Tanzania: Standing up to the challenge of child mortality

I was doing some quick research on Tanzania, just before I went there to train our team to get more people on board with the idea of saving babies from dying of easily preventable and treatable diseases. I found that according to UNICEF, 89% of the population lives below the poverty line.

I had to sit down. 89? I learnt later that the government puts the figure at 37%. Still, how do you reconcile the difference?

Roads: a metaphor for development

The thing that struck me as we drove through Dar Es Salaam, the largest city in Tanzania, were the bumps. There were no proper roads. Roads, to me, are a metaphor for the state of development in a country. And, there’s bound to be a big difference between the capital city and ‘the bush,’ I thought. Imagine being pregnant on those roads. Could they make a baby come too early?

A friend working in Tanzania for years sent me a text: “Welcome to one of the poorest places in the world.”

Challenging the norm

I was feeling a bit troubled about how we were going to create buy-in for our campaign in a country, where surely, babies die all the time. I thought, with some alarm: it probably doesn’t happen in remote pockets, but more or less across the board, and that must mean that it’s seen as ‘normal’ for babies to die! A child’s untimely death is probably mourned, but also ‘expected’ in that sense.

Expected, rather than seen as unnecessary, or outrageous.

Poverty binds, but education can change the tide

The top question in my mind was: how are we going to ‘shake’ Tanzanians into realising that it doesn’t have to be this way? We would need to frame our issue in a way that would ring true with all of them.

One thing was obvious: the majority of 43 million Tanzanians are bound by something in common: their poverty, and their desire to escape from it.

I also clung to what I knew was an opportunity: the literacy rate of youth was in the high seventies. Something other developing countries don’t usually have. With the right information, the youth could turn the tide.

Standing up to the Challenge

“Everyone, please stand up”, I said a number of times to the group I was training. It’s a strategy I use to make things memorable, and it was symbolic, in a way, of standing up to take on the big challenge of convincing Tanzanians to stop accepting child deaths as ‘normal’.

I was telling myself to stand up to the challenge, too, rather than sitting down with shock, as I’d done in the beginning. And, stand up, we did.

Here are a few ‘Aha!’ moments from the group work that impressed me:

1. The value of talking to everyone

We discussed an example from our colleagues in Nigeria, who led thousands of women to the national assembly pavilion to lobby for the passage of a healthcare bill.

They were let in by an armed sergeant, who said, “”This cause you are fighting, it’s for all of us.” A colleague from Zanzibar was so moved by this, she had tears in her eyes. She said, “That’s why they won their campaign. Because everyone knew about it, and supported it. Even the guy at the door.”

2. Educating ourselves

We were wondering whether it was a good idea to engage celebrities. There was a huge divide amongst the group as to which celebrity was more popular. No one could decide. Then we did a simple test, by checking on Google, and got a surprise winner!

It was a lesson in understanding for the group: always check-in with the people whose minds we want to change. What we – or our line managers – think may not be what the majority of Tanzanians think. So: we must educate ourselves about what really matters to Tanzanians.

3. New partnerships

We had a debate on the type of partnerships we needed to seek to get our campaign going. Were they going to be any different from the partnerships we had been seeking before? The side that thought we’d done it all before and didn’t need to do anything differently, lost miserably.

We gave them biscuits (the prize) anyway when they said, “How could we possibly win this debate? The results were ‘fixed’! Of course we need many more and quite different partners than we’ve ever had before!”

4. Poor people have mobile phones

We learnt that ‘mobile penetration’ was going to surpass the 100% mark. The majority will be low-end users. Even if people don’t have homes, education, food, or toilets, they do have mobile phones.

So we can’t ignore the phones as a way to get the message across to them about making sure their babies don’t die of easily preventable causes.

Mobile phones provide a way to engage people continuously, and to keep the campaign alive over time. The other channel to use would be radio. Everyone listens to radio – including on their mobile phones while they work!

5. Simple ideas, big results

We were discussing ‘handraisers’ – i.e. Tanzanians who want to stand up and be counted in the campaign. A colleague said, “How do we know if a hand-raiser is telling the truth?”

The conversation turned immediately to: is signing up enough? Don’t they have to act, to do something, if they really believe? How can we get people to engage, show their support, really change things?

My work was made easy, because it made everyone’s ideas just pour out. All we had to do after that, was choose a deliberate few for the maximum results.

A simple thought or idea can just click, I thought. In fact, it can spark a revolution. We just have to find the thought or idea that will work for all Tanzanians. Sometimes, saying something really thought provoking, or even a little controversial, can create the spark we need.

6. Collective action begins at home

The group work turned out to be pretty powerful, in the end. Everyone got new information, which was exciting. In fact, the debate, as a method of learning, was rated as the most interesting session by the group, because they felt so engaged.

Making sure that we are all on board with the idea was the first, but critical step towards making a difference in the country. And, it wasn’t only about information, but engagement. I thought: collective action begins at home!

7. Time & Money

We realised we needed more resources if we were going to talk to the majority of 43 million Tanzanians about this issue. Even before I left, we began to consider building it into the ongoing proposals we were writing.

Donors may need some educating, too. We must give them a sense of the scale and the nature of the change we are trying to create. We are used to asking for money, but we must equally be ready with a plan of how to engage people who offer ideas, or time.

8 . Snapping up opportunities

We thought of a few activities that might work in Tanzania: concerts/music together with radio and recording distributions for mass appeal, engaging young professionals and student unions through television talk shows and on-campus public dialogue/debates, a public march to demand for more health workers amongst affected populations.

In an ideal world, we could do all this and more. We will start by piggy backing on as many opportunities as there are out there, focusing first on what will give us the best results.

If you are reading this in Tanzania and want to get involved, write to Jasminka at j.milovanovic@savethechildren.or.tz