One refugee's dream to transform maternal health in Tanzania's Nyarugusu refugee camp

Rehema Nyanza (53) is a Congolese refugee woman and a community leader representing refugee women in the health sector at Nyarugusu refugee camp in Tanzania. She is known as “The Minister of Health”. Rehema has been in Nyarugusu refugee camp in Tanzania since 1996, when she fled violence in the Democratic Republic of Congo (DRC).

Since her arrival in Tanzania, Rehema has been supporting health workers and advocating for better health services to ensure pregnant and lactating refugee women are getting the support they need and delivering safely. However, the main challenge was the infrastructure at one of the health centres that she is working at. The center had old buildings which were constructed when the camp was established nearly three decades ago. Several renovations have been done since then, but still, it was not enough.

Rehema has been advocating for the construction of a new building at the health facility. “Every time I raise the issue about this building, the answer was that there is not enough money. I kept on advocating. I kept on hoping that someday my prayers and efforts would be answered. It was very hurtful to see women suffering, and some were opting to go to another heath center, which is a bit far from here,” explains Rehema.

In 2024, Rehema’s prayers were answered. Ireland and Norway contributed funds to the United Nations Kigoma Joint Program (KJP) through which UNHCR, the UN Refugee Agency was able to construct a new maternity building at the health center in Nyarugusu, that would serve both refugees and the host community.

“We were informed about the donors and their support to build the maternity ward,” says Rehema while giving a tour of the new maternity ward and latrines. She recalls how the old building was insufficient, “A pregnant woman waiting for labour could not stay in the ward with her relatives, the relatives had to stay and wait outside. Also, the latrines and maternity ward were separated, so women had to walk from the maternity ward to the latrines that were outside. But in this new building, everything is done under the same roof. Women are delivering and moved to the post-maternity ward with privacy and dignity.”

Nyansa Kashinde (20) is a refugee woman who has experienced both the old and new maternity ward. She delivered her first baby in 2020 at the health center and her second baby in 2025.

“In 2020, it was hard giving birth, thinking that after this, I must go outside to take a bath, leaving my baby here. Sometimes I thought maybe people were peeping through the broken walls. It was uncomfortable,” remembers Nyansa, “This time it is different, everything was perfect, from the midwives to the services after delivery, the washrooms are clean with tap water. My mother was allowed to stay with the baby while I was doing other formalities. I was so happy from the reception to the postnatal ward. Thanks to UNHCR and donors for your thoughtful support to refugee women.”

Building of maternity wards, like the one in Nyarugusu, is one of the priorities under the KJP where UNHCR and partners are working together with the Government of Tanzania, through the Ministry of Home Affairs, to support both refugees and host communities in Kigoma region.

“We have seen changes compared to when the previous maternity ward was used, the number of deliveries has increased. Previously, we had a low number because most of the mothers opted to go to the main hospital, which has better facilities, but it is far from the health center. They are now getting better facilities here, near their residences, and it has also reduced a burden on the main hospital,” said Malika Shakya, UNHCR's Public Health Officer.

Rehema never stops lauding this achievement, “Every day when I come to work and look at this building, the services, and happy mothers before and after deliveries, I feel so much proud of myself and the team. Knowing that our voices can be heard gives me so much hope.”

Currently, UNHCR has only received 18 percent of funds needed for the refugee response in Tanzania. UNHCR continues to urgently appeal for stronger donor support for the refugee response in Tanzania and help refugee mothers and refugee women leaders like Rehema navigate displacement with dignity while building a better future for all.