By Regina Moore, PSI
I recently traveled to Tanzania with PSI Ambassador Mandy Moore and founder of Mom Blogger’s for Social Good Jennifer James to highlight the importance of health workers. Follow each day of the trip here, here and here.
Dr. John Rukazibwa has a warm, welcoming demeanor. When I met him recently at his health clinic in Dar es Salaam, Tanzania, he proudly showed me around the facilities, pointing out the in-house laboratory, dedicated family planning room and other spaces in the small, narrow clinic.
Dr. John opened Mission Mbagala Dispensary more than a decade ago. He’s passionate about serving the people in the low-income community of Mbagala. His house is on the opposite side of town and Dar is infamous for terrible traffic. I quickly learned on this trip that a 20 minute drive at one time of day, easily becomes a two hour drive a few hours later. Nevertheless, he’s committed to his clients and works odd hours to make sure he’s there when he’s needed.
Dr. John’s clinic teemed with activity. Mothers and children filled the waiting room, spilling out onto the porch or front steps. Amid the bustle, mothers entered his office frowning with worry as they held their sick infants and then emerged smiling with relief, thanking the doctor as he led them out and handed over a note with his instructions.
This gentle bedside manner translates into his relationship with his staff. One of his nurses, Zainab, has worked at the clinic for 10 years, longer than any other job, and she credits her tenure to the way he runs the clinic. Dr. John sets aside time each day for staff meetings, and he says he involves the staff in decisions he makes about the clinic. This is difficult given the busy and stretched nature of his work.
This passion for his clients and care for his employees motivated Dr. John to join PSI/Tanzania’s Familia social franchise network five years ago. To serve the most people and retain the best staff, Dr. John recognized the need to strengthen his clinic as a business. But, of course, this is Dr. John’s livelihood. So, while he prices services low – and often sees costs as negotiable when clients struggle to pay – he still needs to meet his bottom line to continue operating his clinic.
Familia helps him do just that. Through the network, Dr. John and key members of his staff receive medical and business training, support to purchase necessary equipment and ongoing supervision to keep each of the providers’ skills sharp and up to date. PSI sets strict quality standards for each of the Familia clinics and checks in regularly to help providers meet them. “I feel more stable now because my staff was trained by Familia,” said Dr. John. “[The network] keeps us a step ahead.”
PSI also pairs each Familia clinic with an outreach worker who goes into the community to educate people about pressing health issues and refer them for services. They spread health information while also driving traffic back to the clinic. “Providing us with Lucy is like marketing,” says Dr. John of the outreach worker paired with the Mission Mbagala Dispensary. A multitude of clients come to the clinic based on Lucy’s referrals and return time and again because of the quality care they received.
The family planning and integrated child health services Familia supports in clinics like Dr. John’s are critical and often unavailable to many communities. According to Tanzania’s most recent Demographic and Health Survey, one in four women who want to use contraception cannot access it and one out of every 12 children dies before his or her fifth birthday. Dr. John and Familia clinics like his are helping to narrow these gaps every day. The network currently incorporates 260 Tanzanian private health facilities, with an average client retention rate of 81 percent.
Because of the support he has received through Familia, Dr. John hopes to soon offer more services to the women of his community. He’s currently working to incorporate cervical cancer screening into his clinic’s offerings. Tanzania has some of the highest rates of cervical cancer in the world, yet cervical cancer prevention services are not readily available. Incorporating screenings into his clinic could tremendously increase his health impact in his community.
“PSI has made me think higher,” said Dr. John. “When a partner thinks high, it makes me want to be better.”
Photo credit: Trevor Snapp