Rural Tanzanian culture is very conservative about male-female roles. But none are more conservative than the Maasai. For centuries, they were nomadic cattle ranchers living in what are now safari game parks. Beginning in the 1960s, the Tanzanian government began displacing them to remote rural areas to increase development of the parks for tourism. The Maasai now live in the equivalent of our Indian reservations, except that their access to services, particularly health services is almost nonexistent.
We met the Maasai of Nadaruru and Pangaro villages through our colleagues in the Same and Mwanga Districts of northeastern Tanzania. Both communities were desperate for some health services, especially for their women and children. They had alarmingly high mortality rates, even greater than those of Tanzania in general, where maternal mortality is 460 per 100,000 live births (the US rate is 27 per 100,000 live births) and in Maasai communities it is reputedly 30 percent higher although the data are incomplete.
We worked together with the Maasai to develop the plan for a service providing prenatal and well- baby care. Rev. Joas Mpinda, a Lutheran pastor and coordinator of another of our projects, facilitated our discussions with the elders of the Nadaruru Maasai. These meetings always included lunch, a critical part of Maasai hospitality, and the roasted goat and rice were served by the women of the tribe who then left us. Men and women eat separately in Maasai communities.
After lunch, on the occasion when we were to make detailed plans, Rev. Mpinda left and went to the women. He said. "This project is for you and your children. You must come to the meeting and you must speak about what you need."
With some reluctance, they joined the rest of us and the elders. Rev. Mpinda said. "We are ready to make the plans for this project and I have asked the women to join us to give us their advice about what we should do. I am asking the permission of the elders to allow them to participate in this planning." Chief Isaiah, the progressive Maasai leader who had invited us, urged that they approve this breach of custom. The elders agreed and the women came.
"We want to be trained to give good care to our pregnant women and their babies. We want to save the lives of those women who have problems delivering their babies," said Mama Maria, the elder woman at Nadaruru, and possessor of great moral authority.
As the day progressed, several more women spoke up with suggestions. This began the process of detailed planning for the project that trained 10 women as birth attendants and constructed a small building to serve as their clinic.
Rev. Mpinda then said to the elders. "We need a committee to oversee the planning for the training and the design of the clinic building. The majority of the committee members should be women and the chair of the committee should also be a woman." In the silence that followed, Chief Isaiah said, "We should do this." The elders agreed to yet another breach of custom.
The project was completed and the 10 birth attendants provide prenatal and well-baby care and make early referrals to the hospital of women who might have problems delivering their babies. Each month, a team from the hospital arrives to review the work of the birth attendants, provide services to post- partum women and immunize the babies.
Things are much better in Nadaruru and the surrounding area now. On "clinic day" when the hospital team arrives, over 200 people show up. Many of them are adults with infections and parasites. The physician needs to triage all of these people. "Pregnant women first, babies next, children next and then everyone else."
Six months after the clinic opened, Rev. Joas Mpinda made a training visit to Iowa. He told the story of the Nadaruru clinic and my wife, Judy, said, "Joas, you are a feminist." His chest swelled with pride and he exclaimed, "Yes, I am a feminist." He continues in his role as an advocate for women and seeks to empower them.