Health care for women at Idjwi island

L.J. Grosfeld is organizing this fundraiser.

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Summary: RWH (Rebuild Women's Hope) is raising EUR 44,500 to improve healthcare access for women at Idjwi island.

Rebuild Women’s Hope (RWH)

Rebuild Women's Hope is a cooperative created in 2013 which consists of two branches - commercial and social - and is located in the province of South Kivu, in particular in the city of Bukavu and on the island of Idjwi.

The majority of RWH's activities take place in the south of the island Idjwi. In this area RWH operates three coffee processing stations, where the coffee beans produced by the cooperative's women farmers are sorted, processed and prepared for export. Part of the income from the coffee export is used by RWH for social activities in the local communities of the area. Social activities that started in the past and are still continuing include: the construction and running of the Matumaini Hospital and the Women's Centre (Vocational Training Centre) besides the construction of 3 water supply systems and 7 community water points.

RWH is a group of women who work to enhance the value of women's work by encouraging a spirit of entrepreneurship and empowerment in order to raise the standard of living of households, driven by the fact that income controlled by women has for 90% a positive impact on the life of the whole family and community.

However, it is clear that in some communities in the DRC, tradition plays a dominant role, meaning that little importance is given to the development of women despite their considerable physical, moral and social capacities. At the same time women are entrusted with heavy responsibilities, particularly in terms of ensuring food, family care, education and schooling of children.

Moreover, women have been the main victims of the repeating wars and conflicts since 1996 in Eastern DR Congo (victims of rape, discrimination and several diseases like sexually transmitted diseases) in both urban and rural areas. Rebuild Women's Hope aims to create a spirit of entrepreneurship and empowerment in women, and to raise women's awareness with the aim to improve their physical, mental and intellectual health. Rebuild Women's Hope believes that through the transparent production, marketing and sales of coffee, sustainable development is possible.

Access to healthcare for all is a right, not a privilege, and is one of the Goals of development. The fact that so many people think it is a privilege reinforces the continuing violence against women and children in many African countries, which is why we need to support initiatives to combat this scourge.

In response to medical needs for women and children, RWH in 2020 decided to construct and install a Maternal and Paediatric Hospital on Idjwi island which was inaugurated in December 2020, at which maternal, paediatric and general health care services are provided to the population of Idjwi South. The construction and installation costs were covered for 90% by RWH’s business partner Mozzo Coffee and for 10% by RWH (revenues coffee sales). The operational running costs of the hospital are until today covered RWH own funds (revenues coffee sales) in combination with fees paid by the patients (low affordable fees).

Health care for women and children at Idjwi Island

Women’s fertility and mortality rates are higher on Idjwi Island as is the natural growth rate of the population - compared to the DRC as a whole. In addition, only less than half of women on Idjwi receive antenatal care and the unmet need for contraception is twice as high as the average for DRC. A woman’s median age at first birth and the number of months between births are both lower on Idjwi than elsewhere in rural DRC. The frequency of childhood diarrhoea, fever and cough are all higher on Idjwi than elsewhere in rural DRC. To treat these diseases, Idjwi has only 0.27 doctors per 10,000 inhabitants, compared to a figure of 1 per 10,000 in DRC. According to the WHO, the average number of doctors per 10,000 inhabitants in the world is 13, with an average of 2 per 10,000 in the African region compared to 32 per 10,000 in the European Region. On average, there are 28 nurses and midwives per 10,000 people in the world, but this proportion varies from 11 per 10,000 in the African Region to 79 per 10,000 in the European Region . On Idjwi only 25% of women on Idjwi receive the minimum 4 recommended antenatal visits, between 30% and 50% of women do not receive preventive antenatal services and only 66% of deliveries are performed by trained staff.

In addition, the risk of mortality among pregnant women is high. Since RWH's presence in 2013 in idjwi, we have recorded at least 58 women who have died due to lack of appropriate care during their pregnancy, other pregnant women had to travel long distances, climbing mountains for 4 hours by motorbike to get treatment at Monvu hospital which offers primary health care and surgical services but no intensive care and maternity and paediatric services. In 2017 and 2018, 17 women from Idjwi drowned while trying to go by boat across lake Kivu to hospitals that offer maternity services in Rwanda and Bukavu. On top of that, many women, men and children in the community on Idjwi are dying every day due to a lack of adequate medical care and poor treatment by traditional healers.

Considering the above and the serious risks people - women and children in particular - face due to the lack of health care services, Rebuild Women's Hope Cooperative built a Maternal and Paediatric Hospital in Idjwi South which was inaugurated in December 2020. During the first year of operation 621 babies were born safely in the hospital and they are doing amazingly well. Besides the hospital has treated more than 2000 outpatients and 2000 inpatients suffering from various diseases such as malaria, infections, anaemia, etc. during the same period. These numbers represent a great success in terms of provision of maternal and paediatric health care on Idjwi island which has saved many lives.

In spite of these achievements, the new hospital still has limitations in terms of the care it is able to provide, notably the lack of surgical services and intensive care services, resulting in the situation that patients sometimes cannot receive the care they need and still die as a result of disease complications or during childbirth, as caesarean sections or other surgeries are not possible at the hospital. The introduction of surgical and intensive care services at the hospital is therefore urgently needed to be able to provide this kind of care that patients regularly need, which will save lives of women and small children in particular.

Objectives and target group

Overall objective: Improvement the health status and reduce the mortality rate of the population of Idjwi South through the construction and running of an operating theatre and intensive care unit at the Maternal and Paediatric Health hospital in Nkuvu, Idjwi South

Target group: Population Idjwi South estimated at 185,000

Specific objectives:

• Construction of an operating theatre and intensive care unit

• Installation of necessary equipment and furniture in the operating theatre and intensive care unit

• Reduce the maternal and infant mortality rate through carrying out caesarean sections / surgical interventions and providing intensive care services by competent medical staff

• Reduce the mortality rate caused by clandestine abortions carried out by traditional practitioners

• Enable safe blood transfusion

• Recruitment of competent medical staff to run the surgical and intensive care services

Expected results

• Operating theatre and intensive care unit constructed, equipped and ready for operation.

• 300 caesarean sections successfully performed on women (6 month period)

• 150 other surgical procedures successfully performed (6 month period).

• 350 patients receive intensive care services (6 month period).

• Reduced mortality rate of 50℅ among pregnant women and infants in the target group

• Decreased mortality rate among girls and women due to expected reduction in clandestine abortions.

• Decrease of 50% in unsafe blood transfusion cases in the target group

• Successful recruitment of 1 general practitioner, 1 surgeon, 2 nurses and other support staff.

RWH financing model for social initiatives (hospital running costs)

Rebuild Women's Hope Cooperative uses its commercial activities to create sustainable development in the community where it is active, producing coffee which is sold and exported abroad. Part of the revenue from each kilo of coffee sold enables RWH to initiate social initiatives that address the priority needs of the Idjwi South community. The current running costs of MATUMAINI Hospital are covered for 75℅ by the sales revenues of the coffee that is exported. The other 25% of the running costs are covered by the modest fees that patients pay for the medical services they receive at the hospital.

Project budget: RWH own funds and need for other funds

The total budget of the project is USD 68,020 which includes funds for the construction (operating theatre and intensive care unit), purchase and installation of equipment and funds to cover the first 6 months running costs. RWH will be able to finance 15% of the budget with own funds (9,303 USD) and is therefore looking for a total of USD 58,717 social investor funds in the form of repayable loans or donations (85% budget)

After the first 6 months of running, the operating theatre and intensive care unit will continue to run and be integrated in the overall RWH plan and financing model for running the Matumaini Maternal and Pediatric hospital. RWH will be able then to cover 75 ℅ of the running costs and the other 25 ℅ will be covered by the reasonable fees paid by patients to ensure the sustainability of the surgical and intensive care services, as already ensured for the other hospital services, which will continue to function without the need for further external funding.

Activities planning – 12 months

The construction and installation period of the operating theatre and intensive care unit is expected to take 6 months, after which the new services be inaugurated and start running. The first 6 months period of running the new services forms part of this project, leading to an overall project duration of 12 months. After the end of the project, the new services will continue to run, integrated in the overall RWH plan and financing model for running the Matumaini Maternal and Pediatric hospital.

Project management

The Rebuild Women's Hope Cooperative management team will manage this project and coordinate all its activities supported by a consultant engineer who will facilitate the construction aspects of the project.

The RWH Board of Directors will be responsible for the recruitment - qualified medical staff and consultant engineer - to support this project. Also, the Board of Directors will review regularly if the project plan is being followed and the project implementation on track. The RWH Supervisory Board will monitor and evaluate the proper use of the funds allocated to this project. The RWH finance team will on a regular basis monitor budget consumption and be responsible for accurate financial administration of the project.