About Kupona Foundation

Kupona means ‘to heal’ in Kiswahili. Kupona Foundation is a nonprofit dedicated to delivering high quality healthcare to those who need it most. We focus on Tanzania, a country rich in potential but severely impacted by extreme poverty, a challenge compounded by one of the highest population growth rates in the world.

Our founding partner, CCBRT (Comprehensive Community Based Rehabilitation in Tanzania), is a leading healthcare provider specializing in disability, rehabilitation and maternal and newborn healthcare. A lynchpin in the Tanzanian healthcare system, CCBRT has over two decades of service to the Tanzanian community and partnership with the Government of Tanzania.

Letter from the Leadership

Dear Friends,

In 2017, CCBRT wrapped up a five-year strategy that drove towards a Tanzania where people have access to quality disability services as well as safe maternal and newborn healthcare. This was a timely moment to evaluate our impact and take stock of the role that you – our Kupona Foundation community – have played in delivering healthcare to those who need it most. Thanks to your support, in the last five years we have made incredible gains:

• More than 50,000 Disability-Adjusted Life Years averted through high quality surgical and rehabilitative interventions
• More than 5,000 maternal and newborn healthcare workers trained by CCBRT’s expert teams
• A more than 20% increase in the number of people with visual impairments served at CCBRT’s hospital

Since Kupona was founded in 2009, we have built a network of over 2,000 donors, advisors and advocates, mobilizing financial and in-kind resources exceeding $5 million, all in support of CCBRT’s life changing programs.

Thanks to the generosity of partners and donors, 2017 was our biggest year yet.

You helped us mobilize more than $1.6 million in financial and in-kind resources this year alone. This number doesn’t include the hours of advice and hands-on support that volunteers and friends also gave so willingly, nor does it take into account the impact of the partners and supporters who shared their platforms to help amplify our story. The achievements you’ll read about in this report are your triumphs, and we’re so proud of our collective progress. 

For thousands of women, children, and people with disabilities, CCBRT is the only option for specialist healthcare. Securing the future of our programs and services, which are vital to many members of the community, is our top priority. It’s a theme you’ll see throughout this report: investments in quality, systems and infrastructure, all designed to sustain CCBRT’s exemplary services at scale and meet the growing demand for quality healthcare in Tanzania.

Of course, there is more work to be done. For many of us, the health, wellbeing and fundamental safety of our global community has rarely, if ever, felt so under threat. There is no denying that the challenges we face in achieving our global goals are complicated and will not be solved overnight. However, as we look ahead, we are full of hope and ambition.

Thank you for your commitment. We’re proud to call you members of our community.

Finances

Governance

Celebrating Our Community

In 2017, the Kupona community mobilized over $1.6 million in financial and in kind resources to enable the continuation and sustainable growth of life changing programs.

Thank you to every member of our community who supported our work in 2017. You donated dollars, time, and photos. You climbed mountains, golfed for good, purchased handmade items from The Mabinti Centre and artwork from our Drawing Out Obstetric Fistula exhibition. You attended and supported cocktail receptions, meetings, and mixers, raised awareness, and shared our story on social media.

You were a passionate force for good, and we are so grateful for your support.

Our special thanks goes to:

The Challenge

Estimates suggest that 4.2 million people in Tanzania live with a disability, and over 20 million people are directly affected by disability in their family.

With one of the highest population growth rates globally, the absolute number of people affected by disability in Tanzania will continue to increase. People living with disabilities experience disproportionate levels of poverty and exclusion from social and economic activities, and children with disabilities are particularly vulnerable. Access to high quality surgical and rehabilitative care can mitigate the impact of a disability on a person’s health and development. Yet, despite the significant need in Tanzania, the availability of specialist healthcare is seriously limited.

The Solution

In 2017, the Kupona community invested in comprehensive treatment and rehabilitation for adults and children with disabilities, training of healthcare providers in specialist fields, and infrastructure and systems improvements to enhance the quality and sustainability of healthcare in Tanzania.

Serve

CCBRT is the largest provider of disability and rehabilitation services in Tanzania, providing comprehensive, specialist care that is accessible for every patient regardless of their ability to pay. In 2017, CCBRT provided clinical and rehabilitation services at two accessible facilities in Dar es Salaam and Moshi, and further supported 30 partner facilities.

In addition to delivering exemplary healthcare services to more patients, CCBRT took action to improve quality and strengthen its systems. A new Chief Medical Officer was recruited in August, who is focused on sustainability and quality of care at CCBRT’s hospital. The quality of the services are reflected in CCBRT’s Level 4 Safe Care certificate, and CCBRT continues to work towards Level 5 (the highest standard). The team’s lean management journey also continued, leveraging management techniques pioneered in the manufacturing industry to reduce waste and increase efficiency.

Technology continued to play a crucial role.

Train

As a specialist in disability and rehabilitation, CCBRT is committed to sharing its expertise and strengthening the network of quality care available to people with disabilities in Tanzania. Our capacity building efforts target every level of the healthcare system, starting in the home and community and ending with regional hospitals. In 2017, the team empowered parents/carers of children with disabilities with the skills and confidence to provide quality care at home, equipped community healthcare workers to identify and refer women and girls living with obstetric fistula for treatment, and trained surgeons to deliver specialist care in obstetric fistula and ophthalmology. Due to its expertise, CCBRT sits on various national technical working groups and is accredited by the International Federation of Gynecology and Obstetrics as a training site for fistula surgeons.

With the support of our partners at Johnson & Johnson, plans progressed to formalize CCBRT’s training efforts through the development of the CCBRT Academy: Centre of Excellence in Clinical Education, which is due to open in 2018. Phase One of the Academy will enable initial training to be offered in a renovated facility on CCBRT’s campus and Phase Two will open in the dedicated training space within the new Maternity and Newborn Hospital in 2019.

CCBRT is also committed to the professional development of its own staff, which cannot be divorced from the continuous improvement of services. In this spirit, Kupona Foundation launched a major new partnership with the Lavelle Fund for the Blind in 2017. Over the next 2.5 years, the Lavelle Fund will support critical financial and technical investments, enabling the CCBRT team to scale the provision of low cost, high quality services to people living with blindness or visual impairment in Tanzania, and to sustain these critical services for future generations. The ophthalmology department is CCBRT’s busiest, accounting for over 60% of the caseload at CCBRT's hospital in 2017. Leveraging the advice and expertise of esteemed advisors from the world of social enterprise and sustainable eye care, the goal is to use investments in staff training, as well as in equipment, community outreach and facility refurbishment, to ensure that CCBRT can reach more people in need of affordable, high quality, specialized services to restore their sight, while investing in organizational sustainability.

Build

CCBRT has served over one million patients since its hospital opened in 2001. As demand for services continues to grow, investments in infrastructure and equipment are critical to maintain and enhance the quality of care available to patients. Through our partnership with Lavelle Fund for the Blind, Kupona provided new equipment for the ophthalmology department to not only improve quality of care, but also to prepare the department’s infrastructure to serve higher volumes of patients in the years to come.

Prior to the opening of the Imaging Center, CCBRT had to refer patients in need of these imaging services to other hospitals across Dar es Salaam. Now, patient scans can be conducted and read by onsite radiologists, streamlining the treatment process and improving the patient experience. Patients from CCBRT’s premium Clinic will be served using the same imaging facilities, and the center will also be a referral unit for other health facilities' imaging needs. As a part of CCBRT’s social enterprise model, revenue from the Imaging Center will be reinvested into CCBRT, to support delivery of free and subsidized care for patients unable to pay. 

The Challenge

Tanzania is one of ten countries in the world that together contribute to 61% of global maternal deaths and 66% of global neonatal deaths. It is estimated that over 80% of these deaths could be prevented if pregnant women had access to comprehensive antenatal care, skilled birth attendants during delivery, and emergency obstetric care.

Improvements to the quality of maternal and newborn healthcare not only save lives but are also the most effective way to prevent disability. For every woman that dies in childbirth in Tanzania, 20 more will develop an injury, infection or debilitating impairment. Each year, thousands of children are born with birth defects like cleft lip/palate and clubfoot in Tanzania. When these impairments aren't properly diagnosed and referred for treatment at birth, they can develop into a long-term disability, compounding the complexity of treatment and adversely affecting a child's development.

Tanzania's largest urban center, Dar es Salaam, is one of the fastest growing cities in the world. Dar es Salaam is on track to become a megacity (with a population greater than 10 million) by 2025, yet the city's healthcare infrastructure was built to serve ~750,000. Healthcare facilities are being stretched to breaking point as demand for service grows. Despite the best efforts of frontline heath workers, shortages of skilled staff, critical gaps in equipment and supplies, and broken referral systems put the lives and welfare of women and newborns at serious risk.

The Solution

As global citizens, we are proud to participate in international, multi-sector discussions in pursuit of real solutions to the challenges facing our international community.

Our participation in conferences and events throughout the year gives us opportunities to build partnerships with organizations and individuals who share our passion for global health. Turning talk into action, we also use storytelling to mobilize a growing community of Kupona supporters. From digital activations and speaking engagements, to golf tournaments and cocktail receptions, our activities in the United States take on many forms, all with one common theme: to shine a spotlight on the causes we champion, and to show individuals and institutions how they can play a tangible role in empowering people and communities living in poverty to realize their full potential.

Sharing Global Platforms

In 2017, our team shared the Kupona Foundation story on several global platforms.

In January, our Executive Director Abbey Kocan joined the ‘Women Entrepreneurs in Africa’ panel at the African Diaspora Investment Symposium (ADIS) in San Jose, California, to talk about The Mabinti Centre’s efforts to foster entrepreneurship in women recovering from obstetric fistula. In April, Abbey made a social impact lab pitch at the Unite for Sight Global Health and Innovation conference at Yale University, entitled ‘What healthcare providers in low resource settings can learn from the Toyota production line’, exploring the impact and lessons learned from CCBRT’s application of lean management techniques in healthcare. In June, our External Affairs Manager, Alexandra Cairns, joined Chrysula Winegar from the UN Foundation and Daphne Metland from Baby Center (a member of the Johnson & Johnson family of companies) on the ‘Health in Your Hands’ panel at Families+Social Good in London, to discuss the power of mobile technology to transform women’s health, focusing on our obstetric fistula program. Abbey and Alex also joined friends, old and new, at the Johnson & Johnson Changemakers Expo in New York City in September. If you missed it, you can rewatch the Familes+Social Good panel discussion here, and see the ADIS panel discussion here.

Fistula in Her Words

As storytellers mobilizing support through narratives, we are acutely aware of our responsibility to do so without jeopardizing the privacy or dignity of the people we serve.

On International Day to End Obstetric Fistula, May 23rd, we reflected on an important question: How do we, as fundraisers, clinicians and global health advocates, talk about fistula without imposing our own narrative and excluding women from their own stories? We asked twenty women and girls undergoing treatment at CCBRT how they identify themselves and prefer to be identified – they chose words like ‘mama’, ‘businesswoman’, ‘entrepreneur’. Not one person wanted to be thought of as a ‘patient’ or a ‘victim’. The women and girls we serve do not want fistula to define them or their place in their community.  It is imperative that we tell these women and girls’ stories on their terms. We also engaged directly with our partners in the fistula space, through interviews and a Twitter chat. With these efforts, we were delighted to be awarded an honorable mention by our friends at GlobalGiving as part of their Top 10 nonprofits committed to impact series. You can learn more about the perspectives of the women and girls we serve here.

Conquering Kilimanjaro, Conquering Fistula

This year, our new friend, Sara Safari, climbed Mount Kilimanjaro to raise funds and awareness for women living with and recovering from obstetric fistula in Tanzania. 

Sara is an author, engineer, professor, mountaineer, TedEx speaker, recipient of the 2015 Global Citizen Award from the United Nations, and advocate for the empowerment of women and girls.

In 2015, Sara was climbing Mt. Everest to raise funds to empower Nepali girls who were trafficked or forced into marriage. On day 25 of Sara’s climb, Nepal was struck by a 7.8 magnitude earthquake. Sara survived the quake and the devastating avalanche that followed while clinging to the edge of the treacherous Khumbu Icefall by her harness and anchor.

Today, Sara continues working, and climbing, to empower women and girls. In 2017, she set out to become the first Iranian in history to climb the highest mountains on every continent (The Seven Summits) to raise funds for seven charities working for women’s empowerment. Kupona Foundation was honored to be Sara’s charity of choice on the African continent. You can learn more about her fundraising efforts and show your support for her challenge here.

Seeing is Believing

There is no better way to grasp the challenges and opportunities in our work than seeing our programs in action.

In March, members of our Board of Directors and Advisory Board were able to do just that. Bob Schwed, Mira Dewji and Jameel Farruk accompanied our Executive Director, Abbey, on a trip to Dar es Salaam to see the impact of high quality, accessible healthcare on the lives of the people and communities we serve, and to gain a deeper understanding of the most pressing needs on the ground. Tours of the CCBRT Hospital, as well as one of the health centers where CCBRT is improving the quality of maternal and newborn healthcare, demonstrated the scale and comprehensive nature of our work in Tanzania. You can read more about their trip and their reactions after visiting CCBRT here.

Photo credits: Kupona Foundation/CCBRT

With investments in scale and sustainability and the opening of the new maternity and newborn hospital, the number of people directly served at CCBRT will increase by over 40% by 2020, and thousands more will benefit from our efforts to strengthen the wider healthcare system. At optimal health, individuals and their families thrive, breaking the cycle of poverty.

Join us in transforming healthcare to help unleash the potential of thousands of people in Tanzania. 

$35 will give one person access to family planning counseling
$50 will train one nurse to provide life saving care to a mother in labor
$160 will help a child with clubfoot walk and play
$300 will help a child to see the world around them
$700 will help a woman with fistula rebuild her life