Tanzania Nursing Scholarship Program
Linda van Werkhooven & Cherie Walton
“Never doubt that a small group of thoughtful committed citizens can change the world, indeed it is the only thing that ever has."
- Margaret Meade
Steve Morris introduced nurses Linda van Werkhooven and Cherie Walton, two of the four founders of the Tanzania Nursing Scholarship Program. Ms. Werkhooven opened with an introduction to Tanzania, a poor nation just south of Uganda She referenced the work of Kurt and Jolly Lux as being similar, and indicated how much she enjoyed hearing Jolly speak about her work at an earlier Club meeting.
Until 1961 Tanzania was a British colony, whereupon it became an independent nation. Tanzania has 130 tribes, each with its own language, however, English is common to most adults. In primary school, the children all learn Swahili to bridge their many individual languages with English following in secondary school.
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The Tanzania Nursing Scholarship Program program was founded by four American nurses. They had noted that with such poverty it was difficult to focus on one particular need, as there are so many, so they went to their expertise as a guide. The nurses chose to focus on improving access to medical care generally and nursing particularly to improve the lot of rural women in that country. Specifically they have focused on assisting young, rural women with completion of their nursing and midwifery training. This eventually brings medical care skills and knowledge to their individual villages, assists their individual families with a better income and standard of living and teaches them the reasoning behind making better family planning choices such as selecting a mate and the number of children to have. This set of outcomes is magnified in the rural village setting, where close proximity to family and neighbors spreads this knowledge.
Tanzania has a population of 49 million people living in predominantly rural settings. 45% are between the ages of 0 - 14 and the average income is the equivalent of just $300.00 a year. In contrast a nurse may earn $350.00 a month ($4,200.00 a year) and there are at this time just 24 nurses per 100,000 people. In contrast, in the United States there are 1000 nurses per 100,000 people. In Tanzania just 50% of women have a nurse or midwife present at childbirth. As a result 4.6 per 1000 women die in childbirth, a figure that dwarfs the United States rate of childbirth deaths, which is just 0.2 per 1000 births. For these reasons rural medical clinics focus on maternal and child care, though minor illnesses can be treated. More serious illnesses are referred to and treated at regional hospitals, which may be at considerable distances from rural villages. While most rural clinics have very limited resources, they manage to practice a reasonable standard of hygiene, with medical and biologic waste being burned to help prevent contagion.
The Tanzania Nursing Scholarship Program recently celebrated its tenth anniversary. It originated with a 2007 safari trip to Tanzania by the four above referenced nurses, which included both Linda and Cherie. They initially sponsored two second year nursing students, Chiku and Jackline. In 2009 the program was incorporated and in 2012 expanded to include a second nursing school. In 2014 a major grant from the Dining for Women organization allowed further expansion, and by 2017 the program had assisted 117 nursing students to graduation, with dual training as nurses and midwives.
One involved nursing school, co-located with Tumaini University, is the Kilimanjaro Christian Medical Center (KCMC). KCMC is a private, 450 bed, Lutheran hospital, founded in 1971, and which serves 11 million people. The nurse to patient ratio is 1:20 and their program has a 3-year duration with graduates attaining both nurse and midwife credentials upon completion.
Other involved nursing schools include Tukuyu, located in the mountains and associated with a 200 bed hospital and which has 10 sponsored nursing students and Mbeya for which this editor did not record specific numerical details.
Challenges to the program include widespread poverty, which makes paying the necessary educational fees difficult to impossible for many students and poor English language skills among many potential students. There is also a shortage of instructors, nursing staff and supplies. Further, there are limited practical skills teaching laboratories in the country, and most books are owned by libraries with few students having access to any textbooks of their own. There is also a dearth of teaching aids and computers, and cultural challenges which favor the economic success of male children, who are given preference within their families for opportunities. Females are frequently married off in exchange for the illegal but still common "bride price", exchanged for girls of marriageable age. Males are instead regarded as economic assets to the family in that they are more likely to contribute financially.
The Tanzania Nursing Scholarship Program generally sponsors second year students through their final two years of the three year nursing program. Having completed their first year, these students have demonstrated the academic ability, perseverance and grit to finish, given a small amount of financial assistance. The scholarship decisions are made using the individual student's files and input from staff. The support is $985.00, which includes $950.00 for educational fees and $35.00 pocket money for incidentals. Most students live in dormitories.
Upon graduation, there are many opportunities for employment, many of which start at $350.00 a month. Thereafter graduates can support themselves, can provide financial support to their families including sending siblings to school and bring home necessary but often financially out-of-reach medicines. Further, the graduates serve as excellent role models for others in rural Tanzania who hope to escape poverty through education. Many graduates say, "You saved our life."
