basic necessities such as food, water and shelter. They may also experience domestic violence.

Of adolescents, the age group hit the hardest are those aged 5-13. In this age group, 73% of children experience deprivation in three or more dimensions. Dimensions are categories that classify different types of poverty. These dimensions are sanitation, protection, housing and education. Poor access to sanitation affects this age group the most (77%) followed by limited protection, housing and education, all lying in the high 60% range.

The Future Stars Academy (FSA)

Future Stars Academy (FSA) is a nonprofit organization that began in 2009 and works out of Arusha, Tanzania. In 2019, the organization had 200 members and saw its members’ school attendance increase by 15%. FSA prioritizes education with the understanding that education is a way out of poverty.

FSA makes an impact by combining a passion for sports with a strict education policy. Education is one of the most important factors in ending global poverty. Education leads to outcomes that positively impact poverty. Some of these outcomes include economic growth, lower income inequality, reduced infant and maternal deaths, decreased vulnerability to HIV/AIDS and reduced violence at home and in society.

Many people all over the world support and participate in soccer, sometimes referred to as football. For FSA, soccer is a way for underprivileged children to develop mentally and physically, giving them the opportunity to live sustainable and healthy lives. The organization believes that soccer can inspire underprivileged children and help them develop into productive citizens with the opportunity to escape poverty. The organization focuses on three core activities: training, education and competition. It works with children aged 6-20, targeting the age group hit hardest by child poverty.

FSA gives youth the opportunity to refine their soccer skills and compete competitively at a certain level. This gives children something to strive for and encourages healthy lifestyles in order for participants to succeed in the sport. Coaches at FSA use the children’s passion for soccer to hone in on other important life skills and values such as teamwork, dedication, discipline and confidence.

FSA’s Success

For FSA, the combination of fun and education has, so far, been successful. The policy of “No school – No play” keeps children in Tanzania on track to progressing toward a better life. The FSA has provided dozens of senior players with the opportunity to play for top tier soccer teams or earn coaching positions where they then have the ability to help children in similar situations.

Education is an extremely important tool for reducing rates of poverty in Tanzania. Many organizations, such as UNICEF, believe that instilling education at a young age is the most effective way for it to be a tool in helping underprivileged children escape poverty. FSA is one of many organizations working to promote the importance of education for children in Tanzania.

– Haleigh Kierman
Photo: Flickr

Female genital mutilation in TanzaniaThe WHO estimates that more than 200 million women and girls across the world have experienced female genital mutilation (FGM). The culturally entrenched practice holds no benefits for girls and women. In fact, FGM puts girls and women at risk of severe health complications. Despite constituting an international human rights violation, in countries such as Tanzania, cases of FGM persist. The government of Tanzania, individuals and organizations aim to address incidents of female genital mutilation in Tanzania.

Female Genital Mutilation in Tanzania

In the year 1998, female genital mutilation became illegal in Tanzania through the Sexual Offences Special Provisions Act. However, the legislation only criminalized the act for women younger than 18. Law enforcement officials intervened in rituals where young girls received their rite of passage through mutilation. The country hopes to end all harmful actions against women and children by 2030. This includes FGM practices.

A few issues surrounding the prosecution of FGM cases include victims refusing to testify against the perpetrators, especially if they are family members. Additionally, bribery by perpetrators is common to avoid prosecution. Inadequate evidence and “witnesses failing to appear in court” also contribute to low prosecution rates.

At times, “community leaders pretend to abandon the practice then organize alternative rite of passage festivals for girls only to continue with female genital mutilation in disguise.” Despite these barriers, Tanzania has seen a decrease in mutilations from 18% in 1996 to around 10% in 2021.

Recommendations From WHO

According to the World Health Organization, nine out of 10 Tanzanian women are against FGM practices. Because the practice is culturally entrenched, it is more difficult to completely abolish. The WHO recommends raising awareness about FGM in order to communicate the dangers the practice holds for girls and women. Furthermore, health professionals should be trained to “manage and prevent” cases on FGM. Furthermore, law enforcement needs to be better supported in order to ensure cases are investigated and prosecuted.

Solutions to FGM in Tanzania

Tanzania has developed a national strategy to address FGM in the country. The strategy launched on March 15, 2021, and will run for four years. The strategy involves “running campaigns on the health consequences of FGM for girls and women, recruitment of change agents from within the communities and the enforcement of legal mechanisms.” Though FGM rates in Tanzania have reduced to 10%, the fight to abolish the practice continues.

Men in the community have also joined the fight to end FGM. Chief Girihuida Gegasa Shulumbu is a traditional leader in the Mara village of Tanzania. As a father of three daughters, Shulumbu works with other male leaders to end the practice and find “alternative rites of passage.” Shulumbu recognizes that FGM impacts the most impoverished people and impacts education by keeping girls out of school due to recovery time and health complications that may ensue.

A lack of education keeps women in poverty, economically impacting Tanzania as a whole. Due to individual efforts and efforts from organizations, in the past three years, 96 ritual leaders have stopped FGM practices in Mara. Furthermore, more than 1,500 girls between 9 and 19 were protected from FGM practices through campaigns and programs.

Efforts to decrease female genital mutilation in Tanzania have proven successful. Although the fight continues, there is much promise that the practice may be eliminated by 2030.

– Selena Soto
Photo: Flickr

International Telehealth CollaborationsDuring and prior to the COVID-19 pandemic, physicians used telehealth technologies to share knowledge, experience and provide technical assistance. International telehealth collaborations have proved particularly beneficial to low-income countries where healthcare workers often lack the resources of their peers in higher-income nations. One recent example of a telehealth collaboration took place when British physicians offered up virtual services to assist India’s overworked healthcare staff. Elsewhere, international telehealth collaborations have increased the quality of care in low-income countries.

Collaboration During COVID-19

Presently, international telehealth collaboration is underway between British and Indian physicians. On May 6, 2021, India reported the highest daily average of COVID-19 cases in the world. As the country’s doctors work tirelessly to care for patients, the British Association of Physicians of Indian Origin (BAPIO) has sought to lend a helping hand. Yet, instead of traveling to the afflicted country, the BAPIO has reached out to Indian peers via the internet.

More than 250 physicians partnered with BAPIO are providing assistance to junior doctors in India by way of video calls. BAPIO’s physicians tackled a surge of cases earlier on in the pandemic and are using the experience to advise Indian doctors during this time of increased strain. Virtual conferencing tools provide a quick way to share information in the chaotic environment of India’s ongoing health crisis. Indian physicians have also been taking advantage of BAPIO’s resources by sending digital medical documents for medical professionals in Britain to review. In this case, telehealth is used to facilitate on-the-spot medical assistance during immediate health crises, but examples of international telehealth collaboration between high- and low-income nations can be found well before the COVID-19 pandemic started.

Collaboration Before the Pandemic

By creating links between medical professionals in high- and low-income nations, telehealth has proven an invaluable tool for strengthening healthcare institutions lacking access to adequate resources. One of the early successes in fully digitized cooperation between high- and low-income healthcare institutions is that of the Swinfen Charitable Trust. In 1998, the United Kingdom-based trust was established in order to fund a communications network that would link healthcare professionals across the globe.

The network, which is still in operation, allows medical professionals in resource-scarce healthcare systems to email questions to affiliated physicians in better-equipped healthcare systems. The physician best qualified to respond will then do so within 48 hours. Though not particularly high-tech, this rudimentary telehealth network has nevertheless been a valuable resource for medical professionals in low-income parts of the world. Since the establishment of the Swinfen Charitable Trust, the scope and quality of such international collaboration programs have only increased.

The University of Virginia (UVA) maintains numerous collaborative telehealth programs with healthcare systems in low-income countries across the globe. One program connects medical experts at UVA with teams at both the National University of Rwanda and Ethiopia’s Jimma University Hospital. As part of the program, participants discuss surgical and anesthesiological cases over the internet. The programs do far more than answer a few questions though. For underdeveloped healthcare systems, connections with resource-rich nations can improve the overall quality of care.

The Value of Collaboration

Healthcare quality suffers in low-income countries, such as those in sub-Saharan Africa, where per-person spending on healthcare is only a fraction of that in higher-income nations. Polling in the region shows that sub-Saharan Africa’s population has the lowest rate of satisfaction with healthcare out of any global region. Only 43% of those surveyed were satisfied with the healthcare in their area. Furthermore, the region suffers from numerous health crises including maternal mortality and the HIV/AIDS epidemic.

In areas where financial limitations clearly impact healthcare resources, international telehealth collaborations can provide a low-cost solution to some of the deficiencies of underfunded healthcare systems. In many cases, international telehealth collaborations have facilitated technical training for healthcare professionals, provided logistical support for the expansion of healthcare infrastructure and created research opportunities.

University Collaboration

International telehealth collaboration programs such as that undertaken by the UVA in Tanzania have successfully changed the way that healthcare is administered to low-income communities. The UVA connected a gyne-oncological expert with teams at Tanzania’s Kilimanjaro Christian Medical Center in an effort that educated local medical personnel on women’s health and led to the development of breast cancer testing infrastructure. The UVA is not the only university working on collaborative telehealth projects. A survey of four African universities identified a total of 129 inter-institutional healthcare programs in the universities alone. The sheer number of these programs suggests the value to both the participating medical professionals and the supported communities.

With the increased availability of advanced communication technologies, the ability to establish and maintain international telehealth collaboration is more possible now than ever before. Virtual spaces have provided medical professionals with platforms that can be used for immediate consultation or long-term development. No matter how the technology is used, it is undoubtedly creating connections that are beneficial to communities around the globe.

Joseph Cavanagh
Photo: Flickr

SMS App in TanzaniaIn low-to-middle-income countries, there are employers and workers who lack a central area to place job postings or find jobs with ease. In Tanzania, this lack of communication causes employers to hire workers from within their own villages, limiting the reach of their network. This limitation, along with unclear instructions and expensive job search costs, ultimately leads to a broad pay range for similar work. To resolve this issue, a researcher tested how an SMS-based messaging app can be effective when people search for a job in rural Tanzania. The findings were that the creation of this SMS app in Tanzania more easily allowed employees to connect with employers and reduced the wage gap.

No Internet Needed

While the SMS app is similar to online job search websites, it does not rely on internet access. The app simply asks a few important questions about their searches. For example, the app asks employers and workers to identify how much they are willing to pay or how much they wish employers to pay them. The intention of this feature is to lower business deal costs, but it may persuade users to bargain and alter the wages. However, the SMS app can also assist in updating the dispersal of wage offerings in the labor market.

When an employer posts a job, the job listing provides answers to frequently asked questions such as the wage, job type and date the job starts. Once qualified workers receive the advertisement, employers can immediately contact them, thereby lowering the costs it would take to meet in person. The advertisement includes a specific job code, so the workers text the correct code to the employers to apply for the position. After the employer receives the application, they exchange phone numbers and names with potential employees in order to further discuss the details of the job.

How the App Works

Employers can announce job descriptions through an SMS that all listed workers in the neighboring areas receive. This enables employers to extend their offer to more workers instantly. When a worker responds to the job advertisement, the app immediately directs the worker’s application to the employer. After experimenting with the app for one agricultural season, the research found that a large number of villagers began to use the SMS app and were finding success in connecting workers and employees. While the app does not increase the number of jobs available, it does decrease the wage spread.

Decreasing the Wage Gap

The agricultural production of Tanzania is self-reliant, and while Tanzanian families typically carry out their own farming responsibilities, farmers still hire some daily laborers to help. The payments for these workers range from $1.20 to $6.50 per day. However, the outcomes of the assessment established that the SMS-based messaging app lowered the wage gap in the villages, which means employers paid workers wages that matched the average payment for that job. High-paying employers contributed to this reduction by lowering the amount they paid workers, while the low-paying employers raised wages. These results suggest that the app could successfully cause a more permanent reduction in the wage gap and job search costs and create a more efficient labor market.

Increasing Communication

An SMS app that announces obtainable jobs and offers simple job applications through the short messaging system has the capability to upgrade the performance of the agricultural labor business. It will be much easier for workers and employers to look for each other because workers will have access to new job openings, and employers will be able to consider potential hires who are not accessible in their current labor network. This system of hiring is necessary because employers routinely have trouble finding new and professional workers, so they have to resort to rehiring previous employees. This lack of communication between villages results in the workers obtaining contrasting wages for comparatively similar agricultural work. Therefore, the SMS app is necessary to enhance the networking of employers and workers.

The SMS app in Tanzania is accessible because about 93% of the Tanzanian population owns quality phones, and 84% are highly literate. The app lowers the cost of job searching, makes wage rates more comparable and announces available jobs to instantly connect employees with employers. This networking expands the possibilities for employers and employees, especially in Tanzania’s agricultural industry.

– Shalman Ahmed
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