The mobile outreach programme covers a radius of 350 km. Screening sessions are announced well in advance using radio, newspaper and posters. Teams regularly conduct screening sessions in the rural regions in collaboration with government hospitals, missionary hospitals and other social institutions. Patients screened receive treatment on the spot or are referred to CCBRT's disability hospital for specialised services. The price of treatment also includes transport to and from the CCBRT disability hospital.
However, in Tanzania the cost of transport is often a major obstacle in accessing treatment for people with disabilities. A bus ticket to Tanzania's capital can cost as much as $30, equivalent to about six months of wages for many Tanzanians. To help offset this cost, the CCBRT hospital is transferring charity funds to patients to pay for the trip.
CCBRT partners with “ambassadors”—mainly health workers and other individual volunteers throughout Tanzania—who call CCBRT when they have identified a woman with fistula. Ambassadors also refer people with cleft palate, through separate funding. When CCBRT confirms the fistula diagnosis, it transfers to the ambassador the funds to cover the woman’s transportation. The ambassador claims the money from an M-PESA (a Vodafone mobile online account phone subscription which more than half of the country is subscribed) agent, buys a bus ticket, and gives it to the woman. Once the woman arrives, CCBRT transfers an additional 5,000 Tanzanian shillings (US $3.50) to the ambassador as a gesture of appreciation and an incentive to send additional fistula patients for care. Including the incentive, the average one-way cost of transporting a patient to the CCBRT hospital is US $33.
CCBRT is also committed to human resource and service development in medical institutions in the surrounding regions of Dar es Salaam. In 2005, a specialist Eye Unit was successfully established in Tanga's Bombo Hospital in collaboration with CCBRT disability hospital. CCBRT now uses this model elsewhere in the country and supports the establishment of independent specialist departments in four additional regions in Tanzania. This is an important step in bringing quality services closer to those most in need.
