Over
the years I have had the privilege of working in the
health field in Tanzania. I am thankful that my professional
experience as a nurse midwife has been very varied,
challenging and quite comprehensive.
Solidarity
Since
1998 I am involved in Micro Health Insurance Schemes
first of all at grass roots level with the Small Christian
Communities and the parishes of the Archdiocese of
Dar es Salaam. It is called the Atiman Micro Health
Insurance Scheme in honor of Dr. Atiman the first
African doctor-catechist who was a redeemed slave
from the banks of the River Niger near Timbuktu in
present day Mali. He arrived in Karema in July 1899
where he ministered to the people till well into old
age.
Sr.
Rita Toutant, from Canada, in mission
in Tanzania
The
scheme was started in 1995 by a priest economist, Fr. Vic
Missiaien of the Missionaries of Africa (M.Afr.) who is
a well known justice and peace policy advocate in Africa
and particularly in Tanzania. The idea was to help parishes
via the already established Small Christian Communities
(SCC) create their own solidarity fund to enable their members
to have access at least to primary health care facilities
and be treated for the most common acute conditions, keeping
in mind that malaria is still the top killer disease in
the country.
Even
though I was a nurse midwife with a long experience in rural
Tanzania it was a challenge for me to get involved in this
new field of health work. However a very enriching collaboration
with the ILO STEP program started at this time.
Training
of Trainers. Promoters Health Insurance
They
had world class expertise in community animation,
informal sector organizational development skills
etc. but lacked the in-put of a grass roots health
professional to participate in the design of micro
health insurance schemes which they were promoting
among informal sector business operators and self
help organizations (SHO's) in line with their poverty
reduction objectives. Together a methodology was designed
and a draft of a Trainers Guide illustrated by culture
specific cartoons was produced.
Networking
Concurrently
since 1998 10 managers\promoters of MHIS from all over
Tanzania were invited to regular regional conferences
with participants from various African countries. So
people from various Churches, informal sector groups
(under VIBINDO the umbrella organization for the informal
sector operators) and government attended.
Evaluation
Health Insurance
ILO
Seminar - Chawana
In
October 2003 with the support of the German Development
and Technical Cooperation Organization (GTZ) the Tanzanian
Network of Community Health Funds (TNCHF) was officially
established and a well-equipped office was set up
in the town center. You are welcomed to find out more
about the vision and activities of the TNCHF on the
website at: www.tnchf.or.tz
Activism
One
priority of the TNCHF since its earliest days is the
emphasis on "advocacy" on two levels. On
one hand to promote our core value of striving to
influence better policies to enable access to basic
quality health care for the majority of the people
who are poor. On the other to also promote grass roots
democracy and activism to build up a vibrant civil
society so that government policies are "demystified"
and "monitored" by ordinary people.
This
might seem like enviable objectives for the citizens
of any democracy but as I have the chance to participate
in two dynamic networks of NGO's: the Feminist Activism
Coalition (FemAct) and the NGO Policy Forum (NPF)
and can assure you that there is now a country wide
outreach with great emphasis on making the voice heard
of those who are so often forgotten and who are the
ones who generate a big portion of the wealth of the
country - the rural dwellers. This is really a case
of "thinking globally" but "acting
locally".
Founding
members, launching the Social Insurance
A successful
lobbying experience involving all the stakeholders was the basis
for further organizing and activism. So we can celebrate the efforts
of so many men and women who are giving of their time and energy
to engage in the democratic processes at all levels of their society.
Rita Toutant
's Ministry presently in Dar es Salaam, Tanzania
