Growing up in Zanzibar, Tanzania, with two physicians for parents, Nafisa Jiddawi (GRD ’14) felt that her house was like an outpatient clinic, with people frequently coming in and out for medical care. This experience made her tune in to the health needs of her community in Zanzibar, fostering a passion for healthcare that has carried into her adult life.
Jiddawi left Zanzibar at age 12, but she followed her parents into the healthcare field, graduating from Georgetown in 2014 with a Master of Science in Nurse Midwifery/Women’s Health and Nurse Practitioners (NM/WHNP). Jiddawi never forgot her home, and in 2019 she returned to Zanzibar, where she founded WAJAMAMA, a women-led hybrid model of a for-profit clinic and a nonprofit foundation that focuses on holistic health promotion and disease prevention in Zanzibar.
Jiddawi noted how the differences in healthcare between the United States and Zanzibar caught her attention and inspired her to establish WAJAMAMA, especially as she began her higher education.
“Having been trained by clinicians and professors who were so deeply invested in making sure that we become leaders in health care, I have been implementing those values in my clinical practice and in WAJAMAMA’s DNA,” Jiddawi wrote to The Hoya..
After her time at Georgetown, Jiddawi turned her focus to maternal and child care. In a WAJAMAMA mission and identity statement Jiddawi provided to The Hoya, she wrote that the volunteer work she pursued in Zanzibar during her educational years made her aware of extreme health disparities and the lack of maternal health care for pregnant women.
“While going through ‘maternal death books’ at all delivery hospitals across Zanzibar to document the demographics and cause of death of each life lost, she was appalled at the volume of unnecessary deaths,” the statement read. “During this time, she also witnessed systemic abuse towards birthing people and their babies. This has been the driving force behind her passion to improve health outcomes in Zanzibar.”
Lauren Arrington (NHS ’05), an assistant professor in the School of Nursing who spent the last several months working with Jiddawi in Zanzibar, emphasized the importance of improving midwifery and maternal health services globally, especially in developing countries.
“Every day around seven hundred women and birthing people are dying during or shortly after pregnancy and most of them are dying because of preventable causes, so we have a responsibility to deliver care and facilities and infrastructures and support for healthcare workers to prevent these deaths,” Arrington wrote to The Hoya.
According to Jiddawi, poor maternal health outcomes in Zanzibar specifically can be attributed to a myriad of factors, including female healthcare professionals leaving their jobs due to underpayment and unfavorable working conditions.
“Nurses and midwives in Zanzibar are also often required to work in settings that are not conducive to favorable outcomes,” Jiddawi said. “For example, the nurse-to-patient ratio of 1:25 on labor and delivery units is not uncommon. Burnout is very common in Zanzibar and it is not unusual to lose the ‘good’ nurses and midwives to ‘better paying jobs’ in mainland Tanzania.”
Jiddawi believes colonialism has also manifested itself in Zanzibari health practices, making them unsafe.
“It is not unusual to witness students from the global North practicing skills they had never practiced before on black bodies without proper training and supervision,” Jiddawi said.
Christina Marea, an assistant professor in the NM/WHNP program who taught Jiddawi, believes Georgetown’s values and emphasis on social justice helped Jiddawi reflect on structural determinants of healthcare in her clinical model.
“Georgetown’s focus on cura personalis — care of the whole person — translates into healthcare very clearly and has served as a deeply influential model for Jiddawi’s work,” Marea said.
Jiddawi plans to work alongside Marea and Arrington to develop global health opportunities for nurse-midwifery and Doctor of Nursing Practice students at Georgetown, which Marea explains is incredibly important to Jiddawi in her current and continued work.
“She believes that students need to enter the healthcare field with an understanding of global health so they get the impacts of colonialism on health and global economies, and how this is all related to the nursing and midwifery workforce,” Marea said. “In this way, we can have a collaboration that is grounded in equity and mutuality so that everyone can rise together.”
Jiddawi is making strides in Zanzibar’s maternal health model, but she recognizes that there is still more to be done. She is committed to improving the status quo of the healthcare system in Zanzibar by addressing maternal and newborn health disparities.
Marea explained that, in these efforts, Jiddawi has maintained a strong relationship with Georgetown.
“She has been very diligent about staying in touch and having an ongoing conversation that has spanned a decade regarding the ways in which we can take some of the things that are incredible about our U.S.-based midwifery education at Georgetown and bring it to Zanzibar,” Marea said.
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